Movement of temporomandibular joint tissues during mastication and passive manipulation in miniature pigs

Sagittal suture strain in capuchin monkeys (Sapajus and Cebus) during feeding

OBJECTIVES

Morphological variation in cranial sutures is used to infer aspects of primate feeding behavior, including diet, but strain regimes across sutures are not well documented. Our aim is to test hypotheses about sagittal suture morphology, strain regime, feeding behavior, and muscle activity relationships in robust Sapajus and gracile Cebus capuchin primates.

MATERIALS AND METHODS

Morphometrics of sinuosity in three regions of the sagittal suture were compared among museum specimens of Sapajus and Cebus, as well as in robust and gracile lab specimens. In vivo strains and bilateral electromyographic (EMG) activity were recorded from these regions in the temporalis muscles of capuchin primates while they fed on mechanically-varying foods.

RESULTS

Sapajus and the anterior suture region exhibited greater sinuosity than Cebus and posterior regions. In vivo data reveal minor differences in strain regime between robust and gracile phenotypes but show higher strain magnitudes in the middle suture region and higher tensile strains anteriorly. After gage location, feeding behavior has the most consistent and strongest impact on strain regime in the sagittal suture. Strain in the anterior suture has a high tension to compression ratio compared to the posterior region, especially during forceful biting in the robust Sapajus-like individual.

DISCUSSION

Sagittal suture complexity in robust capuchins likely reflects feeding behaviors associated with mechanically challenging foods. Sutural strain regimes in other anthropoid primates may also be affected by activity in feeding muscles.

Local Drug-Induced Modulation of gp130 Receptor Signaling Delays Disease Progression in a Pig Model of Temporo-Mandibular Joint Osteoarthritis

Temporomandibular joint disorders (TMJs) are a multifaceted group of chronic disorders characterized by stiffness in the jaw, limited jaw mobility and pain when opening or closing the mouth. TMJs are relatively common, with incidence rates in the range of 5–12%, with nearly twice as many women as men being affected. One of the primary causes of TMJs is a degenerative disease of joints, such as osteoarthritis (OA), characterized by progressive loss of cartilage which causes stiffness, swelling, and pain. Currently, there are no disease-modifying agents on the market for OA. We have recently discovered a small molecule, R805 acting as a modulator of glycoprotein 130 (gp130) receptor for IL-6 family of cytokines. R805 enables regenerative outputs of endogenous joint stem and progenitor cells through immunomodulation in the joint microenvironment by reducing the levels of destructive cytokines and supporting chondrocyte survival and anabolism. Extensive testing has shown R805 to be safe at doses far above the therapeutic level. Here, we have conducted a pivotal efficacy study in our newly-established pig model of TMJ post-traumatic OA. IA injection of R805 has shown a highly significant reduction of articular cartilage degeneration, reduced synovitis and degenerative changes in subchondral bone in the mandibular condyle compared to the vehicle-treated group. These data will support additional pre-clinical development of R805 as a first-in-class injectable therapeutic for TMJ osteoarthritis.

Animal Models of Temporomandibular Joint Osteoarthritis: Classification and Selection

Temporomandibular joint osteoarthritis (TMJOA) is a common degenerative joint disease that can cause severe pain and dysfunction. It has a serious impact on the quality of lives of patients. Since mechanism underlying the pathogenesis of TMJOA is not fully understood, the development of effective tools for early diagnosis and disease-modifying therapies has been hindered. Animal models play a key role in understanding the pathological process of diseases and evaluating new therapeutic interventions. Although some similarities in disease processes between animals and humans are known, no one animal model is sufficient for studying all characteristics of TMJOA, as each model has different translatability to human clinical conditions. For the past 4 decades, TMJOA animal models have been studied by numerous researchers and can be broadly divided into induced, naturally occurring, and genetically modified models. The induced models can be divided into invasive models (intra-articular injection and surgical induction) or non-invasive models (mechanical loading, high-fat diet, and sleep deprivation). Different types of animal models simulate different pathological expressions of TMJOA and have their unique characteristics. Currently, mice, rats, and rabbits are commonly used in the study of TMJOA. This review sought to provide a general description of current experimental models of TMJOA and assist researchers in selecting the most appropriate models for different kinds of research.

Evidence of vasculature and chondrocyte to osteoblast transdifferentiation in craniofacial synovial joints: Implications for osteoarthritis diagnosis and therapy

Temporomandibular joint osteoarthritis (TMJ OA) leads to permanent cartilage destruction, jaw dysfunction, and compromises the quality of life. However, the pathological mechanisms governing TMJ OA are poorly understood. Unlike appendicular articular cartilage, the TMJ has two distinct functions as the synovial joint of the craniofacial complex and also as the site for endochondral jaw bone growth. The established dogma of endochondral bone ossification is that hypertrophic chondrocytes undergo apoptosis, while invading vasculature with osteoprogenitors replace cartilage with bone. However, contemporary murine genetic studies support the direct differentiation of chondrocytes into osteoblasts and osteocytes in the TMJ. Here we sought to characterize putative vasculature and cartilage to bone transdifferentiation using healthy and diseased TMJ tissues from miniature pigs and humans. During endochondral ossification, the presence of fully formed vasculature expressing CD31⁺ endothelial cells and α-SMA⁺ vascular smooth muscle cells were detected within all cellular zones in growing miniature pigs. Arterial, endothelial, venous, angiogenic, and mural cell markers were significantly upregulated in miniature pig TMJ tissues relative to donor matched knee meniscus fibrocartilage tissue. Upon surgically creating TMJ OA in miniature pigs, we discovered increased vasculature and putative chondrocyte to osteoblast transformation dually marked by COL2 and BSP or RUNX2 within the vascular bundles. Pathological human TMJ tissues also exhibited increased vasculature, while isolated diseased human TMJ cells exhibited marked increased in vasculature markers relative to control 293T cells. Our study provides evidence to suggest that the TMJ in higher order species are in fact vascularized. There have been no reports of cartilage to bone transdifferentiation or vasculature in human-relevant TMJ OA large animal models or in human TMJ tissues and cells. Therefore, these findings may potentially alter the clinical management of TMJ OA by defining new drugs that target angiogenesis or block the cartilage to bone transformation.

