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She Y, Sun Y, Jiang N. The mechanics of tissue-engineered temporomandibular joint discs: Current status and prospects for enhancement. J Biomater Appl 2024; 39:269-287. [PMID: 39023922 DOI: 10.1177/08853282241265059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
The temporomandibular joint (TMJ) disc is an essential protective but vulnerable fibrocartilage. Their high mechanical strength is vital in absorbing loads, reducing friction, and protecting the condylar surface. Many diseases can lead to the destruction or degeneration of the mechanical function of the TMJ disc. Unfortunately, conservative treatment is ineffective in restoring the defective mechanical properties of the discs. Tissue engineering has been investigated as a promising alternative treatment approach to approximate the properties of native tissue. However, it is difficult for tissue-engineered discs to obtain sufficient mechanical properties. Several approaches have been proposed to improve the mechanical properties of tissue-engineered constructs. In this review, we summarized the mechanical properties of native TMJ discs and discussed the current mechanical testing methods. We then summarized the current advances in improving the mechanical properties of TMJ disc tissue-engineered constructs. Moreover, existing challenges and outbreak directions are discussed. This review assists future research in better understanding the mechanical properties of both native and tissue-engineered TMJ discs. It provides new insights into future mechanical property enhancement for TMJ disc tissue engineering.
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Affiliation(s)
- Yilin She
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Disease, and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yixin Sun
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Disease, and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases, and National Clinical Research Center for Oral Disease, and West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Teng H, Shu J, Ma H, Shao B, Liu Z. Effect of pre-stress on dynamic finite element analysis of the temporomandibular joint. Comput Methods Biomech Biomed Engin 2023:1-11. [PMID: 38083841 DOI: 10.1080/10255842.2023.2290455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/28/2023] [Indexed: 02/24/2024]
Abstract
The pre-stress of the temporomandibular joint (TMJ) at the intercuspal position (ICP) was often neglected, which would cause errors in the finite element analysis. The purpose of this study was to investigate the effect of pre-stress on dynamic finite element analysis of the TMJs. One healthy female adult was recruited for medical imaging and motion data acquisition of the reference position (RP) to the ICP and the clicking teeth. The three-dimensional maxillofacial model including the maxilla, mandible, articular cartilages, discs, and discal attachments was reconstructed. Motion from the RP to the ICP was simulated to obtain pre-stress at the ICP. Two groups of the clicking teeth were simulated: (1) the group without pre-stress (GWoP); (2) the group with pre-stress (GwP). Significant differences were found between the two groups at the initial moment of movement, during the open-mouth phase, and during the collision phase between the upper and lower teeth. The maximum difference in the discal contact stress between both groups was even more than double. The relaxation of the TMJ at the beginning of the mouth opening was simulated in the GwP. In addition, an increase in the TMJ stress during teeth tapping was simulated in the GwP. These were not reflected in the GWoP. If pre-stress at the ICP was not considered, part of the true results would be lost. It is necessary to consider pre-stress in the dynamic finite element analysis of the TMJ.
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Affiliation(s)
- Haidong Teng
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
| | - Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
| | - Hedi Ma
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
| | - Bingmei Shao
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
- Basic Mechanics Lab, Sichuan University, Chengdu, China
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, China
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Jiang X, Wojtkiewicz M, Patwardhan C, Greer S, Kong Y, Kuss M, Huang X, Liao J, Lu Y, Dudley A, Gundry RL, Fuchs M, Streubel P, Duan B. The effects of maturation and aging on the rotator cuff tendon-to-bone interface. FASEB J 2021; 35:e22066. [PMID: 34822203 DOI: 10.1096/fj.202101484r] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 12/19/2022]
Abstract
Rotator cuff tendon injuries often occur at the tendon-to-bone interface (i.e., enthesis) area, with a high prevalence for the elderly population, but the underlying reason for this phenomenon is still unknown. The objective of this study is to identify the histological, molecular, and biomechanical alterations of the rotator cuff enthesis with maturation and aging in a mouse model. Four different age groups of mice (newborn, young, adult, and old) were studied. Striking variations of the entheses were observed between the newborn and other matured groups, with collagen content, proteoglycan deposition, collagen fiber dispersion was significantly higher in the newborn group. The compositional and histological features of young, adult, and old groups did not show significant differences, except having increased proteoglycan deposition and thinner collagen fibers at the insertion sites in the old group. Nanoindentation testing showed that the old group had a smaller compressive modulus at the insertion site when compared with other groups. However, tensile mechanical testing reported that the old group demonstrated a significantly higher failure stress when compared with the young and adult groups. The proteomics analysis detected dramatic differences in protein content between newborn and young groups but minor changes among young, adult, and old groups. These results demonstrated: (1) the significant alterations of the enthesis composition and structure occur from the newborn to the young time period; (2) the increased risk of rotator cuff tendon injuries in the elderly population is not solely because of old age alone in the rodent model.
