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Wadhwa S, Skelton M, Fernandez E, Paek T, Levit M, Yin MT. Significance of radiographic temporomandibular degenerative joint disease findings. Semin Orthod 2024; 30:277-282. [PMID: 38983798 PMCID: PMC11230652 DOI: 10.1053/j.sodo.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
The field of orthodontics has seen a recent increase in the number of patients over the age of 50 seeking treatment and also an increase in the use of cone beam technology. Similar to other joints in the body, the temporomandibular joint (TMJ) is associated with age-related degeneration. However, unlike other joints, degeneration of the TMJ is rarely symptomatic and when there is pain, it is usually self-limiting. In this article, we will review: a) the incidence and prevalence of TMJ degenerative diseases, b) similarities and differences of TMJ vs knee degenerative diseases, and c) current treatment recommendations for TMJ degenerative diseases. In the vast majority of people, radiographic evidence of TMJ degeneration is an incidental finding. Future longitudinal research is needed to follow the natural course of TMJ degenerative patients.
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Affiliation(s)
- Sunil Wadhwa
- Columbia University College of Dental Medicine, Division of Orthodontics, NYC, NY, USA 10032
| | - Michelle Skelton
- Columbia University College of Dental Medicine, Division of Orthodontics, NYC, NY, USA 10032
| | - Emily Fernandez
- Columbia University College of Dental Medicine, Division of Orthodontics, NYC, NY, USA 10032
| | - Taylor Paek
- Columbia University College of Dental Medicine, Division of Orthodontics, NYC, NY, USA 10032
| | - Michael Levit
- Columbia University College of Dental Medicine, Division of Orthodontics, NYC, NY, USA 10032
| | - Michael T Yin
- Columbia University College of Physicians and Surgeons, Division of Infectious Diseases, NYC, NY, USA 10032
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Nguyen VS, Kofod T, Nisja E, Hosseini M, Worsaae N. Interpositional arthroplasty using cartilage allografts for treating temporomandibular joint arthrosis: a 3- and 5-year retrospective clinical follow-up study. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:573-579. [PMID: 38570274 DOI: 10.1016/j.oooo.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/01/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To evaluate the effect of arthroplasty using interpositional cartilage allografts in patients with temporomandibular joint (TMJ) arthrosis. STUDY DESIGN This retrospective study included patients treated consecutively between 2007 and 2013 using discectomy and interpositional grafting with lyophilized costal cartilage allograft (Tutoplast) sheets. TMJ pain based on the visual analogue scale (VAS), maximal interincisal opening (MIO), joint tenderness to palpation, crepitus from the affected joint, and postoperative complications were assessed. RESULTS Arthroplasty was performed on 37 joints among 34 patients (28 women; mean age: 54 years); 24 joints underwent simultaneous condyle shaving. At final follow-up (3 [n = 37] or 5 [n = 21] years), we observed reduced mean VAS (from 7.6 to 0.9; P < .001) increased mean MIO (from 32.5 to 41.1 mm; P < .001), number of joints with capsule tenderness (from 30 to 3; P < .001), and percentage of joints with crepitus (from 97% to 75%; P = .008). One joint required reoperation because of interposed cartilage fragmentation. No permanent facial nerve injury or malocclusion occurred after treatment. CONCLUSIONS Interpositional arthroplasty is a relatively simple, moderately invasive, and effective surgical treatment for TMJ arthrosis with few complications. However, long-term outcomes of this treatment, specifically beyond 3-5 years postoperatively, remain unknown.
