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Sample records for complejo articular temporomandibular

  1. Absence of the articular disc in the tasmanian devil temporomandibular joint.

    PubMed

    Hayashi, K; Sugisaki, M; Kino, K; Ishikawa, T; Sugisaki, M; Abe, S

    2013-12-01

    The articular disc of the temporomandibular joint is a constant structure in mammals. According to Parsons' report in 1900, however, it is absent in four animals: the armadillo, two kinds of monotremes and the Tasmanian devil. Thereafter, no research was performed to confirm this observation. The aim of this study was to determine by anatomical and histological examination whether the Tasmanian devil has an articular disc in its temporomandibular joint. Six fresh frozen corpses and one dry skull of Tasmanian devils were obtained from the School of Zoology, University of Tasmania. The corpses were dissected and the morphology of the temporomandibular joint was carefully observed by gross anatomical and histological examination. The structure of the temporomandibular joint of the dry skull was examined macroscopically and by micro-computed tomography. In all cases, absence of the articular disc in the Tasmanian devil temporomandibular joint was morphologically confirmed. The surface layer of both the condyle and the glenoid fossa comprised a thick fibrous tissue. Micro-computed tomography revealed dense and fine trabecular bone in the condyle. The thick fibrous tissue covering the condyle and high-density trabecular bone in the condyle might play a role in absorption against powerful mastication and heavy loading of the Tasmanian devil temporomandibular joint. PMID:23438215

  2. The relationship between the temporomandibular joint capsule, articular disc and jaw muscles.

    PubMed Central

    Schmolke, C

    1994-01-01

    The anatomy of the temporomandibular joint capsule and its possible relationships to other structures near the joint are not fully understood. A 3-dimensional analysis based on sagittal, frontal and horizontal serial sections through the human temporomandibular joint region was therefore undertaken. Capsular elements which directly connect the temporal bone with the mandible were seen only on the lateral side of the joint. In the posterior, anterior and medial regions of the joint the upper and lower laminae of the articular disc are attached separately either to the temporal bone or to the mandibular condyle. The shaping of the articular cavities and the texture of the joint capsule permit movements of the articular disc predominantly in the anteromedial direction. On the entire medial side of the joint the articular disc and its capsular attachments are in close contact with the fascia of the lateral pterygoid muscle whereby a small portion of the upper head of this muscle inserts directly into the anteromedial part of the articular disc. Thus both the upper and the lower heads of the lateral pterygoid muscle are likely to influence the position of the articular disc directly during temporomandibular joint movements. Laterally, the articular disc is attached to the fascia of the masseter muscle, and part of the lateral ligament inserts into the temporalis fascia. Since these attachments are relatively weak, neither the temporalis nor the masseter muscles are considered to act directly on the articular disc; instead, via afferents from muscle spindles, they may take part in signalling the position of the temporomandibular joint components, including that of the articular disc. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:8014124

  3. Viscoelastic properties of the pig temporomandibular joint articular soft tissues of the condyle and disc.

    PubMed

    Kuboki, T; Shinoda, M; Orsini, M G; Yamashita, A

    1997-11-01

    It has been suggested that a sustained loading condition such as clenching could compress the temporomandibular joint (TMJ) articular soft tissues. However, there is still no clear understanding of how the TM joint articular tissues respond under compression. To answer this question, we performed in vitro indentation tests on fresh articular discs and cartilage-bone systems of the condyles of 10 Yorkshire pigs (aged 7 months) using a self-developed indentation tester. The indenter was 5 mm in diameter and was controlled by means of a computer-aided feedback mechanism. Bilateral condyles from the same mandible were uniformly prepared; one was used for measurements under sustained compression (SC) and the other for measurements under intermittent compression (IC). The displacements of the indenter induced by a SC of 10, 20, and 30 Newtons (N, units of force) for 10 min and by an IC, also of 10, 20, and 30 N, with one-second duration and two-second intervals for 10 min were measured by means of a displacement sensor with a resolution of 0.001 mm. From these data, the indentation curves of the articular discs and the cartilage-bone systems were calculated. Both the disc and the articular cartilage showed characteristic displacement vs. time curves-namely, an instantaneous deformation upon load application, followed by a time-dependent creep phase of asymptotically increasing deformation under constant load. However, the indentation curves of the two tissues were not identical: The deformation of the articular cartilage was dose-dependent, but that of the disc was not. Moreover, the articular cartilage deformed significantly less under IC than under SC. This difference was not found in the disc. It can be concluded that both the disc and the articular cartilage of the pig temporomandibular joint have viscoelastic properties against compression; however, the disc is stiffer than the articular cartilage. PMID:9372793

  4. Is Mandibular Fossa Morphology and Articular Eminence Inclination Associated with Temporomandibular Dysfunction?

    PubMed Central

    Paknahad, Maryam; Shahidi, Shoaleh; Akhlaghian, Marzieh; Abolvardi, Masoud

    2016-01-01

    Statement of the Problem Finding a significant relationship between temporomandibular joint (TMJ) morphology and the incidence of temporomandibular dysfunction (TMD) may help early prediction and prevention of these problems. Purpose The purpose of the present study was to determine the morphology of mandibular fossa and the articular eminence inclination in patients with TMD and in control group using cone beam computed tomography (CBCT). Materials and Method The CBCT data of bilateral TMJs of 40 patients with TMD and 23 symptom-free cases were evaluated. The articular eminence inclination, as well as the glenoid fossa depth and width of the mandibular fossa were measured. The paired t-test was used to compare these values between two groups. Results The articular eminence inclination and glenoid fossa width and depth were significantly higher in patients with TMD than in the control group (p < 0.05). Conclusion The articular eminence inclination was steeper in patients with TMD than in the control group. Glenoid fossa width and depth were higher in patients with TMD than that in the control group. This information may shed light on the relationship between TMJ morphology and the incidence of TMD. PMID:27284559

  5. Fracture of the articular disc in the temporomandibular joint: two case reports

    PubMed Central

    An, S-Y

    2015-01-01

    Disc fracture of the temporomandibular joint (TMJ) is a little-known pathological condition owing to its extreme rarity. We report two cases of elderly patients who were diagnosed with disc fracture of the TMJ based on MRI, and we review related reports. On physical examination, an incomplete bite and mild joint pain were observed on the affected side in both patients. An MRI showed a complete fracture in the intermediate zone of the articular disc in the TMJ; the posterior fragment was displaced posteriorly, causing occlusal change in the closed position of the condyle and an incomplete bite. Conservative treatment including manual manipulation, physical therapy and oral appliance had no effect on the occlusal abnormality. Although the inciting cause of the disc fracture remained unclear, the degenerative changes in the joint may have been a factor by increasing the brittleness and reducing the elasticity of the disc. PMID:25308829

  6. Temporomandibular Joint Condylar Changes Following Maxillomandibular Advancement and Articular Disc Repositioning

    PubMed Central

    Goncalves, Joao Roberto; Wolford, Larry Miller; Cassano, Daniel Serra; da Porciuncula, Guilherme; Paniagua, Beatriz; Cevidanes, Lucia Helena

    2014-01-01

    Purpose To evaluate condylar changes 1 year after bimaxillary surgical advancement with or without articular disc repositioning using longitudinal quantitative measurements in 3-dimensional (3D) temporomandibular joint (TMJ) models. Methods Twenty-seven patients treated with maxillomandibular advancement (MMA) underwent cone-beam computed tomography before surgery immediately after surgery and at 1-year follow-up. All patients underwent magnetic resonance imaging before surgery to assess disc displacements. Ten patients without disc displacement received MMA only. Seventeen patients with articular disc displacement received MMA with simultaneous TMJ disc repositioning (MMA-Drep). Pre- and postsurgical 3D models were superimposed using a voxel-based registration on the cranial base. Results The location, direction, and magnitude of condylar changes were displayed and quantified by graphic semitransparent overlays and 3D color-coded surface distance maps. Rotational condylar displacements were similar in the 2 groups. Immediately after surgery, condylar translational displacements of at least 1.5 mm occurred in a posterior, superior, or mediolateral direction in patients treated with MMA, whereas patients treated with MMA-Drep presented more marked anterior, inferior, and mediolateral condylar displacements. One year after surgery, more than half the patients in the 2 groups presented condylar resorptive changes of at least 1.5 mm. Patients treated with MMA-Drep presented condylar bone apposition of at least 1.5 mm at the superior surface in 26.4%, the anterior surface in 23.4%, the posterior surface in 29.4%, the medial surface in 5.9%, or the lateral surface in 38.2%, whereas bone apposition was not observed in patients treated with MMA. Conclusions One year after surgery, condylar resorptive changes greater than 1.5 mm were observed in the 2 groups. Articular disc repositioning facilitated bone apposition in localized condylar regions in patients treated with MMA

  7. Relationship of articular soft tissue contour and shape to the underlying eminence and slope profile in young adult temporomandibular joints.

    PubMed

    Pullinger, A G; Bibb, C A; Ding, X; Baldioceda, F

    1993-11-01

    This study examined whether the overall shape of the articular soft tissue overlying the posterior slope and articular eminence of the temporal bone could be predicted by the underlying osseous contour in a histologic model of 51 central sagittal sections of young adult temporomandibular joints. Articular soft tissue and bone contours were traced, and osseous landmarks identified on the basis of joint geometry. Soft tissue thickness measurements were made under low power light microscopy. Seven categories of articular soft tissue pattern were identified. The soft tissue uniformly followed the osseous contour in only one (14%). A progressive increase in soft tissue thickness from the middle of the posterior slope to the articular crest was the most common pattern (35%) but did not describe most of the sample that was more asymmetric. Pattern was poorly predicted by the shape and slope of the temporal bone outline or by dental factors that describe anterior guidance and did not relate to disk displacement. The articular soft tissue compensated for flatter eminence slopes and osseous irregularities and maintained an intact surface. This study has clinical implications for radiographic interpretation of disk space, condyle translation pathways, and the integrity of the functional articular surface. PMID:8247507

  8. Evaluation of Pain Regression in Patients with Temporomandibular Dysfunction Treated by Intra-Articular Platelet-Rich Plasma Injections: A Preliminary Report

    PubMed Central

    Pihut, M.; Szuta, M.; Ferendiuk, E.; Zeńczak-Więckiewicz, D.

    2014-01-01

    Objective. The objective of this study was to evaluate the regression of temporomandibular pain as a result of intra-articular injections of platelet-rich plasma (PRP) to patients with temporomandibular joint dysfunction previously subjected to prosthetic treatment. Materials and Methods. The baseline study material consisted of 10 patients, both males and females, aged 28 to 53 years, previously treated due to painful temporomandibular joint dysfunction using occlusal splints. All patients were carried out to a specialist functional assessment of the dysfunction using the Polish version of the RDC/TMD questionnaire axis I and II. Intra-articular injections were preceded by a preparation of PRP. The injection sites were determined by the method used during arthroscopic surgical procedures. Following aspiration, 0.5 mL of plasma was injected into each temporomandibular joint. Results. The comparison of the intensity of pain during all examinations suggests a beneficial effect of the procedure being performed as the mean VAS score was 6.5 at examination I, 2.8 at examination II, and 0.6 at examination III. Conclusion. Application of the intra-articular injections of platelet-rich plasma into the temporomandibular joints has a positive impact on the reduction of the intensity of pain experienced by patients treated for temporomandibular joint dysfunction. PMID:25157351

  9. Primary intra- and juxta-articular vascular malformations of the temporomandibular joint: a clinical analysis of 8 consecutive patients

    PubMed Central

    Zhou, Qin; Yang, Chi; Chen, Min-Jie; Qiu, Ya-Ting; Qiu, Wei-Liu; Zheng, Jia-Wei

    2015-01-01

    Objective: To analyze primary intra- and juxta-articular vascular malformations of the temporomandibular joint. Patients and methods: This study retrospectively reviewed eight patients (seven venous malformations and one lymphatico-venous malformation) who were treated for intra- or juxta-articular vascular malformations of the temporomandibular joint from November 2005 to January 2011. All patients underwent magnetic resonance imaging (MRI) preoperatively. Results: According to MRI findings, vascular malformations involving TMJ could be divided into 3 types; homogenous, lacunar and mixed types. All patients underwent surgical resection, and the final clinical diagnoses were confirmed by postoperative histopathology and immunohistochemical examinations. All treated patients had no clinical or radiographic signs of recurrence. Conclusion: Owing to the lower incidence and nonspecific clinical presentations, preoperative diagnosis of vascular malformations involving the TMJ region is very difficult. The classification based on MRI manifestations is proposed first, then it may greatly help in the initial diagnosis. Surgical resection is considered the first option for these TMJ lesions with excellent results. PMID:25932158

  10. Effects of mandibular advancement surgery on the temporomandibular joint and muscular and articular adaptive changes-a systematic review.

