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Qadri MM. Targeting CD44 Receptor Pathways in Degenerative Joint Diseases: Involvement of Proteoglycan-4 (PRG4). Pharmaceuticals (Basel) 2023; 16:1425. [PMID: 37895896 PMCID: PMC10609794 DOI: 10.3390/ph16101425] [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: 09/07/2023] [Revised: 10/02/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023] Open
Abstract
Rheumatoid arthritis (RA), osteoarthritis (OA), and gout are the most prevalent degenerative joint diseases (DJDs). The pathogenesis underlying joint disease in DJDs remains unclear. Considering the severe toxicities reported with anti-inflammatory and disease-modifying agents, there is a clear need to develop new treatments that are specific in their effect while not being associated with significant toxicities. A key feature in the development of joint disease is the overexpression of adhesion molecules, e.g., CD44. Expression of CD44 and its variants in the synovial tissues of patients with DJDs is strongly associated with cartilage damage and appears to be a predicting factor of synovial inflammation in DJDs. Targeting CD44 and its downstream signaling proteins has emerged as a promising therapeutic strategy. PRG4 is a mucinous glycoprotein that binds to the CD44 receptor and is physiologically involved in joint lubrication. PRG4-CD44 is a pivotal regulator of synovial lining cell hemostasis in the joint, where lack of PRG4 expression triggers chronic inflammation and fibrosis, driven by persistent activation of synovial cells. In view of the significance of CD44 in DJD pathogenesis and the potential biological role for PRG4, this review aims to summarize the involvement of PRG4-CD44 signaling in controlling synovitis, synovial hypertrophy, and tissue fibrosis in DJDs.
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Affiliation(s)
- Marwa M. Qadri
- Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia;
- Inflammation Pharmacology and Drug Discovery Unit, Medical Research Center (MRC), Jazan University, Jazan 45142, Saudi Arabia
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2
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Ornek Akdogan E, Omezli MM, Torul D. Comparative evaluation of the trabecular structure of the mandibular condyle, the levels of salivary cortisol, MMP-3, TNF-α, IL-1β in individuals with and without temporomandibular joint disorder. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101417. [PMID: 36739977 DOI: 10.1016/j.jormas.2023.101417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Temporomandibular disorder (TMD) is still a challenge in terms of diagnosis and management. The aim of this study is to explore if the evaluation of salivary biomarkers and fractal dimension (FD) of mandibular condyle could be useful for interpreting early degenerative changes and the effectiveness of salivary cortisol in determining the stress levels of TMD patients. MATERIALS AND METHODS 34 patients with TMD, and 34 healthy controls were included in this study. Saliva samples were obtained from all participants between 09:00-12:00 am. Salivary cortisol, IL-1β, TNF-α, and MMP-3 levels were evaluated with ELISA method. FD of the mandibular condyle was determined by means of box-counting method. Depression and anxiety were determined with PHQ-9 and GAD-7 questionnaires. RESULTS The salivary cortisol and depression/anxiety were higher in study group; however, not significant (p>0.05). FD of the study group was found significantly lower than the control group (p<0.01). Salivary TNF-α, IL-1β and MMP-3 levels were showed no significant difference between the two groups (p>0.05). There were no significant correlations between the evaluated parameters. CONCLUSION Salivary cortisol seems to be a non-invasive way of measuring physiological stress of TMD patients. Fractal analysis may be a useful tool in detecting early structural changes in mandibular condyle. Salivary TNF-α. IL-1β and MMP-3 have not a diagnostic value in terms of interpreting early degenerative changes.
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Affiliation(s)
- Emine Ornek Akdogan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Karabük University, Karabük, TURKEY.
| | - Mehmet Melih Omezli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, TURKEY
| | - Damla Torul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, TURKEY
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El-Sayed LK, Elsharaawy E, Elsholkamy M, Tawfik MK. Clinical Evaluation of Intra-Articular Injection of Chondroitin Sulfate and Sodium Hyaluronate in the Management of Degenerative Osteoarthritis of Temporomandibular Joint. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.11078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
AIM: This study aims to evaluate the effectiveness of intra-articular injection of chondroitin sulfate and sodium hyaluronate in cases of temporomandibular joint (TMJ) degenerative osteoarthritis.
MATERIAL AND METHODS: Thirty patients ASA I of both sexes, who were selected from outpatient clinic of Oral Surgery Department, Faculty of Dentistry – Suez Canal University, complaining of painful TMJ, presence of unilateral or bilateral TMJ pain, impairment of jaw movements, and joint sounds. Clinical examination was performed to all patients and pre-operative measurements of visual analog scale (VAS) for morning pain, pain with movement and spontaneous pain, maximum mouth opening, and presence or absence of clicking. Patients were randomly divided into two groups; (a) Study group consisted of 15 patients, they had intra-articular injection of chondroitin sulfate and sodium hyaluronate once weekly for 3 weeks and (b) control group consisted of 15 patients, they had intra-articular injection of sodium hyaluronate once weekly for 3 weeks. Post-operative measurements of VAS for previous pain types, maximum mouth opening, and clicking were obtained at 1 month, 3 months, and 6 months post-injection.
RESULTS: There was a statistically significant reduction of all types of pain in the study group compared to the control group at all time intervals (p ≤ 0.05), for maximum mouth opening, there was a significant improvement in mouth opening in the study group for all time intervals (p ≤ 0.05), but for the clicking, there was not statistically significant difference between the study and control groups after 1 month, 3 months, and 6 months. The difference between groups was barely statistically significant (p = 0.05).
CONCLUSION: Intra-articular injection of a combination of chondroitin sulfate and sodium hyaluronate is an effective tool in reducing pain, clicking, limited mouth opening, and other symptoms associated with degenerative TMJ diseases.
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Zhao Y, An Y, Zhou L, Wu F, Wu G, Wang J, Chen L. Animal Models of Temporomandibular Joint Osteoarthritis: Classification and Selection. Front Physiol 2022; 13:859517. [PMID: 35574432 PMCID: PMC9095932 DOI: 10.3389/fphys.2022.859517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/04/2022] [Indexed: 01/11/2023] Open
Abstract
Temporomandibular joint osteoarthritis (TMJOA) is a common degenerative joint disease that can cause severe pain and dysfunction. It has a serious impact on the quality of lives of patients. Since mechanism underlying the pathogenesis of TMJOA is not fully understood, the development of effective tools for early diagnosis and disease-modifying therapies has been hindered. Animal models play a key role in understanding the pathological process of diseases and evaluating new therapeutic interventions. Although some similarities in disease processes between animals and humans are known, no one animal model is sufficient for studying all characteristics of TMJOA, as each model has different translatability to human clinical conditions. For the past 4 decades, TMJOA animal models have been studied by numerous researchers and can be broadly divided into induced, naturally occurring, and genetically modified models. The induced models can be divided into invasive models (intra-articular injection and surgical induction) or non-invasive models (mechanical loading, high-fat diet, and sleep deprivation). Different types of animal models simulate different pathological expressions of TMJOA and have their unique characteristics. Currently, mice, rats, and rabbits are commonly used in the study of TMJOA. This review sought to provide a general description of current experimental models of TMJOA and assist researchers in selecting the most appropriate models for different kinds of research.
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Affiliation(s)
- Yuqing Zhao
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application & Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, China
| | - Yanxin An
- Department of General Surgery, The First Affiliated Hospital of Xi’an Medical University, Xi’an, China
| | - Libo Zhou
- School of Basic Medicine, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application & Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, China
| | - Fan Wu
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application & Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, China
| | - Gaoyi Wu
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application & Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, China
| | - Jing Wang
- Department of Oral Implants, School of Stomatology, National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology & Shaanxi Key Laboratory of Stomatology, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Lei Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
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5
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Chondrotoxic effects of intra-articular injection of local anaesthetics in the rabbit temporomandibular joint. Int J Oral Maxillofac Surg 2022; 51:1337-1344. [PMID: 35120788 DOI: 10.1016/j.ijom.2022.01.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/01/2021] [Accepted: 01/18/2022] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate the chondrotoxic effects of a single-dose intra-articular injection of articaine, lidocaine, and bupivacaine on the rabbit temporomandibular joint (TMJ). Twenty-four rabbits were divided into four groups: control (group 1), articaine (group 2), lidocaine (group 3), and bupivacaine (group 4). Synovial fluid samples and venous blood were taken to evaluate matrix metalloproteinase 3 (MMP-3) levels. One millilitre of local anaesthetic solution was injected in the study groups and saline solution in the control group. The rabbits were euthanized after 4 weeks and the mandibular condyles and articular discs were evaluated. On histological examination, the study group samples had irregular joint surfaces, decreased collagen, and a thinner cartilage layer. Apoptotic cells were evaluated with the TUNEL method. TUNEL-positive apoptotic cell counts were higher in all study groups compared to the control group, and the difference was significant (P < 0.001). The mean preoperative serum MMP-3 level for all groups was 5.71 ± 3.33 ng/mL, while the mean postoperative level was 22.61 ± 6.36 ng/mL; this difference was significant (P < 0.001). A single-dose intra-articular injection of local anaesthetic had apoptotic effects on chondrocytes, leading to degenerative changes in the TMJ articular structures. Articaine was found to have less harmful effects than lidocaine and bupivacaine. Intra-articular injection of local anaesthetics should be limited in the TMJ because of the potential toxic effects.