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Affiliation(s)
- Van Son Nguyen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Thomas Kofod
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Even Nisja
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mandana Hosseini
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Nils Worsaae
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Gulec M, Erturk M, Tassoker M, Basdemirci M. Evaluation of cortical and trabecular bone structure of the mandible in patients with ankylosing spondylitis. Sci Rep 2023; 13:19762. [PMID: 37957329 PMCID: PMC10643636 DOI: 10.1038/s41598-023-47233-2] [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: 08/28/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023] Open
Abstract
This study aimed to examine the difference between the fractal dimension (FD) values of the mandibular trabecular bone and the panoramic mandibular index (PMI), mandibular cortical index (MCI) and mandibular cortical thickness (MCW) of patients with ankylosing spondylitis (AS) and healthy control group. A total of 184 individuals (92 cases, 92 controls), were examined in our study. PMI, MCI, and MCW values were calculated on panoramic images of all individuals. For FD values, the region of interest (ROI) was selected with the size of 100 × 100 pixels from the right-left gonial and interdental regions and 50 × 50 pixels from the condylar region. Degenerative changes in the temporomandibular joint (TMJ) region were recorded. PMI, MCI, and MCW values showed statistically significant differences between the groups (p = 0.000, p < 0.001). The radiological signs of mandibular cortical resorption were more severe in the case group than in the control group. PMI and MCW values were found to be lower in the case group than in the control group. It was determined that the number of C3 and C2 values, among the MCI values, was higher in the case group. Only the FD values of the ROI selected from the condyle region were found to be statistically significant and were lower in the case group (p = 0.026, p < 0.05). Degenerative changes in the TMJ region were significantly more frequent in the case groups (p = 0.000, p < 0.001). The fact that the mandibular cortex shows more resorptive features in individuals with AS may require further evaluation in terms of osteoporosis. Because of the low FD values of the condylar regions of these patients and the more frequent degenerative changes, the TMJ region should be followed carefully. Detailed examination of the mandibular cortex and condylar region is beneficial in patients with AS for screening and following osteoporotic changes in these individuals, which is essential for the patient's life quality.
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Affiliation(s)
- Melike Gulec
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Mediha Erturk
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Melek Tassoker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey.
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Ottersen MK, Larheim TA, Hove LH, Arvidsson LZ. Imaging signs of temporomandibular joint osteoarthritis in an urban population of 65-year-olds: A cone beam computed tomography study. J Oral Rehabil 2023; 50:1194-1201. [PMID: 37356072 DOI: 10.1111/joor.13547] [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: 06/08/2022] [Revised: 03/29/2023] [Accepted: 06/22/2023] [Indexed: 06/27/2023]
Abstract
BACKGROUND Symptoms of osteoarthritis (OA) in the temporomandibular joint (TMJ) may vary and possible causes should be further explored, such as prevalence and characteristics of imaging features. OBJECTIVES Investigate prevalence, gender differences and characteristics of imaging signs of TMJ-OA by cone beam computed tomography (CBCT) in a population-based sample of 65-year-old Oslo citizens. MATERIALS AND METHODS 159 (86 women, 73 men) individuals randomly recruited from a cohort of 460 Oslo citizens were examined with CBCT. The TMJs were categorised as with imaging signs of OA, no OA or indeterminate for OA. RESULTS CBCT signs of TMJ-OA were found in 35% of the 159 participants: 47% of the women and 22% of the men. CBCT signs of TMJ-OA were unilateral in two-thirds of the TMJs and characterised by articular surface flattening and condylar osteophytes. In almost all joints with bone erosive findings, bone productive findings were also found. Participants with and without CBCT signs of TMJ-OA showed no significant difference in TMD pain screener. Fourteen of the 159 participants (9%) had pain-related TMD and 12 (8%) had been in contact with health care services due to TMD. CONCLUSIONS CBCT signs of TMJ-OA was common in this study group of 65-year-old Oslo citizens, found in every second woman and every fifth man. Articular surface flattening and bone productive changes, in particular condylar osteophytes, were the most frequent imaging features. Despite the high frequency of CBCT signs of TMJ-OA, few of the participants had pain-related TMD.