Computational characterization of the porous-fibrous behavior of the soft tissues in the temporomandibular joint

The prevalence and severity of temporomandibular joint (TMJ) disorders have led to growing research interest in the development of new biomaterials and medical devices for TMJ implant designs. In computational designs, however, the time and stretch direction dependences of the TMJ soft tissues behavior are not considered and they are frequently based on measurements taken from non‐human species or from joints that differ markedly from the human TMJ. The aim of this study was to accurately characterize the porous‐fibrous properties of the TMJ soft tissues by simulating previously published experimental tests, to assist professionals in the design of new TMJ implants. To that end, material parameters were determined assuming a uniform fiber orientation throughout the entire sample. This assumption was then tested by comparing these results with those of considering multiple regions and distinct fiber orientations in each sample. Our findings validated the use of a transversely isotropic hyperelastic material model to characterize the direction dependent behavior of TMJ soft tissues and its combination with porous hyperfoam material models to mimic the compressive response of the TMJ disc. In conclusion, constitutive model proposed accurately reproduce the mechanical response of the TMJ soft tissues at different strain rates and stretch directions.

Preclinical Animal Models for Temporomandibular Joint Tissue Engineering

There is a paucity of in vivo studies that investigate the safety and efficacy of temporomandibular joint (TMJ) tissue regeneration approaches, in part due to the lack of established animal models. Review of disease models for study of TMJ is presented herein with an attempt to identify relevant preclinical animal models for TMJ tissue engineering, with emphasis on the disc and condyle. Although degenerative joint disease models have been mainly performed on mice, rats, and rabbits, preclinical regeneration approaches must employ larger animal species. There remains controversy regarding the preferred choice of larger animal models between the farm pig, minipig, goat, sheep, and dog. The advantages of the pig and minipig include their well characterized anatomy, physiology, and tissue properties. The advantages of the sheep and goat are their easier surgical access, low cost per animal, and its high tissue availability. The advantage of the dog is that the joint space is confined, so migration of interpositional devices should be less likely. However, each species has limitations as well. For example, the farm pig has continuous growth until about 18 months of age, and difficult surgical access due to the zygomatic arch covering the lateral aspect of joint. The minipig is not widely available and somewhat costly. The sheep and the goat are herbivores, and their TMJs mainly function in translation. The dog is a carnivore, and the TMJ is a hinge joint that can only rotate. Although no species provides the gold standard for all preclinical TMJ tissue engineering approaches, the goat and sheep have emerged as the leading options, with the minipig as the choice when cost is less of a limitation; and with the dog and farm pig serving as acceptable alternatives. Finally, naturally occurring TMJ disorders in domestic species may be harnessed on a preclinical trial basis as a clinically relevant platform for translation.

Betwixt and Between: Intracranial Perspective on Zygomatic Arch Plasticity and Function in Mammals

The zygomatic arch is morphologically complex, providing a key interface between the viscerocranium and neurocranium. It also serves as an attachment site for masticatory muscles, thereby linking it to the feeding apparatus. Though morphological variation related to differential loading is well known for many craniomandibular elements, the adaptive osteogenic response of the zygomatic arch remains to be investigated. Here, experimental data are presented that address the naturalistic influence of masticatory loading on the postweaning development of the zygoma and other cranial elements. Given the similarity of bone-strain levels among the zygoma and maxillomandibular elements, a rabbit and pig model were used to test the hypothesis that variation in cortical bone formation and biomineralization along the zygomatic arch and masticatory structures are linked to increased stresses. It was also hypothesized that neurocranial structures would be minimally affected by varying loads. Rabbits and pigs were raised for 48 weeks and 8 weeks, respectively. In both experimental models, CT analyses indicated that elevated masticatory loading did not induce differences in cortical bone thickness of the zygomatic arch, though biomineralization was positively affected. Hypotheses were supported regarding bone formation for maxillomandibular and neurocranial elements. Varying osteogenic responses in the arch suggests that skeletal adaptation, and corresponding variation in performance, may reside differentially at one level of bony architecture. Thus, it is possible that phenotypic diversity in the mammalian zygoma is due more singularly to natural selection (vs. plasticity). These findings underscore the complexity of the zygomatic arch and, more generally, determinants of skull form. Anat Rec, 299:1646-1660, 2016. © 2016 Wiley Periodicals, Inc.