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McKay RM, Vapniarsky N, Hatcher D, Carr N, Chen S, Verstraete FJM, Cissell DD, Arzi B. The Diagnostic Yield of Cone-Beam Computed Tomography for Degenerative Changes of the Temporomandibular Joint in Dogs. Front Vet Sci 2021; 8:720641. [PMID: 34422949 PMCID: PMC8371634 DOI: 10.3389/fvets.2021.720641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022] Open
Abstract
Degenerative changes of the temporomandibular joint (DTMJ) may be diagnosed via cone - beam computed tomography (CBCT). However, despite advancement in CBCT imaging, correlation of DTMJ features identified on CBCT with gross and histological findings is currently limited. This study aimed to correlate CBCT findings of DTMJ of dogs with gross and histopathologic changes. Temporomandibular joints (TMJ) (n = 38) from fresh cadaver heads of asymptomatic dogs (n = 19) were examined radiologically, macroscopically, and microscopically. Association of CBCT - detected DTMJ changes with gross and histological findings were statistically evaluated via kappa statistics and ordinal logistic mixed-effects models. The radiological changes observed on CBCT included joint space narrowing, subchondral/cortical bone changes (i.e., erosions or lysis), osteophytes, and subchondral bone sclerosis. Upon macroscopic evaluation, the majority of examined specimens had mild changes with cartilage defects and osteophytes affecting <10% of the total articular surface area. Histopathologic changes comprised splitting and degeneration of the fibrous cartilage layers, subchondral bone exposure, subchondral bone sclerosis, focal subchondral bone lysis, and occasional cell death. Subchondral sclerosis was the most prevalent finding radiologically and histologically with a fair to excellent agreement. Importantly, the more severe the TMJ degenerative changes, the higher the agreement between CBCT and histology. Based on the correlative results of statistical analysis, CBCT was found to be a suitable modality to evaluate DTMJ.
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Affiliation(s)
- Rachel Marie McKay
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Natalia Vapniarsky
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - David Hatcher
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Nicole Carr
- Department of Animal Sciences, University of California, Davis, Davis, CA, United States
| | - Shuai Chen
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Frank J M Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Derek D Cissell
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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7
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Bielajew BJ, Donahue RP, Espinosa MG, Arzi B, Wang D, Hatcher DC, Paschos NK, Wong MEK, Hu JC, Athanasiou KA. Knee orthopedics as a template for the temporomandibular joint. Cell Rep Med 2021; 2:100241. [PMID: 34095872 PMCID: PMC8149366 DOI: 10.1016/j.xcrm.2021.100241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although the knee joint and temporomandibular joint (TMJ) experience similar incidence of cartilage ailments, the knee orthopedics field has greater funding and more effective end-stage treatment options. Translational research has resulted in the development of tissue-engineered products for knee cartilage repair, but the same is not true for TMJ cartilages. Here, we examine the anatomy and pathology of the joints, compare current treatments and products for cartilage afflictions, and explore ways to accelerate the TMJ field. We examine disparities, such as a 6-fold higher article count and 2,000-fold higher total joint replacement frequency in the knee compared to the TMJ, despite similarities in osteoarthritis incidence. Using knee orthopedics as a template, basic and translational research will drive the development and implementation of clinical products for the TMJ. With more funding opportunities, training programs, and federal guidance, millions of people afflicted with TMJ disorders could benefit from novel, life-changing therapeutics.
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Affiliation(s)
- Benjamin J Bielajew
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Ryan P Donahue
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - M Gabriela Espinosa
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Dean Wang
- Department of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, USA
| | | | - Nikolaos K Paschos
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark E K Wong
- Department of Oral and Maxillofacial Surgery, University of Texas School of Dentistry, Houston, TX, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
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Podčernina J, Urtāne I, Pirttiniemi P, Šalms Ģ, Radziņš O, Aleksejūnienė J. Evaluation of Condylar Positional, Structural, and Volumetric Status in Class III Orthognathic Surgery Patients. ACTA ACUST UNITED AC 2020; 56:medicina56120672. [PMID: 33291272 PMCID: PMC7762172 DOI: 10.3390/medicina56120672] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 11/29/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES The need to evaluate the condylar remodeling after orthognathic surgery, using three-dimensional (3D) images and volume rendering techniques in skeletal Class III patients has been emphasized. The study examined condylar positional, structural, and volumetric changes after bimaxillary or single-jaw maxillary orthognathic surgeries in skeletal Class III patients using the cone-beam computed tomography. MATERIALS AND METHODS Presurgical, postsurgical, and one-year post-surgical full field of view (FOV) cone-beam computed tomography (CBCT) images of 44 patients with skeletal Class III deformities were obtained. Group 1 underwent a bimaxillary surgery (28 patients: 24 females and 4 males), with mean age at the time of surgery being 23.8 ± 6.0 years, and Group 2 underwent maxillary single-jaw surgery (16 patients: 8 females and 8 males), with mean age at the time of surgery being 23.7 ± 5.1 years. After the orthognathic surgery, the CBCT images of 88 condyles were evaluated to assess their displacement and radiological signs of bone degeneration. Three-dimensional (3D) condylar models were constructed and superimposed pre- and postoperatively to compare changes in condylar volume. RESULTS Condylar position was found to be immediately altered after surgery in the maxillary single-jaw surgery group, but at the one-year follow-up, the condyles returned to their pre-surgical position. There was no significant difference in condylar position when comparing between pre-surgery and one-year follow-up in any of the study groups. Condylar rotations in the axial and coronal planes were significant in the bimaxillary surgery group. No radiological signs of condylar bone degeneration were detected one year after the surgery. Changes in condylar volume after surgery were found to be insignificant in both study groups. CONCLUSIONS At one year after orthognathic surgery, there were no significant changes in positional, structural, or volumetric statuses of condyles.
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Affiliation(s)
- Jevgenija Podčernina
- Department of Orthodontics, Rīga Stradiņš University, Dzirciema str. 20, LV-1007 Rīga, Latvia; (I.U.); (O.R.)
- Correspondence: ; Tel.: + 37-16-745-5586
| | - Ilga Urtāne
- Department of Orthodontics, Rīga Stradiņš University, Dzirciema str. 20, LV-1007 Rīga, Latvia; (I.U.); (O.R.)
| | - Pertti Pirttiniemi
- Department of Oral Development and Orthodontics, University of Oulu, 90014 Oulu, Finland;
- Medical Research Center (MRC), Oulu University Hospital, 90014 Oulu, Finland
| | - Ģirts Šalms
- Department of Oral and Maxillofacial Surgery, Rīga Stardiņš University, Dzirciema str. 20, LV-1007 Rīga, Latvia;
| | - Oskars Radziņš
- Department of Orthodontics, Rīga Stradiņš University, Dzirciema str. 20, LV-1007 Rīga, Latvia; (I.U.); (O.R.)
| | - Jolanta Aleksejūnienė
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC V6T1Z3, Canada;
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Ulay G, Pekiner FN, Orhan K. Evaluation of the relationship between the degenerative changes and bone quality of mandibular condyle and articular eminence in temporomandibular disorders by cone beam computed tomography. Cranio 2020; 41:218-229. [PMID: 33272140 DOI: 10.1080/08869634.2020.1853307] [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: 10/22/2022]
Abstract
Objective: To evaluate whether there was a relationship between the degenerative bone changes and bone quality of the mandibular condyle and articular eminence in patients with temporomandibular disorder (TMD).Methods: The study group consisted of 100 patients with TMD. "Diagnostic Criteria/TMD" was used to identify the pathologies. Degenerative bone changes and bone qualities were detected by cone beam computed tomography; the bone qualities were classified using the Bone Quality Index (BQI) scale.Results: No statistically significant difference was found between degenerative bone changes and bone quality of the temporomandibular joint (TMJ) according to gender (p > 0.05). However, degenerative bone changes were more frequent than articular eminence in the mandibular condyle. BQI Type III was the most common bone quality among all types of degenerative bone changes.Discussion: Although no causality relationship was found between the bone quality and degenerative bone changes, low bone quality was found in TMD patients.
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Affiliation(s)
- Gamze Ulay
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Filiz Namdar Pekiner
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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Salles C, Garofalo S, Melo A. Wake‐Up Headache Is Associated With Sleep Bruxism: A Comment. Headache 2020; 60:1805. [DOI: 10.1111/head.13895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Cristina Salles
- Edgard Santos University Hospital Federal University of Bahia Salvador Brazil
| | - Sérgio Garofalo
- Edgard Santos University Hospital Federal University of Bahia Salvador Brazil
| | - Ailton Melo
- Edgard Santos University Hospital Federal University of Bahia Salvador Brazil
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Temporomandibular joint imaging: current clinical applications, biochemical comparison with the intervertebral disc and knee meniscus, and opportunities for advancement. Skeletal Radiol 2020; 49:1183-1193. [PMID: 32162049 DOI: 10.1007/s00256-020-03412-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 02/02/2023]
Abstract
Temporomandibular disorders encompass multiple pathologies of the temporomandibular joint that manifest as middle/inner ear symptoms, headache, and/or localized TMJ symptoms. There is an important although somewhat limited role of imaging in the diagnostic evaluation of temporomandibular disorders. In this manuscript, we provide a comprehensive review of TMJ anatomy, outline potentially important features of TMJ disc ultrastructure and biochemistry in comparison with the intervertebral disc and knee meniscus, and provide imaging examples of the TMJ abnormalities currently evaluable with MRI and CT. In addition, we provide an overview of emerging and investigational TMJ imaging techniques in order to encourage further imaging research based on the biomechanical alterations of the TMJ disc.
