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Sivakumar S, Sivakumar G, Sundramoorthy AK. Effects of Glucosamine in the Temporomandibular Joint Osteoarthritis: A Review. Curr Rheumatol Rev 2024; 20:373-378. [PMID: 38213156 DOI: 10.2174/0115733971283009231225144322] [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] [Received: 09/19/2023] [Revised: 11/27/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Abstract
Osteoarthritis in the temporomandibular joint (TMJ) is a chronic disease characterized by irreversible damage to articular surfaces, including inflammation, loss of articular cartilage, and subchondral bone alterations, which would be radiographically evident only in later stages. Symptomatic slow-acting so-called nutraceutical drugs have been proposed as a treatment for osteoarthritis in comparison to non-steroidal anti-inflammatory drugs (NSAID) because of their appreciable safety profile even in long-term intake. Glucosamine, being one among them, proved highly efficient in knee osteoarthritis. However, its application in TMJ osteoarthritis dates back only to 2001 and is still inconclusive in its efficiency even with systematic reviews, in restoring the structural and functional aspects of damaged TMJ. Glucosamine, being a natural compound and also a contributor to building the matrix of articular cartilage, can be utilized effectively for TMJ osteoarthritis as an adjunct along with other conventional treatment modalities available till now, which also have moderate prognosis in most of the clinical scenarios. This review summarizes data relating to the mechanism of osteoarthritis and its management using glucosamine formulations. The beneficial effects of glucosamine on the pathophysiology of TMJ osteoarthritis are possibly due to its contribution to hyaluronic acid regulation and in establishing a proper balance between anabolism/catabolism in the articular tissues.
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Affiliation(s)
- Sasidharan Sivakumar
- Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Poonamallee High Road, Velappanchavadi, Chennai, 600077, Tamil Nadu, India
- Research Officer, Centre for Dental Education and Research, All India Institute of Medical Sciences, Ansari Nagar, New Delhi- 110029, India
| | - Gowardhan Sivakumar
- Tagore Dental College and Hospital, Near Vandalur, Melakkottaiyur Post, Rathinamangalam, Chennai, 600127, Tamil Nadu, India
| | - Ashok K Sundramoorthy
- Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Poonamallee High Road, Velappanchavadi, Chennai, 600077, Tamil Nadu, India
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2
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Huo J, Liu Y, Yang X, Wang Q. Inclination of the osseous components of the temporomandibular joint related with disc displacement: Magnetic resonance and cone beam computed tomography imaging-based study. Cranio 2022:1-10. [PMID: 35157556 DOI: 10.1080/08869634.2022.2036438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To assess the association between three-dimensional inclination of the osseous structures of temporomandibular joints (TMJ) and the risk of disc displacement (DD). METHODS The 120 TMJs of 60 patients were evaluated. According to magnetic resonance images, disc position was classified as normal, anterior DD with reduction (ADDWR) and without reduction (ADDWoR) and as normal, medial DD (MDD), and lateral DD (LDD) on the sagittal and coronal views, respectively. Condyle and eminence inclinations were measured using cone beam computed tomography. RESULTS Smaller horizontal condylar inclination was associated with ADDWoR (p < 0.05). Larger coronal condylar inclination was associated with ADDWR (p < 0.05) and LDD (p < 0.05). There was no association between sagittal eminence inclination and DD (p < 0.05). CONCLUSION Medial condylar rotation in the axial view may be associated with ADDWoR. The condyle head horizontally inclined in the coronal view may be associated with ADDWR and LDD.
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Affiliation(s)
- Jingyi Huo
- Department of Stomatology, Peking Union Medical College Hospital, Beijing, China
| | - Yuebo Liu
- Department of Stomatology, Peking Union Medical College Hospital, Beijing, China
| | - Xianrui Yang
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qi Wang
- Department of Stomatology, Peking Union Medical College Hospital, Beijing, China
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3
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Osteoarthritis of the temporomandibular joint: A review of aetiology and pathogenesis. Br J Oral Maxillofac Surg 2021; 60:387-396. [PMID: 35307273 DOI: 10.1016/j.bjoms.2021.06.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/11/2021] [Indexed: 11/21/2022]
Abstract
The aim of this review was to assess the level of evidence for genetic, biological, and functional predictive and predisposing factors for end-stage temporomandibular joint arthritis within the published literature. A comprehensive review based upon PRISMA guidelines was performed from all literature relevant to the topic. Case series and animal studies were included given the rare nature of the disease and goal of finding root-cause predictive factors. Clinical and radiographic measures were used specifically to identify factors which may have contributed to disease onset and progression. A total of 249 abstracts were identified based on search terms of major databases. After application of exclusion and inclusion criteria, 63 full-text articles were included in the analysis of this paper. There were few factors that could be reliably used to predict end-stage temporomandibular joint disease. Limited evidence is available to adequately predict end-stage temporomandibular joint osteoarthritis. No descriptive process exists that explains how and why this process can occur in younger adults. A better understanding of the aetiology and pathogenesis of TMJ-OA may lead to prevention and more effective management strategies that may reduce the need for drastic surgical intervention, particularly in young adults.
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Yamashita-Futani Y, Jokaji R, Ooi K, Kobayashi K, Kanakis I, Liu K, Kawashiri S, Bou-Gharios G, Nakamura H. Metalloelastase-12 is involved in the temporomandibular joint inflammatory response as well as cartilage degradation by aggrecanases in STR/Ort mice. Biomed Rep 2021; 14:51. [PMID: 33859822 PMCID: PMC8042671 DOI: 10.3892/br.2021.1427] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/17/2021] [Indexed: 12/02/2022] Open
Abstract
Temporomandibular joint dysfunction (TMJD) is characterised by clinical symptoms involving both the masticatory muscles and the temporomandibular joint (TMJ). Disc internal derangement and osteoarthritis (OA) are the most common forms of TMJD. Currently, the molecular process associated with degenerative changes in the TMJ is unclear. Our previous study showed that elastin-digested peptides act on human TMJ synovial cells and lead to upregulation of interleukin-6 (IL-6) and metalloelastase-12 (MMP-12; an elastin-degrading enzyme) in vitro. However, there is limited information regarding the involvement of elastin-degradation by MMP-12 in the processes of inflammatory responses and cartilage degradation in vivo. STR/Ort mice were used as a model of TMJ OA in the present study. Significant articular cartilage degeneration was observed starting at 20 weeks of age in the STR/Ort mice and this progressed gradually until 40 weeks, compared with the age-matched CBA mice. Immunostaining analysis showed that MMP-12 and IL-6 were expressed in the chondrocytes in the superficial zones of the cartilage. Immunostaining also showed that aggrecanases [a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4 and ADAMTS-5] were expressed in the chondrocytes in the superficial zones of the cartilage. These findings suggest that an inflammatory and degradative process was initiated in the TMJ. Harmful mechanical stimuli, particularly pressure, may cause damage to the elastin fibres in the most elastin-rich superficial layer of the articular cartilage. Elastin-digested peptides are then generated as endogenous warning signals and they initiate a pro-inflammatory cascade. This leads to upregulation of pro-inflammatory mediators, such as IL-6 and MMP-12, which further trigger tissue damage resulting in elevated levels of elastin-digested peptides. IL-6 increases expression of the aggrecanases ADAMTS-4 and ADAMTS-5, following cartilage degradation. This leads to the establishment of a positive feedback loop and may result in chronic inflammation and cartilage degradation of the TMJ in vivo.
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Affiliation(s)
- Yoko Yamashita-Futani
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan
| | - Rei Jokaji
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan
| | - Kazuhiro Ooi
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan
| | - Kazuhiko Kobayashi
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan
| | - Ioannis Kanakis
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool L7 8TX, UK
| | - Ke Liu
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool L7 8TX, UK
| | - Shuichi Kawashiri
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan
| | - George Bou-Gharios
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool L7 8TX, UK
| | - Hiroyuki Nakamura
- Department of Oral and Maxillofacial Surgery, Kanazawa University Graduate School of Medical Science, Kanazawa, Ishikawa 920-8640, Japan.,Department of Oral and Maxillofacial Surgery, Ryukyu University Graduate School of Medical Science, Nishihara, Okinawa 903-0215, Japan
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Elerian AE, Abdelftah E, Elmakaky AM, Ewidea MMA. Effect of dextrose phonophoresis versus pulsed electromagnetic field on temporomandibular dysfunction: A randomized, controlled study. J Bodyw Mov Ther 2020; 26:347-352. [PMID: 33992268 DOI: 10.1016/j.jbmt.2020.12.001] [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: 04/04/2020] [Revised: 10/30/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This study investigated and compared the efficacy of dextrose phonophoresis and Pulsed Electromagnetic Field (PEMF) on pain, range of motion (ROM) and function in patients with Temporomandibular Dysfunction (TMD). METHODS 45 patients with TMD aging from 25 to 45 years, with mean age 29 ± 2.5 years were included in this study, they were assigned randomly into 3 equal groups each contain fifteen TMJ dysfunction patients. Group (A) in which each patient received 50% dextrose phonophoresis for 5 min and therapeutic ultrasound for 5 min, Group (B) in which each patient received Pulsed Electromagnetic Field (PEMF) with frequency of 50 HZ for 50 min, and traditional physiotherapy ultrasound for 5 min, while in the control group (C) the patients received traditional physiotherapy ultrasound for 5 min only, the frequency of treatment session in the three groups was 3 days per week for 4 weeks. The assessment tools were visual analog scale (VAS) for pain evaluation, plastic ruler for TMJ ROM measurements while Fonseca's questionnaire was used for evaluation of TM function at baseline and 4 weeks later. RESULTS Paired t-test for comparison between pre and post treatment measurements in each group showed significant decrease pain as well as improvement of ROM and Fonseca's questionnaire in group A and B than placebo group. CONCLUSIONS The results found that both dextrose phonophoresis and PEMF have beneficial effects considering pain, ROM and function in patients with (TMD).