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Affiliation(s)
- Xiping Jiang
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Molecular Genetics and Cell Biology Program, Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Melinda Wojtkiewicz
- CardiOmics Program, Center for Heart and Vascular Research, Division of Cardiovascular Medicine, and Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Chinmay Patwardhan
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas, USA
| | - Sydney Greer
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Molecular Genetics and Cell Biology Program, Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Yunfan Kong
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Mitchell Kuss
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Xi Huang
- Department of Electrical and Computer Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Jun Liao
- Department of Bioengineering, University of Texas at Arlington, Arlington, Texas, USA
| | - Yongfeng Lu
- Department of Electrical and Computer Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Andrew Dudley
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Molecular Genetics and Cell Biology Program, Department of Genetics, Cell Biology and Anatomy, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Rebekah L Gundry
- CardiOmics Program, Center for Heart and Vascular Research, Division of Cardiovascular Medicine, and Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Matthias Fuchs
- Department of Physics and Astronomy, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Philipp Streubel
- Department of Orthopedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Bin Duan
- Mary & Dick Holland Regenerative Medicine Program, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Division of Cardiology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Department of Surgery, College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.,Department of Mechanical and Materials Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
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Identification of Biomechanical Properties of Temporomandibular Discs. Pain Res Manag 2020; 2020:6032832. [PMID: 33082893 PMCID: PMC7563056 DOI: 10.1155/2020/6032832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/14/2020] [Accepted: 09/03/2020] [Indexed: 11/18/2022]
Abstract
Material Experimental and model tests were conducted on ten fresh porcine temporomandibular joint discs. The average thickness of disc tissue was, accordingly, 2.77 mm for the anterior zone, 3.98 mm for the posterior, and 1.54 mm for the intermediate. The selection of research material in the form of porcine discs was due to the similarity to human discs. Methods Discs were loaded in cycles, a temporary course with the amplitude 3 N and frequency 0.07 Hz, and growth in the load was 1 N/s. The selection of load frequency was due to real conditions of temporomandibular joint functioning during mastication. The necessary experimental research was conducted on a testing machine with a measurement range of 2.5 kN. Results The obtained numeric calculation results indicate that the number of load cycles has a decisive impact on the limitation of energy dispersion capacity through disc tissue. This phenomenon was observed in all the studies on the disc areas. Along with the growth in load cycles, discs are stiffened, and the most significant stiffness was observed in the intermediate area. Conclusions Based on the conducted research, it should be concluded that excessive load affecting temporomandibular joints caused by the act of mastication and occlusal forces generated during parafunction and in people with defined long-term bruxism has crucial importance on biomechanical disc properties and hence the course of temporomandibular joint conditions.
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Guerrero Cota JM, Leale DM, Arzi B, Cissell DD. Regional and disease-related differences in properties of the equine temporomandibular joint disc. J Biomech 2019; 82:54-61. [DOI: 10.1016/j.jbiomech.2018.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 10/28/2022]
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Adams K, Schulz-Kornas E, Arzi B, Failing K, Vogelsberg J, Staszyk C. Functional anatomy of the equine temporomandibular joint: Histological characteristics of the articular surfaces and underlining tissues. Vet J 2018; 239:35-41. [PMID: 30197107 DOI: 10.1016/j.tvjl.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 05/29/2018] [Accepted: 08/09/2018] [Indexed: 12/01/2022]
Abstract
It has been assumed that dental conditions cause disorders of the equine temporomandibular joint (TMJ), due to biomechanical overload or aberrant loading. However, the incidence of published TMJ disorders in horses is low and this leads to the question whether the equine TMJ is adapted well to its biomechanical requirements or is able to remodel its articular surfaces in response to modified loading conditions. The aim of this study was to determine the histological characteristics of healthy equine TMJs. The tissue components of the articular surfaces of 10 TMJs obtained from horses without any clinical history of dental or TMJ disorders were analysed. Apart from the mandibular fossa of the temporal bone, the osseous aspects of the TMJ exhibited a uniform zoning pattern. The articular surfaces were composed of three tissue layers: (1) a superficial cell-rich dense connective tissue layer; (2) a middle fibrocartilage layer; and (3) a deep hyaline-like cartilage layer. The articular disc was composed of an inner core of fibrocartilage and hyaline-like cartilage meshwork covered with both cell-rich dense connective tissue and fibrocartilage at its dorsal and ventral aspects. In contrast, the mandibular fossa was only covered by a dense connective tissue, frequently supplemented by a synovial membrane, suggesting low biomechanical stress. Glycosaminoglycans, which are indicative of compressive loads, were predominantly present within the rostral part of the articular tubercle and the retroarticular process, the dorsal part of articular disc and the entire mandibular head, but were absent within the mandibular fossa. The results of this study suggest the presence of different biomechanical demands in the dorsal and ventral compartment of the equine TMJ.