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12
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Maracci LM, Stasiak G, de Oliveira Chami V, Franciscatto GJ, Milanesi J, Figueiró C, Bernardon Silva T, Guimarães MB, Marquezan M. Treatment of myofascial pain with a rapid laser therapy protocol compared to occlusal splint: A double-blind, randomized clinical trial. Cranio 2020; 40:433-439. [PMID: 32491964 DOI: 10.1080/08869634.2020.1773661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To compare the effect of a rapid low-level laser therapy (LLLT) protocol to Michigan occlusal splint in the treatment of myofascial pain, as well as to evaluate their impact on Oral Health-Related Quality of Life (OHRQoL). METHODS Thirty participants were randomly allocated into three groups: G1: occlusal splint (n = 11), G2: LLLT (n = 10), and G3: LLLT placebo (n = 9). LLLT and placebo were applied in the points of pain upon palpation. RESULTS G1 presented improvement in pain (p = 0.014) and in the diagnosis of myofascial pain (p = 0.008), while G2 and G3 did not. Regarding OHRQoL, G1 and G2 presented significant improvement (p = 0.005, in both), whereas, G3 did not. CONCLUSION Michigan occlusal splint was effective in reducing pain and improving OHRQoL. Treatment with the rapid LLLT protocol only provided an improvement in OHRQoL.
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Affiliation(s)
| | - Gabriela Stasiak
- Federal University of Santa Maria, Sant'Ana do Livramento, RS, Brazil
| | | | | | - Jovana Milanesi
- Private Practice, Volunteer at Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Cláudio Figueiró
- Department of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Magáli Beck Guimarães
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Mariana Marquezan
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, RS, Brazil
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Yamaner FE, Celakil T, Gökcen Roehlig B. Comparison of the efficiency of two alternative therapies for the management of temporomandibular disorders. Cranio 2020; 40:189-198. [DOI: 10.1080/08869634.2020.1727667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Tamer Celakil
- Department of Prosthodontics, Istanbul University, Istanbul, Turkey
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15
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Mehrabani D, Seghatchian J, Acker JP. Platelet rich plasma in treatment of musculoskeletal pathologies. Transfus Apher Sci 2019; 58:102675. [DOI: 10.1016/j.transci.2019.102675] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Qi K, Lin R, Xue C, Liu T, Wang Y, Zhang Y, Li J. Long Non-Coding RNA (LncRNA) CAIF is Downregulated in Osteoarthritis and Inhibits LPS-Induced Interleukin 6 (IL-6) Upregulation by Downregulation of MiR-1246. Med Sci Monit 2019; 25:8019-8024. [PMID: 31653823 PMCID: PMC6827483 DOI: 10.12659/msm.917135] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Background Osteoarthritis (OA) affects about 40% of people older than 40 years of age, and the mechanism is not well understood. Long non-coding RNA (lncRNA) CAIF is a recently identified critical player in myocardial infarction, while its role in other human diseases is unclear. The present study aimed to investigate the role of CAIF in OA. Material/Methods Levels of CAIF in synovial fluid of OA patients (n=60) and healthy controls (n=60) were measuring by performing quantitative real-time polymerase chain reaction (qRT-PCR). MiR-1246 and interleukin (IL)-6 levels in synovial fluid were measured by performing qRT-PCR and enzyme-linked immunosorbent assay (ELISA), respectively. Cell apoptosis analysis was performed after CHON-001 cells were treated with 500 mg/mL lipopolysaccharide (LPS) for 24 hours. Results We found that CAIF in synovial fluid was downregulated in OA patients and inversely correlated with miR-1246 and IL-6. Downregulated CAIF distinguished OA patients from healthy controls. In cells of chondrogenic cell line CHON-001, CAIF overexpression mediated the inhibited expression of miR-1246 and secretion of IL-6, while miR-1246 overexpression reduced the effects of CAIF overexpression on IL-6 secretion. In addition, CAIF overexpression inhibited the apoptosis of CHON-001 cells under LPS treatment, while miR-1246 overexpression attenuated the effects of CAIF overexpression. Conclusions Therefore, CAIF may downregulate miR-1246 to improve OA.
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Affiliation(s)
- Ke Qi
- Department of Joint Surgery, Changhai Hospital, Shanghai, China (mainland)
| | - Rongqiang Lin
- Department of Joint Surgery, Changhai Hospital, Shanghai, China (mainland)
| | - Chenchen Xue
- Department of Joint Surgery, Changhai Hospital, Shanghai, China (mainland)
| | - Tianze Liu
- Department of Joint Surgery, Changhai Hospital, Shanghai, China (mainland)
| | - Yiming Wang
- Department of Joint Surgery, Changhai Hospital, Shanghai, China (mainland)
| | - Yongjin Zhang
- Department of Joint Surgery, Changhai Hospital, Shanghai, China (mainland)
| | - Jia Li
- Department of Joint Surgery, Changhai Hospital, Shanghai, China (mainland)
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Tran Duy TD, Chen MC, Wen-Ching Ko E, Chen YR, Huang CS. Does Sleep Quality Affect Temporomandibular Joint With Degenerative Joint Changes? J Oral Maxillofac Surg 2019; 77:1594-1601. [DOI: 10.1016/j.joms.2019.02.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/12/2019] [Accepted: 02/15/2019] [Indexed: 12/16/2022]
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Coombs MC, She X, Brown TR, Slate EH, Lee JS, Yao H. Temporomandibular Joint Condyle-Disc Morphometric Sexual Dimorphisms Independent of Skull Scaling. J Oral Maxillofac Surg 2019; 77:2245-2257. [PMID: 31125537 DOI: 10.1016/j.joms.2019.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/18/2019] [Accepted: 04/18/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE Approximately 2 to 4% of the US population have been estimated to seek treatment for temporomandibular symptoms, predominately women. The study purpose was to determine whether sex-specific differences in temporomandibular morphometry result from scaling with sex differences in skull size and shape or intrinsic sex-specific differences. MATERIALS AND METHODS A total of 22 (11 male [aged 74.5 ± 9.1 years]; 11 female [aged 73.6 ± 12.8 years]) human cadaveric heads with no history of temporomandibular disc derangement underwent cone beam computed tomography and high-resolution magnetic resonance imaging scanning to determine 3-dimensional cephalometric parameters and temporomandibular morphometric outcomes. Regression models between morphometric outcomes and cephalometric parameters were developed, and intrinsic sex-specific differences in temporomandibular morphometry normalized by cephalometric parameters were determined. Subject-specific finite element (FE) models of the extreme male and extreme female conditions were developed to predict variations in articular disc stress-strain under the same joint loading. RESULTS In some cases, sex differences in temporomandibular morphometric parameters could be explained by linear scaling with skull size and shape; however, scaling alone could not fully account for some differences between sexes, indicating intrinsic sex-specific differences. The intrinsic sex-specific differences in temporomandibular morphometry included an increased condylar medial length and mediolateral disc lengths in men and a longer anteroposterior disc length in women. Considering the extreme male and female temporomandibular morphometry observed in the present study, subject-specific FE models resulted in sex differences, with the extreme male joint having a broadly distributed stress field and peak stress of 5.28 MPa. The extreme female joint had a concentrated stress field and peak stress of 7.37 MPa. CONCLUSIONS Intrinsic sex-specific differences independent of scaling with donor skull size were identified in temporomandibular morphometry. Understanding intrinsic sex-specific morphometric differences is critical to determining the temporomandibular biomechanics given the effect of anatomy on joint contact mechanics and stress-strain distributions and requires further study as one potential factor for the increased predisposition of women to temporomandibular disc derangement.
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Affiliation(s)
- Matthew C Coombs
- Postdoctoral Fellow, Department of Bioengineering, Clemson University, Clemson, SC; and Department of Oral Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Xin She
- Graduate Assistant, Department of Bioengineering, Clemson University, Clemson, SC
| | - Truman R Brown
- Professor, Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC
| | - Elizabeth H Slate
- Professor, Department of Statistics, Florida State University, Tallahassee, FL
| | - Janice S Lee
- Clinical Director, National Institutes of Health National Institute of Dental and Craniofacial Research, Bethesda, MD
| | - Hai Yao
- Professor, Department of Bioengineering, Clemson University, Clemson, SC; and Department of Oral Health Sciences, Medical University of South Carolina, Charleston, SC.
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20
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Guerrero Cota JM, Leale DM, Arzi B, Cissell DD. Regional and disease-related differences in properties of the equine temporomandibular joint disc. J Biomech 2019; 82:54-61. [DOI: 10.1016/j.jbiomech.2018.10.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/15/2018] [Accepted: 10/17/2018] [Indexed: 10/28/2022]
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Farzin M, Taghva M, Babooie M. Comparison of temporomandibular disorders between menopausal and non-menopausal women. J Korean Assoc Oral Maxillofac Surg 2018; 44:232-236. [PMID: 30402415 PMCID: PMC6209692 DOI: 10.5125/jkaoms.2018.44.5.232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 12/27/2017] [Accepted: 12/27/2017] [Indexed: 01/08/2023] Open
Abstract
Objectives Hormonal changes during menopause alter a woman's susceptibility to some disorders. Information regarding the prevalence of temporomandibular disorder (TMD) in menopausal women is limited in the literature. In this study, the prevalence and severity of TMDs were compared between menopausal and non-menopausal women. Materials and Methods The study included 140 women (69 premenopausal and 71 postmenopausal) 45 to 55 years of age that were examined in Shiraz Dental School, Shiraz in Iran. The Helkimo clinical dysfunction index (Di) was used to evaluate temporomandibular joint (TMJ) dysfunction. The data were analyzed using chi-square and Fisher's exact tests. Results Occurrence of TMD was significantly higher in menopausal than non-menopausal women (P<0.001). All the TMD criteria based on Helkimo Di except range of mandibular movement were significantly more common in menopausal women. The range of mandibular movement was not significantly different between menopausal and non-menopausal women (P=0.178). Conclusion The results from this study show that TMD can be considered more common and severe in menopausal than non-menopausal women. This finding indicates that, similar to other conditions in menopausal women such as arthritis and osteoporosis, TMD should be taken into consideration by dental and medical professionals.