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Affiliation(s)
- Ahmed Ebrahim Elerian
- Physical Therapy, Department for Basic Science, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.
| | - Eman Abdelftah
- Physical Therapy, Department for Basic Science, Faculty of Physical Therapy, Kafer-ElSheikh University, Kaferlelshiek, Egypt
| | - Ayman Mohamed Elmakaky
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, South Valley University, Egypt
| | - Mahmoud Mohamed Ahmed Ewidea
- Physical Therapy, Department of Women Health, Faculty of Physical Therapy, Kafer-ElSheikh University, Kaferlelshiek, Egypt
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Helgeland E, Pedersen TO, Rashad A, Johannessen AC, Mustafa K, Rosén A. Angiostatin-functionalized collagen scaffolds suppress angiogenesis but do not induce chondrogenesis by mesenchymal stromal cells in vivo. J Oral Sci 2020; 62:371-376. [PMID: 32684573 DOI: 10.2334/josnusd.19-0327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Tissue engineering for fibrocartilage regeneration using mesenchymal stromal cells (MSC) and biomaterial scaffolds is emerging as a promising strategy, but inhibiting vascularization to prevent endochondral ossification is important to develop stable implants. The objective of this study was to investigate the effect of angiostatin on inhibition of angiogenesis and promotion of chondrogenesis by collagen scaffolds with or without MSC implanted subcutaneously in rats. One scaffold from the following groups was implanted in each animal: Collagen scaffolds only, scaffolds functionalized with angiostatin, scaffolds loaded with MSC and scaffolds functionalized with angiostatin and loaded with MSC. The various scaffolds were harvested after 2 and 8 weeks for histological analysis, Real-time quantitative polymerase chain reaction (RT-qPCR) and immunofluorescence quantification. Results demonstrated significantly decreased expression of inflammatory (interleukin 1 alpha and beta) and angiogenic genes (platelet and endothelial cell adhesion molecule 1) in scaffolds functionalized with angiostatin after 2 weeks in vivo. Histologically, after 8 weeks, the scaffolds with angiostatin had less inflammatory cells and more collagen matrix formation, but no fibrocartilage formation was detected. Thus, although angiostatin suppressed angiogenesis, it did not stimulate ectopic chondrogenesis in tissue engineered constructs in vivo.
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Affiliation(s)
| | - Torbjørn O Pedersen
- Department of Clinical Dentistry, University of Bergen.,Department of Oral and Maxillofacial Surgery, University of Bergen and Haukeland University Hospital
| | - Ahmad Rashad
- Department of Clinical Dentistry, University of Bergen
| | - Anne C Johannessen
- Gade Laboratory for Pathology, Department of Clinical Medicine, University of Bergen.,Department of Pathology, Haukeland University Hospital
| | - Kamal Mustafa
- Department of Clinical Dentistry, University of Bergen
| | - Annika Rosén
- Department of Clinical Dentistry, University of Bergen.,Department of Oral and Maxillofacial Surgery, University of Bergen and Haukeland University Hospital
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The Aging Voice. CURRENT OTORHINOLARYNGOLOGY REPORTS 2020. [DOI: 10.1007/s40136-020-00285-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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8
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Rennó TAS, Chung ACJ, Gitt HA, Corrêa L, Luz JGC. Temporomandibular arthropathies: A retrospective study with histopathological characteristics. Med Oral Patol Oral Cir Bucal 2019; 24:e562-e570. [PMID: 31422407 PMCID: PMC6764716 DOI: 10.4317/medoral.22739] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 05/30/2019] [Indexed: 11/23/2022] Open
Abstract
Background To investigate the incidence of temporomandibular arthropathies diagnosed in a university center and to describe their histopathological characteristics. Material and Methods Temporomandibular arthropathy cases with corresponding slides were selected from an oral and maxillofacial surgical pathology service. Cases of exclusively articular disc disease were not included. Results The mean age was 31.3 years with a predominance of females (69.7%). Of these diagnoses, 53.6% were unilateral condylar hyperplasia, 17.8% were bony ankylosis, 14.3% were degenerative joint disease, 10.7% were osteochondroma, and 3.6% were synovial chondromatosis. Condylar hyperplasia presented as thick fibrocartilage and cartilage nests in the cancellous bone. Bony ankylosis exhibited lamellar bone and nests of chondrocytes. Degenerative joint disease presented as an irregular layer of fibrocartilage with areas of clustered chondrocytes and calcified cartilage. Osteochondroma of the condyle exhibited hyaline cartilage and areas of new bone formation. Synovial chondromatosis presented as immature cartilaginous tissue and randomly arranged chondrocytes. Conclusions The pathological alterations verified in these arthropathies involved diseases that were predominantly proliferative, i.e., unilateral condylar hyperplasia, osteochondroma and synovial chondromatosis of the tumor or pseudotumor type and bony ankylosis associated with callus formation of the reparative type, and less frequent degenerative changes for which the disease is so named. Key words:Temporomandibular joint, pathology, ankylosis, pathology, arthritis, degenerative, osteochondroma, chondromatosis, synovial.
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Affiliation(s)
- T-A-S Rennó
- Av. Prof. Lineu Prestes, 2227, Cidade Universitária 05508-900, São Paulo - SP, Brazil,
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Conte R, Forin Valvecchi F, Gracco AL, Bruno G, De Stefani A. Condylar dysfunctional remodeling and recortication: a case-control study. MINERVA STOMATOLOGICA 2019; 68:74-83. [PMID: 30854837 DOI: 10.23736/s0026-4970.19.04211-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Temporo-mandibular disorders (TMD) is a collective term comprehending different clinical issues involving masticatory muscles, temporo-mandibular joint (TMJ) and other associated structures. TMD diagnosis is not made for its pathogenesis or etiology, but mainly on clinical symptoms. Primary dysfunction develops mostly on four factors: individual predisposition, high psychomotor activity (due to stress or parafunction), occlusal instability and low or absent tissue adaptation capability. On the other hand, secondary disorders can be caused by hereditary or congenital diseases, rheumatic inflammatory diseases, autoimmune and tumoral diseases. During their function, the condyles undergo a structural adaptive and physiological remodeling, but when mechanical stress exceeds adaptive capability, dysfunctional remodeling phenomena may occur. It is characterized by significant condylar morphological modifications at the level of the head of the condyle (smaller condyle), break of cortical integrity and reduced mandibular ramus height with subsequent mandibular retrusion and articular function alteration. The aim of this study is to compare condylar recortication amount, and pain reduction after two different therapeutic protocols. METHODS This is a case-control study. Twenty TMD patients were chosen and each of them underwent a documentation protocol including extraoral and intraoral photographs, dental casts, casts mounting on the articulator to evaluate CPI (CO-CR discrepancy index) and cone beam computed tomography (CBCT) of the mandibular condyles taken in closed mouth position. For the radiographic evaluation, a Planmeca ProMax 3D Mid system was utilized with an acquiring volume of 80×80 mm dimension, exposition 90 kV, 10.0 mA, 12 seconds with a DAP (Dose Area Product) of 1094 mGy·cm2 for each condyle. The acquired volume was elaborated by the Planmeca Romexis software v. 3.2.0.R and TMJ module. Seven coronal cuts and 10 sagittal cuts were performed on the head of the condyle to highlight the amount of cortication, before and after the application of two different therapeutic protocols. Protocol number 1 (N.=10 patients) included the exclusive use of a splint, while protocol number 2 (N.=10 patients) included the use of a splint associated with pharmacological therapy (NSAIDs, antioxidant, omega 3). The revaluation was performed on asymptomatic patient after a period of 6-8 months. The pain for each patient was assessed by a Visual Analogue Scale (VAS) from 0 to 10, 0 meaning no pain and 10 the worst pain ever felt. The VAS was evaluated after 10 days from the beginning of the treatment, after 3 months and after 8 months at the end of the treatment. Statistical analyses were carried using a χ2 test (P value <0.05). RESULTS No significant differences in the amount of cortication were found in the radiographic revaluation between the two different therapeutic protocols, even though it was noticed that the use of medicaments brought to a resolution of the symptoms in a shorter period of time (P=0.00001 after 10 days; P=0.0251 after 3 months). CONCLUSIONS According to this study, pharmacological protocol in the therapy of TMD does not seem to affect condylar cortication. Medicaments although seem to accelerate the disappearance of clinic symptomatology, but more researches are needed to valid these findings.