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Affiliation(s)
- Margareth Kristensen Ottersen
- Department of Maxillofacial Radiology, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Tore A Larheim
- Department of Maxillofacial Radiology, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Lene Hystad Hove
- Department of Cariology and Gerodontology, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
| | - Linda Z Arvidsson
- Department of Maxillofacial Radiology, Faculty of Dentistry, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Xu L, Chen J, Qiu K, Yang F, Wu W. Artificial intelligence for detecting temporomandibular joint osteoarthritis using radiographic image data: A systematic review and meta-analysis of diagnostic test accuracy. PLoS One 2023; 18:e0288631. [PMID: 37450501 PMCID: PMC10348514 DOI: 10.1371/journal.pone.0288631] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/02/2023] [Indexed: 07/18/2023] Open
Abstract
In this review, we assessed the diagnostic efficiency of artificial intelligence (AI) models in detecting temporomandibular joint osteoarthritis (TMJOA) using radiographic imaging data. Based upon the PRISMA guidelines, a systematic review of studies published between January 2010 and January 2023 was conducted using PubMed, Web of Science, Scopus, and Embase. Articles on the accuracy of AI to detect TMJOA or degenerative changes by radiographic imaging were selected. The characteristics and diagnostic information of each article were extracted. The quality of studies was assessed by the QUADAS-2 tool. Pooled data for sensitivity, specificity, and summary receiver operating characteristic curve (SROC) were calculated. Of 513 records identified through a database search, six met the inclusion criteria and were collected. The pooled sensitivity, specificity, and area under the curve (AUC) were 80%, 90%, and 92%, respectively. Substantial heterogeneity between AI models mainly arose from imaging modality, ethnicity, sex, techniques of AI, and sample size. This article confirmed AI models have enormous potential for diagnosing TMJOA automatically through radiographic imaging. Therefore, AI models appear to have enormous potential to diagnose TMJOA automatically using radiographic images. However, further studies are needed to evaluate AI more thoroughly.
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Affiliation(s)
- Liang Xu
- The School of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
- Department of Stomatology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jiang Chen
- The School of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Kaixi Qiu
- Fuzhou No. 1 Hospital Affiliated with Fujian Medical University, Fuzhou, Fujian, China
| | - Feng Yang
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
| | - Weiliang Wu
- The School of Stomatology, Fujian Medical University, Fuzhou, Fujian, China
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Rosa VLM, Zwir LMF, Dutra MEP, Russo GCS, Rodrigues WDR, Terreri MT. Does the use of panoramic radiography add information in the temporomandibular joint evaluation in Juvenile Idiopathic Arthritis patients? A case control study. Adv Rheumatol 2023; 63:6. [PMID: 36782277 DOI: 10.1186/s42358-023-00285-4] [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: 06/10/2022] [Accepted: 01/19/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE To determine the frequency of radiographic changes in the temporomandibular joint, in a representative population of patients with Juvenile Idiopathic Arthritis (JIA) and to compare with findings in healthy controls matched by sex and age. PATIENTS AND METHODS One hundred and thirty-seven panoramic radiographies (PR) from JIA patients of a pediatric rheumatology outpatient clinic were prospectively evaluated and compared to 137 PR from healthy individuals. RESULTS 102 (74.5%) JIA patients and 47 (34.3%) controls showed at least one radiological alteration (p < 0.001). The following radiographic alterations were more frequently observed in JIA patients than in controls: erosion (p < 0.001), altered condylar morphology (p < 0.001), disproportion between condylar process and the coronoid process (p < 0.001) and accentuated curve in the antegonial notch (p = 0.002). Twenty patients (14.6%) presented the four radiographic alterations simultaneously compared to only two controls (1.5%) (p < 0.001). CONCLUSION Due to the difference in the frequency of findings in the PR of patients and controls, we concluded that PR has value as a screening tool. In the presence of major changes in the mandible head in the PR of patients with a confirmed diagnosis of JIA, MRI should be considered to detect an active inflammatory process in this joint.