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Affiliation(s)
- Mitra Farzin
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masumeh Taghva
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Moslem Babooie
- Postgraduate Student of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Lemos GA, da Silva PLP, Batista AUD, Palomari ET. Experimental model of temporomandibular joint arthritis: Evaluation of contralateral joint and masticatory muscles. Arch Oral Biol 2018; 95:79-88. [DOI: 10.1016/j.archoralbio.2018.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 07/05/2018] [Accepted: 07/07/2018] [Indexed: 12/16/2022]
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Surgical Versus Nonsurgical Management of Degenerative Joint Disease. Oral Maxillofac Surg Clin North Am 2018; 30:291-297. [DOI: 10.1016/j.coms.2018.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Coombs MC, Bonthius DJ, Nie X, Lecholop MK, Steed MB, Yao H. Effect of Measurement Technique on TMJ Mandibular Condyle and Articular Disc Morphometry: CBCT, MRI, and Physical Measurements. J Oral Maxillofac Surg 2018; 77:42-53. [PMID: 30076808 DOI: 10.1016/j.joms.2018.06.175] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/28/2018] [Accepted: 06/26/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Accurate description of the temporomandibular size and shape (morphometry) is critical for clinical diagnosis and surgical planning and the design and development of regenerative scaffolds and prosthetic devices and to model the temporomandibular loading environment. The study objective was to determine the 3-dimensional morphometry of the temporomandibular joint (TMJ) condyle and articular disc using cone-beam computed tomography (CBCT), magnetic resonance imaging (MRI), and physical measurements of the same joints using a repeated measures design and to determine the effect of the measurement technique on temporomandibular size and shape. MATERIALS AND METHODS Human cadaveric heads underwent a multistep protocol to acquire physiologically meaningful measurements of the condyle and disc. The heads first underwent CBCT scanning, and solid models were automatically generated. The superficial soft tissues were dissected, and intact TMJs were excised and underwent MRI scanning, with solid models generated after manual segmentation. After MRI, the intact joints were dissected, and physical measurements of the condyle and articular disc were performed. The CBCT-based model measurements, MRI-based model measurements, and physical measurements were standardized, and a repeated measures study design was used to determine the effect of the measurement technique on the morphometric parameters. RESULTS Multivariate general linear mixed effects models showed significant effects for measurement technique for condylar morphometric outcomes (P < .001) and articular disc morphometric outcomes (P < .001). The physical measurements after dissection were larger than either the CBCT-based or MRI-based measurements. Differences in imaging-based morphometric parameters followed a complex relationship between imaging modality resolution and contrast between tissue types. CONCLUSIONS Physical measurements after dissection are still considered the reference standard. However, owing to their inaccessibility in vivo, understanding how the imaging technique affects the temporomandibular size and shape is critical toward the development of high-fidelity solid models to be used in the design and development of regenerative scaffolds, surgical planning, prosthetic devices, and anatomic investigations.
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Affiliation(s)
- Matthew C Coombs
- Postdoctoral Fellow, Department of Bioengineering, Clemson University, Clemson, SC; and Department of Oral Health Sciences, Medical University of South Carolina, Charleston, SC
| | - Daniel J Bonthius
- MD/PhD Student, Department of Bioengineering, Clemson University, Clemson, SC
| | - Xingju Nie
- Research Associate, Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC
| | - Michael K Lecholop
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Medical University of South Carolina, Charleston, SC
| | - Martin B Steed
- Professor and Department Head, Department of Oral and Maxillofacial Surgery, Medical University of South Carolina, Charleston, SC
| | - Hai Yao
- Professor, Department of Bioengineering, Clemson University, Clemson, SC; and Department of Oral Health Sciences, Medical University of South Carolina, Charleston, SC.
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Ye T, Sun D, Mu T, Chu Y, Miao H, Zhang M, Yang H, Liu Q, Lu L, Xing X, Yu S. Differential effects of high-physiological oestrogen on the degeneration of mandibular condylar cartilage and subchondral bone. Bone 2018. [PMID: 29530720 DOI: 10.1016/j.bone.2018.03.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The striking predilection of temporomandibular disorders (TMD) in women, especially during gonad-intact puberty or reproductive years, indicates that oestrogen plays an important role in the progression of TMD, but the underlying mechanism remains unclear. In this study, unilateral anterior crossbite (UAC) was used to create temporomandibular joint osteoarthritis (TMJ OA) models in rats, while 17β-estradiol (E2) injections were applied to mimic patients with high-physiological levels of oestrogen. Micro-CT scanning, histological staining and real-time PCR assays were preformed to observe the degenerative changes in the mandibular condylar cartilage and subchondral bone. The results showed that obvious degradation was found in the condylar cartilage and subchondral bone of rats with UAC procedure, including decreased cartilage thickness, loss of extracellular matrix, increased apoptotic chondrocytes and expression of pro-inflammatory and catabolic factors, decreased bone mineral density and increased osteoclast activity. E2 supplements aggravated the condylar cartilage degradation but reversed the abnormal bone resorption in the subchondral bone induced by UAC. Our results revealed that high-physiological oestrogen plays a destructive role in condylar cartilage but a protective role in subchondral bone at the early stage of TMJ OA. These dual and distinct effects should be given serious consideration in future OA treatments.
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Affiliation(s)
- Tao Ye
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China
| | - Dongliang Sun
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China
| | - Tong Mu
- China Meitan General Hospital, Beijing 100028, PR China
| | - Yi Chu
- State Key Laboratory of Cancer Biology, Xijing Hospital of Digestive Diseases, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China
| | - Hui Miao
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China
| | - Mian Zhang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China
| | - Hongxu Yang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China
| | - Qian Liu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China
| | - Lei Lu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China
| | - Xianghui Xing
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China.
| | - Shibin Yu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Oral Diseases, School of Stomatology, The Fourth Military Medical University, Xi'an, Shaanxi 710032, PR China.
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Michaelis M, Lucius R, Wiltfang J, Birkenfeld F. Determination of VEGF, collagen type 1 and versican in the discus articularis of the temporomandibular joint in relation to dental status. J Craniomaxillofac Surg 2017; 46:67-74. [PMID: 29198579 DOI: 10.1016/j.jcms.2017.09.013] [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: 02/02/2017] [Revised: 07/08/2017] [Accepted: 09/14/2017] [Indexed: 10/18/2022] Open
Abstract
The aim of this study was the investigation and comparison of the presence of vascular endothelial growth factor (VEGF), collagen type 1 and the proteoglycan versican in the discus articularis in relation to dental status (full dentition [1], partial dentition [2] and edentulous [3]). The right disci articulares were removed from 17 donated bodies (6 with full dentition, 5 with partial dentition and 6 edentulous). The specimens were immunohistochemically stained for VEGF, collagen type 1 and versican. Semiquantitative analysis of the disci was conducted within the groups based on the intensity of immunoreactivity of VEGF, collagen type 1 and versican. In addition, a pairwise comparison was carried out between the three experimental groups. The results revealed significantly higher immunoreactivity for VEGF and versican in groups 2 and 3 than in group 1. Conversely, determination of immunoreactivity was significantly higher in group 1 for collagen type 1 than in the other two groups. These results indicate an elevated presence of the proteoglycan versican and the neoangiogenesis factor VEGF when the occlusal supporting zone has been lost. By contrast, detection of collagen type 1 is reduced. The loss of collagen type 1 and rise in versican and VEGF suggest increasing degeneration when the supporting zone is lost due to the loss of teeth.
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Affiliation(s)
- Malte Michaelis
- Institute of Anatomy (Head: Prof. Dr. Ralph Lucius), Christian-Albrechts-University of Kiel, Olshausenstraße 40, 24118 Kiel, Germany
| | - Ralph Lucius
- Institute of Anatomy (Head: Prof. Dr. Ralph Lucius), Christian-Albrechts-University of Kiel, Olshausenstraße 40, 24118 Kiel, Germany
| | - Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Jörg Wiltfang), University Hospital Schleswig-Holstein, Arnold-Heller-Straße 16, 24105 Kiel, Germany
| | - Falk Birkenfeld
- Department of Oral and Maxillofacial Surgery (Head: Prof. Dr. Dr. Jörg Wiltfang), University Hospital Schleswig-Holstein, Arnold-Heller-Straße 16, 24105 Kiel, Germany.