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Affiliation(s)
- Roberto Conte
- Department of Neuroscience, University of Padua, Padua, Italy
| | | | | | - Giovanni Bruno
- Department of Neuroscience, University of Padua, Padua, Italy
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10
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Cui SJ, Fu Y, Liu Y, Kou XX, Zhang JN, Gan YH, Zhou YH, Wang XD. Chronic inflammation deteriorates structure and function of collagen fibril in rat temporomandibular joint disc. Int J Oral Sci 2019; 11:2. [PMID: 30783108 PMCID: PMC6381164 DOI: 10.1038/s41368-018-0036-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 08/23/2018] [Accepted: 08/28/2018] [Indexed: 11/09/2022] Open
Abstract
Collagen is the building component of temporomandibular joint (TMJ) discs and is often affected by inflammation in temporomandibular disorders. The macromechanical properties of collagen are deteriorated by chronic inflammation. However, the mechanism by which inflammation influences disc function remains unknown. The relationship between the ultrastructure and nanomechanical properties of collagen in inflamed discs should be clarified. Seven-week-old female Sprague-Dawley rats were randomly divided into two groups. Chronic TMJ inflammation was induced by intra-articular injection of complete Freund's adjuvant, and samples were harvested after 5 weeks. Picrosirius staining revealed multiple colours under polarized light, which represented alternative collagen bundles in inflamed discs. Using atomic force microscopy scanning, the magnitude of Young's modulus was reduced significantly accompanied with disordered collagen fibril arrangement with porous architecture of inflamed discs. Transmission electron microscopy scanning revealed a non-uniform distribution of collagen fibres, and oversized collagen fibrils were observed in inflamed discs. Fourier transform infrared microspectroscopy revealed a decrease in 1 338 cm-1/amide II area ratio of collagen in different regions. The peak positions of amide I and amide II bands were altered in inflamed discs, indicating collagen unfolding. Our results suggest that sustained inflammation deteriorates collagen structures, resulting in the deterioration of the ultrastructure and nanomechanical properties of rat TMJ discs.
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Affiliation(s)
- Sheng-Jie Cui
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China.,Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China
| | - Yu Fu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China.,Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China
| | - Yan Liu
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China.,Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China
| | - Xiao-Xing Kou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China.,Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China
| | - Jie-Ni Zhang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China.,Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China
| | - Ye-Hua Gan
- Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China
| | - Yan-Heng Zhou
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China. .,Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China.
| | - Xue-Dong Wang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China. .,Center for Craniofacial Stem Cell Research and Regeneration, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing, China.
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11
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Xiong H, Li W, Li J, Fang W, Ke J, Li B, Cheng Y, Wei L. Elevated leptin levels in temporomandibular joint osteoarthritis promote proinflammatory cytokine
IL
‐6 expression in synovial fibroblasts. J Oral Pathol Med 2019; 48:251-259. [PMID: 30597628 DOI: 10.1111/jop.12819] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Haofei Xiong
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University Wuhan China
- Department of Oral EmergencySchool and Hospital of Stomatology, Wuhan University Wuhan China
| | - Wei Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University Wuhan China
- Department of Oral RadiologySchool and Hospital of Stomatology, Wuhan University Wuhan China
| | - Jiajie Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University Wuhan China
- Department of Oral RadiologySchool and Hospital of Stomatology, Wuhan University Wuhan China
| | - Wei Fang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University Wuhan China
- Department of Oral and Maxillofacial SurgerySchool and Hospital of Stomatology, Wuhan University Wuhan China
| | - Jin Ke
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University Wuhan China
- Department of Oral and Maxillofacial SurgerySchool and Hospital of Stomatology, Wuhan University Wuhan China
| | - Bo Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University Wuhan China
- Department of Oral RadiologySchool and Hospital of Stomatology, Wuhan University Wuhan China
| | - Yong Cheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University Wuhan China
- Department of Oral RadiologySchool and Hospital of Stomatology, Wuhan University Wuhan China
| | - Lili Wei
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei‐MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University Wuhan China
- Department of Oral RadiologySchool and Hospital of Stomatology, Wuhan University Wuhan China
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12
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Lin AW, Vapniarsky N, Cissell DD, Verstraete FJM, Lin CH, Hatcher DC, Arzi B. The Temporomandibular Joint of the Domestic Dog (Canis lupus familiaris) in Health and Disease. J Comp Pathol 2018; 161:55-67. [PMID: 30173858 DOI: 10.1016/j.jcpa.2018.05.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 05/02/2018] [Accepted: 05/14/2018] [Indexed: 11/29/2022]
Abstract
This study aimed to characterize the histological, biomechanical and biochemical properties of the temporomandibular joint (TMJ) of the domestic dog in health and disease. In addition, we sought to identify structure-function relationships and to characterize TMJ degenerative lesions that may be found naturally in this species. TMJs (n = 20) from fresh cadaver heads (n = 10) of domestic dogs were examined macroscopically and microscopically and by cone-beam computed tomography. The TMJ discs were evaluated for their mechanical and biochemical properties. If TMJ arthritic changes were found, pathological characteristics were described and compared with healthy joints. Five (50%) dogs demonstrated macroscopically normal fibrocartilaginous articular surfaces and fibrous discs and five (50%) dogs exhibited degenerative changes that were observed either in the articular surfaces or the discs. In the articulating surfaces, these changes included erosions, conformational changes and osteophytes. In the discs, degenerative changes were represented by full-thickness perforations. Histologically, pathological specimens demonstrated fibrillations with or without erosions, subchondral bone defects and subchondral bone sclerosis. Significant anisotropy in the TMJ discs was evident on histology and tensile mechanical testing. Specifically, the discs were significantly stiffer and stronger in the rostrocaudal direction compared with the mediolateral direction. No significant differences were detected in compressive properties of different disc regions. Biochemical analyses showed high collagen content and low glycosaminoglycan (GAG) content. No significant differences in biochemical composition, apart from GAG, were detected among the disc regions. GAG concentration was significantly higher in the central region as compared with the caudal (posterior) region. The TMJ of the domestic dog exhibits similarities, but also differences, compared with other mammals with regards to structure-function relationships. The TMJ articular surfaces and the disc exhibit degenerative changes as seen in other species, including perforation of the disc as seen in man. The degenerative changes had greater effects on the mechanical properties compared with the biochemical properties of the TMJ components. Translational motion of the TMJ does occur in dogs, but is limited.
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Affiliation(s)
- A W Lin
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA
| | - N Vapniarsky
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, California, USA.
| | - D D Cissell
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA
| | - F J M Verstraete
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA
| | - C H Lin
- Department of Biomedical Engineering, University of California, Davis, California, USA
| | - D C Hatcher
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA
| | - B Arzi
- Department of Surgical and Radiological Sciences, University of California, Davis, California, USA.
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Helgeland E, Shanbhag S, Pedersen TO, Mustafa K, Rosén A. Scaffold-Based Temporomandibular Joint Tissue Regeneration in Experimental Animal Models: A Systematic Review. TISSUE ENGINEERING PART B-REVIEWS 2018; 24:300-316. [PMID: 29400140 DOI: 10.1089/ten.teb.2017.0429] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Reconstruction of degenerated temporomandibular joint (TMJ) structures remains a clinical challenge. Tissue engineering (TE) is a promising alternative to current treatment options, where the TMJ is either left without functional components, or replaced with autogenous, allogeneic, or synthetic grafts. The objective of this systematic review was to answer the focused question: in experimental animal models, does the implantation of biomaterial scaffolds loaded with cells and/or growth factors (GFs) enhance regeneration of the discal or osteochondral TMJ tissues, compared with scaffolds alone, without cells, or GFs? Following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines, electronic databases were searched for relevant controlled preclinical in vivo studies. Thirty studies reporting TMJ TE strategies in both small (rodents, rabbits; n = 25) and large animals (dogs, sheep, goats; n = 5) reporting histological and/or radiographic outcomes were included. Twelve studies reported ectopic (subcutaneous) implantation models in rodents, whereas 18 studies reported orthotopic, surgically induced defect models in large animals. On average, studies presented with an unclear-to-high risk of bias. In most studies, mesenchymal stem cells or chondrocytes were used in combination with either natural or synthetic polymer scaffolds, aiming for either TMJ disc or condyle regeneration. In summary, the overall preclinical evidence (ectopic [n = 6] and orthotopic TMJ models [n = 6]) indicate that addition of chondrogenic and/or osteogenic cells to biomaterial scaffolds enhances the potential for TMJ tissue regeneration. Standardization of animal models and quantitative outcome evaluations (biomechanical, biochemical, histomorphometric, and radiographic) in future studies, would allow more reliable comparisons and increase the validity of the results.