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Affiliation(s)
- Vera Lucia Mestre Rosa
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil.
| | - Liete M Figueiredo Zwir
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil
| | - Marcelo Eduardo Pereira Dutra
- Department of Oral Diagnosis/Radiology/Stomatology, Dental School in Integrated Clínic of Nove de Julho University, São Paulo, Brazil
| | - Gleice Clemente Souza Russo
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil
| | - Wellington Douglas R Rodrigues
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil
| | - Maria Teresa Terreri
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil
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Chung MK, Wang S, Alshanqiti I, Hu J, Ro JY. The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models. FRONTIERS IN PAIN RESEARCH 2023; 4:1038808. [PMID: 36846071 PMCID: PMC9947567 DOI: 10.3389/fpain.2023.1038808] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Temporomandibular disorders (TMD) represent a group of musculoskeletal conditions involving the temporomandibular joints (TMJ), the masticatory muscles and associated structures. Painful TMD are highly prevalent and conditions afflict 4% of US adults annually. TMD include heterogenous musculoskeletal pain conditions, such as myalgia, arthralgia, and myofascial pain. A subpopulations of TMD patients show structural changes in TMJ, including disc displacement or degenerative joint diseases (DJD). DJD is a slowly progressing, degenerative disease of the TMJ characterized by cartilage degradation and subchondral bone remodeling. Patients with DJD often develop pain (TMJ osteoarthritis; TMJ OA), but do not always have pain (TMJ osteoarthrosis). Therefore, pain symptoms are not always associated with altered TMJ structures, which suggests that a causal relationship between TMJ degeneration and pain is unclear. Multiple animal models have been developed for determining altered joint structure and pain phenotypes in response to various TMJ injuries. Rodent models of TMJOA and pain include injections to induce inflammation or cartilage destruction, sustained opening of the oral cavity, surgical resection of the articular disc, transgenic approaches to knockout or overexpress key genes, and an integrative approach with superimposed emotional stress or comorbidities. In rodents, TMJ pain and degeneration occur during partially overlapping time periods in these models, which suggests that common biological factors may mediate TMJ pain and degeneration over different time courses. While substances such as intra-articular pro-inflammatory cytokines commonly cause pain and joint degeneration, it remains unclear whether pain or nociceptive activities are causally associated with structural degeneration of TMJ and whether structural degeneration of TMJ is necessary for producing persistent pain. A thorough understanding of the determining factors of pain-structure relationships of TMJ during the onset, progression, and chronification by adopting novel approaches and models should improve the ability to simultaneously treat TMJ pain and TMJ degeneration.
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Affiliation(s)
- Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, Program in Neuroscience, Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
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Association between an Increased Serum CCL5 Level and Pathophysiology of Degenerative Joint Disease in the Temporomandibular Joint in Females. Int J Mol Sci 2023; 24:ijms24032775. [PMID: 36769097 PMCID: PMC9917489 DOI: 10.3390/ijms24032775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Degenerative joint disease of the temporomandibular joints (DJD-TMJ) clinically manifests with symptoms such as orofacial pain, joint sounds and limited jaw movements. Our research group previously reported the functional necessity of a chemokine-chemokine receptor axis of CCL5-CCR5 in osteoclasts. Accumulated studies reported that this axis was involved in the pathogenesis of bone and joint destructive diseases, suggesting CCL5 as a potent biomarker. This study investigated whether or not the serum level of CCL5 can be a biomarker of DJD-TMJ and concomitantly analyzed changes in the serum and urine levels of bone markers to see whether or not changes in the rate of bone metabolism were predisposing. We enrolled 17 female subjects with diagnosed DJD-TMJ and sexually and age-matched 17 controls. The serum CCL5 level in DJD-TMJ subjects was significantly higher than that in the control subjects. Multivariate analyses indicated an association between an augmented CCL5 level and the rate of bone metabolism, especially in relatively young DJD-TMJ subjects without other systemic symptoms. A principal component analysis of serum markers and our pharmacological experiment using a postmenopausal model of ovariectomized rats suggested that an augmented serum CCL5 level specifically reflected DJD-TMJ and that covert changes in the rate of bone metabolism predisposed individuals to DJD-TMJ.