    PubMed

    Bermell-Baviera, A; Bellot-Arcís, C; Montiel-Company, J M; Almerich-Silla, J M

    2016-05-01

    The objective of this study was to assess the anatomical changes to the condyle and articular disc following mandibular advancement surgery, the adaptation of the masticatory muscles, and the improvement or worsening of temporomandibular disorders (TMD) in patients with pre-existing disorders and those who developed them following surgery. Four databases were searched systematically: PubMed, Scopus, Embase, and Cochrane Library. Of the 544 articles initially selected, 219 were duplicates and a further 165 were excluded on the basis of their titles and abstracts. On reading the full text, 89 were excluded because they were of no interest and 43 because they did not meet the inclusion criteria. Of the remaining 28 articles, six were excluded because they were considered of low quality and 22 articles were reviewed. Mandibular advancement surgery with condyle repositioning is associated with less TMD. Condylar resorption is a physiological process with a multifactorial aetiology. It is accelerated following mandibular advancement surgery but is not a contraindication to this procedure. Despite the large number of studies on the effects of mandibular advancement surgery on the temporomandibular joint (TMJ), this surgery can neither be said to improve nor to worsen TMJ health. PMID:26644217

  11. Ultrastructure of the articular surface of the condyle in temporomandibular arthropathy.

    PubMed

    Toller, P A; Wilcox, J H

    1978-02-01

    The ultrastructure of the surface of normal human mandibular condyles is described and compared with specimens from condyles in cases of degenerative joint disease (arthropathy). Normal surfaces exhibited a nearly structurless layer about 2 microns thick, which seemed to correspond with the lamina splendens of other joints. The underlying structure of dense interlacing bundles of collagen is described. Surfaces of all pathologic condyles showed loss of lamina splendens, alteration of collagen size, and evidence of dissociation of both the collagen and its surrounding ground substance. Deeper levels showed aggregations of bizarre structures, which the authors term "vermiform bodies," and which appear to be collections of abnormal amounts and types of elastic tissue. Its distribution suggests a stress elastosis, which may contribute to the loss of mechanical integrity of articular surfaces in arthropathy. The surface changes may be reflected at the clinical level as impairment of the normal low-friction qualities of joint components associated with limitation of movement and joint sounds. PMID:272604

  12. Diagnostic accuracy of fat-saturated T2-weighted magnetic resonance imaging in the diagnosis of perforation of the articular disc of the temporomandibular joint.

    PubMed

    Yura, Shinya; Nobata, Koji; Shima, Tsuyoshi

    2012-06-01

    The accuracy of diagnosing a perforation of the articular disc of the temporomandibular joint (TMJ) is poor with conventional magnetic resonance imaging (MRI). We recently reported that a high signal-intensity area is usually found on fat-saturated T2-weighted MRI in the joint space between the articular disc and cartilage surface in joints in which the disc is displaced. A discrete image with an area of high signal-intensity in the middle of the articular disc may indicate perforation or rupture. The purpose of this study was to compare the accuracy of diagnosis of a perforated articular disc by fat-saturated T2-weighted MRI with that of arthroscopy. We studied 50 joints in 50 patients with closed lock of the TMJ who were examined with MRI and then by arthroscopy using an ultra-thin arthroscope. The agreement between the two methods of diagnosis was assessed using the κ coefficient. Evidence of perforation of the disc on MRI and arthroscopically was found in the same 7 joints; there was complete concordance (κ=1.00, p<0.001). The accuracy of diagnosis of perforation of a disc by fat-saturated MRI was therefore the same as that by arthroscopy using an ultra-thin arthroscope. PMID:21723011

  13. Comparative study in patients with symptomatic internal derangements of the temporomandibular joint: analgesic outcomes of arthrocentesis with or without intra-articular morphine and tramadol.

    PubMed

    Sipahi, A; Satilmis, T; Basa, S

    2015-04-01

    Our aim was to find out whether pain was better controlled if morphine or tramadol was injected intra-articularly after arthrocentesis with Ringer's lactate in patients with painful temporomandibular joints (TMJ). This placebo-controlled, double-blind study involved 30 patients who had not responded to conservative treatment and who were divided randomly into 3 groups of 10 patients each. All patients had arthrocentesis, and the drugs were given as intra-articular injections immediately after the procedure. One group was give 5% Ringer's lactate 1ml, the second morphine 1mg, and the third tramadol 50mg. Visual analogue scales (VAS) for pain were recorded at maximum mouth opening and at rest before intra-articular injection and after 15 and 30min; at 1, 2, 3, 8, 12, 24, 36 and 48h; and at 1, 3, and 6 monthly follow-up. The mean (SD) VAS decreased from 6.90 (1.45) to 2.6 (2.5) in the control group, from 7.30 (1.64) to 1.20 (0.79) in the morphine group (p=0.005), and from 7.10 (1.73) to 1.50 (1.78) in the tramadol group (p=0.005). We conclude that morphine given by intra-articular injection after arthrocentesis gives a significant, sustained (6 months) improvement in pain relief compared with simple arthrocentesis alone. The effect was similar with tramadol except that it was shorter lived. PMID:25623934

  14. Expression of lumican related to CD34 and VEGF in the articular disc of the human temporomandibular joint

    PubMed Central

    Kiga, N.; Tojyo, I.; Matsumoto, T.; Hiraishi, Y.; Shinohara, Y.; Fujita, S.

    2010-01-01

    Lumican belongs to the small leucine-rich repeat proteoglycan (SLRP) gene family and has been reported to exist in the cornea, intervertebral disc and tendon. Lumican plays a significant role in the assembly and regulation of collagen fibres. The human temporomandibular joint (TMJ) disc is made up of fibrocartilage with an extracellular matrix (ECM) composed of collagen and proteoglycans. The existence and behaviour of lumican have not been studied in the human TMJ disc. Therefore, we used immunohistochemical methods to detect lumican, CD34 and vascular endothelial growth factor (VEGF) and histochemical staining with toluidine blue in 13 human TMJ specimens (10 surgically removed and 3 obtained from autopsy). In both normal and deformed discs we observed staining with toluidine blue. We found that the area of metachromasia inside the deformed disc was uneven and expression of lumican was strong in the areas negative for metachromasia. Staining of VEGF and CD34 inside the deformed disc was seen. We confirmed the expression of lumican in the human TMJ disc and showed that a large number of fibroblast-like cells existed in the area of strong lumican expression. These new findings about the behaviour of lumican suggest that it may play a key role in the generation of a new collagen network by fibroblast-like cells. PMID:20819773

  15. Temporomandibular Joint, Closed

    MedlinePlus

    ... Oral Health > The Temporomandibular Joint, Closed The Temporomandibular Joint, Closed Main Content Title: The Temporomandibular Joint, Closed Description: The temporomandibular joint connects the lower ...

  16. Temporomandibular pain.

    PubMed

    Prasad, S Raghavendra; Kumar, N Ravi; Shruthi, H R; Kalavathi, S D

    2016-01-01

    Temporomandibular joint pain has various medical and dental etiological factors. The etiology of the temporomandibular joint pain is enigmatic, no single etiological factor is regarded as the cause. Its distribution is also not confined to a single area. This article presents the basic etiologic factors, its epidemiology, distribution of pain, classification of patients and the psychosocial behavior of patients suffering with temporomandibular pain. As overwhelming majority of medical and dental conditions/issues related to etiology of temporomandibular pain in patients have traditionally been presented and interpreted from the clinician's point of view. PMID:27601822

  17. Temporomandibular pain

    PubMed Central

    Prasad, S Raghavendra; Kumar, N Ravi; Shruthi, HR; Kalavathi, SD

    2016-01-01

    Temporomandibular joint pain has various medical and dental etiological factors. The etiology of the temporomandibular joint pain is enigmatic, no single etiological factor is regarded as the cause. Its distribution is also not confined to a single area. This article presents the basic etiologic factors, its epidemiology, distribution of pain, classification of patients and the psychosocial behavior of patients suffering with temporomandibular pain. As overwhelming majority of medical and dental conditions/issues related to etiology of temporomandibular pain in patients have traditionally been presented and interpreted from the clinician's point of view. PMID:27601822

  18. Epidemiology, diagnosis, and treatment of temporomandibular disorders.

    PubMed

    Liu, Frederick; Steinkeler, Andrew

    2013-07-01

    Temporomandibular disorder (TMD) is a multifactorial disease process caused by muscle hyperfunction or parafunction, traumatic injuries, hormonal influences, and articular changes. Symptoms of TMD include decreased mandibular range of motion, muscle and joint pain, joint crepitus, and functional limitation or deviation of jaw opening. Only after failure of noninvasive options should more invasive and nonreversible treatments be initiated. Treatment can be divided into noninvasive, minimally invasive, and invasive options. Temporomandibular joint replacement is reserved for severely damaged joints with end-stage disease that has failed all other more conservative treatment modalities. PMID:23809304

  19. Effects of several temporomandibular disorders on the stress distributions of temporomandibular joint: a finite element analysis.

    PubMed

    Liu, Zhan; Qian, Yingli; Zhang, Yuanli; Fan, Yubo

    2016-01-01

    The aim of this study was to evaluate stress distributions in the temporomandibular joints (TMJs) with temporomandibular disorders (TMDs) for comparison with healthy TMJs. A model of mandible and normal TMJs was developed according to CT images. The interfaces between the discs and the articular cartilages were treated as contact elements. Nonlinear cable elements were used to simulate disc attachments. Based on this model, seven models of various TMDs were established. The maximum stresses of the discs with anterior, posterior, medial and lateral disc displacement (ADD, PDD, MDD and LDD) were 12.09, 9.33, 10.71 and 6.07 times magnitude of the identically normal disc, respectively. The maximum stresses of the posterior articular eminences in ADD, PDD, MDD, LDD, relaxation of posterior attachments and disc perforation models were 21, 59, 46, 21, 13 and 15 times greater than the normal model, respectively. TMDs could cause increased stresses in the discs and posterior articular eminences. PMID:25587737

  20. Morphological characteristics of the temporomandibular joint in the pouch young of the Tasmanian devil.

    PubMed

    Hayashi, K; Sugisaki, M; Kino, K; Ishikawa, T; Kawashima, S; Amemiya, T

    2015-04-01

    We recently reported the absence of the articular disc, which is a constant structure in mammals, in the temporomandibular joint of the adult Tasmanian devil. However, whether the articular disc disappears with growth of the animal was unknown. The aim of this study was to determine whether a pouch young of the Tasmanian devil has the articular disc. The temporomandibular joint of a fresh carcass of the pouch young, whose crown-rump length was 43 mm, was examined microscopically and by microcomputed tomography. The absence of the articular disc in the pouch young temporomandibular joint was histologically confirmed. It is suggested that the articular disc of the Tasmanian devil is naturally absent. PMID:24809824

  1. Temporomandibular joint computed tomography: development of a direct sagittal technique

    SciTech Connect

    van der Kuijl, B.; Vencken, L.M.; de Bont, L.G.; Boering, G. )

    1990-12-01

    Radiology plays an important role in the diagnosis of temporomandibular disorders. Different techniques are used with computed tomography offering simultaneous imaging of bone and soft tissues. It is therefore suited for visualization of the articular disk and may be used in patients with suspected internal derangements and other disorders of the temporomandibular joint. Previous research suggests advantages to direct sagittal scanning, which requires special positioning of the patient and a sophisticated scanning technique. This study describes the development of a new technique of direct sagittal computed tomographic imaging of the temporomandibular joint using a specially designed patient table and internal light visor positioning. No structures other than the patient's head are involved in the imaging process, and misleading artifacts from the arm or the shoulder are eliminated. The use of the scanogram allows precise correction of the condylar axis and selection of exact slice level.

  2. Temporomandibular joint disorders' impact on pain, function, and disability.

    PubMed

    Chantaracherd, P; John, M T; Hodges, J S; Schiffman, E L

    2015-03-01

    The aim of this study was to determine the association between more advanced stages of temporomandibular joint (TMJ) intra-articular disorders ("TMJ intra-articular status"), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability ("TMD impact"). This cross-sectional study included 614 cases from the RDC/TMD Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intra-articular status was determined by 3 blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject's most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of 1) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), 2) jaw function (Jaw Functional Limitation Scale), and 3) disability (Disability Points from GCPS). A structural equation model estimated the association of TMJ intra-articular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (n = 614) and in cases with a TMD pain diagnosis (n = 500). The correlations between TMJ intra-articular status and TMD impact were 0.05 (95% confidence interval [CI], -0.04 to 0.13) for all TMD cases and 0.07 (95% CI, -0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conceptualizing worsening of TMJ intra-articular disorders as 4 stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intra-articular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored. PMID:25572112

  3. Temporomandibular Joint Dysfunction

    MedlinePlus

    The temporomandibular joint (TMJ) connects your jaw to the side of your head. When it works well, it enables you to ... For people with TMJ dysfunction, problems with the joint and muscles around it may cause Pain that ...