The Yucatan Minipig Temporomandibular Joint Disc Structure-Function Relationships Support Its Suitability for Human Comparative Studies

Frequent involvement of the disc in temporomandibular joint (TMJ) disorders warrants attempts to tissue engineer TMJ disc replacements. Physiologically, a great degree of similarity is seen between humans and farm pigs (FPs), but the pig's rapid growth confers a significant challenge for in vivo experiments. Minipigs have a slower growth rate and are smaller than FPs, but minipig TMJ discs have yet to be fully characterized. The objective of this study was to determine the suitability of the minipig for TMJ studies by extensive structural and functional characterization. The properties of minipig TMJ discs closely reproduced previously reported morphological, biochemical, and biomechanical values of human and FP discs. The width/length dimension ratio of the minipig TMJ disc was 1.95 (1.69 for human and 1.94 for FP). The biochemical evaluation revealed, on average per wet weight, 24.3% collagen (22.8% for human and 24.9% for FP); 0.8% glycosaminoglycan (GAG; 0.5% for human and 0.4% for FP); and 0.03% DNA (0.008% for human and 0.02% for FP). Biomechanical testing revealed, on average, compressive relaxation modulus of 50 kPa (37 kPa for human and 32 kPa for FP), compressive instantaneous modulus of 1121 kPa (1315 kPa for human and 1134 kPa for FP), and coefficient of viscosity of 13 MPa·s (9 MPa·s for human and 3 MPa·s for FP) at 20% strain. These properties also varied topographically in accordance to those of human and FP TMJ discs. Anisotropy, quantified by bidirectional tensile testing and histology, again was analogous among minipig, human, and FP TMJ discs. The minipig TMJ's ginglymoarthrodial nature was verified through cone beam computer tomography. Collectively, the similarities between minipig and human TMJ discs support the use of minipig as a relevant model for TMJ research; considering the practical advantages conferred by its growth rate and size, the minipig may be a preferred model over FP.

Laboratory Stresses and Tractional Forces on the TMJ Disc Surface

The etiology of degenerative disease of the TMJ may involve fatigue produced by surface tractional forces and compressive stresses. This study tested the time-dependent effects of compressive loading and stress-field translation on TMJ disc-surface tractional forces and stresses. In laboratory experiments with 50 porcine discs, an acrylic indenter imposed 10 N static loads for 10 and 60 sec, followed by translation of the loaded indenter along the mediolateral axis of the disc. Maximum tractional forces were found to occur following 60 sec of static loading (p < 0.001), and increased with translation velocity (R2 = 0.73); whereas maximum compressive stresses occurred after 10 sec of static loading (p < 0.001). Overall, the results were consistent with current mechanical theories of the time-dependent effects of compressive loading of cartilage.

Dynamic Compressive Properties of the Mandibular Condylar Cartilage

The mandibular condylar cartilage plays an important role as a stress absorber during function. However, relatively little information is available on its dynamic properties under compression. We hypothesized that these properties are region-specific and depend on loading frequency. To characterize the viscoelastic properties of the condylar cartilage, we performed dynamic indentation tests over a wide range of loading frequencies. Ten porcine mandibular condyles were used; the articular surface was divided into 4 regions, anteromedial, anterolateral, posteromedial, and posterolateral. The dynamic complex, storage, and loss moduli increased with frequency, and these values were the highest in the anteromedial region. Loss tangent decreased with frequency from 0.68 to 0.17, but a regional difference was not found. The present results suggest that the dynamic compressive modulus is region-specific and is dependent on the loading frequency, which might have important implications for the transmission of load in the temporomandibular joint.

Biomechanical and biochemical outcomes of porcine temporomandibular joint disc deformation

OBJECTIVE

The structure-function relationship in the healthy temporomandibular joint (TMJ) disc has been well established, however the changes in dysfunctional joints has yet to be systematically evaluated. Due to the poor understanding of the etiology of temporomandibular disorders (TMDs) this study evaluated naturally occurring degenerative remodeling in aged female porcine temporomandibular joint (TMJ) discs in order to gain insight into the progression and effects on possible treatment strategies of TMDs.

DESIGN

Surface and regional biomechanical and biochemical properties of discal tissues were determined in grossly deformed (≥Wilkes Stage 3) and morphologically normal (≤Wilkes Stage 2) TMJ discs.

RESULTS

Compared to normal disc structure the deformed discs lacked a smooth biconcave shape and characteristic ECM organization. Reduction in tensile biomechanical integrity and increased compressive stiffness and cellularity was found in deformed discs. Regionally, the posterior and intermediate zones of the disc were most frequently affected along with the inferior surface.

CONCLUSIONS

The frequency of degeneration observed on the inferior surface of the disc (predominantly posterior), suggests that a disruption in the disc-condyle relationship likely contributes to the progression of joint dysfunction more than the temporodiscal relationship. As such, the inferior joint space may be an important consideration in early clinical diagnosis and treatment of TMDs, as it is overlooked in techniques performed in the upper joint space, including arthroscopy and arthrocentesis. Furthermore, permanent damage to the disc mechanical properties would limit the ability to successfully reposition deformed discs, highlighting the importance of emerging therapies such as tissue engineering.

XROMM analysis of tooth occlusion and temporomandibular joint kinematics during feeding in juvenile miniature pigs

Like humans, domestic pigs are omnivorous and thus are a common model for human masticatory function. Prior attempts to characterize food-tooth interactions and jaw movements associated with mastication have been limited to aspects of the oral apparatus that are visible externally (with videography) and/or to 2D movements of oral structures (with monoplanar videofluoroscopy). We used XROMM, a 3D technique that combines CT-based morphology with biplanar videofluoroscopy, to quantify mandibular kinematics, tooth occlusion, and mandibular condylar displacements within the temporomandibular joint during feeding. We observed that the pig TMJ moved detectably in only 3 of 6 possible degrees of freedom during mastication: 2 rotations, pitch and yaw; and 1 translation, protraction-retraction. Asymmetrical yaw around a dorsoventral axis produced the observed alternating left-right chewing cycles responsible for food reduction. Furthermore, the relative motions of the upper and lower premolars contained a substantial mesiodistal component in addition to the buccolingual component, resulting in an oblique (rather than a strictly transverse) power stroke. This research demonstrates the capacity of XROMM to explore the kinematic underpinnings of key masticatory movements, such as the occlusal power stroke, by integrating tooth, joint, and rigid body jaw movements. XROMM also allowed us to test kinematic hypotheses based on skeletal anatomy with actual kinematics observed during naturalistic feeding behaviors. We observed that the soft tissue structures of the TMJ appear to play a significant role in limiting the range of motion of a joint, and thus analyses based solely on osseous morphology may over-estimate joint mobility.