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Wright GJ, Coombs MC, Wu Y, Damon BJ, Bacro TH, Kern MJ, Chen X, Yao H. Electrical Conductivity Method to Determine Sexual Dimorphisms in Human Temporomandibular Disc Fixed Charge Density. Ann Biomed Eng 2017; 46:310-317. [PMID: 29181723 DOI: 10.1007/s10439-017-1963-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/14/2017] [Indexed: 11/30/2022]
Abstract
To investigate potential mechanisms associated with the increased prevalence of temporomandibular joint (TMJ) disorders among women, the study objective was to determine sex-dependent and region-dependent differences in fixed charge density (FCD) using an electrical conductivity method. Seventeen TMJ discs were harvested from nine males (77 ± 4 years) and eight females (86 ± 4 years). Specimens were prepared from the anterior band, posterior band, intermediate zone, medial disc and lateral disc. FCD was determined using an electrical conductivity method, assessing differences among disc regions and between sexes. Statistical modeling showed significant effects for donor sex (p = 0.002), with cross-region FCD for male discs 0.051 ± 0.018 milliequivalent moles per gram (mEq/g) wet tissue and 0.043 ± 0.020 mEq/g wet tissue for female discs. FCD was significantly higher for male discs compared to female discs in the posterior band, with FCD 0.063 ± 0.015 mEq/g wet tissue for male discs and 0.032 ± 0.020 mEq/g wet tissue for female discs (p = 0.050). These results indicate FCD contributes approximately 20% towards TMJ disc compressive modulus, through osmotic swelling pressure regulation. Additionally, FCD regulates critical extracellular ionic/osmotic and nutrient environments. Sexual dimorphisms in TMJ disc FCD, and resulting differences in extracellular ionic/osmotic and nutrient environments, could result in altered mechano-electro-chemical environments between males and females and requires further study.
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Affiliation(s)
- Gregory J Wright
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, 173 Ashley Avenue MSC 508, Charleston, SC, 29425, USA
| | - Matthew C Coombs
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, 173 Ashley Avenue MSC 508, Charleston, SC, 29425, USA.,Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Yongren Wu
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, 173 Ashley Avenue MSC 508, Charleston, SC, 29425, USA
| | - Brooke J Damon
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, 173 Ashley Avenue MSC 508, Charleston, SC, 29425, USA.,Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Thierry H Bacro
- Center for Anatomical Studies and Education, MUSC, Charleston, SC, USA
| | - Michael J Kern
- Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - Xiaojing Chen
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, 173 Ashley Avenue MSC 508, Charleston, SC, 29425, USA. .,Xiangya School of Stomatology, Central South University, 72 Xiangya Rd, Changsha, China.
| | - Hai Yao
- Clemson-MUSC Bioengineering Program, Department of Bioengineering, Clemson University, 173 Ashley Avenue MSC 508, Charleston, SC, 29425, USA. .,Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA.
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Ravosa MJ, Kane RJ. Dietary variation and mechanical properties of articular cartilage in the temporomandibular joint: implications for the role of plasticity in mechanobiology and pathobiology. ZOOLOGY 2017; 124:42-50. [PMID: 29032864 DOI: 10.1016/j.zool.2017.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 08/18/2017] [Accepted: 08/19/2017] [Indexed: 01/26/2023]
Abstract
Due to their nature as tissue composites, skeletal joints pose an additional challenge in terms of evaluating the functional significance of morphological variation in their bony and cartilaginous components in response to altered loading conditions. Arguably, this complexity requires more direct means of investigating joint plasticity and performance than typically employed to analyze macro- and micro-anatomical phenomena. To address a significant gap in our understanding of the plasticity of the mammalian temporomandibular joint (TMJ), we investigated the histology and mechanical properties of condylar articular cartilage in rabbits subjected to long-term variation in diet-induced masticatory stresses, specifically cyclical loading. Three cohorts of male weanlings were raised for six months on different diets until adulthood. Following euthanasia, the TMJ condyles on one side were dissected away, fixed, decalcified, dehydrated, embedded and sectioned. Safranin O staining was employed to identify variation in proteoglycan content, which in turn was used to predict patterns of articular cartilage stiffness in contralateral condylar specimens for each treatment group. Hematoxylin and eosin staining was used to quantify diet-induced changes in chondrocyte hypertrophy and cellularity. Mechanical tests document significant decreases in articular cartilage stiffness corresponding to patterns of extracellular matrix relative protein abundance in rabbits subjected to greater cyclical loading. This indicates that TMJs routinely subjected to higher masticatory stresses due to a challenging diet eventually develop postnatal decreases in the ability to counter compressive loads during postcanine biting and chewing. These findings provide novel information regarding TMJ performance, with broader implications about the costs and benefits of phenotypic plasticity as well as implications for how such biological processes affect connective tissue mechanobiology and pathobiology.
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Affiliation(s)
- Matthew J Ravosa
- Department of Biological Sciences, Galvin Life Science Center, University of Notre Dame, Notre Dame, IN 46556, USA; Department of Aerospace and Mechanical Engineering, University of Notre Dame, Notre Dame, IN 46556, USA; Department of Anthropology, University of Notre Dame, Notre Dame, IN 46556, USA.
| | - Robert J Kane
- Department of Biological Sciences, Galvin Life Science Center, University of Notre Dame, Notre Dame, IN 46556, USA.
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Abstract
OBJECTIVE Our previous study showed that WNT5A, a member of the noncanonical WNT pathway, is involved in interleukin-1beta induced matrix metalloproteinase expression in temporomandibular joint (TMJ) condylar chondrocytes. The purpose of this study is to further explore the roles of WNT5A in cartilage biology of the TMJ. METHODS An early TMJ osteoarthritis-like rat model was constructed by a mechanical method (steady mouth-opening). The gene and protein levels of WNT5A during the condylar cartilage changes were measured. Effects of WNT5A on chondrocyte proliferation, hypertrophy and migration were analyzed after WNT5A gain or loss of function in vitro. A c-Jun N-terminal kinase (JNK) inhibitor SP600125 was used to evaluate the involvement of JNK pathway in these effects of WNT5A. The expression and transcription activity of cell cycle regulators c-MYC and Cyclin D1 were examined to determine the mechanism behind WNT5A regulation of chondrocyte proliferation. RESULTS WNT5A was significantly upregulated in the condylar cartilage of rats in the early TMJ osteoarthritis-like model. Activating WNT5A facilitated condylar chondrocyte proliferation, hypertrophy and migration. Conversely, inhibiting WNT5A activity in chondrocytes decreased their proliferation, hypertrophy and migration. Blockage of the JNK pathway by its inhibitor, SP600125, impaired these effects of WNT5A on chondrocytes. WNT5A regulated both the expression and transcriptional activity of c-MYC and Cyclin D1 in chondrocytes, both of which were upregulated in condylar cartilage of the rat early TMJ osteoarthritis. CONCLUSION WNT5A regulates condylar chondrocyte proliferation, hypertrophy and migration. These findings provide new insights into the role of WNT5A signaling in TMJ cartilage biology and its potential in future therapy for TMJ degenerative diseases.
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Huang Q, Opstelten D, Samman N, Tideman H. Experimentally Induced Unilateral Tooth Loss: Histochemical Studies of the Temporomandibular Joint. J Dent Res 2017. [DOI: 10.1177/0810209] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Occlusal abnormality may contribute to osteoarthrosis of the temporomandibular joint (TMJ). Since mechanical force may induce changes in the extracellular matrix, we tested the hypothesis that unilateral removal of teeth and the resulting unilateral mastication change the content of glycosaminoglycans (GAGs) in the TMJ condyle and disc. Lower-right-side teeth were extracted from 12 adult male rabbits, which were killed 3 or 6 weeks later. Three normal rabbits served as controls. Sections were analyzed for morphological changes and levels of sulfated GAGs in the condyle and disc. Unilateral removal of teeth led to thickening of the condylar cartilage, alterations in the morphology of chondrocyte nuclei in the condylar cartilage and disc, and increases in levels of negatively charged ions in the hypertrophic layer of condylar cartilage. Small differences were observed, after unilateral removal of teeth, between the functional and non-functional sides of the TMJ. The results suggest that in response to mechanical stress, chondrocytes alter sulfated glycosaminoglycan (GAGs) synthesis and degradation rates, resulting in an elevated level of sulfated GAGs in the condylar cartilage.
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Affiliation(s)
- Q. Huang
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Prince Philip Dental Hospital, 34 Hospital Road, and
- Department of Biochemistry, Faculty of Medicine, The University of
Hong Kong, Hong Kong
| | - D. Opstelten
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Prince Philip Dental Hospital, 34 Hospital Road, and
- Department of Biochemistry, Faculty of Medicine, The University of
Hong Kong, Hong Kong
| | - N. Samman
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Prince Philip Dental Hospital, 34 Hospital Road, and
- Department of Biochemistry, Faculty of Medicine, The University of
Hong Kong, Hong Kong
| | - H. Tideman
- Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Prince Philip Dental Hospital, 34 Hospital Road, and
- Department of Biochemistry, Faculty of Medicine, The University of
Hong Kong, Hong Kong
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32
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Coombs MC, Petersen JM, Wright GJ, Lu SH, Damon BJ, Yao H. Structure-Function Relationships of Temporomandibular Retrodiscal Tissue. J Dent Res 2017; 96:647-653. [PMID: 28530471 DOI: 10.1177/0022034517696458] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It is estimated that 2% to 4% of the US population will seek treatment for temporomandibular joint (TMJ) symptoms, typically occurring with anterior disc displacement. The temporomandibular retrodiscal tissue (RDT) has been postulated to restrict pathologic disc displacement. To elucidate RDT function, understanding regional RDT biomechanics and ultrastructure is required. No prior biomechanical analysis has determined regional variations in RDT properties or associated biomechanical outcomes with regional variations in collagen and elastin organization. The purpose of this study was to determine direction- and region-dependent tensile biomechanical characteristics and regional fibrillar arrangement of porcine RDT. Incremental stress relaxation experiments were performed on 20 porcine RDT specimens, with strain increments from 5% to 50%, a ramp-strain rate of 2% per second, and relaxation periods of 2.5 min. Tensile characteristics were determined between temporal and condylar regions and anteroposterior and mediolateral directions. RDT preparations were imaged using second-harmonic generation (SHG) microscopy for both collagen and elastin. Young's modulus showed significant differences by region ( P < 0.001) and strain ( P < 0.001). Young's modulus was <1 MPa from 5% to 20% strain, before increasing from 20% to 50% strain to a maximum of 2.9 MPa. Young's modulus trended higher in the temporal region and mediolateral direction. Instantaneous and relaxed moduli showed no significant difference by region or direction. Collagen arrangement was most organized near the disc boundary, with disorganization increasing posteriorly. Elastin was present at the disc boundary and RDT mid-body. Porcine RDT demonstrated region- and strain-dependent variations in tensile moduli, associated with regional differences in collagen and elastin. The small tensile moduli suggest that the RDT is not resistive to pathologic disc displacement. Further biomechanical analysis of the RDT is required to fully define RDT functional roles. Understanding regional variations in tissue stiffness and ultrastructure for TMJ components is critical to understanding joint function and for the long-term goal of improving TMJ disorder treatment strategies.