  4. Temporomandibular Joint Disorder

    MedlinePlus

    ... 2008 Previous Next Related Articles: Temporomandibular Joint Disorder (TMD) Are You Biting Off More Than You Can Chew? Equilibration May Lessen TMD Pain Fender-benders: Source of TMD? First Comes ...

  5. Temporomandibular joint diagnostics using CBCT

    PubMed Central

    Abrahamsson, A-K; Kristensen, M; Arvidsson, L Z

    2015-01-01

    The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost- and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome. PMID:25369205

  6. Temporomandibular joint involvement in ankylosing spondylitis

    PubMed Central

    Arora, Pallak; Amarnath, Janardhan; Ravindra, Setru Veerabhadrappa; Rallan, Mandeep

    2013-01-01

    Frequency of temporomandibular joint (TMJ) involvement in patients with ankylosing spondylitis (AS) has varied from 4% to 35%. It is more common in men and produces generalised stiffness in involved joints. Clinician should be suspicious of AS when a patient reports with painful restricted movements of joint, neck or back and with no trauma history. Conventional radiographic methods have allowed the demonstration of TMJ abnormalities in patients with AS, but CT is necessary to establish joint space relations and bony morphology. We describe a case of severe AS with TMJ involvement in a 40-year-old female patient and demonstrated TMJ changes on CT. A CT was able to demonstrate articular cartilage changes, disc- and joint abnormalities. Thus, if conventional radiographs in a symptomatic patient with rheumatic diseases are unable to demonstrate changes, CT can provide valuable additional information of the changes in the TMJ. PMID:23645650

  7. Imaging the temporomandibular joint

    SciTech Connect

    Katzberg, R.W.; Manzione, J.V.; Westesson, P.L.

    1988-01-01

    This book encompasses all imaging modalities as they apply to the Temporomandibular Joint and its disorders. The volume employs correlative line drawings to elaborate on diagnostic images. It helps teach methods of TMJ imaging and describes findings identified by different imaging modalities to both radiologists and dental clinicians.

  8. Septic arthritis of the temporomandibular joint: a case report.

    PubMed

    Yang, Sung-Won; Cho, Jin-Yong; Kim, Hyeon-Min

    2016-08-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature. PMID:27595091

  9. Septic arthritis of the temporomandibular joint: a case report

    PubMed Central

    2016-01-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature. PMID:27595091

  10. Fibrous Ankylosis of the Temporomandibular Joint in a Young Child.

    PubMed

    Figueiredo, Nigel R; Meena, Manoj; Dinkar, Ajit D; Khorate, Manisha M

    2015-01-01

    Temporomandibular joint (TMJ) ankylosis is an intracapsular union of the disccondyle complex to the temporal articular surface that restricts mandibular movements, including fibrous adhesions or bony fusion between the condyle, disc, glenoid fossa, and articular eminence. The leading causes include trauma and infection. It can be a serious and disabling condition that leads to difficulties in mastication, swallowing, speaking, esthetics and oral hygiene. Disturbances of facial and mandibular growth and acute compromise of the airway invariably result in physical and psychological disability. Treatment should be initiated as soon as the condition is recognized, with the main objective of re-establishing joint function and harmonious jaw function. The purpose of this report is to describe a case of unilateral fibrous ankylosis of the right TMJ in a three-year-old girl. PMID:26349799

  11. Clinical treatment of a ruptured temporomandibular joint disc: morphological changes at 5-year follow-up.

    PubMed

    Cardinal, Lucas; Porto, Felipe; Agarwal, Sachin; Grossman, Eduardo

    2014-01-01

    Osteoarthrosis is a disease that affects the temporomandibular joint (TMJ). This case report chronicles the diagnosis and treatment of a patient for whom this pathological condition was accompanied by a rupture of the articular disc. The patient presented with loud sounds in the left TMJ and an irregular mandibular occlusal plane due to condylar intrusion in the glenoid fossa on the ipsilateral side. A noninvasive treatment was selected. A 4-month follow-up revealed remission of the articular sounds, and tissue regeneration was noted. These improvements remained visible at 5-year follow-up. PMID:24598507

  12. Temporomandibular joint dislocation.

    PubMed

    Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal; Singh, Shreya

    2015-01-01

    Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation. PMID:26668447

  13. Temporomandibular joint dislocation

    PubMed Central

    Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal; Singh, Shreya

    2015-01-01

    Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation. PMID:26668447

  14. Stem Cells for Temporomandibular Joint Repair and Regeneration.

    PubMed

    Zhang, Shipin; Yap, Adrian U J; Toh, Wei Seong

    2015-10-01

    Temporomandibular Disorders (TMD) represent a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles and/or associated structures. They are a major cause of non-dental orofacial pain. As a group, they are often multi-factorial in nature and have no common etiology or biological explanations. TMD can be broadly divided into masticatory muscle and TMJ disorders. TMJ disorders are characterized by intra-articular positional and/or structural abnormalities. The most common type of TMJ disorders involves displacement of the TMJ articular disc that precedes progressive degenerative changes of the joint leading to osteoarthritis (OA). In the past decade, progress made in the development of stem cell-based therapies and tissue engineering have provided alternative methods to attenuate the disease symptoms and even replace the diseased tissue in the treatment of TMJ disorders. Resident mesenchymal stem cells (MSCs) have been isolated from the synovia of TMJ, suggesting an important role in the repair and regeneration of TMJ. The seminal discovery of pluripotent stem cells including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have provided promising cell sources for drug discovery, transplantation as well as for tissue engineering of TMJ condylar cartilage and disc. This review discusses the most recent advances in development of stem cell-based treatments for TMJ disorders through innovative approaches of cell-based therapeutics, tissue engineering and drug discovery. PMID:26123357

  15. Posttraumatic temporomandibular joint disorders.

    PubMed

    Giannakopoulos, Helen E; Quinn, Peter D; Granquist, Eric; Chou, Joli C

    2009-05-01

    The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding, and with opposing approaches. The following article explores various treatment options for problems presenting as a result of a history of trauma to the TMJ. PMID:22110802

  16. Temporomandibular disorders and headaches.

    PubMed

    Graff-Radford, Steven B; Bassiur, Jennifer P

    2014-05-01

    Headache and temporomandibular disorders should be treated together but separately. If there is marked limitation of opening, imaging of the joint may be necessary. The treatment should then include education regarding limiting jaw function, appliance therapy, instruction in jaw posture, and stretching exercises, as well as medications to reduce inflammation and relax the muscles. The use of physical therapies, such as spray and stretch and trigger point injections, is helpful if there is myofascial pain. Tricyclic antidepressants and the new-generation antiepileptic drugs are effective in muscle pain conditions. Arthrocentesis and/or arthroscopy may help to restore range of motion. PMID:24703543

  17. Temporomandibular Disorders and Headache.

    PubMed

    Graff-Radford, Steven B; Abbott, Jeremy J

    2016-08-01

    Temporomandibular disorders (TMD) and primary headaches can be perpetual and debilitating musculoskeletal and neurological disorders. The presence of both can affect up to one-sixth of the population at any one time. Initially, TMDs were thought to be predominantly musculoskeletal disorders, and migraine was thought to be solely a cerebrovascular disorder. The further understanding of their pathophysiology has helped to clarify their clinical presentation. This article focuses on the role of the trigeminal system in associating TMD and migraine. By discussing recent descriptions of prevalence, diagnosis, and treatment of headache and TMD, we will further elucidate this relationship. PMID:27475510

  18. Role of Articular Disc in Condylar Regeneration of the Mandible

    PubMed Central

    Hayashi, Hidetaka; Fujita, Tadashi; ShIrakura, Maya; Tsuka, Yuji; Fujii, Eri; Terao, Akiko; Tanimoto, Kotaro

    2014-01-01

    The articular disc in the temporomandibular joint plays an important role in mandibular growth. Functional appliances induce regeneration of the condyle even after condylectomy. The aim of this study was to examine the role of the articular disc in regeneration of the condyle after unilateral condylectomy with use of a functional appliance in growing rats. Fifty growing rats were subjected to unilateral condylectomy and then half of them underwent discectomy. The functional appliance was applied to half of the rats in each group to induce regeneration of the condyle. Four and eight weeks later, morphometric and histologic analyses of the mandible were performed. Regeneration of the condyle was demonstrated in the two condylectomy groups. In the condylectomy+appliance group, the shape and cartilage of the condyle were equivalent to a normal condyle. However, regeneration of the condyle was not observed in the two discectomy groups even with the use of the functional appliance. The articular disc appears to be crucial in the regeneration of a damaged condyle, suggesting that defects or damage to the articular disc may influence mandibular growth and regeneration or repair of the condyle. PMID:25030880

  19. Myofascial Temporomandibular Disorder.

    PubMed

    Fernandez-de-Las-Penas, César; Svensson, Peter

    2016-01-01

    Temporomandibular disorders (TMD) have been discussed for more than 70 years without reaching consensus on causes, etiological factors, pathophysiology, or rationale management. Indeed, TMD pain remains an enigma and a diagnostic and management challenge for many clinicians. Perhaps the many and often conflicting views on TMD pain by different health care providers are routed in professional traditions, personal beliefs, experience, and clinical training. This review aims to provide an updated and critical discussion on what is known and supported by scientific evidence about myofascial TMD pain and which gaps there still may be in our understanding of this condition. It has not been the intention to make a systematic review on all aspects of TMD but rather to point out some of the more recent (and important) pieces of information that may help us to better appreciate TMD pain as a complex and multifaceted pain disorder manifested in the craniofacial system. PMID:26717949

  20. Genetic Influences on Temporomandibular Joint Development and Growth.

    PubMed

    Hinton, Robert J; Jing, Junjun; Feng, Jian Q

    2015-01-01

    The temporomandibular joint (TMJ) is a small synovial joint at which the mandible articulates with the skull during movements involved in speaking and mastication. However, the secondary cartilage lining its joint surfaces is indicative of a very different developmental history than limb cartilages. This review summarizes our current knowledge of genes that regulate the formation of primary components of the TMJ, as well as genes that regulate postnatal growth of the TMJ. Although the TMJ is regulated by some of the same genes that are important in limb joints, others appear unique to the TMJ or have different actions. Runx2, Sox9, and members of the TGF-β/BMP family are critical drivers of chondrogenesis during condylar cartilage morphogenesis, and Indian hedgehog (Ihh) is important for formation of the articular disc and cavitation. Osterix (Osx) is a critical regulator of endochondral bone formation during postnatal TMJ growth. PMID:26589922

  1. Temporomandibular joints: high-resolution computed tomographic evaluation

    SciTech Connect

    Thompson, J.R.; Christiansen, E.; Hasso, A.N.; Hinshaw, D.B. Jr.

    1984-01-01

    High-resolution computed tomography of the temporomandibular joint (TMJ) was performed in 43 patients. Exquisite detail of the face, skull base, and TMJs was obtained with CT using soft tissue and bone algorithms, narrow collimation, and multiplanar images. In 10 patients clinically suspected of joint derangement, CT results were in close agreement with surgical findings and arthrography in 13/15 joints. CT showed indirect signs of disc dislocation, and the dislocated disc itself in 81% of affected joints. In two patients, arthrography with CT proved to be more helpful than conventional arthrography alone. CT without intra-articular contrast material provided information not appreciated on conventional radiogaphs in 28 patients (65%) and was particularly helpful in evaluating patients with disc pathosis and trauma. Early experience with CT of the TMJ shows that it is an excellent method of evaluation at acceptable radiation exposure levels that adds essential information not seen on standard radiographs.