Tensile characterization of porcine temporomandibular joint disc attachments

The frequency and impact of temporomandibular joint (TMJ) disorders necessitate research in characterizing the joint's function. The 6 discal attachments have not yet been systematically characterized under tension. Understanding their role in joint function may guide our study of TMJ pathologies, including disc displacement. In the present study, a porcine model was used to characterize the attachments in tension anteroposteriorly and mediolaterally, based on previously identified similarities in the porcine and human masticatory behaviors and discal properties. Tensile stiffness, strength, toughness, and maximum strain were quantified. Collagen alignment was characterized via polarized light and scanning electron microscopy. Anisotropy was demonstrated in all attachments, with the exception of the anterior inferior attachment. Anteroposteriorly, the lateral attachment was stiffest (8.3 MPa) and the anterior superior was least stiff (1.4 MPa). Mediolaterally, the posterior superior attachment was stiffest (16.3 MPa) and the medial was least stiff (1.4 MPa). The greatest strain was observed in the lateral attachment in the mediolateral direction and the posterior superior attachment in the anteroposterior direction. With greatest strains in the most commonly observed directions of disc displacement, it is suggested that compromise in the posterior and lateral attachments contributes to partial lateral and anterior disc displacement.

Dynamic compressive properties of articular cartilages in the porcine temporomandibular joint

The mandibular condylar and temporal cartilages in the temporomandibular joint (TMJ) play an important role as a stress absorber during function. However, relatively little information is available on its viscoelastic properties in dynamic compression, particularly in a physiological range of frequencies. We hypothesized that these properties are region-specific and depend on loading frequency. To characterize the viscoelastic properties of both cartilages, we performed dynamic indentation tests over a wide range of loading frequencies. Nine porcine TMJs were used; the articular surface was divided into five regions: anterior; central; posterior; medial and lateral. Sinusoidal compressive strain was applied with an amplitude of 1.0% and a frequency range between 0.01 and 10 Hz. In both cartilages, the dynamic storage modulus increased with frequency, and the value was the highest in the lateral region. These values of E' in the temporal cartilage were smaller than those in the mandibular condylar cartilage in all five regions except the lateral region. The Loss tangent values were higher in the temporal cartilage (0.35-0.65) than in the mandibular condylar one (0.2-0.45), which means that the temporal cartilage presents higher viscosity. The present results suggest that the dynamic compressive moduli in both cartilages are region-specific and dependent on the loading frequency, which might have important implications for the transmission of load in the TMJ.

The impact of bone and suture material properties on mandibular function in Alligator mississippiensis: testing theoretical phenotypes with finite element analysis

The functional effects of bone and suture stiffness were considered here using finite element models representing three different theoretical phenotypes of an Alligator mississippiensis mandible. The models were loaded using force estimates derived from muscle architecture in dissected specimens, constrained at the 18th and 19th teeth in the upper jaw and 19th tooth of the lower jaw, as well as at the quadrate-articular joint. Stiffness was varied systematically in each theoretical phenotype. The three theoretical phenotypes included: (i) linear elastic isotropic bone of varying stiffness and no sutures; (ii) linear elastic orthotropic bone of varying stiffness with no sutures; and (iii) linear elastic isotropic bone of a constant stiffness with varying suture stiffness. Variation in the isotropic material properties of bone primarily resulted in changes in the magnitude of principal strain. By comparison, variation in the orthotropic material properties of bone and isotropic material properties of sutures resulted in: a greater number of bricks becoming either more compressive or more tensile, changing between being either dominantly compressive or tensile, and having larger changes in the orientation of maximum principal strain. These data indicate that variation in these model properties resulted in changes to the strain regime of the model, highlighting the importance of using biologically verified material properties when modeling vertebrate bones. When bones were compared within each set, the response of each to changing material properties varied. In two of the 12 bones in the mandible, varied material properties within sutures resulted in a decrease in the magnitude of principal strain in bricks adjacent to the bone/suture interface and decreases in stored elastic energy. The varied response of the mandibular bones to changes in suture stiffness highlights the importance of defining the appropriate functional unit when addressing relationships of performance and morphology.

Static and dynamic mechanics of the temporomandibular joint: plowing forces, joint load and tissue stress

OBJECTIVES - To determine the combined effects 1) of stress-field aspect ratio and velocity and compressive strain and 2) joint load, on temporomandibular joint (TMJ) disc mechanics. SETTING AND SAMPLE POPULATION - Fifty-two subjects (30 female; 22 male) participated in the TMJ load experiments. MATERIAL AND METHODS - In the absence of human tissue, pig TMJ discs were used to determine the effects of variables 1) on surface plowing forces, and to build a biphasic finite element model (bFEM) to test the effect of human joint loads and 2) on tissue stresses. In the laboratory, discs received a 7.6 N static load via an acrylic indenter before cyclic movement. Data were recorded and analysed using anova. To determine human joint loads, Research Diagnostic Criteria calibrated investigators classified subjects based on signs of disc displacement (DD) and pain (+DD/+pain, n = 18; +DD/-pain, n = 17; -DD/-pain, n = 17). Three-dimensional geometries were produced for each subject and used in a computer model to calculate joint loads. RESULTS - The combined effects of compressive strain, and aspect ratio and velocity of stress-field translation correlated with plowing forces (R(2) = 0.85). +DD/-pain subjects produced 60% higher joint loads (ANOVA, p < 0.05), which increased bFEM-calculated compressive strain and peak total normal stress. CONCLUSIONS - Static and dynamic variables of the stress-field and subject-dependent joint load significantly affect disc mechanics.