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Affiliation(s)
- Espen Helgeland
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Siddharth Shanbhag
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Torbjørn Ostvik Pedersen
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway .,2 Department of Oral and Maxillofacial Surgery, University of Bergen and Haukeland University Hospital , Bergen, Norway
| | - Kamal Mustafa
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway
| | - Annika Rosén
- 1 Department of Clinical Dentistry, Center for Clinical Dental Research, University of Bergen , Bergen, Norway .,2 Department of Oral and Maxillofacial Surgery, University of Bergen and Haukeland University Hospital , Bergen, Norway
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Martin-Granizo R, Correa-Muñoz DC. Chondromalacia as pathological finding in arthroscopy of the temporomandibular joint: A retrospective study. J Craniomaxillofac Surg 2018; 46:82-89. [DOI: 10.1016/j.jcms.2016.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Revised: 09/27/2016] [Accepted: 11/09/2016] [Indexed: 10/20/2022] Open
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Abstract
Temporomandibular disorders (TMD) and primary headaches can be perpetual and debilitating musculoskeletal and neurological disorders. The presence of both can affect up to one-sixth of the population at any one time. Initially, TMDs were thought to be predominantly musculoskeletal disorders, and migraine was thought to be solely a cerebrovascular disorder. The further understanding of their pathophysiology has helped to clarify their clinical presentation. This article focuses on the role of the trigeminal system in associating TMD and migraine. By discussing recent descriptions of prevalence, diagnosis, and treatment of headache and TMD, we will further elucidate this relationship.
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Affiliation(s)
- Steven B Graff-Radford
- The Pain Center, Cedars-Sinai Medical Center, 444 South San Vicente Boulevard #1101, Los Angeles, CA 90048, USA; The Program for Headache and Orofacial Pain, Cedars-Sinai Medical Center, Los Angeles, CA, USA; UCLA School of Dentistry, Los Angeles, CA, USA.
| | - Jeremy J Abbott
- West Coast Ear, Nose & Throat Medical Group, 301 South Moorpark Road, Thousand Oaks, CA 91361, USA
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Bodine TP, Wolford LM, Araujo E, Oliver DR, Buschang PH. Surgical treatment of adolescent internal condylar resorption (AICR) with articular disc repositioning and orthognathic surgery in the growing patient--a pilot study. Prog Orthod 2016; 17:2. [PMID: 26763528 PMCID: PMC4716014 DOI: 10.1186/s40510-015-0115-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 12/20/2015] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the Mitek mini-anchor technique affects condylar growth in growing patients with adolescent internal condylar resorption (AICR). Methods Twenty-two adolescent patients diagnosed with AICR and anterior temporomandibular disc displacement were compared to untreated control subjects without AICR matched for age, sex, and Angle classification. Pre-surgical (T1 and T2) and post-surgical (T3 and T4) mandibular tracings were superimposed on natural stable structures to evaluate the horizontal, vertical, and total changes in the position of condylion. Results The treated group showed an overall decrease in condylar height pre-surgically and statistically significant changes in condylar growth direction between the pre- and post-surgical observation periods. Pre-surgically, the treated group showed significantly more posterior condylar growth than the control group; they also showed inferior condylar growth, while the controls showed superior growth. Controls and patients in the treated group showed no significant differences in condylar growth post-surgically. Conclusions Adolescent patients diagnosed with AICR and anterior disc displacement treated with mandibular ramus and maxillary osteotomies, along with Mitek anchors to reposition internally deranged discs, showed post-surgical normalization of condylar growth.
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Affiliation(s)
- Trevor P Bodine
- Department of Orthodontics, Texas A&M University Baylor College of Dentistry, 3302 Gaston Ave, Dallas, TX, 75246, USA
| | - Larry M Wolford
- Department of Orthodontics, Texas A&M University Baylor College of Dentistry, 3302 Gaston Ave, Dallas, TX, 75246, USA
| | - Eustaquio Araujo
- Department of Orthodontics, Texas A&M University Baylor College of Dentistry, 3302 Gaston Ave, Dallas, TX, 75246, USA
| | - Donald R Oliver
- Department of Orthodontics, Texas A&M University Baylor College of Dentistry, 3302 Gaston Ave, Dallas, TX, 75246, USA
| | - Peter H Buschang
- Department of Orthodontics, Texas A&M University Baylor College of Dentistry, 3302 Gaston Ave, Dallas, TX, 75246, USA.
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Ghawsi S, Aagaard E, Thygesen T. High condylectomy for the treatment of mandibular condylar hyperplasia: a systematic review of the literature. Int J Oral Maxillofac Surg 2016; 45:60-71. [DOI: 10.1016/j.ijom.2015.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 08/25/2015] [Accepted: 09/04/2015] [Indexed: 10/23/2022]
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Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review. Cytokine 2016; 77:98-106. [DOI: 10.1016/j.cyto.2015.11.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 10/23/2015] [Accepted: 11/02/2015] [Indexed: 12/22/2022]
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Senyuk AN, Nerobeev AI, Starikov NA, Romanovskiy MA, Tkachuk OE. [Cephalometric findings in patients with TMJ anterior disk displacement without reduction]. STOMATOLOGII︠A︡ 2015; 94:53-57. [PMID: 26343404 DOI: 10.17116/stomat201594453-57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective of the study was to determine representative cephalometric signs for the patients with TMJ anterior disk displacement without reduction (ADWoR). Twenty one female patients with ADWoR, which was confirmed by MRI, were included in the study. Cephalometric parameters described by Arnett-McLaughlin and Jarabak were measured by means of lateral cephalograms and computed tomograms (CT) to determine the growth pattern of the facial skeleton. All the data obtained was evaluated statistically. The investigation has revealed reduction in vertical measurements of facial skeleton and several signs of hyperdivergent growth pattern in the sample.
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Affiliation(s)
- A N Senyuk
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - A I Nerobeev
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - N A Starikov
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - M A Romanovskiy
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Arzi B, Cissell DD, Pollard RE, Verstraete FJM. Regenerative Approach to Bilateral Rostral Mandibular Reconstruction in a Case Series of Dogs. Front Vet Sci 2015; 2:4. [PMID: 26664933 PMCID: PMC4672177 DOI: 10.3389/fvets.2015.00004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/14/2015] [Indexed: 12/02/2022] Open
Abstract
Extensive rostral mandibulectomy in dogs typically results in instability of the mandibles that may lead to malocclusion, difficulty in prehension, mastication, and pain of the temporomandibular joint. Large rostral mandibular defects are challenging to reconstruct due to the complex geometry of this region. In order to restore mandibular continuity and stability following extensive rostral mandibulectomy, we developed a surgical technique using a combination of intraoral and extraoral approaches, a locking titanium plate, and a compression resistant matrix (CRM) infused with rhBMP-2. Furthermore, surgical planning that consisted of computed tomographic (CT) scanning and 3D model printing was utilized. We describe a regenerative surgical technique for immediate or delayed reconstruction of critical-size rostral mandibular defects in five dogs. Three dogs had healed with intact gingival covering over the mandibular defect and had immediate return to normal function and occlusion. Two dogs had the complication of focal plate exposure and dehiscence, which was corrected with mucosal flaps and suturing; these dogs have since healed with intact gingival covering over the mandibular defect. Mineralized tissue formation was palpated clinically within 2 weeks and solid bone formation within 3 months. CT findings at 6 months postoperatively demonstrated that the newly regenerated mandibular bone had increased in mineral volume with evidence of integration between the native bone, new bone, and CRM compared to the immediate postoperative CT. We conclude that rostral mandibular reconstruction using a regenerative approach provides an excellent solution for restoring mandibular continuity and preventing mandibular instability in dogs.
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Affiliation(s)
- Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis , Davis, CA , USA
| | - Derek D Cissell
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis , Davis, CA , USA ; Department of Biomedical Engineering, University of California Davis , Davis, CA , USA
| | - Rachel E Pollard
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis , Davis, CA , USA
| | - Frank J M Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis , Davis, CA , USA
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Dagenais M, MacDonald D, Baron M, Hudson M, Tatibouet S, Steele R, Gravel S, Mohit S, El Sayegh T, Pope J, Fontaine A, Masseto A, Matthews D, Sutton E, Thie N, Jones N, Copete M, Kolbinson D, Markland J, Nogueira-Filho G, Robinson D, Gornitsky M. The Canadian Systemic Sclerosis Oral Health Study IV: oral radiographic manifestations in systemic sclerosis compared with the general population. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:104-11. [PMID: 25959972 DOI: 10.1016/j.oooo.2015.03.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/20/2015] [Accepted: 03/09/2015] [Indexed: 02/08/2023]
Abstract
OBJECTIVE The aim of this study was to compare oral radiologic abnormalities associated with systemic sclerosis (SSc) against abnormalities in the general population. STUDY DESIGN Patients with SSc and healthy controls were enrolled in a multi-site cross-sectional study. Included in the radiology examination were a panoramic radiograph, four bitewings, and an anterior mandibular periapical radiograph. Radiographs were evaluated by two oral and maxillofacial radiologists tested for interobserver and intraobserver reliability. Chi-squared tests, Fisher exact tests, and Mann Whitney U tests were used to summarize the radiologic manifestations of patients and controls. RESULTS We assessed 163 SSc patients and 231 controls. Widening of the periodontal ligament space (PLS) (P < .001), with higher percentage of teeth with PLS widening (P < .001), was significantly more frequent in patients with SSc than in controls. The most significant differences between the two groups were found in the molars and premolars (P < .001). Moreover, 26% of the patients with SSc had a periapical PLS greater than 0.19 mm compared with 13% of the controls (P = .003). Patients with SSc had significantly more erosions compared with controls (14.5% vs. 3.6%; P < .001), mostly in the condyles (P = .022), coronoid processes (P = .005) and other locations (P = .012). CONCLUSION Patients with SSc had more teeth with PLS widening and erosions of the mandible compared with controls.