  2. Imaging of Temporomandibular Joint: Approach by Direct Volume Rendering

    PubMed Central

    Caradonna, Carola; Bruschetta, Daniele; Vaccarino, Gianluigi; Milardi, Demetrio

    2014-01-01

    Background: The purpose of this study was to conduct a morphological analysis of the temporomandibular joint, a highly specialized synovial joint that permits movement and function of the mandible. Materials and Methods: We have studied the temporom-andibular joint anatomy, directly on the living, from 3D images obtained by medical imaging Computed Tomography and Nuclear Magnetic Resonance acquisition, and subsequent re-engineering techniques 3D Surface Rendering and Volume Rendering. Data were analysed with the goal of being able to isolate, identify and distinguish the anatomical structures of the joint, and get the largest possible number of information utilizing software for post-processing work. Results: It was possible to reproduce anatomy of the skeletal structures, as well as through acquisitions of Magnetic Resonance Imaging; it was also possible to visualize the vascular, muscular, ligamentous and tendinous components of the articular complex, and also the capsule and the fibrous cartilaginous disc. We managed the Surface Rendering and Volume Rendering, not only to obtain three-dimensional images for colour and for resolution comparable to the usual anatomical preparations, but also a considerable number of anatomical, minuter details, zooming, rotating and cutting the same images with linking, graduating the colour, transparency and opacity from time to time. Conclusion: These results are encouraging to stimulate further studies in other anatomical districts. PMID:25664280

  3. Early-onset osteoarthritis of mouse temporomandibular joint induced by partial discectomy

    PubMed Central

    Xu, L.; Polur, I.; Lim, C.; Servais, J. M.; Dobeck, J.; Li, Y.; Olsen, B. R.

    2010-01-01

    Summary Objective The objective of this study is to characterize mouse temporomandibular joint (TMJ) following partial discectomy, since there is no documentation of whether or not partial discectomy can induce early-onset osteoarthritis (OA) in mouse TMJ. Methods Partial discs of TMJ in mice were removed by microsurgery. Histology was performed to characterize articular cartilages from the TMJ of mice. The morphology of the articular cartilages was evaluated using a modified Mankin scoring system. Immunohistostaining was carried out to examine the expression of discoidin domain receptor 2 (Ddr2), a type II collagen receptor, matrix metalloproteinase 13 (Mmp-13), and Mmp-derived type II collagen fragments in the articular cartilage of condyles from the mouse TMJ. Results Articular cartilage degeneration was seen in the mouse TMJ post discectomy, including increased proteoglycan staining in the extracellular matrix at 4 weeks, the appearance of chondrocyte clusters at 8 weeks, reduced proteoglycan staining and fibrillation at 12 weeks and the loss of articular cartilage at 16 weeks. Increased immunostaining for Ddr2, Mmp-13, and Mmp-derived type II collagen fragments was detected. Conclusion Results indicate that partial discectomy induces early-onset OA in mouse TMJ and that increased expression of Mmp-13, likely due to the elevated expression of Ddr2, may be one of the factors responsible for the early-onset OA in mouse TMJ. PMID:19230720

  4. Human temporomandibular joint morphogenesis.

    PubMed

    Carini, Francesco; Scardina, Giuseppe Alessandro; Caradonna, Carola; Messina, Pietro; Valenza, Vincenzo

    2007-01-01

    Temporomandibular joint morphogenesis was studied. Ranging in age of fetuses examined was from 6 to14 weeks' gestation. Our results showed the condyle so first element that appear between 6 degrees and 8 degrees week (condylar blastema). After a week appear temporal elements. Disk appear at the same time of glenoid blastema and it reaches an advanced differentation before of the condyle and temporal element, so these don't effect machanical compression on mesenchyma where we find the disk. So we think that the disk result of genetic expression and it isn't the result of mechanical compression. The inferior joint cavity appear to 12 week. The superior joint cavity appear to 13-14 week. In conclusion, the appearance of the condyle is the first event during TMJ morphogenesis, with its initial bud, in form of a mesenchymal thickening, becoming detectable between the sixth and eight week of development, when all the large joints of the limbs are already well defined. PMID:18333411

  5. On the anatomy of the temporomandibular joint and the muscles that act upon it: observations on the gray whale, Eschrichtius robustus.

    PubMed

    El Adli, Joseph J; Deméré, Thomas A

    2015-04-01

    The temporomandibular joint and its associated musculature are described in a neonate gray whale (Eschrichtius robustus) and serve as the basis for direct anatomical comparisons with the temporomandibular region in other clades of baleen whales (Mysticeti). Members of the right whale/bowhead whale clade (Balaenidae) are known to possess a synovial lower jaw joint, while members of the rorqual clade (Balaenopteridae) have a nonsynovial temporomandibular joint characterized by a highly flexible fibrocartilaginous pad and no joint capsule. In contrast, the gray whale possesses a modified temporomandibular joint (intermediate condition), with a vestigial joint cavity lacking a fibrous capsule, synovial membrane, and articular disk. In addition, the presence of a rudimentary fibrocartilaginous pad appears to be homologous to that seen in balaenopterid mysticetes. The intrinsic temporomandibular musculature in the gray whale was found to include a multibellied superficial masseter and a single-bellied deep masseter. The digastric and internal pterygoid muscles in E. robustus are enlarged relative to the condition documented in species of Balaenoptera. A relatively complex insertion of the temporalis muscle on the dentary is documented in the gray whale and the low, knob-like process on the gray whale dentary is determined to be homologous with the prominent coronoid process of rorquals. Comparison with the anatomy of the temporomandibular musculature in rorquals reveals an increased importance of alpha rotation of the dentary in the gray whale. This difference in muscular morphology and lines of muscle action is interpreted as representing adaptations for suction feeding. PMID:25737135

  6. Pharmacologic Treatment for Temporomandibular Disorders.

    PubMed

    Dym, Harry; Bowler, Dustin; Zeidan, Joseph

    2016-04-01

    Pharmacologic agents play an integral role in the overall management of temporomandibular joint disorder. The general dentist should be familiar with the different classes of drugs currently in use for dealing with this often complex medical/dental problem. PMID:27040290

  7. Development of Synovial Membrane in the Temporomandibular Joint of the Human Fetus

    PubMed Central

    Tedesco, R.C.; Arraéz-Aybar, L.A.; Klein, O.; Mérida-Velasco, J.R.; Alonso, L.G.

    2015-01-01

    The development of the synovial membrane was analyzed in serial sections of 21 temporomandibular joints of human fetuses at 9 to 13 weeks of gestation. Sections of two fetuses at 12 weeks of development were used to perform immunohistochemical expression of the markers CD68 and Hsp27 on the synovial lining. Macrophage-like type A and fibroblast-like type B cells, which express CD68 and Hsp27, respectively, were observed at the twelfth week of development. Our results suggest that the development of the synovial membrane is related to the vascularization of the joint and the formation of the articular cavities. PMID:26708184

  8. Alterations of the Temporomandibular Joint on Magnetic Resonance Imaging according to Growth and Development in Schoolchildren

    PubMed Central

    Tanaka, Tatsurou; Konoo, Tetsuro; Habu, Manabu; Oda, Masafumi; Kito, Shinji; Kodama, Masaaki; Kokuryo, Shinya; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Nishida, Ikuko; Morikawa, Kazumasa; Saeki, Katsura; Maki, Kenshi; Tominaga, Kazuhiro; Masumi, Shin-ichi; Terashita, Masamichi; Morimoto, Yasuhiro

    2012-01-01

    The paper explains the alterations of the temporomandibular joint (TMJ) visualized by magnetic resonance imaging (MRI) according to the growth and development of schoolchildren. Appearance and disappearance of a “double contour-like structure” (DCLS) of the mandibular condyle on MRI according to the growth and development of schoolchildren were demonstrated. In addition, possible constituents of DCLS and the significance of detection of DCLS on MRI were also speculated. The relationship between red marrow and yellow marrow in the articular eminence of temporal bone, the disappearance of DCLS, and alterations of the mandibular condyle have been elucidated. PMID:23316233

  9. Inaudible temporomandibular joint vibrations.

    PubMed

    Widmalm, Sven E; Bae, Hanna E K; Djurdjanovic, Dragan; McKay, Duane C

    2006-07-01

    The aim was to test the hypothesis that inaudible vibrations with significant amounts of energy increasing during jaw movements can be recorded in the temporomandibular joint (TMJ) area. Twenty one subjects, who could perform wide opening movements without feeling discomfort, 12 with and 9 without TMJ sounds audible at conventional auscultation with a stethoscope, were included. Recordings were made during opening-closing, 2/s without tooth contact, and during mandibular rest, using accelerometers with a flat frequency response between the filter cutoff frequencies 0.1 Hz and 1000 Hz. The signals were digitized using a 24 bits card and sampled with the rate 96000 Hz. Power spectral analyses, and independent and paired samples t-tests were used in the analysis of the vibration power observed in frequency bands corresponding to audible and inaudible frequencies. An alpha-level of 5% was chosen for accepting a difference as being significant. In the group with audible sounds, about 47% of the total vibration energy was in the inaudible area below 20 Hz during opening-closing and about 76% during mandibular rest. In the group without audible sounds, the corresponding proportions were significantly different, 85% vs. 69%. The energy content of the vibrations, both those below and those above 20 Hz, increased significantly during jaw movement in both groups. Furthermore, percentage of signal energy above 20 Hz showed a noticeable increase in the group of subjects with audible sounds. This can physically be explained by decreased damping properties of damaged tissues surrounding the TMJ. Vibrations in the TMJ area can be observed with significant portions in the inaudible area below 20 Hz both during mandibular rest and during jaw movements whether or not the subjects have audible joint sounds. Further studies are needed to identify sources and evaluate possible diagnostic value. PMID:16933462

  10. Primary headaches interfere with the efficacy of temporomandibular disorders management

    PubMed Central

    PORPORATTI, André Luís; COSTA, Yuri Martins; CONTI, Paulo César Rodrigues; BONJARDIM, Leonardo Rigoldi; CALDERON, Patrícia dos Santos

    2015-01-01

    OBJECTIVES: This cross-sectional study aimed to evaluate the influence of Primary Headache (PH) on efficacy of a Temporomandibular Disorders (TMD) conservative therapy and its association with the presence of self-reported parafunctional habits. SAMPLE AND METHODS: Sample was composed of 400 medical records, divided into four groups: I) Muscular TMD (n=64); II) Muscular TMD+PH (n=48); III) Muscular TMD+Articular TMD (n=173); IV) Muscular TMD+Articular TMD+PH (n=115). All groups had undergone a TMD therapy for three months with a stabilization appliance and counseling for habits and behavioral changes, with no specific headache management. Current pain intensity and existence or not of self-reported bruxism were assessed. Repeated measures ANOVA and Chi-Square test followed by Odds were used for statistical analysis, with a significance level of 5%. RESULTS: results of this study showed that: (1) A conservative therapy with stabilization appliance and counseling for habits and behavioral changes was effective in the TMD pain relief; (2) Groups with an additional diagnosis of PH had worsened the pain improvement significantly; and (3) no association between the presence of self-reported bruxism and PH was found. CONCLUSIONS: this study could elucidate the important effect that headache may have on the TMD management. PMID:25004051

  11. Estrogen receptors in the temporomandibular joint of the baboon (Papio cynocephalus): an autoradiographic study

    SciTech Connect

    Aufdemorte, T.B.; Van Sickels, J.E.; Dolwick, M.F.; Sheridan, P.J.; Holt, G.R.; Aragon, S.B.; Gates, G.A.

    1986-04-01

    Using an autoradiographic method, the temporomandibular joint (TMJ) complex of five aged female baboons was studied for the presence of receptors for estradiol-17 beta. The study was performed in an effort to learn more of the pathophysiology of this joint and in an attempt to provide a scientific basis to explain the reported preponderance of women who seek and undergo treatment for signs and symptoms referable to the TMJ. This experiment revealed that the TMJ complex contains numerous cells with receptors for estrogen, particularly the articular surface of the condyle, articular disk, and capsule. Muscles of mastication contained relatively fewer receptors. As a result, one may postulate a role for the sex steroid hormones in the maintenance, repair, and/or pathogenesis of the TMJ. Additional studies are necessary to fully determine the significance of hormone receptors in this site and any correlation between diseases of the TMJ and the endocrine status of affected patients.