Tractional Forces on Porcine Temporomandibular Joint Discs

Tractional forces on the temporomandibular joint (TMJ) disc predispose tissue fatigue. This study tested the hypotheses that tractional forces: (1) increased with stress-field velocity ( V) and aspect ratio ( AR, contact area diameter/cartilage thickness), and compressive strain (ε); and (2) varied depending on cartilage thickness. Porcine TMJ discs (n = 187) received a 10-N vertical static load via an acrylic indenter for 1, 5, 10, 30, or 60 sec, followed by movement. Physical data were recorded and analyzed by quadratic regression relations and a likelihood ratio test. Results showed non-linear increases in tractional forces that were positively correlated with increased V, AR, and ε when the stress-field moved onto relatively thicker (R2 = 0.83) and thinner cartilage (R2 = 0.86). When V was > 27 mm/sec and AR·ε3, was > 0.09, tractional forces were significantly higher (≤ 12% of peak) when the stress-field moved onto thicker cartilage. Stress-field dynamic mechanics and cartilage thickness significantly affected TMJ disc tractional forces.

A biphasic finite element model of in vitro plowing tests of the temporomandibular joint disc

Disorders of the temporomandibular joint (TMJ) afflict 3-29% of people aged 19-40 years. Degenerative joint disease (DJD) of the TMJ generally occurs 15 years earlier than in other human joints and 1.5-2 times more often in women than men. The TMJ disc is the primary stress distribution mechanism within the joint. Mechanical failure of the TMJ disc precedes clinical signs of DJD. Unlike postcranial synovial joints, biomimetic replacements of the disc have not been successful, probably due to the paucity of knowledge about TMJ biomechanics. Translation of stress-fields mediolaterally across the TMJ disc may lead to fatigue failure because of the effect of traction forces on the tissue surface and because the disc is relatively weak in this aspect. Traction forces are composed of friction forces, which are known to be low in the TMJ, and plowing forces which are relatively much higher and result from movement and pressurization of fluids within the tissues due to translating surface loads. In the in vitro plowing experiment, a rigid curve-ended indenter is lowered into a TMJ disc that has been mounted on a stage with pressure gauges, and the indenter is then translated in a prescribed mediolateral motion that is intended to simulate the motion of the mandibular condyle on the TMJ disc in vivo. As a first step, these plowing experiments have quantified the variables thought to be important in tissue failure. A next step is to define the full role of these variables in the pathomechanics of TMJ disc tissue through a validated model. Therefore, the aim of this study was to develop and test a finite element model of the plowing experiments based on an orthotropic biphasic description of the soft tissue behavior of the TMJ disc. For this plowing model, the arbitrary Lagrange Eulerian method was used to approximate the moving load problem, where in vitro the indenter slid along the tissue's superior surface. Approximate validation of the plowing model was based on comparisons of model-predicted temporal and spatial distribution of indenter displacement and total normal stresses (+/-15%) and laboratory measurements during one complete cycle of plowing motion. Other useful predictions from the plowing model include spatial and temporal distributions of biomechanical variables of interest that cannot be measured experimentally, such as total stress, pressure, strain, and the relative significance of the orthotropic solid phase properties.

Biomechanical properties of the mandibular condylar cartilage and their relevance to the TMJ disc

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.

Tensile properties of the mandibular condylar cartilage

Mandibular condylar cartilage plays a crucial role in temporomandibular joint (TMJ) function, which includes facilitating articulation with the temporomandibular joint disc and reducing loads on the underlying bone. The cartilage experiences considerable tensile forces due to direct compression and shear. However, only scarce information is available about its tensile properties. The present study aims to quantify the biomechanical characteristics of the mandibular condylar cartilage to aid future three-dimensional finite element modeling and tissue engineering studies. Porcine condylar cartilage was tested under uniaxial tension in two directions, anteroposterior and mediolateral, with three regions per direction. Stress relaxation behavior was modeled using the Kelvin model and a second-order generalized Kelvin model, and collagen fiber orientation was determined by polarized light microscopy. The stress relaxation behavior of the tissue was biexponential in nature. The tissue exhibited greater stiffness in the anteroposterior direction than in the mediolateral direction as reflected by higher Young's (2.4 times), instantaneous (1.9 times), and relaxed (1.9 times) moduli. No significant differences were observed among the regional properties in either direction. The predominantly anteroposterior macroscopic fiber orientation in the fibrous zone of condylar cartilage correlated well with the biomechanical findings. The condylar cartilage appears to be less stiff and less anisotropic under tension than the anatomically and functionally related TMJ disc. The anisotropy of the condylar cartilage, as evidenced by tensile behavior and collagen fiber orientation, suggests that the shear environment of the TMJ exposes the condylar cartilage to predominantly but not exclusively anteroposterior loading.