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Affiliation(s)
- Marie Dagenais
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1
| | - David MacDonald
- Faculty of Dentistry, Division of Oral & Maxillofacial Radiology, University of British Columbia, Room 380, J.B. Macdonald Building, 2199 Wesbrook Mall, Vancouver, British Columbia V6T 1Z3
| | - Murray Baron
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-725, Montreal, Quebec H3T 1E2; Division of Rheumatology, Faculty of Medicine, McGill University, MUHC-MGH, Room A6.123, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4
| | - Marie Hudson
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-725, Montreal, Quebec H3T 1E2; Division of Rheumatology, Faculty of Medicine, McGill University, MUHC-MGH, Room A6.123, 1650 Cedar Avenue, Montreal, Quebec H3G 1A4
| | - Solène Tatibouet
- Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, 3755 Côte Ste-Catherine, Montreal, Quebec H3T 1E2
| | - Russell Steele
- Epidemiology, Lady Davis Institute, SMBD Jewish General Hospital, 3755 Côte Ste-Catherine, Montreal, Quebec H3T 1E2; Department of Mathematics and Statistics, McGill University, Burnside Hall, Room 1005, 805 Sherbrooke Street West, Montreal, Quebec, H3A 0B9
| | - Sabrina Gravel
- Division of Rheumatology, Department of Internal Medicine, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-725, Montreal, Quebec H3T 1E2
| | - Shrisha Mohit
- Department of Dentistry, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-024, Montreal, Quebec H3T 1E2
| | - Tarek El Sayegh
- School of Dentistry, University of Western Ontario, Dental Sciences Building, Schulich School of Medicine & Dentistry, Western University, London, Ontario N6A 5C1
| | - Janet Pope
- Division of Rheumatology, Department of Medicine, University of Western Ontario, Room 3700, Clinical Skills Building, London, Ontario N6A 5C1
| | - Audrey Fontaine
- Dentistry, Clinique Dentaire Ayotte et associées, 91 Rue Peel, bureau 300, Sherbrooke, Quebec J1H 4J9
| | - Ariel Masseto
- Department of Rheumatology, Université de Sherbrooke, 3001, 12e avenue Nord Sherbrooke, Sherbrooke, Quebec J1H 5N4
| | - Debora Matthews
- Department of Periodontology, Faculty of Dentistry, Dentistry Building, Dalhousie University 5981 University Avenue, PO Box 15000, Halifax, Nova Scotia B3H 4R2
| | - Evelyn Sutton
- Division of Rheumatology, Faculty of Medicine, Dalhousie University, 1459 Oxford Street, Halifax, Nova Scotia B3H 4R2
| | - Norman Thie
- Division of Oro-facial Pain, School of Dentistry, University of Alberta, Edmonton, Alberta, Edmonton Clinic Health Academy, 5th Floor, 11405-87 Avenue NW, Edmonton, Alberta T6G 1 C9
| | - Niall Jones
- Department of Medicine, University of Alberta, Edmonton, Alberta, Edmonton Clinic Health Academy, 5th Floor, 11405 - 87 Avenue NW, Edmonton, Alberta T6G 1C9
| | - Maria Copete
- Department of Pathology, College of Dentistry, University of Saskatchewan, 174 Dental Clinic Building, 105 Wiggins Road, Saskatoon, Saskatchewan S7N 5E4
| | - Dean Kolbinson
- Department of Pathology, College of Dentistry, University of Saskatchewan, 174 Dental Clinic Building, 105 Wiggins Road, Saskatoon, Saskatchewan S7N 5E4
| | - Janet Markland
- Division of Rheumatology, College of Medicine, University of Saskatchewan, 5 D40 Health Sciences Building, 107 Wiggins Road, Saskatoon, SK S7N 5E5
| | - Getulio Nogueira-Filho
- Department of Periodontology, Faculty of Dentistry, D 212, 780 Bannatyne Avenue, University of Manitoba, Winnipeg, Manitoba R3T 2N2; Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, Ontario M5G 1G6
| | - David Robinson
- Rheumatology, Faculty of Medicine, University of Manitoba, 260 Brodie Centre, 727 McDermot Avenue, Winnipeg, Manitoba R3E 3P5
| | - Mervyn Gornitsky
- Faculty of Dentistry, McGill University, 2001 McGill College Avenue, Suite 500, Montreal, Quebec H3A 1G1; Department of Dentistry, SMBD Jewish General Hospital, 3755 Cote-Ste-Catherine, A-024, Montreal, Quebec H3T 1E2.
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Zhuo Z, Cai X, Xie Q. Is anterior disc displacement without reduction associated with temporomandibular joint condylar height in juvenile patients younger than 20 years? J Oral Maxillofac Surg 2014; 73:843-9. [PMID: 25799357 DOI: 10.1016/j.joms.2014.12.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/02/2014] [Accepted: 12/08/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Because disc displacement might be accompanied by degenerative changes in the condyle, this study explored the association between condylar height and anterior disc displacement without reduction in juvenile patients. MATERIALS AND METHODS This was a retrospective cohort study that enrolled a sample of patients younger than 20 years with unilateral disc displacement without reduction. All patients had 2 magnetic resonance imaging records taken from January 2010 to June 2013 (interval, >6 months). Condylar height, disc length, and displacement distance were measured. The predictor variable was joint status (healthy vs affected side), and the outcome variables were changes in condylar height, displacement distance, and disc length over time. SAS 9.13 was used for analysis and the P value was set at .05. RESULTS One hundred twenty-four patients (101 female and 23 male; mean age, 16.4 yr; mean interval, 13.6 months) were included. During the interval, the condylar height of the healthy side increased 0.75 mm, whereas the condylar height of the affected side decreased 0.41 mm. The disc of the affected side was shortened and more anteriorly displaced. CONCLUSION Anterior disc displacement without reduction could be accompanied by a decrease in condylar height in juvenile patients, and the disc might be shortened and more anteriorly displaced.
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Affiliation(s)
- Ziang Zhuo
- Resident, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xieyi Cai
- Associate Professor, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
| | - Qianyang Xie
- Resident, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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Wang XD, Cui SJ, Liu Y, Luo Q, Du RJ, Kou XX, Zhang JN, Zhou YH, Gan YH. Deterioration of mechanical properties of discs in chronically inflamed TMJ. J Dent Res 2014; 93:1170-6. [PMID: 25266714 DOI: 10.1177/0022034514552825] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Temporomandibular joint (TMJ) discs frequently undergo degenerative changes in arthritis. However, the biomechanical properties of pathogenic discs remain to be explored. In this study, we evaluated the effects of chronic inflammation on the biomechanical properties of TMJ discs in rats. Chronic inflammation of TMJs was induced by double intra-articular injections of complete Freund's adjuvant for 5 weeks, and biomechanical properties and ultrastructure of the discs were examined by mechanical testing, scanning electron microscopy, and transmission electron microscopy. The instantaneous compressive moduli of the anterior and posterior bands of discs in inflamed TMJs were decreased significantly compared with those in the control group. The instantaneous tensile moduli of the discs of inflamed TMJs also showed significant decreases in both the anterior-posterior and mesial-lateral directions. The relaxation moduli of the discs of inflamed TMJs showed nearly the same tendency as the instantaneous moduli. The surfaces of the discs of inflamed TMJs became rough and porous due to the loss of the superficial gel-like stratum, with many collagen fibers exposed and degradation of the sub-superficial collagen fibrils. Our results suggested that chronic inflammation of TMJ could lead to deterioration of mechanical properties and alteration of disc ultrastructure, which might contribute to TMJ disc displacement.