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Affiliation(s)
- K Adams
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany
| | - E Schulz-Kornas
- Max Planck Weizmann Centre for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, 04103 Leipzig, Germany
| | - B Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis 95616, CA, USA
| | - K Failing
- Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany
| | - J Vogelsberg
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany
| | - C Staszyk
- Institute of Veterinary-Anatomy, -Histology and -Embryology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, 35390 Giessen, Germany.
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Kijak E, Margielewicz J, Lietz-Kijak D, Wilemska-Kucharzewska K, Kucharzewski M, Śliwiński Z. Model identification of stomatognathic muscle system activity during mastication. Exp Ther Med 2017; 13:135-145. [PMID: 28123482 PMCID: PMC5245084 DOI: 10.3892/etm.2016.3921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2015] [Accepted: 02/11/2016] [Indexed: 01/24/2023] Open
Abstract
The present study aimed to determine the numeric projection of the function of the mandible and muscle system during mastication. An experimental study was conducted on a healthy 47 year-old subject. On clinical examination no functional disorders were observed. To evaluate the activity of mastication during muscle functioning, bread cubes and hazelnuts were selected (2 cm2 and 1.2/1.3 cm in diameter, respectively) for condyloid processing. An assessment of the activity of mastication during muscle functioning was determined on the basis of numeric calculations conducted with a novel software programme, Kinematics 3D, designed specifically for this study. The efficacy of the model was verified by ensuring the experimentally recorded trajectories were concordant with those calculated numerically. Experimental measurements of the characteristic points of the mandible trajectory were recorded six times. Using the configuration coordinates that were calculated, the dominant componential harmonics of the amplitude-frequency spectrum were identified. The average value of the dominant frequency during mastication of the bread cubes was ~1.16±0.06 Hz, whereas in the case of the hazelnut, this value was nearly two-fold higher at 1.84±0.07 Hz. The most asymmetrical action during mastication was demonstrated to be carried out by the lateral pterygoid muscles, provided that their functioning was not influenced by food consistency. The consistency of the food products had a decisive impact on the frequency of mastication and the number of cycles necessary to grind the food. Model tests on the function of the masticatory organ serve as effective tools since they provide qualitative and quantitative novel information on the functioning of the human masticatory organ.
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Affiliation(s)
- Edward Kijak
- Department of Prosthetic Dentistry, Faculty of Medicine and Dentistry, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Jerzy Margielewicz
- Department of Logistics and Transport, Silesian University of Technology, 44-019 Katowice, Poland
| | - Danuta Lietz-Kijak
- Department of Propedeutics and Dental Physiodiagnostics, Pomeranian Medical University, 70-204 Szczecin, Poland
| | | | - Marek Kucharzewski
- Institute of Physiotherapy, The Jan Kochanowski University of Humanities and Sciences, 25-317 Kielce, Poland
| | - Zbigniew Śliwiński
- School of Medicine with the Division of Dentistry in Zabrze, Department of Descriptive and Topographic Anatomy, Medical University of Silesia, 41-808 Zabrze, Poland
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Wright GJ, Coombs MC, Hepfer RG, Damon BJ, Bacro TH, Lecholop MK, Slate EH, Yao H. Tensile biomechanical properties of human temporomandibular joint disc: Effects of direction, region and sex. J Biomech 2016; 49:3762-3769. [PMID: 27743627 DOI: 10.1016/j.jbiomech.2016.09.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/23/2016] [Accepted: 09/30/2016] [Indexed: 11/18/2022]
Abstract
Approximately 30% of temporomandibular joint (TMJ) disorders include degenerative changes to the articular disc, with sex-specific differences in prevalence and severity. Limited tensile biomechanical properties of human TMJ discs have been reported. Stress relaxation tests were conducted on TMJ disc specimens harvested bilaterally from six males and six females (68.9±7.9 years), with step-strain increments of 5%, 10%, 15%, 20% and 30%, at 1% strain-per-second. Stress versus strain plots were constructed, and Young׳s Modulus, Instantaneous Modulus and Relaxed Modulus were determined. The effects of direction, region, and sex were examined. Regional effects were significant (p<0.01) for Young׳s Modulus and Instantaneous Modulus. Anteroposteriorly, the central region was significantly stiffer than medial and lateral regions. Mediolaterally, the posterior region was significantly stiffer than central and anterior regions. In the central region, anteroposteriorly directed specimens were significantly stiffer compared to mediolateral specimens (p<0.04). TMJ disc stiffness, indicated by Young׳s Modulus and Instantaneous Modulus, was higher in directions corresponding to high fiber alignment. Additionally, human TMJ discs were stiffer for females compared to males, with higher Young׳s Modulus and Instantaneous Modulus, and female TMJ discs relaxed less. However, sex effects were not statistically significant. Using second-harmonic generation microscopy, regional collagen fiber organization was identified as a potentially significant factor in determining the biomechanical properties for any combination of direction and region. These findings establish structure-function relationships between collagen fiber direction and organization with biomechanical response to tensile loading, and may provide insights into the prevalence of TMJ disorders among women.