  12. Lubricin protects the temporomandibular joint surfaces from degeneration.

    PubMed

    Hill, Adele; Duran, Juanita; Purcell, Patricia

    2014-01-01

    The temporomandibular joint (TMJ) is a specialized synovial joint essential for the mobility and function of the mammalian jaw. The TMJ is composed of the mandibular condyle, the glenoid fossa of the temporal bone, and a fibrocartilagenous disc interposed between these bones. A fibrous capsule, lined on the luminal surface by the synovial membrane, links these bones and retains synovial fluid within the cavity. The major component of synovial fluid is lubricin, a glycoprotein encoded by the gene proteoglycan 4 (Prg4), which is synthesized by chondrocytes at the surface of the articular cartilage and by synovial lining cells. We previously showed that in the knee joint, Prg4 is crucial for maintenance of cartilage surfaces and for regulating proliferation of the intimal cells in the synovium. Consequently, the objective of this study was to determine the role of lubricin in the maintenance of the TMJ. We found that mice lacking lubricin have a normal TMJ at birth, but develop degeneration resembling TMJ osteoarthritis by 2 months, increasing in severity over time. Disease progression in Prg4-/- mice results in synovial hyperplasia, deterioration of cartilage in the condyle, disc and fossa with an increase in chondrocyte number and their redistribution in clusters with loss of superficial zone chondrocytes. All articular surfaces of the joint had a prominent layer of protein deposition. Compared to the knee joint, the osteoarthritis-like phenotype was more severe and manifested earlier in the TMJ. Taken together, the lack of lubricin in the TMJ causes osteoarthritis-like degeneration that affects the articular cartilage as well as the integrity of multiple joint tissues. Our results provide the first molecular evidence of the role of lubricin in the TMJ and suggest that Prg4-/- mice might provide a valuable new animal model for the study of the early events of TMJ osteoarthritis. PMID:25188282

  13. Spontaneously developed osteoarthritis in the temporomandibular joint in STR/ort mice

    PubMed Central

    KUMAGAI, KENICHI; SUZUKI, SATSUKI; KANRI, YORIAKI; MATSUBARA, RYOTA; FUJII, KEISUKE; WAKE, MASAHIRO; SUZUKI, RYUJI; HAMADA, YOSHIKI

    2015-01-01

    Temporomandibular joint (TMJ) osteoarthritis is typically a slowly progressive asymmetric disease. Little is known regarding the natural destruction of TMJ articular tissues. The aim of the present study was to investigate morphological changes in the TMJ of STR/ort mice, known to be the model for spontaneous osteoarthritis in the knee joint, and to evaluate STR/ort mice as a suitable animal model for TMJ osteoarthritis. TMJs from 32 STR/ort mice euthanized at 30, 40, 50 or 60 weeks of age, and from 6 CBA mice euthanized at 30, 40 or 60 weeks of age were examined. Toluidine blue and tartrate-resistant acid phosphatase staining were used to assess histological changes in the articular cartilage. Morphological changes in the articular cartilage of the TMJ were evaluated using microcomputed tomography. At the age of 40–50 weeks, 17 (68%) of the 25 STR/ort mice had loss of articular cartilage on histology, with cavitation and erosion of the exposed bone and gradual changes in condylar shape. Furthermore, osteoarthritic morphological changes, and structural alterations were observed by microcomputed tomography. The STR/ort mouse strain appears to develop spontaneous osteoarthritis-like lesions in the TMJ with age, and would be a useful model to study the pathogenesis of TMJ osteoarthritis. PMID:26171147

  14. [Gout in the temporomandibular joint].

    PubMed

    Deferm, J T; Barkhuysen, R; de Rooy, J; Coppen, C; Merkx, M Aw

    2016-06-01

    A 76-year-old woman, with a medical history of diabetes mellitus and hypertension, presented herself to an oral and maxillofacial surgeon with a sudden pre-auricular swelling of the right temporomandibular joint. As a result of the atypical clinical appearance and signs of local destruction in the initial panoramic x-ray, a malign process was first eliminated from consideration. With the aid of extensive diagnostics and an open biopsy, the diagnosis of gout was established. PMID:27275659

  15. Temporomandibular Joint Disorders and Orofacial Pain.

    PubMed

    Ahmad, Mansur; Schiffman, Eric L

    2016-01-01

    Temporomandibular disorders (TMD) affect 5% to 12% of the United States population. This article discusses common conditions related to temporomandibular joints, including disc displacements, inflammatory disturbances, loose joint bodies, traumatic disturbances, and developmental conditions. Also addressed are the appropriate imaging modalities and diagnostic criteria for TMD. PMID:26614951

  16. Clinical-surgical treatment of temporomandibular joint disorder in a psoriatic arthritis patient

    PubMed Central

    2013-01-01

    Introduction Condylotomy is a surgical procedure that has been used as an option to treat temporomandibular disorder (TMD) patients. This technique has the advantage of avoiding intra-capsular alterations that might be found involving other surgical procedures. Its use, even when unilateral, has positive effect on treatment of both joints. Methods In order to better evaluate the benefits of a clinical-surgical treatment for TMD, the present report describes the case of a psoriatic arthritis patient. The case was clinically characterized by dental malloclusion, and imaging exams showed joint degeneration of the right mandibular condyle. The patient was treated by condylotomy technique after a prosthetic oral rehabilitation. Results No clinical-radiological signs or symptoms of progression of articular disease were observed within a period of 16 months after surgery. Furthermore, there was functional stability of the temporomandibular joint, total absence of local pain and improvement of mouth opening. Conclusion The present study suggests that condylotomy can be considered as a valid option for the management of TMD, since it has low surgical morbidity and favorable clinical outcomes. In this case, the patient had a medical diagnosis of systemic disease presenting general pain and pain at the temporomandibular joint (TMJ), in addition of causal agent of TMD (dental malloclusion). The difficulty of finding a single etiology (malocclusion vs. systemic disease) did not exclude the indication of a clinical-surgical treatment to re-establish the balance of TMJ. PMID:23556553

  17. Towards Regeneration of Articular Cartilage

    PubMed Central

    Iwamoto, Masahiro; Ohta, Yoichi; Larmour, Colleen; Enomoto-Iwamoto, Motomi

    2014-01-01

    Articular cartilage is classified into permanent hyaline cartilage and has significant differences in structure, extracelluar matrix components, gene expression profile, and mechanical property from transient hyaline cartilage found in growth plate. In the process of synovial joint development, articular cartilage is originated from the interzone, developing at the edge of the cartilaginous anlagen, it establishes zonal structure over time and supports smooth movement of the synovial joint through life. The cascade actions of key regulators such as Wnts, GDF5, Erg, and PTHLH coordinate sequential steps of articular cartilage formation. Articular chondrocytes are restrictedly controlled not to differentiate into a hypertrophic stage by autocrine and paracrine factors and extracerllular matrix microenvironment, but retain potential to undergo hypertrophy. The basal calcified zone of articular cartilage is connected with subchondral bone, but not invaded by blood vessels nor replaced by bone, which is highly contrasted with the growth plate. Articular cartilage has limited regenerative capacity, but likely possesses and potentially uses intrinsic stem cell source in the superficial layer, Ranvier’s groove, the intra-articular tissues such as synovium and fat pad, and marrow below the subchondral bone. Considering the biological views on articular cartilage, several important points are raised for regeneration of articular cartilage. We should evaluate the nature of regenerated cartilage as permanent hyaline cartilage and not just hyaline cartilage. We should study how a hypertrophic phenotype of transplanted cells can be lastingly suppressed in regenerating tissue. Further, we should develop the methods and reagents to activate recruitment of intrinsic stem/progenitor cells into the damaged site. PMID:24078496

  18. Evaluation of condylar positions in patients with temporomandibular disorders: A cone-beam computed tomographic study

    PubMed Central

    Imanimoghaddam, Mahrokh; Madani, Azam Sadat; Mahdavi, Pirooze; Bagherpour, Ali; Darijani, Mansoreh

    2016-01-01

    Purpose This study was performed to compare the condylar position in patients with temporomandibular joint disorders (TMDs) and a normal group by using cone-beam computed tomography (CBCT). Materials and Methods In the TMD group, 25 patients (5 men and 20 women) were randomly selected among the ones suffering from TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The control group consisted of 25 patients (8 men and 17 women) with normal temporomandibular joints (TMJs) who were referred to the radiology department in order to undergo CBCT scanning for implant treatment in the posterior maxilla. Linear measurements from the superior, anterior, and posterior joint spaces between the condyle and glenoid fossa were made through defined landmarks in the sagittal view. The inclination of articular eminence was also determined. Results The mean anterior joint space was 2.3 mm in the normal group and 2.8 mm in the TMD group, respectively. The results showed that there was a significant correlation between the superior and posterior joint spaces in both the normal and TMD groups, but it was only in the TMD group that the correlation coefficient among the dimensions of anterior and superior spaces was significant. There was a significant correlation between the inclination of articular eminence and the size of the superior and posterior spaces in the normal group. Conclusion The average dimension of the anterior joint space was different between the two groups. CBCT could be considered a useful diagnostic imaging modality for TMD patients. PMID:27358820

  19. [Articular cartilage regeneration using scaffold].

    PubMed

    Ishimoto, Yoshiyuki; Hattori, Koji; Ohgushi, Hajime

    2008-12-01

    The self-healing capacity of articular cartilage for repair is limited. For articular cartilage injury, several surgical techniques are used in clinical practice, namely drilling, abrasion arthroplasty, microfracture, or autologous osteochondral grafting, while various methods of autologous chondrocyte transplantation to cartilage defect sites have been reported since 1990s. In a case of chondrocyte transplantation to cartilage defect site, the use of proper scaffold is important. Currently, collagen gel or PLGA is used widely as a scaffold. PMID:19043192

  20. The intra-articular distance within the TMJ during free and loaded closing movements.

    PubMed

    Huddleston Slater, J J; Visscher, C M; Lobbezoo, F; Naeije, M

    1999-12-01

    Previous studies on free opening and closing movements of the mandible have demonstrated that the opening movement traces of the condylar kinematic center (i.e., the condylar point for which the protrusive and the opening movement traces coincide) lie closer to the articular eminence than the closing traces. This indicates the presence of an intra-articular distance within the joint during free closing. Since the mandible behaves like a class III biomechanical lever, a counteracting mechanical load on the mandible during closing will press the condyle-disc complex against the articular eminence. Therefore, in this study the hypothesis was tested that the difference between opening and closing movement traces of the kinematic center is reduced when the closing movements are counteracted by a mechanical load. From 10 healthy participants, 20-second movement recordings were obtained by a six-degrees-of-freedom opto-electronic jaw movement recording system (OKAS-3D) for three types of movements: (1) free opening and closing movements, (2) free opening and loaded closing movements (i.e., the participants closed against a small or high manually applied downward-directed force to the chin), and (3) gum chewing. Off-line, the opening and closing movement traces of the kinematic center were reconstructed, and the average difference between the traces (the intra-articular distance) was calculated. The average intraarticular distance was significantly smaller during loaded closing than during free closing, whereas no significant differences were found in the intra-articular distances between the loaded situations of low and high manual loading and contralateral chewing (ANOVA and post hoc Bonferroni multiple comparisons of means test, p<0.005). In conclusion, loading of the mandible during closing movements reduces the intra-articular distance within the temporomandibular joint. PMID:10598911

  1. Management of temporomandibular joint ankylosis.

    PubMed

    Movahed, Reza; Mercuri, Louis G

    2015-02-01

    Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life threatening when struggling to acquire an airway in an emergency. Trauma is the most common cause of TMJ ankylosis, followed by infection. Diagnosis of TMJ ankylosis is usually made by clinical examination and imaging studies. The management goal in TMJ ankylosis is to increase the patient's mandibular function, correct associated facial deformity, decrease pain, and prevent reankylosis. PMID:25483442

  2. [Condylar fracture and temporomandibular joint ankylosis].