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Affiliation(s)
- M C Coombs
- 1 Department of Bioengineering, Clemson University, Clemson, SC, USA.,2 Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - J M Petersen
- 2 Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - G J Wright
- 1 Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - S H Lu
- 1 Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - B J Damon
- 1 Department of Bioengineering, Clemson University, Clemson, SC, USA.,2 Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
| | - H Yao
- 1 Department of Bioengineering, Clemson University, Clemson, SC, USA.,2 Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, USA
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Disk displacement, eccentric condylar position, osteoarthrosis - misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts. BMC Oral Health 2016; 16:124. [PMID: 27855674 PMCID: PMC5114831 DOI: 10.1186/s12903-016-0319-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/09/2016] [Indexed: 01/25/2023] Open
Abstract
Background Clinical decision-making and prognostic statements in individuals with manifest or suspected temporomandibular disorders (TMDs) may involve assessment of (a) the position of articular disc relative to the mandibular condyle, (b) the location of the condyle relative to the temporal joint surfaces, and (c) the depth of the glenoid fossa of the temporomandibular joints (TMJs). The aim of this study was twofold: (1) Determination of the prevalence of these variables in two representative population-based birth cohorts. (2) Reinterpretation of the clinical significance of the findings. Methods From existing magnetic resonance imaging (MRI) scans of the TMJs that had been taken in 2005 and 2006 from 72 subjects born between 1930 and 1932 and between 1950 and 1952, respectively, the condylar position at closed jaw was calculated as percentage displacement of the condyle from absolute centricity. By using the criteria introduced by Orsini et al. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:489-97, 1998), a textbook-like disc position at closed jaw was distinguished from an anterior location. TMJ morphology of the temporal joint surfaces was assessed at open jaw by measuring the depth of the glenoid fossa, using the method proposed by Muto et al. (J Oral Maxillofac Surg 52:1269-72, 1994). Frequency distributions were recorded for the condylar and disc positions at closed jaw. Student’s t-test with independent samples was used as test of significance to detect differences of condylar positions between the age cohorts (1930 vs. 1950) and the sexes. The significance levels were set at 5%. First, the results from the measurement of the age cohorts were compared without differentiation of sexes, i.e., age cohort 1930–1932 versus age cohort 1950–1952. Subsequently, the age cohorts were compared by sex, i.e., men in cohort 1930–1932 versus men in cohort 1950–1952, and women in cohort 1930–1932 women men in cohort 1950–1952. Results In both cohorts, condylar position was characterized by great variability. About 50% of the condyles were located centrically, while the other half was either in an anterior or in a posterior position. In both female cohorts, a posterior position predominated, whereas a centric position prevailed among men. Around 75% of the discs were positioned textbook-like, while the remaining forth was located anteriorly. Age had no statistically significant influence on condylar or on disc position. Conversely, comparison between the age groups revealed a statistically significant decrease of the depth of the glenoid fossa in both older cohorts. This age-dependent changes may be interpreted as flattening of the temporal joint surfaces. Conclusions We call for a re-interpretation of imaging findings because they may insinuate pathology which usually is not present. Instead, anterior or posterior positions of the mandibular condyle as well as an anterior location of the articular disc should be construed as a variation of normalcy. Likewise, flattening of articular surfaces of the TMJs may be considered as normal adaptive responses to increased loading, rather than pathological degenerative changes. Trial registration Not applicable.
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Wright GJ, Coombs MC, Hepfer RG, Damon BJ, Bacro TH, Lecholop MK, Slate EH, Yao H. Tensile biomechanical properties of human temporomandibular joint disc: Effects of direction, region and sex. J Biomech 2016; 49:3762-3769. [PMID: 27743627 DOI: 10.1016/j.jbiomech.2016.09.033] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/23/2016] [Accepted: 09/30/2016] [Indexed: 11/18/2022]
Abstract
Approximately 30% of temporomandibular joint (TMJ) disorders include degenerative changes to the articular disc, with sex-specific differences in prevalence and severity. Limited tensile biomechanical properties of human TMJ discs have been reported. Stress relaxation tests were conducted on TMJ disc specimens harvested bilaterally from six males and six females (68.9±7.9 years), with step-strain increments of 5%, 10%, 15%, 20% and 30%, at 1% strain-per-second. Stress versus strain plots were constructed, and Young׳s Modulus, Instantaneous Modulus and Relaxed Modulus were determined. The effects of direction, region, and sex were examined. Regional effects were significant (p<0.01) for Young׳s Modulus and Instantaneous Modulus. Anteroposteriorly, the central region was significantly stiffer than medial and lateral regions. Mediolaterally, the posterior region was significantly stiffer than central and anterior regions. In the central region, anteroposteriorly directed specimens were significantly stiffer compared to mediolateral specimens (p<0.04). TMJ disc stiffness, indicated by Young׳s Modulus and Instantaneous Modulus, was higher in directions corresponding to high fiber alignment. Additionally, human TMJ discs were stiffer for females compared to males, with higher Young׳s Modulus and Instantaneous Modulus, and female TMJ discs relaxed less. However, sex effects were not statistically significant. Using second-harmonic generation microscopy, regional collagen fiber organization was identified as a potentially significant factor in determining the biomechanical properties for any combination of direction and region. These findings establish structure-function relationships between collagen fiber direction and organization with biomechanical response to tensile loading, and may provide insights into the prevalence of TMJ disorders among women.
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Affiliation(s)
- Gregory J Wright
- Department of Bioengineering, Clemson University, Clemson, SC, United States
| | - Matthew C Coombs
- Department of Bioengineering, Clemson University, Clemson, SC, United States; Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, United States
| | - R Glenn Hepfer
- Department of Bioengineering, Clemson University, Clemson, SC, United States
| | - Brooke J Damon
- Department of Bioengineering, Clemson University, Clemson, SC, United States; Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, United States
| | - Thierry H Bacro
- Center for Anatomical Studies and Education, MUSC, Charleston, SC, United States
| | - Michael K Lecholop
- Department of Oral & Maxillofacial Surgery, MUSC, Charleston, SC, United States
| | - Elizabeth H Slate
- Department of Statistics, Florida State University, Tallahassee, FL, United States
| | - Hai Yao
- Department of Bioengineering, Clemson University, Clemson, SC, United States; Department of Oral Health Sciences, Medical University of South Carolina (MUSC), Charleston, SC, United States.
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Kim K, Wojczyńska A, Lee JY. The incidence of osteoarthritic change on computed tomography of Korean temporomandibular disorder patients diagnosed by RDC/TMD; a retrospective study. Acta Odontol Scand 2016; 74:337-42. [PMID: 26881919 DOI: 10.3109/00016357.2015.1136678] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective Osteoarthritis (OA) of the temporomandibular joint (TMJ) is generally thought to be an age-related disease like those of other joints. This study aims to investigate the incidence of computed tomographic (CT) OA changes in Korean temporomandibular disorder (TMD) patients diagnosed by the Research Diagnostic Criteria for TMD (RDC/TMD). Materials and methods The clinical records and radiographs of 1038 TMD patients (297 men and 741 women with mean age 31.1 ± 17.4 and 34.0 ± 16.2, respectively) diagnosed based on RDC/TMD Axis I in 2010 were reviewed. Results The incidence rate of OA changes in TMD patients is estimated to 27.3%, and higher in women than in men (15.5% in men and 32.0% in women) by 2.3 odds (p < 0.001). It has no correlation with age, showing an almost flat incidence rate throughout the age from the 2nd decade and has no correlation as well with pain or disc displacement diagnosed according to RDC/TMD, while arthrosis/arthritis diagnosis based on RDC/TMD supplemented by plain radiographs shows high risk of OA changes on CT by 38.8 odds (p < 0.05). Conclusions These results imply that the OA changes in young Korean TMD patients are as common as in the old and have no correlation with clinical pain and noise. Considered with high prevalence of TMDs known in the young population, the overall/absolute OA changes in the TMJ can be even higher in the young than in the old population, not like in other joints.