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Affiliation(s)
- Gregory J Wright
- Department of Bioengineering, Clemson University, Clemson, SC, United States
| | - Matthew C Coombs
- Department of Bioengineering, Clemson University, Clemson, SC, United States; Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, United States
| | - R Glenn Hepfer
- Department of Bioengineering, Clemson University, Clemson, SC, United States
| | - Brooke J Damon
- Department of Bioengineering, Clemson University, Clemson, SC, United States; Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, United States
| | - Thierry H Bacro
- Center for Anatomical Studies and Education, MUSC, Charleston, SC, United States
| | - Michael K Lecholop
- Department of Oral & Maxillofacial Surgery, MUSC, Charleston, SC, United States
| | - Elizabeth H Slate
- Department of Statistics, Florida State University, Tallahassee, FL, United States
| | - Hai Yao
- Department of Bioengineering, Clemson University, Clemson, SC, United States; Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, United States.
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Murphy MK, MacBarb RF, Wong ME, Athanasiou KA. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. Int J Oral Maxillofac Implants 2014; 28:e393-414. [PMID: 24278954 DOI: 10.11607/jomi.te20] [Citation(s) in RCA: 184] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Temporomandibular disorders (TMD) are a class of degenerative musculoskeletal conditions associated with morphologic and functional deformities that affect up to 25% of the population, but their etiology and progression are poorly understood and, as a result, treatment options are limited. In up to 70% of cases, TMD are accompanied by malpositioning of the temporomandibular joint (TMJ) disc, termed "internal derangement." Although the onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Because of the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient's disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches that can restore joint functionality while responding to changes in the joint have become a necessity. One such approach, tissue engineering, which may be capable of integration and adaptation in the TMJ, carries significant potential for the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. An analysis of native tissue characterization to assist clinicians in identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ is followed by a discussion of current trends in tissue engineering.
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Willard VP, Arzi B, Athanasiou KA. The attachments of the temporomandibular joint disc: a biochemical and histological investigation. Arch Oral Biol 2011; 57:599-606. [PMID: 22129470 DOI: 10.1016/j.archoralbio.2011.10.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 10/01/2011] [Accepted: 10/06/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The complex movement of the temporomandibular joint (TMJ) disc during mastication is controlled in large part by the disc's attachments to the surrounding tissues. This study seeks to address the lack of available quantitative data characterizing the extracellular matrix composition of the discal attachments and how these properties compare to the disc. DESIGN Porcine TMJ disc-attachment complexes were carefully dissected into six discal attachments and five TMJ disc regions. All samples were assayed biochemically for total collagen, glycosaminoglycan (GAG), DNA, and hydration. Additionally, histology was performed on the whole joint to investigate the anatomy of the disc-attachment complex, and to verify the regional distribution of matrix components. RESULTS Quantitative biochemical assays showed that overall water content was fairly constant in all disc and attachment regions. Disc regions generally showed higher sulfated GAG and collagen content than the attachments. In contrast, the attachments contained greater DNA content than the disc. Histological staining supported the quantitative results and also indicated more elastic fibres to be present in the attachments than the disc. CONCLUSIONS Although macroscopically the TMJ disc and its attachments form a seamless complex within the joint, a closer look at regional biochemical constituents reveals that these two components are distinct. Whilst the disc and attachments both contain the same major constituents, the relative amounts of these components vary based on the functional requirements of the tissue. These results can further understanding of both TMJ biology and pathology.