Advances in biological structure, function, and physiology using synchrotron X-ray imaging*

Studies of the physiology and biomechanics of small ( approximately 1 cm) organisms are often limited by the inability to see inside the animal during a behavior or process of interest and by a lack of three-dimensional morphology at the submillimeter scale. These constraints can be overcome by an imaging probe that has sensitivity to soft tissue, the ability to penetrate opaque surfaces, and high spatial and temporal resolution. Synchrotron X-ray imaging has been successfully used to visualize millimeter-centimeter-sized organisms with micrometer-range spatial resolutions in fixed and living specimens. Synchrotron imaging of small organisms has been the key to recent novel insights into structure and function, particularly in the area of respiratory physiology and function of insects. X-ray imaging has been effectively used to examine the morphology of tracheal systems, the mechanisms of tracheal and air sac compression in insects, and the function of both chewing and sucking mouthparts in insects. Synchrotron X-ray imaging provides an exciting new window into the internal workings of small animals, with future promise to contribute to a range of physiological and biomechanical questions in comparative biology.

Biomechanical response of condylar cartilage-on-bone to dynamic shear

Shear stress can result in fatigue, damage, and irreversible deformation of the mandibular condylar cartilage. However, little information is available on its dynamic properties in shear. We tested the hypothesis that the dynamic shear properties of the condylar cartilage depend on the frequency and amplitude of shear strain. Ten porcine mandibular condyles were used for dynamic shear tests. Two cartilage-bone plugs were dissected from each condyle and tested in a simple shear sandwich configuration under a compressive strain of 10%. Sinusoidal shear strain was applied with an amplitude of 1.0, 2.0, and 3.0% and a frequency range between 0.01 and 10 Hz. The magnitudes of the shear dynamic moduli were found to be dependent on the frequency and the shear strain amplitude. They increased with shear strain. tan delta ranged from 0.2 to 0.4, which means that the cartilage is primarily elastic in nature and has a small but not negligible viscosity. In conclusion, the present results show that the shear behavior of the mandibular condylar cartilage is dependent on the frequency and amplitude of the applied shear strain. The observed shear characteristics suggest a significant role of shear strain on the interstitial fluid flow within the cartilage.

Masticatory mechanics of a mandibular distraction osteogenesis site: interfragmentary micromovement

Micromovement at a fracture or distraction osteogenesis (DO) site may play a significant role in bone formation and healing. Mastication is an important physiological process that can cause substantial micromovement at a mandibular disjunction. The purpose of this study is to characterize and quantify the micromovement caused by mastication. Eighteen pigs, divided into three groups based on duration of consolidation, received a unilateral (right) mandibular angle distraction osteogenesis protocol. Differential variable reluctance transducers (DVRTs) and ultrasound crystals were used to measure the change of gap width as well as interfragmentary movement during mastication. Synchronized chewing video and interfragmentary movement recordings were used to determine the magnitude and direction of micromovement at different phases of the chewing cycle. The magnitude of micromovement did not increase significantly with distraction up to almost 5 mm, but did decrease gradually with consolidation. The average micromovement magnitude during the distraction phase was 0.2-0.3 mm, equaling 50,000-250,000 microstrain (muepsilon) on interfragmentary tissue. The dominant deformation pattern was bending in the sagittal plane. The most common direction of bending at the power stroke of chewing was concave dorsally, i.e., superior shortening and inferior lengthening. These findings elucidate how masticatory mechanics affect a mandibular distraction site, and the measurements may be useful for future simulation studies.

A call to action for bioengineers and dental professionals: directives for the future of TMJ bioengineering

The world's first TMJ Bioengineering Conference was held May 25-27, 2006, in Broomfield, Colorado. Presentations were given by 34 invited speakers representing industry, academics, government agencies such as NIH, and private practice, which included surgeons, engineers, biomedical scientists, and patient advocacy leaders. Other attendees included documentary film makers and FDA officials. The impetus for the conference was that the field of TMJ research has been lacking continuity, with no open forum available for surgeons, scientists, and bioengineers to exchange scientific and clinical ideas and identify common goals, strengths, and capabilities. The goal was thus to plant the seeds for establishing a forum for multidisciplinary and interdisciplinary interactions. The collective wisdom and interactions brought about by a melting pot of these diverse individuals has been pooled and is disseminated in this article, which offers specific directives to bioengineers, basic scientists, and medical and dental professionals including oral and maxillofacial surgeons, pain specialists, orthodontists, prosthodontists, endocrinologists, rheumatologists, immunologists, radiologists, neurologists, and orthopaedic surgeons. A primary goal of this article was to attract researchers across a breadth of research areas to lend their expertise to a significant clinical problem with a dire need for new talent. For example, researchers with expertise in finite element modeling will find an extensive list of clinically significant problems. Specific suggestions for TMJ research were presented by the leading organizations for TMJ surgeons and TMJ patients, and further research needs were identified in a series of group discussions. The specific needs identified at the conference and presented here will be essential for those who endeavor to engage in TMJ research, especially in the areas of tissue engineering and biomechanics. Collectively, it is our hope that many of the questions and directives presented here find their way into the proposals of multidisciplinary teams across the world with new and promising approaches to diagnose, prevent and treat TMJ disorders.