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Affiliation(s)
- Kilyong Kim
- Department of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University, Daehak-Ro 101, Jongno-Gu, Seoul, 110-744, Korea (ROK)
| | - Aleksandra Wojczyńska
- Clinic of Masticatory Disorders, Removable Prosthodontics, Geriatric and Special Care Dentistry, Center of Dental Medicine, University of Zürich, Plattenstrasse 11, CH-8032, Switzerland
| | - Jeong-Yun Lee
- Department of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University, Daehak-Ro 101, Jongno-Gu, Seoul, 110-744, Korea (ROK)
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Zhang C, Wang P, Jiang P, Lv Y, Dong C, Dai X, Tan L, Wang Z. Upregulation of lncRNA HOTAIR contributes to IL-1β-induced MMP overexpression and chondrocytes apoptosis in temporomandibular joint osteoarthritis. Gene 2016; 586:248-53. [PMID: 27063559 DOI: 10.1016/j.gene.2016.04.016] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 02/21/2016] [Accepted: 04/05/2016] [Indexed: 12/22/2022]
Abstract
Temporomandibular joint osteoarthritis (TMJ OA) is a common and heterogeneous disease that causes painful and progressive joint degeneration, which restricts daily activities, including talking and chewing. Long noncoding RNAs (lncRNAs) are an important class of genes involved in various physiological and pathological functions, including osteoarthritis (OA).The present study aimed to identify the lncRNAs that are important in TMJ OA and their potential functions. Here, we found that HOTAIR was significantly upregulated in the synovial fluid of TMJ OA patients compared with that of normal controls. Increased HOTAIR was similarly observed in the synovial fluid of TMJ OA rabbits as compared to control rabbits. Furthermore, in interleukin-1β (IL-1β)-induced TMJ OA in vitro model (primary rabbit condylar chondrocytes), the expressions of matrix metalloproteinase (MMP)-1, MMP3, MMP9 and HOTAIR were all dramatically increased. Most importantly, knockdown of HOTAIR in IL-1β-induced TMJ OA in vitro model could not only reverse the IL-1β-stimulated expressions of MMP1, MMP3 and MMP9, but also significantly decrease the apoptosis rate induced by IL-1β in primary rabbit condylar chondrocytes. Our data provides new insight into the mechanisms of chondrocytes destruction in TMJ OA.
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Affiliation(s)
- Chunping Zhang
- Department of Stomatology, Yantai Yuhuangding Hospital, China
| | - Peng Wang
- Department of Stomatology, Dental Hospital of Yantai City, China
| | - Pengfei Jiang
- Department of Medical Service, Yantai Yuhuangding Hospital, China
| | - Yongbin Lv
- Department of Radiology, Yantai Yuhuangding Hospital, China
| | - Changxia Dong
- Department of Ophthalmology, Yantai Yuhuangding Hospital, China
| | - Xiuyu Dai
- Department of Ophthalmology, Yantai Yuhuangding Hospital, China
| | - Lixia Tan
- Department of Ophthalmology, Yantai Yuhuangding Hospital, China
| | - Zhenlin Wang
- Department of Stomatology, Yantai Yuhuangding Hospital, China.
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Zhu M, Zhou S, Huang Z, Wen J, Li H. Ca2+-Dependent Endoplasmic Reticulum Stress Regulates Mechanical Stress-Mediated Cartilage Thinning. J Dent Res 2016; 95:889-96. [PMID: 27053115 DOI: 10.1177/0022034516640206] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Our previous study identified that endoplasmic reticulum stress (ERS) plays a critical role in chondrocyte apoptosis and mandibular cartilage thinning in response to compressive mechanical force, although the underlying mechanisms remain elusive. Because the endoplasmic reticulum (ER) is a primary site of intracellular Ca(2+) storage, we hypothesized that Ca(2+)-dependent ERS might be involved in mechanical stress-mediated mandibular cartilage thinning. In this study, we used in vitro and in vivo models to determine Ca(2+) concentrations, histological changes, subcellular changes, apoptosis, and the expression of ERS markers in mandibular cartilage and chondrocytes. The results showed that in chondrocytes, cytosolic Ca(2+) ([Ca(2+)]i) was dramatically increased by compressive mechanical force. Interestingly, the inhibition of Ca(2+) channels by ryanodine and 2-aminoethoxydiphenyl borate, inhibitors of ryanodine receptors and inositol trisphosphate receptors, respectively, partially rescued mechanical force-mediated mandibular cartilage thinning. Furthermore, chondrocyte apoptosis was also compromised by inhibiting the increase in [Ca(2+)]i that occurred in response to compressive mechanical force. Mechanistically, the ERS induced by compressive mechanical force was also repressed by [Ca(2+)]i inhibition, as demonstrated by a decrease in the expression of the ER stress markers 78 kDa glucose-regulated protein (GRP78) and 94 kDa glucose-regulated protein (GRP94) at both the mRNA and protein levels. Collectively, these data identified [Ca(2+)]i as a critical mediator of the pathological changes that occur in mandibular cartilage under compressive mechanical force and shed light on the treatment of mechanical stress-mediated cartilage degradation.
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Affiliation(s)
- M Zhu
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - S Zhou
- Department of Stomatology, Central Hospital of Taian, Taian, China
| | - Z Huang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - J Wen
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - H Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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38
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Matuska AM, Muller S, Dolwick MF, McFetridge PS. Biomechanical and biochemical outcomes of porcine temporomandibular joint disc deformation. Arch Oral Biol 2016; 64:72-9. [PMID: 26774186 DOI: 10.1016/j.archoralbio.2016.01.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 11/24/2015] [Accepted: 01/06/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The structure-function relationship in the healthy temporomandibular joint (TMJ) disc has been well established, however the changes in dysfunctional joints has yet to be systematically evaluated. Due to the poor understanding of the etiology of temporomandibular disorders (TMDs) this study evaluated naturally occurring degenerative remodeling in aged female porcine temporomandibular joint (TMJ) discs in order to gain insight into the progression and effects on possible treatment strategies of TMDs. DESIGN Surface and regional biomechanical and biochemical properties of discal tissues were determined in grossly deformed (≥Wilkes Stage 3) and morphologically normal (≤Wilkes Stage 2) TMJ discs. RESULTS Compared to normal disc structure the deformed discs lacked a smooth biconcave shape and characteristic ECM organization. Reduction in tensile biomechanical integrity and increased compressive stiffness and cellularity was found in deformed discs. Regionally, the posterior and intermediate zones of the disc were most frequently affected along with the inferior surface. CONCLUSIONS The frequency of degeneration observed on the inferior surface of the disc (predominantly posterior), suggests that a disruption in the disc-condyle relationship likely contributes to the progression of joint dysfunction more than the temporodiscal relationship. As such, the inferior joint space may be an important consideration in early clinical diagnosis and treatment of TMDs, as it is overlooked in techniques performed in the upper joint space, including arthroscopy and arthrocentesis. Furthermore, permanent damage to the disc mechanical properties would limit the ability to successfully reposition deformed discs, highlighting the importance of emerging therapies such as tissue engineering.
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Affiliation(s)
- Andrea M Matuska
- J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, United States
| | - Stephen Muller
- J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, United States
| | - M Franklin Dolwick
- Department of Oral and Maxillofacial Surgery, University of Florida, United States
| | - Peter S McFetridge
- J Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, United States.
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Abstract
TMDs are a group of conditions affecting the joint and or the muscles of mastication.TMDs consist of three main groups of conditions: myofascial pain; disc disorders; TMJ arthritides.The gold standard diagnostic criteria for research involving TMDs are the Research Diagnostic Criteria for TMDs (RDC/TMD). A pragmatic clinically applicable alternative is the Clinical examination protocol for TMDs (CEP-TMD).Signs and symptoms can include: pain in masticatory musculature and or the joint; noises associated with joint movements; locking; headache; otalgia.TMDs' aetiology is multifactorial and biopsychosocial in nature.Reversible conservative management as defined by the American Association of Dental Research is the initial management of choice for all subgroups of TMDs.
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Affiliation(s)
- J Durham
- NIHR Academic Clinical Lecturer in Oral Surgery
| | - R W Wassell
- Senior Lecturer/Hon Consultant in Restorative Dentistry School of Dental Sciences, Newcastle University. United Kingdom
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Da Costa FF, Santos GSMQ, Farias-Neto A, Sanchez-Ayala A, Rizzatti-Barbosa CM. The relationship between occlusal support and maxillary development: An animal study. Eur J Dent 2015; 9:400-403. [PMID: 26430370 PMCID: PMC4569993 DOI: 10.4103/1305-7456.163230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: To test the hypothesis that maxillary development may be affected by occlusal support. Materials and Methods: The sample was composed by Wistar rats (5 weeks old) divided into three groups: Control (n = 10), extraction of mandibular molar teeth – left side (n = 10), extraction mandibular molar teeth – left and right sides (n = 10). The rats were sacrificed 8 weeks postextraction. Cone beam computed tomography scan images were taken for posterior measurement of maxillary length and width. Data were analyzed by one-way analysis of variance (Tukey test as post-hoc test). Results: Maxillary length was significantly shorter (P < 0.005) in both groups after tooth extraction. No difference was observed regarding maxillary width and body weight. Conclusion: Reduced occlusal support may impair the development of the maxilla in rats.