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Affiliation(s)
- Vincent P Willard
- Department of Bioengineering, Rice University, Houston, TX 77005, USA
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Singh M, Detamore MS. Biomechanical properties of the mandibular condylar cartilage and their relevance to the TMJ disc. J Biomech 2009; 42:405-17. [PMID: 19200995 DOI: 10.1016/j.jbiomech.2008.12.012] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 12/16/2008] [Accepted: 12/17/2008] [Indexed: 10/21/2022]
Abstract
Mandibular condylar cartilage plays a crucial role in temporomandibular joint (TMJ) function, which includes facilitating articulation with the TMJ disc, reducing loads on the underlying bone, and contributing to bone remodeling. To improve our understanding of the TMJ function in normal and pathological situations, accurate and validated three-dimensional (3-D) finite element models (FEMs) of the human TMJ may serve as valuable diagnostic tools as well as predictors of thresholds for tissue damage resulting from parafunctional activities and trauma. In this context, development of reliable biomechanical standards for condylar cartilage is crucial. Moreover, biomechanical characteristics of the native tissue are important design parameters for creating functional tissue-engineered replacements. Towards these goals, biomechanical characteristics of the condylar cartilage have been reviewed here, highlighting the structure-function correlations. Structurally, condylar cartilage, like the TMJ disc, exhibits zonal and topographical heterogeneity. Early structural investigations of the condylar cartilage have suggested that the tissue possesses a somewhat transversely isotropic orientation of collagen fibers in the fibrous zone. However, recent tensile and shear evaluations have reported a higher stiffness of the tissue in the anteroposterior direction than in the mediolateral direction, corresponding to an anisotropic fiber orientation comparable to the TMJ disc. In a few investigations, condylar cartilage under compression was found to be stiffer anteriorly than posteriorly. As with the TMJ disc, further compressive characterization is warranted. To draw inferences for human tissue using animal models, establishing stiffness-thickness correlations and regional evaluation of proteoglycan/glycosaminoglycan content may be essential. Efforts directed from the biomechanics community for the characterization of TMJ tissues will facilitate the development of reliable and accurate 3-D FEMs of the human TMJ.
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Affiliation(s)
- M Singh
- Department of Chemical and Petroleum Engineering, University of Kansas, 1530 W. 15th Street, Room 4132, Lawrence, KS 66045-7609, USA
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Athanasiou KA, Almarza AJ, Detamore MS, Kalpakci KN. Tissue Engineering of Temporomandibular Joint Cartilage. ACTA ACUST UNITED AC 2009. [DOI: 10.2200/s00198ed1v01y200906tis002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
The potential impact of a tissue-engineered temporomandibular joint (TMJ) disc is immense. Currently, patients suffering from a severely dysfunctional TMJ have few options. Facing the general lack of safe, effective TMJ disc implants, many patients undergo discectomy, a procedure that removes the injured TMJ disc in hopes of reducing debilitating symptoms associated with severe TMJ disorders. This procedure may not be ideal as the TMJ is left without an important functional component. Tissue engineering is a promising approach for the creation of viable, effective implants. The first attempt to investigate TMJ disc cells on a biomaterial was conducted in 1991. The first TMJ tissue-engineered constructs to be tested biochemically and biomechanically were formed in 1994; however, in examining this study in retrospect, it is clear how little TMJ knowledge was available at that time. Within the last 10 to 15 years, multiple studies have investigated critical TMJ disc characteristics, and while this characterization is not complete, these data have created a solid foundation for tissue-engineering research. Thus, the last 5 years have yielded core studies investigating the principal elements of tissue engineering: scaffold, cell source, and biological/biomechanical stimuli. Although TMJ disc tissue engineering is still in its formative years, its future is quite promising. Key studies are now being conducted that will assist in the establishment of a solid TMJ disc tissue-engineering approach. As the challenges of tissue engineering are faced and met, the ultimate goal of creating a functional biological implant nears.
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Affiliation(s)
- Kyle D Allen
- Department of Bioengineering, Rice University, Houston, Texas 77251-1892, USA
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Tanaka E, Hirose M, Yamano E, Dalla-Bona DA, Fujita R, Tanaka M, van Eijden T, Tanne K. Age-associated changes in viscoelastic properties of the bovine temporomandibular joint disc. Eur J Oral Sci 2006; 114:70-3. [PMID: 16460344 DOI: 10.1111/j.1600-0722.2006.00265.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To test the hypothesis that compressive properties of the temporomandibular joint (TMJ) disc change with age, we investigated its viscoelastic properties and stress-relaxation behavior under compression. Compressive stress-relaxation tests were performed in different regions of bovine discs of various ages. For each disc, specimens were derived from three different regions (anterior, central, and posterior). For four strain levels (5, 10, 15, and 20%), a stress-relaxation test was conducted over a 5-min period. Values of the instantaneous modulus, E(0), appeared to be larger in the anterior than in the posterior region of the disc, irrespective of age. The E(0) value increased with age, especially in the central region. Values of the relaxed modulus, E(R), also increased significantly with age. There were no regional differences in values of the relaxed modulus. Under stress-relaxation, the relaxation time became longer with age, especially in the posterior region. The results suggest that the compressive properties, instantaneous and relaxed moduli, increase with age, while the relaxation time becomes longer. This implies that the TMJ disc becomes harder with age. Furthermore, the compressive properties of the TMJ disc are region-specific. As a result of the harder disc, it is likely that the TMJ becomes more vulnerable to secondary damage, such as fracture and tissue degradation.
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Affiliation(s)
- Eiji Tanaka
- Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima 734-8553, Japan.