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Affiliation(s)
- X D Wang
- Department of Orthodontics Center for Craniofacial Stem Cell Research and Regeneration
| | - S J Cui
- Department of Orthodontics Center for Craniofacial Stem Cell Research and Regeneration
| | - Y Liu
- Department of Orthodontics Center for Craniofacial Stem Cell Research and Regeneration
| | - Q Luo
- Department of Orthodontics Center for Craniofacial Stem Cell Research and Regeneration
| | - R J Du
- Department of Orthodontics Center for Craniofacial Stem Cell Research and Regeneration
| | - X X Kou
- Department of Orthodontics Center for Craniofacial Stem Cell Research and Regeneration
| | - J N Zhang
- Department of Orthodontics Center for Craniofacial Stem Cell Research and Regeneration
| | - Y H Zhou
- Department of Orthodontics Center for Craniofacial Stem Cell Research and Regeneration
| | - Y H Gan
- Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology, 22# Zhongguancun South Avenue, Haidian District, Beijing 100081, China
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Otonari-Yamamoto M, Sano T, Okano T, Wakoh M. Association between osseous changes of the condyle and temporomandibular joint (TMJ) fluid in osteoarthritis. Oral Radiol 2014. [DOI: 10.1007/s11282-014-0185-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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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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Tecco S, Festa F, Salini V, Epifania E, D'Attilio M. Treatment of Joint Pain and Joint Noises Associated with a Recent TMJ Internal Derangement: A Comparison of an Anterior Repositioning Splint, a Full-Arch Maxillary Stabilization Splint, and an Untreated Control Group. Cranio 2014; 22:209-19. [PMID: 15293777 DOI: 10.1179/crn.2004.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Pain and joint noises associated with temporomandibular joint (TMJ) internal derangement are often treated by using an intra-oral splint. This study evaluated whether an anterior repositioning splint (AR splint) could be more effective in the treatment of these symptoms than a full-arch maxillary stabilization splint (FAMS splint), because of its capability to re-establish immediately the normal condyle/disk relationship. The authors treated 40 patients (average age 16.8; range 8.0-24.0) with confirmed internal derangement, joint pain, and joint noises in at least one TMJ for at least two months, with AR splint (20 subjects) or FAMS splint (20 subjects); 10 untreated patients comprised the control group. Joint noise, joint pain, and the intensity of pain were assessed using a visual analogic scale (VAS), and the pain was characterized (i.e., constant or chewing/biting pain) and evaluated monthly for eight months. Significantly fewer AR splint patients experienced pain after four months of treatment. A significantly lower intensity of pain was experienced by the AR splint patients after two months of treatment. Significantly fewer AR splint patients experienced chewing/biting pain after eight months of treatment. The frequency of joint noises decreased over time, with no significant differences between the groups. In conclusion, the AR splint seems to be more effective in decreasing pain, but it seems to make no difference in the treatment of joint noises.
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Affiliation(s)
- Simona Tecco
- Faculty of Dentistry, University of Chieti, Italy.
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Mendez-Angulo JL, Tatarniuk DM, Ruiz I, Ernst N. Extensive Rostral Mandibulectomy for Treatment of Ameloblastoma in a Horse. Vet Surg 2014; 43:222-6. [DOI: 10.1111/j.1532-950x.2014.12110.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Accepted: 11/28/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Jose L. Mendez-Angulo
- Veterinary Population Medicine Department; University of Minnesota; St. Paul Minnesota
| | - Dane M. Tatarniuk
- Veterinary Population Medicine Department; University of Minnesota; St. Paul Minnesota
| | - Indalecio Ruiz
- Department of Animal Medicine and Surgery; University of Córdoba; Córdoba Spain
| | - Nicolas Ernst
- Veterinary Population Medicine Department; University of Minnesota; St. Paul Minnesota
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Cohen WA, Servais JM, Polur I, Li Y, Xu L. Articular cartilage degeneration in the contralateral non-surgical temporomandibular joint in mice with a unilateral partial discectomy. J Oral Pathol Med 2013; 43:162-5. [PMID: 24044578 DOI: 10.1111/jop.12113] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2013] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The objective was to characterize the contralateral non-surgical temporomandibular joint (TMJ) in mice that had an opposing osteoarthrosis(OA)-like joint induced by unilateral partial discectomy. METHODS TMJs on one side in mice were subjected to partial discectomy. Both surgical and contralateral non-surgical TMJs were collected at 4, 8, 12 and 16 weeks post-surgery for histological examination. The morphology of the articular cartilage of the condyle was evaluated using a scoring system. RESULTS A progression of articular cartilage degeneration was seen in the TMJs following unilateral partial discectomy, including increased proteoglycan staining in the extracellular matrix at 4 weeks, the appearance of chondrocyte clusters at 8 weeks, reduced proteoglycan staining and fibrillation at 12 weeks and the loss of articular cartilage at 16 weeks. In the contralateral non-surgical TMJs, increased proteoglycan staining occurred in the articular cartilage of the condyle at 8 weeks and continued to age. CONCLUSION The result indicated that OA-like changes in one TMJ by partial discectomy could initiate early-onset articular cartilage degeneration in the contralateral non-surgical TMJ in mice.
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Affiliation(s)
- Wendy A Cohen
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, MA, USA
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31
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Camejo FDA, Almeida LE, Doetzer AD, Caporal KST, Ambros V, Azevedo M, Alanis LRA, Olandoski M, Noronha L, Trevilatto PC. FasL expression in articular discs of human temporomandibular joint and association with osteoarthrosis. J Oral Pathol Med 2013; 43:69-75. [PMID: 23750602 DOI: 10.1111/jop.12089] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Apoptosis is a programme of cell death which does not induce an inflammatory response. Recent previous research has suggested a correlation between temporomandibular internal derangement and apoptosis. Fas ligand (FasL) is an apoptosis-inducing factor, known to trigger apoptosis through distinct signal pathways. This study aims to examine, by immunohistochemistry, the expression of FasL in temporomandibular joint (TMJ) articular discs of patients with anterior disc displacement with reduction (ADDwR) and without reduction (ADDwoR) in patients with and without osteoarthrosis (OA). METHODS Forty-two (n = 42) TMJ articular discs were divided into two cut-offs: (i) 8 control, 17 ADDwR, 17 ADDwoR, and (ii) without OA (n = 25) and with OA (n = 17). The area of immunostaining was compared statistically between groups (P < 0.05). RESULTS Statistically significant differences were found in the expression of FasL in TMJ discs between the three groups (P = 0.001). ADDwR presented significant higher FasL expression when compared with ADDwoR (P < 0.001). Significant higher FasL expression was observed in the group without OA (P = 0.001). All patients without OA presented ADDwR, while all the patients with OA presented ADDwoR. CONCLUSION A higher area of in situ immunostaining of FasL was found in temporomandibular discs with reduction, which is the less severe condition. Moreover, a reduced expression of FasL in the discs of patients with osteoarthrosis was found, suggesting that some aspects of apoptosis might underlie the progression of TMJ disorders.
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Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings. J Craniomaxillofac Surg 2012; 40:283-6. [DOI: 10.1016/j.jcms.2011.04.006] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 03/15/2011] [Accepted: 04/08/2011] [Indexed: 11/20/2022] Open
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Huang B, Takahashi K, Sakata T, Kiso H, Sugai M, Fujimura K, Shimizu A, Kosugi S, Sato T, Bessho K. Increased risk of temporomandibular joint closed lock: a case-control study of ANKH polymorphisms. PLoS One 2011; 6:e25503. [PMID: 22003394 PMCID: PMC3189194 DOI: 10.1371/journal.pone.0025503] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2011] [Accepted: 09/06/2011] [Indexed: 11/18/2022] Open
Abstract
Objectives This study aimed to carry out a histological examination of the temporomandibular joint (TMJ) in ank mutant mice and to identify polymorphisms of the human ANKH gene in order to establish the relationship between the type of temporomandibular disorders (TMD) and ANKH polymorphisms. Materials and Methods Specimens from the TMJ of ank mutant and wild-type mice were inspected with a haematoxylin and eosin staining method. A sample of 55 TMD patients were selected. Each was examined with standard clinical procedures and genotyping techniques. Results The major histological finding in ank mutant mice was joint space narrowing. Within TMD patients, closed lock was more prevalent among ANKH-OR homozygotes (p = 0.011, OR = 7.7, 95% CI 1.6–36.5) and the elder (p = 0.005, OR = 2.4, 95% CI 1.3–4.3). Conclusions Fibrous ankylosis was identified in the TMJ of ank mutant mice. In the human sample, ANKH-OR polymorphism was found to be a genetic marker associated with TMJ closed lock. Future investigations correlating genetic polymorphism to TMD are indicated.
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Affiliation(s)
- Boyen Huang
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Katsu Takahashi
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- * E-mail:
| | - Tomoko Sakata
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Honoka Kiso
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Manabu Sugai
- Translational Research Center, Kyoto University Hospital, Kyoto University, Kyoto, Japan
| | - Kazuma Fujimura
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akira Shimizu
- Translational Research Center, Kyoto University Hospital, Kyoto University, Kyoto, Japan
| | - Shinji Kosugi
- Department of Biomedical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tosiya Sato
- Department of Biostatistics, School of Public Health, Kyoto University, Kyoto, Japan
| | - Kazuhisa Bessho
- Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Limited fatty infiltration due to apoptosis in human degenerated temporomandibular joint disks: an immunohistochemical study. J Craniofac Surg 2011; 21:1508-11. [PMID: 20856040 DOI: 10.1097/scs.0b013e3181ef2dc9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
In this study, we hypothesized that caspase 3, which plays a central role in the execution phase of cell apoptosis, could be involved in limiting fatty degeneration of the temporomandibular joint (TMJ) disks and therefore inhibit the TMJ disk tissue from completely degenerating into fatty tissue. Therefore, caspase 3 immunohistochemical expression in human TMJ degenerated disks was studied. Fifty-nine degenerated TMJ disks were stained with Harry's hematoxylin, and they were then examined with light microscopy to detect any pathologic changes typical of fatty degeneration. Sections from the same TMJ disk were immunostained also by a polyclonal anti-caspase 3 antibody. On morphologic observations, 11 disks of 59 degenerated ones also presented a fatty infiltration. Immunostaining with caspase 3 antibody was detected on adipocytes in the cytoplasm as well as the nuclei. Our results sustain the hypothesis that fatty degeneration is limited by apoptosis, being adipocytes immunolabeled by caspase 3 antibody. Hence, apart from the several factors that can trigger degeneration changes in TMJ disk, their appearance, spread, and permanence, at least for fatty degeneration, seem to be influenced by apoptosis.