Roles of intrinsic and extrinsic tongue muscles in feeding: electromyographic study in pigs

The performance of tongue muscles in various feeding behaviours is not well defined. This study was undertaken to examine the role of the intrinsic and extrinsic tongue muscles during natural drinking, food ingestion and chewing. Ten 12-week-old Yucatan miniature pigs (5 in each gender) were used. Under anesthesia, fine-wire electrodes were inserted into three intrinsic (verticalis and transversus [V/T]; superior and inferior longitudinalis [SL and IL]) and two extrinsic (genioglossus [GG] and styloglossus [SG]) tongue muscles and two jaw muscles (masseter [MA] and anterior digastricus [DI]). Electromyogram (EMG) and jaw movement were recorded and synchronized when pigs were drinking water, ingesting and chewing food freely. Chewing frequency (CF), onset of activation, burst duration and integrated activity (IEMG) were assessed quantitatively, and EMG activities during drinking and ingestion were examined qualitatively. Results indicate that during chewing, the V/T and GG had one phase of activity starting at early jaw opening, and the V/T activity lasted through late of jaw closing. The SL, IL and SG had double phases with the first starting at jaw opening and the second at late jaw closing phases. The three intrinsic tongue muscles and the SG were active during 35-48% of the chewing cycle. IEMG values of the SL, IL and SG of both sides were significantly greater compared to the other muscles (p<0.05-0.01). Both the SL and the IL showed significantly higher activities in the contralateral than ipsilateral sides (p<0.05). The timing sequences of both extrinsic and intrinsic muscles were similar between ingestion and chewing, but amplitudes of the GG and IL were greatly enhanced and those of the MA and SL were reduced during ingestion. The simultaneous activation of the MA, GG and V/T were seen during drinking, along with major activity in the GG and V/T. These results suggested that the majority of activity in the intrinsic and extrinsic tongue muscles occurred during jaw opening and the occlusal phases of chewing. The activity of the GG and IL played a major role during ingestion, whereas simultaneous activation of jaw, extrinsic and intrinsic tongue muscles and major activity in the GG and V/T occurred during drinking.

Static and dynamic loading effects on temporomandibular joint disc tractional forces

Mechanical fatigue-related degeneration of the temporomandibular joint (TMJ) disc may be promoted by tractional forces. This study tested the hypotheses that tractional forces following static loading of the TMJ disc: (1) increase with compressive strain at the start of movement, and (2) are velocity-dependent during movement. Sixty-four porcine discs received a 10-N static load via an acrylic indenter for 1 or 30 sec before cyclic movement. Physical data were recorded and analyzed by ANOVA. The results showed that compressive strain and tractional forces were largest for the start of movement following 30 sec of static loading (p <or= 0.0001) and were correlated (R(2) = 0.84). Peak tractional forces were linearly and positively related to velocity of movement (R(2) = 0.85), and were highest during Cycle 1 after 30 sec of loading (p <or= 0.0067). The results demonstrated that tractional forces were strain-related at the start of movement and velocity-dependent during movement.

ABBREVIATIONS

ANOVA = analysis of variance, PBS = phosphate-buffered physiological saline solution, TMJ = temporomandibular joint, mu(T) =tractional coefficient, mu(s) = static coefficient of friction.

Soft tissue mechanics of the temporomandibular joint

Direct measurement of temporomandibular joint (TMJ) tissue deformation requires animal experimentation. Most of the available data pertain to the mechanical strain on the bone surfaces around the joint. However, bone is rarely the first joint tissue to show injury, being affected after damage to collagenous tissues such as the disc or capsule. Capsular ligaments guide or limit movement, while the intra-articular disc may also distribute joint loads. However, these tissues are difficult to visualize dynamically and not suitable for strain gage attachment, so in vivo deformations are poorly understood. Using pigs as the best nonprimate model for human TMJ function, we implanted differential variable reluctance transducers to measure antero-posterior strain in the lateral aspect of the intra-articular disc. The results were compared to previously published data on the TMJ capsule. Passive manipulation in anesthetized animals indicated that opening, protrusion, and contralateral movements caused the disc to elongate. On the contrary, closing, retrusion and ipsilateral movements caused disc shortening. These strains are opposite to those observed in the capsule and are expected on anatomical grounds. Surprisingly, disc strain during mastication differed from that during manipulation. The disc elongated during jaw closure, more on the retruding balancing side (16% +/- 1) than on the working side (8% +/- 2). This anomalous behavior may reflect compressive loading, such that the disc elongates as a result of the Poisson effect rather than condylar movement. Because the capsule also elongates during the power stroke, especially on the balancing side, both disc and capsule are maximally loaded on the same side at the same moment.

Bone--special problems of the craniofacial region

PROBLEMS

The craniofacial region presents special problems for tissue engineering. First, the stresses and strains that engineered tissues will encounter are mostly unknown. Second, if tissue engineering is to be useful in ameliorating craniofacial anomalies, it will have to mimic the growth activity of the native tissues. These problems are interrelated in that bone growth responds to loading conditions.

METHODS

Our work uses miniature technology to measure skull deformation during function in the miniature pig. Growth is quantified in the same animals by labeling replicating cells with bromodeoxyuridine and newly mineralized bone with fluorochromes. The mandibular condyle and the cranial sutures are both candidate areas for tissue engineering, and craniofacial periosteum is a promising graft material.

RESULTS

The condyle is compressed by the reaction load at the temporomandibular joint (TMJ). Cell divisions in the perichondrium are negatively correlated with bone strain. Craniofacial sutures deform during function much more than adjacent bones, and strains can be either tensile or compressive. In contrast to expectation, functional tension is not correlated with sutural growth rate. However, functional strain does predict sutural morphology, with compressed sutures showing complex interdigitation. Periosteum shows striking differences between resorptive and appositional surfaces. The resorptive medial side of the zygomatic arch is under pressure during function. Tensile strain perpendicular to the surface is probably greater on the temporal than on the zygomatic bone, thus correlating with more rapid periosteal apposition on the temporal.