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Allen KD, Athanasiou KA. Viscoelastic characterization of the porcine temporomandibular joint disc under unconfined compression. J Biomech 2005; 39:312-22. [PMID: 16321633 DOI: 10.1016/j.jbiomech.2004.11.012] [Citation(s) in RCA: 129] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2004] [Accepted: 11/15/2004] [Indexed: 11/30/2022]
Abstract
Pathophysiology of the temporomandibular joint (TMJ) disc is central to many orofacial disorders; however, mechanical characterization of this tissue is incomplete. In this study, we identified surface-regional mechanical variations in the porcine TMJ disc under unconfined compression. The intermediate zone, posterior, anterior, lateral, and medial regions of eight TMJ discs were sectioned into inferior and superior surface samples. Surface-regional sections were then subjected to incremental stress relaxation tests. Single strain step (SSS) and final deformation (FD) viscoelastic models were fit to experimental data. Both models represented the experimental data with a high degree of accuracy (R(2)=0.93). The instantaneous modulus and relaxation modulus for the TMJ disc sections were approximately 500 kPa and 80 kPa, respectively; the coefficient of viscosity was approximately 3.5 MPa-s. Strain dependent material properties were observed across the disc's surface-regions. Regional variations in stiffness were observed in both models. The relaxation modulus was largest in the inferior-medial parts of the disc. The instantaneous modulus was largest in the posterior and anterior regions of the disc. Surface-to-surface variations were observed in the relaxation modulus for only the FD model; the inferior surface was found to be more resistant to compression than the superior surface. The results of this study imply the stiffness of the TMJ disc may change as strain is applied. Furthermore, the lateral region exhibited a lower viscosity and stiffness compared to other disc regions. Both findings may have important implications on the TMJ disc's role in jaw motion and function.
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Affiliation(s)
- Kyle D Allen
- Department of Bioengineering, Rice University, MS142, E-100-A George R. Brown Hall, P.O. Box 1892, Houston, TX 77251-1892, USA.
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Komatsu K, Kanazashi M, Shimada A, Shibata T, Viidik A, Chiba M. Effects of age on the stress–strain and stress–relaxation properties of the rat molar periodontal ligament. Arch Oral Biol 2004; 49:817-24. [PMID: 15308426 DOI: 10.1016/j.archoralbio.2004.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2004] [Indexed: 11/15/2022]
Abstract
OBJECTIVE We examined the stress-strain and stress-relaxation properties of the periodontal ligament (PDL) in the rat molar at 2, 6, 12, and 24 months of age to elucidate age-related changes in the tooth support function of the PDL. DESIGN From the dissected left and right mandibles in each rat, a pair of transverse sections (ca. 0.45 mm in thickness) of the first molar was cut at the middle part of the mesial root. We then obtained a load-deformation curve for the PDL, using one of the paired sections. The other section was loaded to as much as 50% of the maximum load as determined from the contralateral section, and keeping the deformation constant for 10 min, a load-relaxation curve was obtained and analysed. RESULTS The maximum shear stress and tangent modulus decreased between 2 and 24 months of age. As the maximum shear strain increased with age (P < 0.001), the failure strain energy density did not change between 2 and 24 months of age. The stress-relaxation during the 10 min period decreased from 2 to 24 months of age (P < 0.01). The relaxation process of the PDL in each age was well described by a sum of three exponential decay functions. The age-related decrease in the relaxation was found to be mainly due to the increase in the relaxation time for the long-term relaxation component. CONCLUSION These results indicate that the maximum shear stress and stiffness of the rat molar PDL decrease between 2 and 24 months of age; but its toughness remains unchanged due to an increase in the extensibility. Our findings further indicate that the fluid flow and movements of macromolecules within the stretched PDL fibres during the stress-relaxation decrease with advancing age.
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Affiliation(s)
- K Komatsu
- Department of Pharmacology, School of Dental Medicine, Tsurumi University, 2-1-3, Tsurumi-ku, Yokohama 230-8501, Japan.
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Detamore MS, Athanasiou KA. Motivation, characterization, and strategy for tissue engineering the temporomandibular joint disc. ACTA ACUST UNITED AC 2004; 9:1065-87. [PMID: 14670096 DOI: 10.1089/10763270360727991] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this review is to serve as the standard point of reference in guiding researchers investigating the tissue engineering of the temporomandibular joint (TMJ) disc. Tissue engineering of the TMJ disc is in its infancy, and currently there exists a gap between the tissue engineering community and the TMJ characterization community. The primary goal is to help bridge that gap by consolidating the characterization studies here as a reference to researchers attempting to tissue engineer the TMJ disc. A brief review of TMJ anatomy is provided, along with a description of relevant pathology, current treatment, and a rationale for engineering the TMJ disc. The biochemical composition and organization of the disc are reviewed, including glycosaminoglycan (GAG) and collagen content. The collagen of the disc is almost exclusively type I and primarily runs anteroposteriorly through the center and in a ringlike fashion around the periphery. The GAG content is approximately an order of magnitude less than that of hyaline cartilage, and although the distribution is not entirely clear, it seems as though chondroitin and dermatan sulfate are by far the primary GAGs. Cellular characterization and mechanical properties under compression, tension, and shear are reviewed as well. The cells of the disc are not chondrocytes, but rather resemble fibrocytes and fibrochondrocytes and may be of the same lineage. Mechanically, the disc is certainly anisotropic and nonhomogeneous. Finally, a review of efforts in tissue engineering and cell culture studies of the disc is provided and we close with a description of the direction we envision/propose for successful tissue engineering of the TMJ disc.