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Rosado LPL, Barbosa IS, Junqueira RB, Martins APVB, Verner FS. Morphometric analysis of the mandibular fossa in dentate and edentulous patients: A cone beam computed tomography study. J Prosthet Dent 2021; 125:758.e1-758.e7. [PMID: 33610327 DOI: 10.1016/j.prosdent.2021.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 01/06/2023]
Abstract
STATEMENT OF PROBLEM Mandibular fossa roof thickness and lateral inclination could be associated with the presence of bone changes in the mandibular condyle in dentate and edentulous patients. However, literature regarding the relationship between the presence and absence of teeth and the morphologic features of the temporomandibular joint is lacking. This knowledge could provide a better understanding of changes affecting the correct functioning of the stomatognathic system. PURPOSE The purpose of this clinical study was to assess the mandibular fossa roof thickness and lateral inclination in relation to sex, presence or absence of teeth, and bone changes in the mandibular condyle through cone beam computed tomography (CBCT). MATERIAL AND METHODS CBCT scans of 100 individuals (50 dentate and 50 edentulous) were evaluated in terms of mandibular fossa roof thickness and lateral inclination. Bone changes in the mandibular condyle were classified dichotomously in relation to osteophytes, erosion, sclerosis, and flattening. Differences were assessed with the Student t test, the chi-square test, and 2-way analysis of variance (ANOVA), with Tukey post hoc tests (α=.05). RESULTS Sex was not related to mandibular fossa measurements. Edentulous participants showed a higher mandibular fossa lateral inclination (P<.001) and lower roof thickness (P=.001) than dentate participants. When the association between bone changes in the mandibular condyle was evaluated in dentate and edentulous groups, only sclerosis showed a statistically significant association (P<.001). The 2-way ANOVA showed that the mandibular fossa roof thickness was lower in edentulous participants in the presence of flattening and erosion and that the mandibular fossa lateral inclination was higher in the presence of osteophytes, erosion, and sclerosis (P<.001). Among dentate participants, the mandibular fossa lateral inclination was higher in the presence of flattening (P=.024). CONCLUSIONS Mandibular fossa roof thickness and lateral inclination are not associated with sex. However, tooth absence and bone changes in the mandibular condyle are related to mandibular fossa measurements.
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Affiliation(s)
- Lucas P Lopes Rosado
- PhD Researcher, Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Izabele Sales Barbosa
- Research Associate, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil
| | - Rafael Binato Junqueira
- Professor, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil.
| | - Ana Paula Varela Brown Martins
- Professor, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil
| | - Francielle Silvestre Verner
- Professor, Department of Dentistry, Federal University of Juiz de Fora/Campus GV (UFJF/GV), Governador Valadares, MG, Brazil
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Zhao X, Xiong X, Sun W, Shu C, Gu J, Liu Y. Symptoms, disc position, occluding pairs, and facial skeletal characteristics of older patients with temporomandibular disorders. J Int Med Res 2021; 49:300060521990530. [PMID: 33583228 PMCID: PMC7890733 DOI: 10.1177/0300060521990530] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective To describe the proportions of different osseous diagnoses in older patients with temporomandibular disorders (TMD) and to analyze the symptoms, disc position, occluding pairs, and facial skeletal characteristics of patients with bilateral osteoarthrosis (BOA) and bilateral normal joints (BNJ). Methods This retrospective cross-sectional study constituted 88 older patients (age ≥60 years). The osseous diagnosis, symptoms, disc position, occluding pairs, and facial skeletal characteristics were evaluated. Variables in BOA patients and BNJ patients were compared using the t-test and chi-square test. Results Forty-eight patients had BOA, 7 had unilateral osteoarthrosis, 11 had intermediate osteoarthrosis, and 22 had BNJ. The prevalence of disc displacement without reduction (DDw/oR) in BOA patients was significantly higher than in BNJ patients. BOA patients exhibited greater ANB angle, PP-MP, U1-NPo, L1-NPo, and facial convexity angle; shorter posterior cranial base; and decreased ramus height. Conclusion BOA patients with associated DDw/oR had more complaints of orofacial pain and exhibited a shorter posterior cranial base, and greater mandibular retrusion, anterior tooth protrusion, and protruded profile than BNJ patients.