    PubMed

    Zhang, Yi

    2016-03-01

    This article summarized the advances in treatment and research of temporomandibular joint surgery in the last 5 years which was presented in "The 2nd Condyle Fracture and Temporomandibular Joint Ankylosis Symposium". The content includes 5 parts: non-surgical treatment of children condyle fracture and long-term follow-up, the improvement of operative approach for condyle fracture and key techniques, the importance and the method for the simultanesous reduction of disc in condylar fracture treatment, the development of traumatic temporomandibular joint ankylosis similar to hypertrophic non-union and the improved safety and accuracy by applying digital surgery in joint surgery. PMID:26980648

  3. Chitosan-Based Thermosensitive Hydrogel for Controlled Drug Delivery to the Temporomandibular Joint.

    PubMed

    Talaat, Wael M; Haider, Mohamed; Kawas, Sausan Al; Kandil, Nadia G; Harding, David R K

    2016-05-01

    Intra-articular injections of hyaluronic acid (HA) and corticosteroids have been extensively used in treating temporomandibular disorders. However, rapid clearance from the site of injection is a major concern that is commonly managed by frequent dosing, which is not without complications. This study aimed to determine the suitability of thermosensitive chitosan-based hydrogels for intra-articular controlled release of drugs in the rabbit temporomandibular joint (TMJ). A series of hydrogels were prepared using different chitosan (Ch) to β-glycerophosphate (β-GP) ratios. The gelation time, swelling ratio, the shape, and surface morphology of the prepared gels were investigated to select the formulation with optimum characteristics. The left TMJ in 13 adult male New Zealand white rabbits was injected with 0.2 mL of Chitosan/β-glycerophosphate/HA while the right TMJ was injected with 0.2 mL of control solution of HA. Hyaluronic acid concentrations in experimental and control groups were measured using Hyaluronan Quantikine Enzyme-Linked Immunosorbent Assay Kit. In vitro characterization showed that both the Ch:β-GP ratio and incorporation of HA had a significant effect on gelation time, degree of swelling, and surface morphology of the hydrogels. No morphological changes were observed in the joints in both groups. The mean concentration of HA in the experimental joints after 7 days (1339.79 ± 244.98 μg/g) was significantly higher than that in the control (474.52 ± 79.36 μg/g). In conclusion, the chitosan-based thermosensitive hydrogel can be considered as a promising controlled drug release system to the TMJ in a rabbit model that would potentially overcome many of the current limitations of intra-articular formulations. PMID:27100649

  4. Temporomandibular juxtaarticular chondroma: case report.

    PubMed

    Vázquez Mahía, Inés; López-Cedrún Cembranos, José Luis; Ferreras Granado, José; Lorenzo Franco, Fernanda

    2007-03-01

    Chondromas are benign tumours composed of mature hyaline cartilage. We present here the first case in the English language medical literature of juxtaarticular chondroma of the temporomandibular joint in the parotid region. Within the rarity of cartilage disorders of the temporo-mandibular joint (TMJ), this particular condition is a diagnostic curiosity. The patient, a 54 year old woman, presented a right preauricular tumour of 3.5 cm. which had been developing for 4 years. It was not painful but there was a recent symptomology of TMJ dysfunction, with pain and clicks. The diagnostic possibilities of a parotid pleomorphic adenoma and of a cartilage tumour of the TMJ suggested a difficult preoperative differential diagnosis, which influenced our approach regarding therapy. The tumour was excised, preserving the parotid gland. This enabled us to confirm the histological diagnosis of chondroma, composed solely of chondroide tissue. We have described the clinical characteristics of our case, and carried out a review of the relevant literature, emphasising the differential diagnoses. PMID:17322809

  5. Engineering Alloplastic Temporomandibular Joint Replacements

    PubMed Central

    Sinno, Hani; Tahiri, Youssef; Gilardino, Mirko; Bobyn, Dennis

    2011-01-01

    Temporomandibular disorders (TMD) are part of a heterogeneous group of pathologies that manifest with a constellation of signs and symptoms. They are the most frequent cause of chronic orofacial pain and are prevalent in 12% of the general population. Despite the debilitating nature of these disorders, there is no standardization for treatment of the diseased temporomandibular joint (TMJ). In this review, we present an overview of the functional anatomy of the TMJ and the engineering concepts that must be understood to better understand the indications for surgical management, the types of available treatments and the requirements for reconstruction. A comparison is made of the clinical outcomes with autogenous versus alloplastic reconstruction, including a history of alloplastic materials and the design features of currently available implants. Emphasis is made on material selection, modulus, stiffness, notch sensitivity and modularity. For the treatment of TMD, engineered TMJ alloplastic replacements have had considerable promise with additional room for improvement using new materials and recent design concepts. PMID:22363183

  6. TNF Accelerates Death of Mandibular Condyle Chondrocytes in Rats with Biomechanical Stimulation-Induced Temporomandibular Joint Disease

    PubMed Central

    Zhang, Hongyun; Zhang, Jing; Jing, Lei; Liao, Lifan; Wang, Meiqing

    2015-01-01

    Objective To determine if temporomandibular joint chondrocyte apoptosis is induced in rats with dental biomechanical stimulation and what a role TNF takes. Methods Thirty-two rats were divided into 4 groups (n = 8/group) and exposed to incisor mal-occlusion induced by unilateral anterior crossbite biomechanical stimulation. Two groups were sampled at 2 or 4 weeks. The other two groups were treated with local injections of a TNF inhibitor or PBS into the temporomandibular joints area at 2 weeks and then sampled at 4 weeks. Twenty-four rats either served as unilateral anterior crossbite mock operation controls (n = 8/group) with sampling at 2 or 4 weeks or received a local injection of the TNF inhibitor at 2 weeks with sampling at 4 weeks. Chondrocytes were isolated from the temporomandibular joints of 6 additional rats and treated with TNF in vitro. Joint samples were assessed using Hematoxylin&eosin, Safranin O, TUNEL and immunohistochemistry staining, real-time PCR, fluorogenic activity assays and Western blot analyses. The isolated chondrocytes were also analyzed by flow cytometry. Results Unilateral anterior crossbite stimulation led to temporomandibular joint cartilage degradation, associated with an increase in TUNEL-positive chondrocytes number, caspase-9 expression levels, and the release of cytochrome c from mitochondria at 2 weeks without changes in TNF and caspase-8 levels until after 4 weeks. TNF stimulated apoptosis of the isolated chondrocytes and up-regulated caspase-8 expression, but did not change caspase-9 expression levels. Local injection of TNF inhibitor down-regulated caspase-8 expression and reduced TUNEL-positive cell number, but did not reverse cartilage thickness reduction, caspase-9 up-regulation or cytochrome c release. Conclusions Unilateral anterior crossbite stimulation induces mitochondrion-mediated apoptosis of articular chondrocytes. TNF accelerated the unilateral anterior crossbite induced chondrocytes apoptosis via death

  7. The Biomechanical Effect of Different Denture Base Materials on the Articular Disc in Complete Denture Wearers: A Finite Element Analysis

    PubMed Central

    El-Zawahry, Mohamed M.; El-Ragi, Ahmed A.; El-Anwar, Mohamed I.; Ibraheem, Eman M.

    2015-01-01

    AIM: The objective of the present study was to evaluate the effect of different denture base materials on the stress distribution in TMJ articular disc (AD) in complete denture wearers. MATERIAL AND METHODS: A three dimensional Finite Element (FEA) models of an individual temporomandibular joint (TMJ) was built on the basis CT scan. The FEA model consisted of four parts: the condyle, the articular disc, the denture base, and the articular eminence skull. Acrylic resin and chrome-cobalt denture base materials were studied. Static loading of 300N was vertically applied to the central fossa of the mandibular second premolar. Stress and strain were calculated to characterize the stress/strain patterns in the disc. RESULTS: The maximum tensile stresses were observed in the anterior and posterior bands of (AD) on load application with the two denture base materials. The superior boundaries of the glenoid fossa showed lower stress than those on the inferior boundaries facing the condyle. CONCLUSIONS: Within the limitations of the present study it may be concluded that: The denture base material may have an effect in stress-strain pattern in TMJ articular disc. The stiffer denture base material, the better the distribution of the load to the underling mandibular supporting structures & reducing stresses induced in the articular disc. PMID:27275270

  8. Fracture of articular cartilage.

    PubMed

    Chin-Purcell, M V; Lewis, J L

    1996-11-01

    Crack formation and propagation is a significant element of the degeneration process in articular cartilage. In order to understand this process, and separate the relative importance of structural overload and material failure, methods for measuring the fracture toughness of cartilage are needed. In this paper, two such methods are described and used to measure fracture properties of cartilage from the canine patella. A modified single edge notch (MSEN) specimen was used to measure J, and a trouser tear test was used to measure T, both measures of fracture toughness with units of kN/m. A pseudo-elastic modulus was also obtained from the MSEN test. Several potential error sources were examined, and results for the MSEN test compared with another method for measuring the fracture parameter for urethane rubber. Good agreement was found. The two test methods were used to measure properties of cartilage from the patellae of 12 canines: 4-9 specimens from each of 12 patellae, with 5 right-left pairs were tested. Values of J ranged from 0.14-1.2 kN/m. J values correlated with T and were an average of 1.7 times larger than T. A variety of failure responses was seen in the MSEN tests, consequently a grade of 0 to 3 was assigned to each test, where 0 represented a brittle-like crack with minimal opening and 3 represented plastic flow with no crack formation. The initial cracks in 12/82 specimens did not propagate and were assigned to grade 3. The method for reducing data in the MSEN test assumed pseudo-elastic response and could not be used for the grade 3 specimens. Stiffness did not correlate with J. Neither J nor T was statistically different between right-left pairs, but varied between animals. The test methods appear useful for providing a quantitative measure of fracture toughness for cartilage and other soft materials. PMID:8950659

  9. [MRI of the temporomandibular joint--the gold standard].

    PubMed

    Barmeir, E; Teich, S; Gutmcher, Z

    2014-04-01

    MRI has been established as the imaging modality of choice for the evaluation of temporomandibular joint disorders (TMD), as it allows for a noninvasive detailed evaluation of the joint that is not otherwise available. During the last decade, the introduction of dynamic (cine-mode) MR imaging has made functional evaluation feasible in addition to the morphologic study of the joint. The major advantage of MRI is its ability to study the articular disc and its congruity as well as its location relative to the condyle in both closed- and open-mouth positions. Due to its high contrast resolution, MRI is unique in demonstrating joint effusion, bone edema and sclerosis, rupture of the retrodiscal layers and impairment of the lateral pterigoid muscle. In Mor-Mar Imaging Center we performed during the last two years MRI studies of the TMJ in 234 subjects, 172 (74%) female and 62 (26%) male patients. The average age of the patients was 29 years. In this article we present our experience in the evaluation of TMD and review the main indications and findings. In addition, our experience in optimizing the MRI sequence protocols in both static and dynamic modes are discussed. MRI examinations provide the clinician with anatomic and physiologic information that can guide treatment decisions. It has a special role in monitoring and evaluating treatment results, both conservative and surgical. PMID:25252468

  10. Synovial fluid dynamics with small disc perforation in temporomandibular joint.

    PubMed

    Xu, Y; Zhan, J; Zheng, Y; Han, Y; Zhang, Z; Xi, Y; Zhu, P

    2012-10-01

    The articular disc plays an important role as a stress absorber in joint movement, resulting in stress reduction and redistribution in the temporomandibular joint (TMJ). The flow of synovial fluid in the TMJ may follow a regular pattern during movement of the jaw. We hypothesised that the regular pattern is disrupted when the TMJ disc is perforated. By computed tomography arthrography, we studied the upper TMJ compartment in patients with small disc perforation during jaw opening-closing at positions from 0 to 3 cm. Finite element fluid dynamic modelling was accomplished to analyse the pattern of fluid flow and pressure distribution during the movements. The results showed that the fluid flow in the upper compartment generally formed an anticlockwise circulation but with local vortexes with the jaw opening up to 2 cm. However, when the jaw opening-closing reached 3 cm, an abnormal flow field and the fluid pressure change associated with the perforation may increase the risk of perforation expansion or rupture and is unfavourable for self-repair of the perforated disc. PMID:22582815

  11. Widespread pain in temporomandibular disorders.

    PubMed

    Lim, Pei Feng; Maixner, William; Khan, Asma A

    2011-03-01

    SUMMARY Chronic widespread pain (CWP) represents pain involving several regions of the body. Various psychological and social risk factors such as poor general health status, sleep disturbance, fatigue and high psychological distress have been identified for the development of CWP. Numerous chronic pain conditions are comorbid, resulting in the development of CWP in many of these patients. Temporomandibular disorder is one of the most extensively studied chronic musculoskeletal pain condition in terms of its comorbidity with CWP and fibromyalgia. It has been proposed that these comorbid pain disorders share common denominators, including exposure to certain environmental events, elevated psychological distress, pain amplification and genetic predisposition. Increased awareness of CWP is important for improved diagnoses and more effective pain management. Patients with CWP can be effectively managed in multidisciplinary pain clinics. PMID:24646357

  12. Rheumatoid arthritis affecting temporomandibular joint

    PubMed Central

    Sodhi, Amandeep; Naik, Shobha; Pai, Anuradha; Anuradha, Ardra

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease. PMID:25684928

  13. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  14. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  15. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  16. Development of artificial articular cartilage.