CONCLUSION

Engineered implants may be more likely to succeed if their architecture suits the strain environment in which they will function.

A Surface–Regional and Freeze–Thaw Characterization of the Porcine Temporomandibular Joint Disc

The temporomandibular joint (TMJ) disc is a central element in several TMJ disorders. Tissue-engineered TMJ disc replacements may alleviate discomfort associated with TMJ disorders; however, prior to developing a replacement, a thorough understanding of the native disc must be attained. Toward this end, we developed an unconfined compression, incremental stress relaxation viscoelastic model which simultaneously incorporates the strain increment magnitude and total deformation in the stress relaxation solution. This multiple strain step model was fit to stress relaxation data from (i) 80 test sites from eight porcine TMJ discs for the purposes of a surface-regional characterization and (ii) 30 test sites from five porcine TMJ discs for the purposes of a freeze-thaw characterization. The model estimated viscoelastic parameters accurately and surface-regional variations were detected throughout the TMJ disc. Regionally, the medial and anterior regions have the largest relaxation moduli, and the posterior and anterior regions have the largest instantaneous moduli. The inferior surface was found to have higher instantaneous modulus values than the superior surface. Furthermore, material properties were retained over five freeze-thaw cycles. The results of this study allow for the creation of design and validation criteria for future engineering efforts and shed light on the disc's role in TMJ function and dysfunction.

Time series analysis of jaw muscle contraction and tissue deformation during mastication in miniature pigs

Masticatory muscle contraction causes both jaw movement and tissue deformation during function. Natural chewing data from 25 adult miniature pigs were studied by means of time series analysis. The data set included simultaneous recordings of electromyography (EMG) from bilateral masseter (MA), zygomaticomandibularis (ZM) and lateral pterygoid muscles, bone surface strains from the left squamosal bone (SQ), condylar neck (CD) and mandibular corpus (MD), and linear deformation of the capsule of the jaw joint measured bilaterally using differential variable reluctance transducers. Pairwise comparisons were examined by calculating the cross-correlation functions. Jaw-adductor muscle activity of MA and ZM was found to be highly cross-correlated with CD and SQ strains and weakly with MD strain. No muscle's activity was strongly linked to capsular deformation of the jaw joint, nor were bone strains and capsular deformation tightly linked. Homologous muscle pairs showed the greatest synchronization of signals, but the signals themselves were not significantly more correlated than those of non-homologous muscle pairs. These results suggested that bone strains and capsular deformation are driven by different mechanical regimes. Muscle contraction and ensuing reaction forces are probably responsible for bone strains, whereas capsular deformation is more likely a product of movement.

Viscoelastic properties of bovine retrodiscal tissue under tensile stress-relaxation

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.

No effects of cervical spine motion on cranial dura mater strain

OBJECTIVE

The aim of this study was to analyze the effects of cervical spine motion on cranial dura mater length variations in anatomical specimens using high-resolution linear displacement transducers. We hypothesized that transducer resolution was sufficient to measure dura mater length changes if they occurred during cervical spine motion.

DESIGN

Cranial dura mater strain was measured using differential variable reluctance transducers during cervical spine motion in 11 formaldehyde-fixed whole-body anatomical specimens (mean age: 82 years).

BACKGROUND

Several theories hypothesize that functional maneuvers carried out on the spine have an effect on intra-cranial structures due to the supposed continuity of spinal and cranial dura mater. The displacements of the spinal dura mater are supposed to be transmitted to the cranial dura mater.

METHODS

Eleven anatomical specimens were used. Each specimen (positioned supine) was provided with three openings in the skull (frontal and parietal regions), leaving the dura mater intact. A differential variable reluctance transducer was inserted in frontal or sagittal orientation in the dura mater exposed in each opening. Strain was recorded during cyclic motions of cervical spine flexion-extension, lateral bending and axial rotation.

RESULTS

Average length changes ranged from 0.01 to 0.13% (SD 0.01-0.21%) of initial length for all motions and locations studied, which in all cases was less than the accuracy of the transducers.

CONCLUSION

It can thus be concluded that cervical spine motion does not induce significant strain of the cerebral dura mater.

RELEVANCE

The present study does not support theories that are based on the transmission of strains from spinal to cranial dura mater.

Modelling the masticatory biomechanics of a pig

The relationships between muscle tensions, jaw motions, bite and joint forces, and craniofacial morphology are not fully understood. Three-dimensional (3-D) computer models are able to combine anatomical and functional data to examine these complex relationships. In this paper we describe the construction of a 3-D dynamic model using the anatomical (skeletal and muscle form) and the functional (muscle activation patterns) features of an individual pig. It is hypothesized that the model would produce functional jaw movements similar to those recordable in vivo. Anatomical data were obtained by CT scanning (skeletal elements) and MR imaging (muscles). Functional data (muscle activities) of the same animal were obtained during chewing by bipolar intramuscular electrodes in six masticatory muscles and combined with previously published EMG data. The model was driven by the functional data to predict the jaw motions and forces within the masticatory system. The study showed that it is feasible to reconstruct the complex 3-D gross anatomy of an individual's masticatory system in vivo. Anatomical data derived from the 3-D reconstructions were in agreement with published standards. The model produced jaw motions, alternating in chewing side, typical for the pig. The amplitude of the jaw excursions and the timing of the different phases within the chewing cycle were also in agreement with previously published data. Condylar motions and forces were within expected ranges. The study indicates that key parameters of the pig's chewing cycle can be simulated by combining general biomechanical principles, individual-specific data and a dynamic modelling approach frequently used in mechanical engineering.