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Affiliation(s)
- Michael S Detamore
- Department of Bioengineering, Rice University, Houston, Texas 77251, USA
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Komatsu K, Shibata T, Shimada A, Viidik A, Chiba M. Age-related and regional differences in the stress–strain and stress–relaxation behaviours of the rat incisor periodontal ligament. J Biomech 2004; 37:1097-106. [PMID: 15165880 DOI: 10.1016/j.jbiomech.2003.11.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2003] [Indexed: 11/18/2022]
Abstract
Groups of rats were killed at 2, 6, 12, and 24 months of age. From dissected left and right mandibles in each rat, three pairs of transverse sections were cut at the incisal, middle, and basal regions of the incisor. One section in each pair was loaded until failure and a stress-strain curve for the periodontal ligament (PDL) was obtained. The other section was loaded to up to 50% of the maximum shear stress as determined from the contralateral section and then kept at a constant strain for 10 min, to obtain the stress-relaxation curve at the same region of the PDL. The maximum shear stress and toughness increased with age at the incisal region and the maximum shear strain increased with age at the incisal and middle regions. The tangent modulus decreased with advancing age at the middle region. The stress-relaxation during 10 min decreased with advancing age at the incisal and basal regions, but not at the middle region. The relaxation process was well described by a sum of three exponential decay functions, reflecting the short-, medium-, and long-term relaxation components. The age-related decrease in the relaxation was mainly attributable to increases in the ratio and relaxation time of the long-term relaxation component. These results suggest that with advancing age the mechanical strength and toughness of the PDL are enhanced mostly at the incisal region and that the viscous fraction is relatively decreased at the incisal and basal regions along the long axis of the rat incisor.
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Affiliation(s)
- K Komatsu
- Department of Pharmacology, School of Dental Medicine, Tsurumi University, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama 230-8501, Japan.
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Tanaka E, Hanaoka K, Tanaka M, Van Eijden T, Iwabe T, Ishino Y, Sasaki A, Tanne K. Viscoelastic properties of bovine retrodiscal tissue under tensile stress-relaxation. Eur J Oral Sci 2003; 111:518-22. [PMID: 14632689 DOI: 10.1111/j.0909-8836.2003.00081.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
To test the hypothesis that the condylar part of the retrodiscal tissue of the temporomandibular joint exhibits resistance to tensile force, we investigated its viscoelastic properties and stress-relaxation behavior under tension. Ten specimens were tested. Stress-relaxation tests were conducted from four different initial stress levels. The tissue exhibited a non-linear stress-strain relationship, which could be represented by a bilinear relation of two line segments. The stress-relaxation curves showed a marked drop in load during the initial 10 s and after 2 min the stress reached an almost steady non-zero level. This feature can be well represented by Kelvin's model. It is concluded that the condylar part of the retrodiscal tissue (a) exhibits a non-linear strain-dependent viscoelastic behavior (b), has a great capacity for energy dissipation and resistance to tensile forces, and (c) contributes to maintain the position of the disc relative to the condyle during jaw closing.
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Affiliation(s)
- Eiji Tanaka
- Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
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Detamore MS, Athanasiou KA. Tensile properties of the porcine temporomandibular joint disc. J Biomech Eng 2003; 125:558-65. [PMID: 12968581 DOI: 10.1115/1.1589778] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Despite the significant morbidity associated with the temporomandibular joint (TMJ), little is known about the pathophysiology of this complex joint. TMJ disc degeneration plays a central role in the progression of TMJ disorders, and therefore disc regeneration would be a crucial treatment modality. Unfortunately, scarce information about the structural and functional characteristics of the TMJ disc is available. The current study aims to provide a standard for the biomechanical behavior of the TMJ disc for future tissue engineering studies. The disc was loaded under uniaxial tension in two directions, mediolateral and anteroposterior, and in three locations per direction. In the mediolateral direction, the posterior band was 2.5 times stiffer, 2.4 times tougher (energy to maximum stress), and 2.2 times stronger than the anterior band, which was in turn 16 times stiffer and 5.7 times stronger than the intermediate zone. In the anteroposterior direction, the central and medial regions were 74% and 35% stiffer and 56% and 59% stronger than the lateral region, respectively, although similar to each other in strength and stiffness. There was no significant difference in toughness between regions in the anteroposterior direction. These results correlated qualitatively with collagen fiber orientation and fiber size obtained using polarized light microscopy.