    PubMed

    Oka, M; Ushio, K; Kumar, P; Ikeuchi, K; Hyon, S H; Nakamura, T; Fujita, H

    2000-01-01

    Attempts have been made to develop an artificial articular cartilage on the basis of a new viewpoint of joint biomechanics in which the lubrication and load-bearing mechanisms of natural and artificial joints are compared. Polyvinyl alcohol hydrogel (PVA-H), 'a rubber-like gel', was investigated as an artificial articular cartilage and the mechanical properties of this gel were improved through a new synthetic process. In this article the biocompatibility and various mechanical properties of the new improved PVA-H is reported from the perspective of its usefulness as an artificial articular cartilage. As regards lubrication, the changes in thickness and fluid pressure of the gap formed between a glass plate and the specimen under loading were measured and it was found that PVA-H had a thicker fluid film under higher pressures than polyethylene (PE) did. The momentary stress transmitted through the specimen revealed that PVA-H had a lower peak stress and a longer duration of sustained stress than PE, suggesting a better damping effect. The wear factor of PVA-H was approximately five times that of PE. Histological studies of the articular cartilage and synovial membranes around PVA-H implanted for 8-52 weeks showed neither inflammation nor degenerative changes. The artificial articular cartilage made from PVA-H could be attached to the underlying bone using a composite osteochondral device made from titanium fibre mesh. In the second phase of this work, the damage to the tibial articular surface after replacement of the femoral surface in dogs was studied. Pairs of implants made of alumina, titanium or PVA-H on titanium fibre mesh were inserted into the femoral condyles. The two hard materials caused marked pathological changes in the articular cartilage and menisci, but the hydrogel composite replacement caused minimal damage. The composite osteochondral device became rapidly attached to host bone by ingrowth into the supporting mesh. The clinical implications of

  17. Differences in articular-eminence inclination between medieval and contemporary human populations.

    PubMed

    Kranjčić, Josip; Vojvodić, Denis; Žabarović, Domagoj; Vodanović, Marin; Komar, Daniel; Mehulić, Ketij

    2012-08-01

    The articular-eminence inclination is an important element in the biomechanics of the temporomandibular joint and the entire masticatory system; however, very little is known about this inclination in archaeological human populations. Therefore, the aim of this study was to determine the values of, in addition to the differences between, the articular-eminence inclination in medieval and contemporary human populations. The study was carried out on two dry skull groups. The first group consisted of 14 dry skulls from the medieval culture group Bijelo Brdo (BB) of East Croatia, and the other consisted of 137 recent dry skulls from the osteologic collection of the Institute of Anatomy (IA) in Zagreb. All BB skulls were dentulous, whereas the IA skulls were divided into dentulous and edentulous groups. The articular-eminence inclination was measured in relation to the Frankfurt horizontal plane on digital images of the skull's two lateral views using AutoCAD computer software. The mean value of the articular-eminence inclination in the BB sample group (49.57°) was lower, with a statistical significance (p<0.01), than those of the IA dentulous (61.56°), the IA edentulous (62.54°), and all the combined IA (61.99°) specimens. Because the values of the articular-eminence inclination can vary a lot with reference to the number of specimens and the different methods used for measuring, the obtained values yield only orientational information. Further investigations including a larger number of medieval specimens are needed to confirm the results obtained from this study. PMID:22721644

  18. Conditional Deletion of Fgfr3 in Chondrocytes leads to Osteoarthritis-like Defects in Temporomandibular Joint of Adult Mice.

    PubMed

    Zhou, Siru; Xie, Yangli; Li, Wei; Huang, Junlan; Wang, Zuqiang; Tang, Junzhou; Xu, Wei; Sun, Xianding; Tan, Qiaoyan; Huang, Shuo; Luo, Fengtao; Xu, Meng; Wang, Jun; Wu, Tingting; Chen, Liang; Chen, Hangang; Su, Nan; Du, Xiaolan; Shen, Yue; Chen, Lin

    2016-01-01

    Osteoarthritis (OA) in the temporomandibular joint (TMJ) is a common degenerative disease in adult, which is characterized by progressive destruction of the articular cartilage. To investigate the role of FGFR3 in the homeostasis of TMJ cartilage during adult stage, we generated Fgfr3(f/f); Col2a1-CreER(T2) (Fgfr3 cKO) mice, in which Fgfr3 was deleted in chondrocytes at 2 months of age. OA-like defects were observed in Fgfr3 cKO TMJ cartilage. Immunohistochemical staining and quantitative real-time PCR analyses revealed a significant increase in expressions of COL10, MMP13 and AMAMTS5. In addition, there was a sharp increase in chondrocyte apoptosis at the Fgfr3 cKO articular surface, which was accompanied by a down-regulation of lubricin expression. Importantly, the expressions of RUNX2 and Indian hedgehog (IHH) were up-regulated in Fgfr3 cKO TMJ. Primary Fgfr3 cKO chondrocytes were treated with IHH signaling inhibitor, which significantly reduced expressions of Runx2, Col10, Mmp13 and Adamts5. Furthermore, the IHH signaling inhibitor partially alleviated OA-like defects in the TMJ of Fgfr3 cKO mice, including restoration of lubricin expression and improvement of the integrity of the articular surface. In conclusion, our study proposes that FGFR3/IHH signaling pathway plays a critical role in maintaining the homeostasis of TMJ articular cartilage during adult stage. PMID:27041063

  19. Conditional Deletion of Fgfr3 in Chondrocytes leads to Osteoarthritis-like Defects in Temporomandibular Joint of Adult Mice

    PubMed Central

    Zhou, Siru; Xie, Yangli; Li, Wei; Huang, Junlan; Wang, Zuqiang; Tang, Junzhou; Xu, Wei; Sun, Xianding; Tan, Qiaoyan; Huang, Shuo; Luo, Fengtao; Xu, Meng; Wang, Jun; Wu, Tingting; chen, Liang; Chen, Hangang; Su, Nan; Du, Xiaolan; Shen, Yue; Chen, Lin

    2016-01-01

    Osteoarthritis (OA) in the temporomandibular joint (TMJ) is a common degenerative disease in adult, which is characterized by progressive destruction of the articular cartilage. To investigate the role of FGFR3 in the homeostasis of TMJ cartilage during adult stage, we generated Fgfr3f/f; Col2a1-CreERT2 (Fgfr3 cKO) mice, in which Fgfr3 was deleted in chondrocytes at 2 months of age. OA-like defects were observed in Fgfr3 cKO TMJ cartilage. Immunohistochemical staining and quantitative real-time PCR analyses revealed a significant increase in expressions of COL10, MMP13 and AMAMTS5. In addition, there was a sharp increase in chondrocyte apoptosis at the Fgfr3 cKO articular surface, which was accompanied by a down-regulation of lubricin expression. Importantly, the expressions of RUNX2 and Indian hedgehog (IHH) were up-regulated in Fgfr3 cKO TMJ. Primary Fgfr3 cKO chondrocytes were treated with IHH signaling inhibitor, which significantly reduced expressions of Runx2, Col10, Mmp13 and Adamts5. Furthermore, the IHH signaling inhibitor partially alleviated OA-like defects in the TMJ of Fgfr3 cKO mice, including restoration of lubricin expression and improvement of the integrity of the articular surface. In conclusion, our study proposes that FGFR3/IHH signaling pathway plays a critical role in maintaining the homeostasis of TMJ articular cartilage during adult stage. PMID:27041063

  20. An inferior alveolar intraneural cyst: a case example and an anatomical explanation to support the articular theory within cranial nerves.

    PubMed

    Capek, Stepan; Koutlas, Ioannis G; Strasia, Rhys P; Amrami, Kimberly K; Spinner, Robert J

    2015-06-01

    The authors describe the case of an intraneural ganglion cyst involving a cranial nerve (V3), which was found to have a joint connection in support of an articular origin within the cranial nerves. An inferior alveolar intraneural cyst was incidentally discovered on a plain radiograph prior to edentulation. It was resected from within the mandibular canal with no joint connection perceived at surgery. Histologically, the cyst was confirmed to be an intraneural ganglion cyst. Reinterpretation of the preoperative CT scan showed the cyst arising from the temporomandibular joint. This case is consistent with the articular (synovial) theory of intraneural ganglion cysts. An anatomical explanation and potential joint connection are provided for this case as well as several other cases of intraneural cysts in the literature, and thus unifying cranial nerve involvement with accepted concepts of intraneural ganglion cyst formation and propagation. PMID:25658786

  1. Engineering lubrication in articular cartilage.

    PubMed

    McNary, Sean M; Athanasiou, Kyriacos A; Reddi, A Hari

    2012-04-01

    Despite continuous progress toward tissue engineering of functional articular cartilage, significant challenges still remain. Advances in morphogens, stem cells, and scaffolds have resulted in enhancement of the bulk mechanical properties of engineered constructs, but little attention has been paid to the surface mechanical properties. In the near future, engineered tissues will be able to withstand and support the physiological compressive and tensile forces in weight-bearing synovial joints such as the knee. However, there is an increasing realization that these tissue-engineered cartilage constructs will fail without the optimal frictional and wear properties present in native articular cartilage. These characteristics are critical to smooth, pain-free joint articulation and a long-lasting, durable cartilage surface. To achieve optimal tribological properties, engineered cartilage therapies will need to incorporate approaches and methods for functional lubrication. Steady progress in cartilage lubrication in native tissues has pushed the pendulum and warranted a shift in the articular cartilage tissue-engineering paradigm. Engineered tissues should be designed and developed to possess both tribological and mechanical properties mirroring natural cartilage. In this article, an overview of the biology and engineering of articular cartilage structure and cartilage lubrication will be presented. Salient progress in lubrication treatments such as tribosupplementation, pharmacological, and cell-based therapies will be covered. Finally, frictional assays such as the pin-on-disk tribometer will be addressed. Knowledge related to the elements of cartilage lubrication has progressed and, thus, an opportune moment is provided to leverage these advances at a critical step in the development of mechanically and tribologically robust, biomimetic tissue-engineered cartilage. This article is intended to serve as the first stepping stone toward future studies in functional

  2. Engineering Lubrication in Articular Cartilage

    PubMed Central

    McNary, Sean M.; Athanasiou, Kyriacos A.

    2012-01-01

    Despite continuous progress toward tissue engineering of functional articular cartilage, significant challenges still remain. Advances in morphogens, stem cells, and scaffolds have resulted in enhancement of the bulk mechanical properties of engineered constructs, but little attention has been paid to the surface mechanical properties. In the near future, engineered tissues will be able to withstand and support the physiological compressive and tensile forces in weight-bearing synovial joints such as the knee. However, there is an increasing realization that these tissue-engineered cartilage constructs will fail without the optimal frictional and wear properties present in native articular cartilage. These characteristics are critical to smooth, pain-free joint articulation and a long-lasting, durable cartilage surface. To achieve optimal tribological properties, engineered cartilage therapies will need to incorporate approaches and methods for functional lubrication. Steady progress in cartilage lubrication in native tissues has pushed the pendulum and warranted a shift in the articular cartilage tissue-engineering paradigm. Engineered tissues should be designed and developed to possess both tribological and mechanical properties mirroring natural cartilage. In this article, an overview of the biology and engineering of articular cartilage structure and cartilage lubrication will be presented. Salient progress in lubrication treatments such as tribosupplementation, pharmacological, and cell-based therapies will be covered. Finally, frictional assays such as the pin-on-disk tribometer will be addressed. Knowledge related to the elements of cartilage lubrication has progressed and, thus, an opportune moment is provided to leverage these advances at a critical step in the development of mechanically and tribologically robust, biomimetic tissue-engineered cartilage. This article is intended to serve as the first stepping stone toward future studies in functional

  3. Anatomy of the temporomandibular joint in the cat: a study by microdissection, cryosection and vascular injection.

    PubMed

    Arredondo, Jorge; Agut, Amalia; Rodríguez, María Jesús; Sarriá, Ricardo; Latorre, Rafael

    2013-02-01

    The minute anatomy of the temporomandibular joint (TMJ) is of great clinical relevance in cats owing to a high number of lesions involving this articulation. However, the precise anatomy is poorly documented in textbooks and scientific articles. The aim of this study was to describe, in detail, the TMJ anatomy and its relationship with other adjacent anatomical structures in the cat. Different anatomical preparations, including vascular and articular injection, microdissection, cryosection and plastination, were performed in 12 cadaveric cats. All TMJ anatomical structures were identified and described in detail. A thorough understanding of the TMJ anatomy is essential to understand the clinical signs associated with TMJ disorders, to locate lesions precisely and to accurately interpret the results in all diagnostic imaging techniques. PMID:23015066

  4. Characteristics of temporomandibular joint in patients with temporomandibular joint complaint

    PubMed Central

    Li, Yanfeng; Guo, Xiaoqian; Sun, Xiaoxue; Wang, Ning; Xie, Min; Zhang, Jianqiang; Lv, Yuan; Han, Weili; Hu, Min; Liu, Hongchen

    2015-01-01

    Introduction: This study was to investigate whether there was statistical difference between the bilateral temporomandibular joint (TMJ) in patients with unilateral TMJ pain or joint sounds, using cone beam computed tomography (CBCT). Methods: TMJ CBCT images of 123 cases were used to preliminarily determine the indicators suitable for the measuring method. TMJ CBCT image reconstruction was performed and 19 indicators were measured. Thirty-six cases without TMJ complaint served as controls. The comparison of bilateral TMJs was analyzed by paired t-test to find out the indicators without statistical significance. Twenty-nine patients with unilateral TMJ pain or joint sounds who underwent CBCT at the hospital were enrolled for the comparative study. The measured values were analyzed by paired t-test to determine the indicators with statistical difference. Results: In the control group, only radius value of bilateral TMJ was different statistically (P < 0.05). In the TMJ complaint group, the vertical 60° joint space of the bilateral TMJ was statistically different (P < 0.05) and the rest of the measured values showed no statistical difference. Conclusions: In the patients with unilateral TMJ pain or joint sounds, the vertical 60° joint space of the symptomatic side was significantly increased comparing with the asymptomatic side. PMID:26629112

  5. Influence of orthodontic treatment on temporomandibular disorders. A systematic review

    PubMed Central

    Cañigral, Aránzazu; López-Caballo, José L.; Brizuela, Aritza; Moreno-Hay, Isabel; del Río-Highsmith, Jaime; Vega, José A.