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Affiliation(s)
- Fabricio F Da Costa
- Department of Dentistry, Health School, Potiguar University - Laureate International Universities, Natal, RN, Brazil
| | - Gabriela S M Q Santos
- Department of Dentistry, Health School, Potiguar University - Laureate International Universities, Natal, RN, Brazil
| | - Arcelino Farias-Neto
- Department of Dentistry, Health School, Potiguar University - Laureate International Universities, Natal, RN, Brazil
| | - Alfonso Sanchez-Ayala
- Department of Dentistry, Ponta Grossa State University, School of Dentistry, Ponta Grossa, Paraná, Brazil
| | - Célia M Rizzatti-Barbosa
- Department of Dentistry, Piracicaba Dental School, Campinas State University, Piracicaba, São Paulo, Brazil
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41
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Asakawa-Tanne Y, Su S, Kunimatsu R, Hirose N, Mitsuyoshi T, Okamoto Y, Tanaka E, Tanne K, Tanimoto K. Effects of enzymatic degradation after loading in temporomandibular joint. J Dent Res 2015; 94:337-343. [PMID: 25503611 PMCID: PMC4438732 DOI: 10.1177/0022034514560588] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
Synovial fluid of the joint decreases friction between the cartilage surfaces and reduces cartilage wear during articulation. Characteristic changes of synovial fluid have been shown in patients with osteoarthritis (OA) in the temporomandibular joint (TMJ). OA is generally considered to be induced by excessive mechanical stress. However, whether the changes in synovial fluid precede the mechanical overloading or vice versa remains unclear. In the present study, our purpose was to examine if the breakdown of joint lubrication affects the frictional properties of mandibular condylar cartilage and leads to subsequent degenerative changes in TMJ. We measured the frictional coefficient in porcine TMJ by a pendulum device after digestion with hyaluronidase (HAase) or trypsin. Gene expressions of interleukin-1β (IL-1β), cyclooxygenase-2 (COX-2), matrix metalloproteinases (MMPs), type II collagen, and histology were examined after prolonged cyclic loading by an active pendulum system. The results showed that the frictional coefficient increased significantly after HAase (35%) or trypsin (74%) treatment. Gene expression of IL-1β, COX-2, and MMPs-1, -3, and -9 increased significantly in enzyme-treated TMJs after cyclic loading. The increase in the trypsin-treated group was greater than that in the HAase-treated group. Type II collagen expression was reduced in both enzyme-treated groups. Histology revealed surface fibrillation and increased MMP-1 in the trypsin-treated group, as well as increased IL-1β in both enzyme-treated groups after cyclic loading. The findings demonstrated that the compromised lubrication in TMJ is associated with altered frictional properties and surface wear of condylar cartilage, accompanied by release of pro-inflammatory and matrix degradation mediators under mechanical loading.
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Affiliation(s)
- Y Asakawa-Tanne
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Minami-ku, Hiroshima, Japan
| | - S Su
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Minami-ku, Hiroshima, Japan
| | - R Kunimatsu
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Minami-ku, Hiroshima, Japan
| | - N Hirose
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Minami-ku, Hiroshima, Japan
| | - T Mitsuyoshi
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Minami-ku, Hiroshima, Japan
| | - Y Okamoto
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Minami-ku, Hiroshima, Japan
| | - E Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramoto-cho, Tokushima, Japan
| | - K Tanne
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Minami-ku, Hiroshima, Japan
| | - K Tanimoto
- Department of Orthodontics, Applied Life Sciences, Hiroshima University Institute of Biomedical & Health Sciences, Minami-ku, Hiroshima, Japan
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Mahmood NMA. Relationship between Serum Levels of Some Trace Elements, Disease Duration and Severity in Patients with Knee Osteoarthritis. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/pp.2015.611051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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43
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Vos L, Huddleston Slater J, Stegenga B. Arthrocentesis as initial treatment for temporomandibular joint arthropathy: A randomized controlled trial. J Craniomaxillofac Surg 2014; 42:e134-9. [DOI: 10.1016/j.jcms.2013.07.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 05/08/2013] [Accepted: 07/17/2013] [Indexed: 10/26/2022] Open
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44
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Bredell M, Grätz K, Obwegeser J, Gujer AK. Management of the temporomandibular joint after ablative surgery. Craniomaxillofac Trauma Reconstr 2014; 7:271-9. [PMID: 25379124 DOI: 10.1055/s-0034-1378181] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Accepted: 10/27/2013] [Indexed: 10/25/2022] Open
Abstract
Management of the temporomandibular joint in ablative head and neck surgery is controversial with no standardized approach. The aim of the study was to establish risk-based guidelines for the management of the temporomandibular joint after ablative surgery. Analysis of all patients' records receiving ablative surgery involving the temporomandibular joint in the Department of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zürich, from 2001 to 2012, was performed, identifying 15 patients and 14 reconstructive procedures. A literature search was done identifying all relevant literature on current approaches. Applicable cohorts were constructed, and relevant risks were extrapolated. Evaluated studies are not uniform in their reporting with nonhomogeneous patient groups. A diverse approach is used in the management of these patients with complications such as infection, ankylosis, limited mouth opening, plate penetration in the skull base, and plate loosening. Risk factors for complications appear to be radiation, costochondral graft, disk loss, and plate use alone. Clinical data suggest use of a plate with metal condyle reconstructions and previous radiation therapy as potential risks factors. Employing literature evidence and cumulated clinical data, a risk-based flowchart was developed to assist surgical decision making. Risk factors such as radiation, disk preservation, and soft tissue conditions are important complication-associated factors when planning surgery. Free vascularized fibula grafts appear to have the least complications that must be weighed against donor site morbidity.
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Affiliation(s)
- Marius Bredell
- Department of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zürich, Zürich, Switzerland
| | - Klaus Grätz
- Department of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zürich, Zürich, Switzerland
| | - Joachim Obwegeser
- Department of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zürich, Zürich, Switzerland
| | - Astrid Kruse Gujer
- Department of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zürich, Zürich, Switzerland
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Effect of Platelet-Rich Plasma on Fibrocartilage, Cartilage, and Bone Repair in Temporomandibular Joint. J Oral Maxillofac Surg 2014; 72:277-84. [DOI: 10.1016/j.joms.2013.09.011] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 08/29/2013] [Accepted: 09/07/2013] [Indexed: 11/22/2022]
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Ishizuka Y, Shibukawa Y, Nagayama M, Decker R, Kinumatsu T, Saito A, Pacifici M, Koyama E. TMJ degeneration in SAMP8 mice is accompanied by deranged Ihh signaling. J Dent Res 2014; 93:281-7. [PMID: 24453178 DOI: 10.1177/0022034513519649] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The temporomandibular joint (TMJ) functions as a load-bearing diarthrodial joint during mastication, and its continuous use and stress can lead to degeneration over age. Using senescence-accelerated (SAMP8) mice that develop early osteoarthritis-like changes in synovial joints at high frequency, we analyzed possible molecular mechanisms of TMJ degeneration and tested whether and how malocclusion may accelerate it. Condylar articular cartilage in young SAMP8 mice displayed early-onset osteoarthritic changes that included reductions in superficial/chondroprogenitor cell number, proteoglycan/collagen content, and Indian hedgehog (Ihh)-expressing chondrocytes. Following malocclusion induced by tooth milling, the SAMP8 condyles became morphologically defective, displayed even lower proteoglycan levels, and underwent abnormal chondrocyte maturation compared with malocclusion-treated condyles in wild-type mice. Malocclusion also induced faster progression of pathologic changes with increasing age in SAMP8 condyles as indicated by decreased PCNA-positive proliferating chondroprogenitors and increased TUNEL-positive apoptotic cells. These changes were accompanied by steeper reductions in Ihh signaling and by expression of matrix metalloproteinase 13 at the chondro-osseous junction in SAMP8 articular cartilage. In sum, we show for the first time that precocious TMJ degeneration in SAMP8 mice is accompanied by--and possibly attributable to--altered Ihh signaling and that occlusal dysfunction accelerates progression toward degenerative TMJ disease in this model.
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Affiliation(s)
- Y Ishizuka
- Department of Periodontology, Tokyo Dental College, Tokyo, Japan
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Al-Baghdadi M, Durham J, Steele J. Timing interventions in relation to temporomandibular joint closed lock duration: a systematic review of 'locking duration'. J Oral Rehabil 2014; 41:24-58. [PMID: 24393132 DOI: 10.1111/joor.12126] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2013] [Indexed: 11/30/2022]
Abstract
Temporomandibular joint (TMJ) 'closed lock' (CL) is a clinical condition causing TMJ pain and limited mouth opening (painful locking) that is mostly attributed to disc displacement without reduction (DDwoR), or less commonly to anchored disc phenomenon (ADP). Both conditions are described clinically as CL that can be 'acute' or 'chronic' depending on the duration of locking. There is, however, no consensus about the duration of locking that defines the acute state and its effect on the success of interventions. This review paper, therefore, aims to provide: (i) a narrative review of the pathophysiological need for early intervention in DDwoR and the clinical implications of acute/chronic CL stages on the management pathway; (ii) a systematic review investigating the effects of locking duration on the success of interventions for CL management. Electronic and manual searches until mid-August 2013 were conducted for English-language studies of any design investigating the effects of non-surgical and surgical interventions for acute or chronic CL (DDwoR or ADP). A total of 626 records were identified, and 113 studies were included. Data extraction and quality assessment were completed for all included studies. Included studies were, however, heterogeneous and mostly of poor-quality leading to contradictory and inconsistent evidence on the effect of the duration of locking on treatment outcomes. Future high-quality trials investigating the effect of CL duration on treatment outcome are needed. At present, early intervention by 'unlock' mandibular manipulation seems to be the most practical and realistic approach that can be attempted first in every CL patient as an initial diagnostic/therapeutic approach.
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Affiliation(s)
- M Al-Baghdadi
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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