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Affiliation(s)
- Xiaokai Zhao
- Department of Dental Research, The Affiliated Stomatological Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xin Xiong
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Sun
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chang Shu
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinning Gu
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yang Liu
- Department of Temporomandibular Joint, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Cafferata EA, Monasterio G, Castillo F, Carvajal P, Flores G, Díaz W, Fuentes AD, Vernal R. Overexpression of MMPs, cytokines, and RANKL/OPG in temporomandibular joint osteoarthritis and their association with joint pain, mouth opening, and bone degeneration: A preliminary report. Oral Dis 2020; 27:970-980. [PMID: 32871032 DOI: 10.1111/odi.13623] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/15/2020] [Accepted: 08/18/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study aimed to determine the expression of distinct matrix metalloproteinases, cytokines, and bone resorptive factors in temporomandibular joint osteoarthritis (TMJ-OA) patients and their association with joint pain, mouth opening, and subchondral bone degeneration. MATERIALS AND METHODS Twelve patients affected with TMJ-OA (n = 5), disk displacement without reduction (DDWoR) (n = 3), or disk displacement with reduction (DDWR) (n = 4) were selected. Joint pain was quantified by using visual analog scale, mouth opening was quantified at the maximum pain-free aperture, and bone degeneration was quantified using joint imaging. Synovial fluid samples were collected and immediately processed for cell and synovial fluid recovering. From cells, the MMP-1, MMP-2, MMP-8, MMP-13, IL-6, IL-23, and TNF-α expression was quantified by qPCR. From synovial fluid, the RANKL and OPG levels were quantified by ELISA. RESULTS Higher levels of MMP-1, MMP-8, MMP-13, IL-6, IL-23, TNF-α, and RANKL/OPG ratio were detected in TMJ-OA compared with DDWoR and DDWR patients (p < .05). Joint pain significantly correlated with TNF-α levels (r = .975, p = .029). Besides, imaging signs of bone degeneration significantly correlated with RANKL/OPG ratio (r = .949, p = .042). Conversely, mouth opening did not correlate with any of the analyzed mediators. CONCLUSION During TMJ-OA, a pathological response characterized by the overexpression of TNF-α and RANKL/OPG could be involved in joint pain and subchondral bone degeneration.