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Tanaka E, van Eijden T. Biomechanical behavior of the temporomandibular joint disc. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2003; 14:138-50. [PMID: 12764076 DOI: 10.1177/154411130301400207] [Citation(s) in RCA: 143] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The temporomandibular joint (TMJ) disc consists mainly of collagen fibers and proteoglycans constrained in the interstices of the collagen fiber mesh. This construction results in a viscoelastic response of the disc to loading and enables the disc to play an important role as a stress absorber during function. The viscoelastic properties depend on the direction (tension, compression, and shear) and the type of the applied loading (static and dynamic). The compressive elastic modulus of the disc is smaller than its tensile one because the elasticity of the disc is more dependent on the collagen fibers than on the proteoglycans. When dynamic loading occurs, the disc is likely to behave less stiffly than under static loading because of the difference of fluid flow through and out of the disc during loading. In addition, the mechanical properties change as a result of various intrinsic and extrinsic factors in life such as aging, trauma, and pathology. Information about the viscoelastic behavior of the disc is required for its function to be understood and, for instance, for a suitable TMJ replacement device to be constructed. In this review, the biomechanical behavior of the disc in response to different loading conditions is discussed.
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Affiliation(s)
- Eiji Tanaka
- Department of Orthodontics and Craniofacial Developmental Biology, Hiroshima University Graduate School of Biomedical Sciences, Japan.
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Detamore MS, Athanasiou KA. Structure and function of the temporomandibular joint disc: implications for tissue engineering. J Oral Maxillofac Surg 2003; 61:494-506. [PMID: 12684970 DOI: 10.1053/joms.2003.50096] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The temporomandibular joint (TMJ) disc is a little understood structure that, unfortunately, exhibits a plethora of pathologic disorders. Tissue engineering approaches may be warranted to address TMJ disc pathophysiology, but first a clear understanding of structure-function relationships needs to be developed, especially as they relate to the regenerative potential of the tissue. In this review, we correlate the biochemical content of the TMJ disc to its mechanical behavior and discuss what this correlation infers for tissue engineering studies of the TMJ disc. The disc of the TMJ exhibits a somewhat biconcave shape, being thicker in the anterior and posterior bands and thinner in the intermediate zone. The disc, which is certainly an anisotropic and nonhomogeneous tissue, consists almost entirely of type I collagen with trace amounts of type II and other types. In general, collagen fibers in the intermediate zone appear to run primarily in an anteroposterior direction and in a ringlike fashion around the periphery. Collagen orientation is reflected in higher tensile stiffness and strength in the center anteroposteriorly than mediolaterally and in the anterior and posterior bands than the intermediate zone mediolaterally. Tensile tests have shown the disc is stiffer and stronger in the direction of the collagen fibers. Elastin fibers in general appear along the collagen fibers and most likely function in restoring and retaining disc form after loading. The 2 primary glycosaminoglycans of the disc by far are chondroitin sulfate and dermatan sulfate, although their distribution is not clear. Compression studies are conflicting, but evidence suggests the disc is compressively stiffest in the center. Only a few tissue engineering studies of the TMJ disc have been performed to date. Tissue engineering studies must take advantage of existing information for experimental design and construct validation, and more research is necessary to characterize the disc to create a clearer picture of our goals in tissue engineering the TMJ disc.
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Tanaka E, Aoyama J, Tanaka M, Watanabe M, Hattori Y, Hanaoka K, Tanne K. Biomechanical response of bovine temporomandibular joint disc to prolonged tensile stress. Arch Oral Biol 2002; 47:413-6. [PMID: 12015223 DOI: 10.1016/s0003-9969(02)00013-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study was designed to evaluate the influence of prolonged tensile stress on the viscoelasticity of the temporomandibular joint (TMJ) disc. Twenty discs from 10, 3-year-old cattle were used. Tensile stress of 1.5 MPa was applied to specimens from the discs for 10, 20, 40 and 60 min. Following the prescribed period of tension for creep, the specimens were removed from the tension device and any recovery observed for 20 min. In all specimens, strain increased at the onset of stress application and reached almost steady conditions after 5 min. Although, the strain became slightly larger when the creep time was longer, no significant differences were found in the strains between any two tests with different periods of creep. The residual strain increased significantly with creep duration, and similarly the degree of recovery decreased significantly. In 10- and 20-min creep tests, the residual strains were 0.1 and 1.0%, the specimens in 40- and 60-min tests revealed irreversible changes in length. It was concluded that continuous loading for >40 min causes creep damage in bovine TMJ disc, and that prolonged sustained tension affects the recovery of joint homeostasis.
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Affiliation(s)
- E Tanaka
- Department of Orthodontics, Faculty of Dentistry, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan.
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