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Saridin CP, Raijmakers PG, Tuinzing DB, Becking AG. Bone scintigraphy as a diagnostic method in unilateral hyperactivity of the mandibular condyles: a review and meta-analysis of the literature. Int J Oral Maxillofac Surg 2011; 40:11-7. [DOI: 10.1016/j.ijom.2010.09.015] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Revised: 05/25/2010] [Accepted: 09/20/2010] [Indexed: 10/18/2022]
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Taylan Filinte G, Akan M, Bilgic I, Karaca M, Akoz T. Chondrogenic effect of the perichondrium graft on the internal derangement and osteoarthritis of the temporomandibular joint of the rabbit. J Craniomaxillofac Surg 2010; 39:351-8. [PMID: 21067936 DOI: 10.1016/j.jcms.2010.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2009] [Revised: 07/25/2010] [Accepted: 09/14/2010] [Indexed: 11/16/2022] Open
Abstract
Internal derangement of the temporomandibular joint is usually defined as the disruption of the condyle and disc relationship. In addition to this description the other elements of the joint including the cartilage surface, synovial fluid, the ligaments and the bony surface itself demonstrate varying degrees of pathology in concordance with the stage of the internal derangement, as well. This study is designed to create an osteoarthritic model in the rabbit temporomandibular joint. A 2×2mm defect was performed on the cartilage surface of the both condyles of each animal (n=30). The osteoarthritic changes were demonstrated by computerised tomography sections. The right joints of the animals constituted the control group and the left, the study group. At the time of the defect generation, a perichondrium graft from the animal's ear was implanted onto the defect in the study group. The control group was left to heal secondarily. The joints of three randomized groups of 10 animals for each were inspected at the 4th, 6th, and 8th weeks. Cartilage regeneration and regression of the osteoarthritic changes were demonstrated in the study group both in the 6th and 8th week groups. However, the control group showed less cartilage regeneration and progression of the osteoarthritic changes in all weeks, with progression with time. The perichondrium graft has demonstrated chondrogenic effect on the condyle and this in turn changed the progression to internal derangement.
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Affiliation(s)
- Gaye Taylan Filinte
- Dr. Lutfi Kirdar Kartal Education and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery Clinic, Istanbul, Turkey.
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37
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Saridin CP, Gilijamse M, Kuik DJ, te Veldhuis EC, Tuinzing DB, Lobbezoo F, Becking AG. Evaluation of Temporomandibular Function After High Partial Condylectomy Because of Unilateral Condylar Hyperactivity. J Oral Maxillofac Surg 2010; 68:1094-9. [PMID: 20149509 DOI: 10.1016/j.joms.2009.09.105] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 09/02/2009] [Accepted: 09/23/2009] [Indexed: 10/19/2022]
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Saridin CP, Raijmakers PG, Slootweg PJ, Tuinzing DB, Becking AG, van der Waal I. Unilateral Condylar Hyperactivity: A Histopathologic Analysis of 47 Patients. J Oral Maxillofac Surg 2010; 68:47-53. [DOI: 10.1016/j.joms.2009.07.033] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Revised: 04/26/2009] [Accepted: 07/26/2009] [Indexed: 11/26/2022]
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Imirzalioğlu P, Uçkan S, Güler N, Haberal A, Uçkan D. Synovial apoptosis in temporomandibular joint disc displacement without reduction. ACTA ACUST UNITED AC 2009; 108:693-8. [PMID: 19716717 DOI: 10.1016/j.tripleo.2009.05.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2008] [Revised: 05/05/2009] [Accepted: 05/21/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Our hypothesis is that increased apoptosis in synovium might contribute to temporomandibular joint (TMJ) degeneration. To investigate this, we measured soluble Fas (sFas) and nuclear matrix protein (NMP) levels in TMJ synovial fluid from patients with disc displacement without reduction as indicators of apoptosis in the synovium. PATIENTS AND METHODS Synovial fluid was obtained from 17 joints in 17 patients (11 female, 6 male; mean age, 31.5 +/- 11.9 years; range, 19 to 55). Patients were referred to our clinic because of limited mouth opening, joint sounds, or TMJ pain. Synovial fluid obtained by arthrocentesis for therapeutic reasons was analyzed by enzyme-linked immunosorbent assays for APO-1/Fas and cell death detection (NMP). RESULTS We studied 12 left (71%) and 5 right (29%) joints with disc displacement without reduction. The chief complaint was pain on the affected side and limited mouth opening. Only 2 patients had a click in the affected joint, whereas 14 reported pain and 17 had the limited mouth opening. All patients experienced a significant (P < .01) increase in maximal mouth opening immediately after arthrocentesis. Mean sFas and NMP levels were 484.9 +/- 466.7 pg/mL (range, 17 to 1501) and 29.2 +/- 13.7 U/mL (range, 8 to 52.8) respectively. CONCLUSION Considering reports that increased sFas blocks apoptosis by inhibiting binding of FasL to Fas on the cell membrane, low level of sFas in our patients' synovial fluid (compared with amounts reported in joint inflammation or degeneration) suggests vulnerability to apoptosis in patients with internal derangement.
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Affiliation(s)
- Pervin Imirzalioğlu
- Department of Prosthodontics, Baskent University, Faculty of Dentistry, Ankara, Turkey
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40
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Alonso A, Kaimal S, Look J, Swift J, Fricton J, Myers S, Kehl L. A Quantitative Evaluation of Inflammatory Cells in Human Temporomandibular Joint Tissues From Patients With and Without Implants. J Oral Maxillofac Surg 2009; 67:788-96. [DOI: 10.1016/j.joms.2008.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2008] [Revised: 08/13/2008] [Accepted: 09/05/2008] [Indexed: 10/25/2022]
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41
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Prevalence and distribution of intracapsular derangement of TMJ in an asymptomatic and a symptomatic population. INTERNATIONAL JOURNAL OF STOMATOLOGY & OCCLUSION MEDICINE 2009. [DOI: 10.1007/s12548-008-0004-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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42
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Expression of proinflammatory cytokines in osteoarthritis of the temporomandibular joint. Arch Oral Biol 2008; 53:910-5. [DOI: 10.1016/j.archoralbio.2008.04.004] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Revised: 03/20/2008] [Accepted: 04/17/2008] [Indexed: 02/03/2023]
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43
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Effect of Estrogen on the Expression of Cytokines of the Temporomandibular Joint Cartilage Cells of the Mouse. J Oral Maxillofac Surg 2008; 66:882-7. [DOI: 10.1016/j.joms.2008.01.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 01/14/2008] [Indexed: 11/23/2022]
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44
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Almeida LE, Baioni CS, Martins APC, Line SRP, Noronha L, Trevilatto PC, de Lima AAS, de Oliveira Filho MA, Ignácio SA. Histologic and histomorphometric analysis of posterior region of the human temporomandibular disc. ACTA ACUST UNITED AC 2008; 105:e6-11. [PMID: 18329568 DOI: 10.1016/j.tripleo.2007.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2007] [Revised: 09/25/2007] [Accepted: 10/04/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to analyze histologic and histomorphometric features of the articular disc in groups with and without disc displacement. STUDY DESIGN A sample of 39 temporomandibular joints TMJs (31 case specimens, 8 control specimens) from 28 patients (mean age 31.2 years) were recruited for this study. The patients were considered to be affected and treated surgically with disc repositioning when presenting painful clinical signs of disc displacement after unsuccessful nonsurgical treatment for at least 6 months. Of the control patients, 4 presented condyle fracture which required opening to be reduced for treatment, and 4 displayed active condyle hyperplasia. The posterior region of the disc was removed and sent for histologic and histomorphometric analysis. Histologic (hematoxylin-eosin) and histomorphometric (picro-Sirius red) analyses were performed. Statistically significant differences between the analyzed groups were accessed through the chi-squared test (P <or= .05). The Mann-Whitney U test was used to observe the differences between mean values when variables did not present normal distribution [Kolmogorov-Smirnov(a) test]. RESULTS There were no significant differences between the groups in relation to the parameters studied by histologic and histomorphometric analysis (using or not using polarization). CONCLUSIONS To the limits of this study, there were no significant histologic and histomorphometric differences in the articular disc between groups with and without TMJ dysfunction.