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Affiliation(s)
- Emilio A Cafferata
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Periodontology, School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Gustavo Monasterio
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Francisca Castillo
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Paola Carvajal
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Guillermo Flores
- Department of Prosthesis, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Walter Díaz
- Department of Prosthesis, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Aler D Fuentes
- Institute for Research in Dental Sciences, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Oral Physiology Laboratory, Faculty of Medicine, Biomedical Sciences Institute, Universidad de Chile, Santiago, Chile
| | - Rolando Vernal
- Periodontal Biology Laboratory, Faculty of Dentistry, Universidad de Chile, Santiago, Chile.,Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
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Oruba Z, Malisz P, Sendek J, Aardal VE, Kopycińska N, Krzystyniak K, Darczuk D, Kaczmarzyk T. Flattening of the articular eminence is associated with the loss of occlusal support: radiological study. Aust Dent J 2019; 65:53-57. [PMID: 31705654 DOI: 10.1111/adj.12736] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Degenerative changes in the temporomandibular joint might be associated with ageing and/or with the loss of occlusal support. OBJECTIVE The aim of the study was to evaluate whether the inclination of the posterior slope of the articular eminence changes in association with: (i) ageing in patients with maintained occlusal support zones (OSZs); and (ii) the loss of OSZs in elders. METHODS In this retrospective radiological study, selected orthopantomograms were allocated into the following groups: I-age 18-35, maintained OSZs, II-age 36-60, maintained OSZs, III-age >60, at least one OSZ per side maintained, IV-age >60, loss of all OSZs. The inclination of the articular eminence was measured relative to the Frankfort plane. RESULTS The mean values of the inclination of the slope of the articular eminence amounted 34.05° ± 5.17°, 36.68° ± 5.65°, 34.86° ± 6.26° and 26.31° ± 5.12° for group I, II, III and IV respectively. There were no significant differences between the groups I to III. Group IV differed significantly from each of the previous groups. CONCLUSIONS Flattening of the articular eminence is associated with the loss of OSZs rather than ageing.
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Affiliation(s)
- Z Oruba
- Chair of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - P Malisz
- Department of Electroradiology, Faculty of Health Science, Medical College, Jagiellonian University, Kraków, Poland
| | - J Sendek
- Student Research Group, Chair of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - V E Aardal
- Student Research Group, Chair of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - N Kopycińska
- Student Research Group, Chair of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - K Krzystyniak
- Student Research Group, Chair of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - D Darczuk
- Chair of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - T Kaczmarzyk
- Chair of Periodontology and Clinical Oral Pathology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,Department of Oral Surgery, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Wu Y, Kadota-Watanabe C, Ogawa T, Moriyama K. Combination of estrogen deficiency and excessive mechanical stress aggravates temporomandibular joint osteoarthritis in vivo. Arch Oral Biol 2019; 102:39-46. [PMID: 30959278 DOI: 10.1016/j.archoralbio.2019.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE It has been suggested that degenerative conditions of the temporomandibular joint (TMJ), such as osteoarthritis (OA) and progressive condylar resorption, are caused by multiple etiological factors, such as hormonal imbalance and excessive mechanical stress. However, it is unclear whether these factors interrelate in the degenerative process of the condyle. The aim of this study was to observe the effects of combined hormonal imbalance and excessive mechanical stress on the condyle using a mouse model. MATERIALS AND METHODS Ovariectomy (OVX) was performed in 8-week-old female mice. Three weeks after OVX, a build-up resin was bonded to the right maxillary molars to create imbalanced occlusion (increased occlusal vertical dimension, iOVD). Mice were divided into four groups: control, OVX, iOVD, and OVX + iOVD. RESULTS Histomorphometric analysis showed the lowest cartilage thickness and the highest TMJ-OA score in the OVX + iOVD group. Bone structural analysis showed significantly lower subchondral bone mass in all experimental groups. Additionally, the OVX + iOVD group showed up-regulated osteoclastic activity and increased apoptosis in the condyle. Gene expression analysis showed significantly elevated expression of pre-inflammatory cytokines in the OVX + iOVD group. These data showed that the OVX + iOVD group exhibited the most severe inflammatory TMJ-OA. Upregulation of ERα and activation of the ERK pathway was observed in the OVX + iOVD group. CONCLUSIONS Additive effects of estrogen deficiency and excessive mechanical stress on the condyle exacerbate TMJ-OA. Furthermore, estrogen deficiency and excessive mechanical stress combined may exacerbate TMJ-OA though activation of the ERK pathway.