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Affiliation(s)
- Luis Eduardo Almeida
- Department of Oral and Maxillofacial Surgery, Hospital Evalgelico e Curitiba, Curitiba, Brazil.
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Møystad A, Mork-Knutsen BB, Bjørnland T. Injection of sodium hyaluronate compared to a corticosteroid in the treatment of patients with temporomandibular joint osteoarthritis: a CT evaluation. ACTA ACUST UNITED AC 2008; 105:e53-60. [PMID: 18230379 DOI: 10.1016/j.tripleo.2007.08.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2007] [Revised: 07/23/2007] [Accepted: 08/21/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Osseous changes in the temporomandibular joint (TMJ) were evaluated using computed tomography (CT) examinations before and after TMJ injections of sodium hyaluronate or a corticosteroid in patients with osteoarthritis (OA). STUDY DESIGN Forty patients were randomly allocated into 2 groups for 2 intra-articular injections with either sodium hyaluronate or a corticosteroid. Bilateral TMJ examinations with high resolution CT were obtained in 36 patients before and 6 months after treatment. Treated and contralateral TMJs were evaluated for the presence of osteoarthritic osseous abnormalities by 2 reviewers independently. RESULTS Progression, regression, and no changes of osseous abnormalities were demonstrated in 13, 9, and 14 TMJs, respectively, 6 months after treatment. There was no significant difference between the groups. CONCLUSIONS Progression/regression and no changes of osteoarthritic abnormalities were observed on CT examinations in both the treated and the contralateral TMJs after treatment with intra-articular injection with sodium hyaluronate or corticosteroid.
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Affiliation(s)
- Anne Møystad
- Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
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46
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Bjørnland T, Gjaerum AA, Møystad A. Osteoarthritis of the temporomandibular joint: an evaluation of the effects and complications of corticosteroid injection compared with injection with sodium hyaluronate. J Oral Rehabil 2008; 34:583-9. [PMID: 17650168 DOI: 10.1111/j.1365-2842.2007.01759.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to compare the efficacy and the complications of intra-articular temporomandibular joint (TMJ) injections in 40 patients with osteoarthritis of the TMJ. The subjects were randomly divided into two groups, and the patients received either two intra-articular injections with sodium hyaluronate or two intra-articular injections with corticosteroids, 14 days apart. The effect of the treatment was evaluated 14 days, 1 and 6 months after the initial injection and was based on the following measurements: pain intensity, pain localization, joint sounds, mandibular function and complications. Both groups of patients had less pain intensity at the 6-month follow-up, and there was significantly less pain intensity in the group of patients receiving sodium hyaluronate compared with corticosteroids (P = 0.001). A decrease in crepitation was seen in both groups. In the 20 subjects receiving sodium hyaluronate both the mandibular vertical opening and protrusion increased significantly (P < 0.000). Lateral movement from the affected side increased both in subjects injected with sodium hyaluronate (P = 0.024), and those injected with corticosteroids (P = 0.042). In conclusion, this study confirms that injections in the TMJ with sodium hyaluronate or corticosteroids may reduce pain and improve function in patients with osteoarthritis. The injections were more effective in patients with only TMJ pain compared with patients suffering from both TMJ and myofascial pain. Injection with sodium hyaluronate was significantly more effective in decreasing pain intensity than corticosteroids. Temporary pain after injections may be observed.
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Affiliation(s)
- T Bjørnland
- Department of Oral Surgery and Oral Medicine, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway.
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47
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Kaneyama K, Segami N, Sato J, Yoshimura H, Nishiura R. Expression of receptor activator of nuclear factor-κb ligand in synovial tissue: Comparison with degradation of articular cartilage in temporomandibular joint disorders. ACTA ACUST UNITED AC 2007; 104:e12-7. [PMID: 17560137 DOI: 10.1016/j.tripleo.2007.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2006] [Revised: 02/01/2007] [Accepted: 02/23/2007] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The present study was performed to investigate the correlations between expression of the receptor activator of nuclear factor-kappaB ligand (RANKL) in synovial tissue and the degrees of synovitis, degeneration of articular cartilage, and adhesions in patients with internal derangement (ID) of the temporomandibular joint (TMJ). STUDY DESIGN Expression of RANKL, detected immunohistochemically, and the severity of arthroscopic features (synovitis, degenerative changes of articular eminence, and adhesion) in 30 patients with ID of the TMJ were assessed and the correlations between them were analyzed statistically. RESULTS RANKL expression was detected in the cytoplasm of synovial lining cells, endothelial cells, and fibroblast cells. However, there were no correlations between RANKL expression in any cell type and the severity of arthroscopic features. CONCLUSION These observations indicated that the cellular source of osteoclastic differentiation exists in TMJ with ID and may provide insight into the mechanism of osteoclast differentiation.
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Affiliation(s)
- Keiseki Kaneyama
- Department of Oral and Maxillofacial Surgery, Kanazawa Medical University, Ishikawa, Japan.
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48
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Molinari F, Manicone PF, Raffaelli L, Raffaelli R, Pirronti T, Bonomo L. Temporomandibular joint soft-tissue pathology, I: Disc abnormalities. Semin Ultrasound CT MR 2007; 28:192-204. [PMID: 17571702 DOI: 10.1053/j.sult.2007.02.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The internal derangements are the most common noninflammatory abnormalities of the disc, observed even in asymptomatic subjects. Because the temporomandibular joint shows large adaptative and compensatory mechanisms over dysfunctional disc motion, these disorders may be asymptomatic or minimally evident for a long time. A careful clinical evaluation, reinforced by imaging findings, should help differentiate asymptomatic derangements from painful conditions that may require treatment.
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Affiliation(s)
- Francesco Molinari
- Department of Bioimaging and Radiological Sciences, Catholic University of Rome, Italy.
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Matsumoto K, Honda K, Ohshima M, Yamaguchi Y, Nakajima I, Micke P, Otsuka K. Cytokine profile in synovial fluid from patients with internal derangement of the temporomandibular joint: a preliminary study. Dentomaxillofac Radiol 2007; 35:432-41. [PMID: 17082335 DOI: 10.1259/dmfr/77288976] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES Temporomandibular joint disorders (TMD) comprise a group of chronic painful conditions of mastication in the temporomandibular joint (TMJ). Although the association between TMD and internal derangement of the TMJ is well documented, the functional relevance is still unclear. Increased concentrations of inflammatory mediators have been identified in the synovial fluid of affected patients with TMD, suggesting an underlying degenerative or inflammatory process. The aim of this study was to generate a comprehensive cytokine expression profile in TMD. METHODS 15 samples from patients with internal derangement of TMJ were analysed using a novel cytokine array that enables the analysis of 79 different cytokines simultaneously. RESULTS Cytokine levels were correlated with the presence of joint effusion (JE) determined by MRI. In the majority of synovial fluid samples, angiogenin (Ang), fibroblast growth factor (FGF)-9, insulin-like growth factor-binding protein (IGFBP)-3, interleukin (IL)-1alpha, IL-1beta, IL-8, inducible protein (IP)-10, macrophage inflammatory protein (MIP)-1beta, osteoprotegerin (OPG), transforming growth factor (TGF)-beta2, tissue inhibitor of metalloproteinase (TIMP)-1, TIMP-2, tumour necrosis factor (TNF)-beta and vascular endothelial growth factor (VEGF) were detectable. Furthermore, the expression levels of Ang, brain-derived neurotrophic factor (BDNF), FGF-4, FGF-9, IGFBP-2, IL-8, MIP-1beta, OPG, pulmonary and activation-regulated protein (PARC), TGF-beta2, TIMP-2 and VEGF were significantly associated with the presence of JE; among these, nine cytokines (Ang, BDNF, FGF-4, FGF-9, IGFBP-2, MIP-1beta, PARC, TGF-beta2 and TIMP-2) were hitherto not described in TMD. CONCLUSIONS This study confirmed previous reports of elevated cytokine levels in TMD. Additionally, we identified previously undescribed cytokines that were upregulated and correlated significantly with the presence of JE. We were able to identify novel cytokines that have hitherto not been described in TMD. Strategies targeting the identified cytokines may represent a novel therapy option in TMD.
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Affiliation(s)
- K Matsumoto
- Department of Radiology, Nihon University School of Dentistry, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-8310, Japan
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Abstract
Pain caused by temporomandibular disorders originates from either muscular or articular conditions, or both. Distinguishing the precise source of the pain is a significant diagnostic challenge to clinicians, and effective management hinges on establishing a correct diagnosis. This paper examines terminology and regional anatomy as it pertains to functional and dysfunctional states of the temporomandibular joint and muscles of mastication. A review of the pathophysiology of the most common disorders is provided. Trends in evaluation, diagnosis, treatment, and research are presented.
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Affiliation(s)
- Kathleen Herb
- Department of Oral and Maxillofacial Surgery, Thomas Jefferson University Hospital, 909 Walnut Street, Suite 300, Philadelphia, PA 19107, USA
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