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Affiliation(s)
- Yuyun Wu
- Department of Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Chiho Kadota-Watanabe
- Department of Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Takuya Ogawa
- Department of Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Keiji Moriyama
- Department of Maxillofacial Orthognathics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
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14
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Ghapanchi J, Zahed M, Haghnegahdar A, Niakan N, Sadeghzadeh A. Osteoporosis and Jaw Abnormalities in Panoramic Radiography of Chronic Liver Failure Patients. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4280312. [PMID: 30225253 PMCID: PMC6129325 DOI: 10.1155/2018/4280312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 06/22/2018] [Accepted: 07/24/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Patients with chronic liver failure (CLF) are faced with many complications, because this organ is involved in various metabolic activities. Hepatic osteodystrophy is one of the major health issues encountered by this group of patients. The current study evaluated osteoporosis and bone changes in oral panoramic radiographies of cirrhotic patients. MATERIALS AND METHODS In this study, 138 panoramic views of CLF patients, candidates for liver transplant (65 females, 73 males, aged 19-68 years) referred to Shiraz University Dental Clinic (Shiraz, Iran) for pretransplant oral examination, were evaluated. Also 138 healthy individuals (69 females, 69 males, aged 18-70 years) referred to the same clinic were examined. Abnormalities such as osteoporosis, pathologic radiolucencies, pathologic calcifications, tonsilloliths, condylar degeneration, and other findings in the alveolar bones were recorded. RESULTS Osteoporosis was a common finding in CLF patients (p<0.001), and the probability of detecting low bone density in the panoramic view was 20.37 times higher among patients than healthy subjects. The probability of detecting pathologic jaw radiolucencies was 8.92 times higher in the case group than in the controls (p<0.001). Other bone abnormalities such as condylar degeneration and idiopathic osteosclerosis were also more prevalent in CLF patients compared to healthy subjects (p<0.001). CONCLUSION Cirrhotic patients are prone to osteoporosis of the alveolar bones. Also, pathologic jaw radiolucencies as a result of oral infections are more prevalent in this group of patients. Routine oral panoramic views are acceptable and cost-effective radiographies for use in detecting such abnormalities in the alveolar bones as well as overall dental health. These findings also support the importance of dental health examinations prior to liver transplantation to reduce the risk of organ rejection.
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Affiliation(s)
- Janan Ghapanchi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Zahed
- Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abdolaziz Haghnegahdar
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Niloofar Niakan
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Sadeghzadeh
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Yadav S, Yang Y, Dutra EH, Robinson JL, Wadhwa S. Temporomandibular Joint Disorders in Older Adults. J Am Geriatr Soc 2018; 66:1213-1217. [PMID: 29719041 DOI: 10.1111/jgs.15354] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To review the literature and summarize the evidence of temporomandibualar joint (TMJ) disorders (TMDs) in older adults, focusing on clinical manifestations of TMDs in older adults, highlighting the incidence and sexual dimorphism of TMJ degeneration and the role of sex hormones in this process, and providing potential treatment options for TMD in older adults. DESIGN Two review authors performed the literature search, study inclusion, and data extraction. PubMed, Embase, and Google scholar were searched for literature until August 2017 (Figure ). We adopted a combination of Medical Subject Headings with related free text words for the search in PubMed and optimized the search in other search engines. RESULTS Traditionally, it was believed that TMDs predominantly affected women of childbearing age, but recent large studies in Europe and the United States have shown that the prevalence of TMD peaks after childbearing age (45-64) and then gradually decreases with age, although not much is known about the disease in older adults. CONCLUSION Most older adults have TMJ degeneration, which affects women more than men. In most older adults, the symptoms of TMD are mild and self-limiting and can usually be treated with self management.
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Affiliation(s)
- Sumit Yadav
- Division of Orthodontics, University of Connecticut Health Center, Farmington, Connecticut, China
| | - Yun Yang
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Eliane H Dutra
- Division of Orthodontics, University of Connecticut Health Center, Farmington, Connecticut, China
| | - Jennifer L Robinson
- Division of Orthodontics, College of Dental Medicine, Columbia University, New York, New York
| | - Sunil Wadhwa
- Division of Orthodontics, University of Connecticut Health Center, Farmington, Connecticut, China
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