    2015-01-01

    Objectives The aim of this literature systematic review was to evaluate the possible association between malocclusions, orthodontic treatment and development of temporomandibular disorders. Material and Methods: A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords “orthodontics and temporomandibular disorders”, “orthodontics and facial pain” and “malocclusion and temporomandibular disorders”. Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. Material and Methods A search was carried out on PubMed-Medline database from January 2000 to August 2013 using the keywords “orthodontics and temporomandibular disorders”, “orthodontics and facial pain” and “malocclusion and temporomandibular disorders”. Human studies included in the study were those assessing signs and symptoms of temporomandibular disorders in relation to orthodontic treatment. Results The search strategy resulted in 61 articles. After selection according to the inclusion/exclusion criteria 9 articles qualified for the final analysis. The articles which linked orthodontics and development of temporomandibular disorders showed very discrepant results. Some indicated that orthodontic treatment could improve signs and symptoms of temporomandibular disorders, but none of them obtained statistically significant differences. Conclusions According to the authors examined, there is no evidence for a cause-effect relationship between orthodontic treatment and temporomandibular disorders, or that such treatment might improve or prevent them. More longitudinal studies are needed to verify any possible interrelationship. Key words:Malocclusion and temporomandibular disorders, orthodontics and facial pain, orthodontics and temporomandibular disorders, temporomandibular disorders, temporomandibular dysfunction. PMID:26155354

  6. Bayesian belief network analysis applied to determine the progression of temporomandibular disorders using MRI

    PubMed Central

    2015-01-01

    Objectives: This study investigated the applicability of a Bayesian belief network (BBN) to MR images to diagnose temporomandibular disorders (TMDs). Our aim was to determine the progression of TMDs, focusing on how each finding affects the other. Methods: We selected 1.5-T MRI findings (33 variables) and diagnoses (bone changes and disc displacement) of patients with TMD from 2007 to 2008. There were a total of 295 cases with 590 sides of temporomandibular joints (TMJs). The data were modified according to the research diagnostic criteria of TMD. We compared the accuracy of the BBN using 11 algorithms (necessary path condition, path condition, greedy search-and-score with Bayesian information criterion, Chow–Liu tree, Rebane–Pearl poly tree, tree augmented naïve Bayes model, maximum log likelihood, Akaike information criterion, minimum description length, K2 and C4.5), a multiple regression analysis and an artificial neural network using resubstitution validation and 10-fold cross-validation. Results: There were 191 TMJs (32.4%) with bone changes and 340 (57.6%) with articular disc displacement. The BBN path condition algorithm using resubstitution validation and 10-fold cross-validation was >99% accurate. However, the main advantage of a BBN is that it can represent the causal relationships between different findings and assign conditional probabilities, which can then be used to interpret the progression of TMD. Conclusions: Osteoarthritic bone changes progressed from condyle to articular fossa and finally to mandibular bone contours. Disc displacement was directly related to severe bone changes. Early bone changes were not directly related to disc displacement. TMJ functional factors (condylar translation, bony space and disc form) and age mediated between bone changes and disc displacement. PMID:25472616

  7. Temporomandibular joint internal derangements: CT diagnosis

    SciTech Connect

    Helms, C.A.; Vogler, J.B. III; Morrish, R.B. Jr.; Goldman, S.M.; Capra, R.E.; Proctor, E.

    1984-08-01

    Two hundred patients with suspected displaced temporomandibular joint meniscus were studied with computed tomography. In 75 cases confirmation of the CT diagnosis was subsequently obtained via surgery or arthrography; correlation was found in 73 cases (97%), with one false-negative and one false-positive examination. When meniscus displacement was graded as mild, moderate, or severe, those cases diagnosed as moderate or severe were more likely to require surgery. The technique and interpretation of this technique is described; in most cases CT can replace arthrography in diagnosing displaced temporomandibular joint menisci.

  8. Autophagy modulates articular cartilage vesicle formation in primary articular chondrocytes.

    PubMed

    Rosenthal, Ann K; Gohr, Claudia M; Mitton-Fitzgerald, Elizabeth; Grewal, Rupinder; Ninomiya, James; Coyne, Carolyn B; Jackson, William T

    2015-05-22

    Chondrocyte-derived extracellular organelles known as articular cartilage vesicles (ACVs) participate in non-classical protein secretion, intercellular communication, and pathologic calcification. Factors affecting ACV formation and release remain poorly characterized; although in some cell types, the generation of extracellular vesicles is associated with up-regulation of autophagy. We sought to determine the role of autophagy in ACV production by primary articular chondrocytes. Using an innovative dynamic model with a light scatter nanoparticle counting apparatus, we determined the effects of autophagy modulators on ACV number and content in conditioned medium from normal adult porcine and human osteoarthritic chondrocytes. Healthy articular chondrocytes release ACVs into conditioned medium and show significant levels of ongoing autophagy. Rapamycin, which promotes autophagy, increased ACV numbers in a dose- and time-dependent manner associated with increased levels of autophagy markers and autophagosome formation. These effects were suppressed by pharmacologic autophagy inhibitors and short interfering RNA for ATG5. Caspase-3 inhibition and a Rho/ROCK inhibitor prevented rapamycin-induced increases in ACV number. Osteoarthritic chondrocytes, which are deficient in autophagy, did not increase ACV number in response to rapamycin. SMER28, which induces autophagy via an mTOR-independent mechanism, also increased ACV number. ACVs induced under all conditions had similar ecto-enzyme specific activities and types of RNA, and all ACVs contained LC3, an autophagosome-resident protein. These findings identify autophagy as a critical participant in ACV formation, and augment our understanding of ACVs in cartilage disease and repair. PMID:25869133

  9. Temporomandibular joint multidisciplinary team clinic.

    PubMed

    Ahmed, Nabeela; Poate, Tim; Nacher-Garcia, Cristina; Pugh, Nicola; Cowgill, Helen; Page, Lisa; Matthews, N Shaun

    2014-11-01

    Patients with dysfunction of the temporomandibular joint (TMJ) commonly present to oral and maxillofacial departments and are increasingly being managed by a subspecialist group of surgeons. We review the outcomes of patients attending a specialist TMJ multidisciplinary team (MDT) clinic. All patients are simultaneously reviewed by a consultant oral and maxillofacial surgeon, consultant in oral medicine, specialist physiotherapist, and maxillofacial prosthetist, and they can also see a consultant liaison psychiatrist. They are referred from primary, secondary, and tertiary care when medical and surgical treatment in the routine TMJ clinic has failed, and are triaged by the attending maxillofacial surgeon. On discharge they are returned to the care of the referring practitioner. We review the outcomes of patients attending this clinic over a 2-year period and show improvements in pain scores and maximal incisal opening, as well as quality of life outcome measures. All units in the UK with an interest in the management of diseases of the TMJ should consider establishing this type of clinic and should use available resources and expertise to maximise outcomes. PMID:25179688

  10. Effect of clenching on biomechanical response of human mandible and temporomandibular joint to traumatic force analyzed by finite element method

    PubMed Central

    Yamamoto, Kazuhiko; Sugiura, Tsutomu; Kawakami, Masayoshi; Kang, Yu B.; Tsutsumi, Sadami; Kirita, Tadaaki

    2013-01-01

    Purpose: The purpose of the present study was to analyze the effect of clenching on the biomechanical response of human mandible and temporomandibular joint (TMJ) to traumatic force by the finite element (FE) method. Material and Methods: FE models of the mandible and the TMJ in resting and clenching positions were prepared. Distribution and magnitude of von Mises stress were analyzed by applying force as a point load in the symphyseal, canine, body and angle regions of the mandible. In addition, strain energy density (SED) at the articular disc and in posterior connective tissue of TMJ was analyzed. Results: In the resting position, von Mises stress was mainly concentrated at the condylar neck and in the retromolar region of the mandible. In the clenching position, the stress at the condylar neck decreased in all loadings. The stress in the retromolar region similary decreased in the symphyseal, canine and body loading, respectively; however, higher stress was observed in the retromolar region on the loading side in the angle loading. High SED was generated at the articular disc and in posterior connective tissues of TMJ in the resting position. The SED in these tissues decreased in all loadings in the clenching position. Conclusions: Clenching generally reduces stress at the condylar neck and in the retromolar region of the mandible, and strain energy at the articular disc and in posterior connective tissue of TMJ by traumatic forces on the mandible; however, clenching induces greater stress in the retromolar region on the loading side by traumatic force to the angle region. Key words:Mandibular, temporomandibular joint, traumatic force, clenching, finite element analysis. PMID:23524422

  11. Correlation Between Clinical Findings of Temporomandibular Disorders and MRI Characteristics of Disc Displacement

    PubMed Central

    Kumar, Raman; Pallagatti, Shambulingappa; Sheikh, Soheyl; Mittal, Amit; Gupta, Deepak; Gupta, Sonam

    2015-01-01

    Objectives : Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers. It is important for the maxillofacial radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its advanced and irreversible phase which is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further the MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms. Henceforth, the aim of the study was to evaluate whether MRI findings of various degrees of disk displacement could be correlated with the presence or absence of clinical signs and symptoms of temporomandibular disorders in symptomatic and asymptomatic subjects. Materials and Methods : In this clinical study, 44 patients (88 TMJs) were examined clinically and divided into two groups. Group 1 consisted of 22 patients with clinical signs and symptoms of TMDs either unilaterally or bilaterally and considered as study group. Group 2 consisted of 22 patients with no signs and symptoms of TMDs and considered as control group. MRI was done for both the TMJs of each patient. Displacement of the posterior band of articular disc in relation to the condyle was quantified as anterior disc displacement with reduction (ADDR), anterior disc displacement without reduction (ADDWR), posterior disc displacement (PDD). Results : Disk displacement was found in 18 (81.8%) patients of 22 symptomatic subjects in Group 1

  12. Temporomandibular joint dislocation: experiences from Zaria, Nigeria

    PubMed Central

    Fomete, Benjamin; Obiadazie, Athanasius Chukwudi; Idehen, Kelvin; Okeke, Uche

    2014-01-01

    Objectives Dislocation of the temporomandibular joint may occur for various reasons. Although different invasive methods have been advocated for its treatment, this study highlights the value of non-invasive treatment options even in chronic cases in a resource-poor environment. Materials and Methods A seven-year retrospective analysis of all patients managed for temporomandibular joint dislocation in our department was undertaken. Patient demographics, risk factors associated with temporomandibular joint dislocation and treatment modalities were retrieved from patient records. Results In all, 26 patients were managed over a seven-year period. Males accounted for 62% of the patients, and yawning was the most frequent etiological factor. Conservative treatment methods were used successfully in 86.4% of the patients managed. Two (66.7%) of the three patients who needed surgical treatment developed complications, while only one (5.3%) patient who was managed conservatively developed complications. Conclusion Temporomandibular joint dislocation appears to be associated with male sex, middle age, yawning, and low socio-economic status, although these observed relationships were not statistically significant. Non-invasive methods remain an effective treatment option in this environment in view of the low socio-economic status of the patients affected. PMID:25045637

  13. Condylar hyperplasia following unilateral temporomandibular joint replacement.

    PubMed

    Machon, V; Levorova, J; Hirjak, D; Foltan, R

    2015-06-01

    Total joint replacement of the temporomandibular joint (TJR) can be associated with intraoperative and postoperative complications. We report herein the occurrence of a postoperative open bite malocclusion, the result of condylar hyperplasia affecting the non-operated joint at 1 year after unilateral total joint replacement. PMID:25662429

  14. Dietary correlates of temporomandibular joint morphology in New World primates.

    PubMed

    Terhune, Claire E

    2011-11-01

    Previous analyses of the masticatory apparatus have demonstrated that the shape of the temporomandibular joint (TMJ) is functionally and adaptively linked to variation in feeding behavior and diet in primates. Building on previous research, this study presents an analysis of the link between diet and TMJ morphology in the context of functional and dietary differences among New World primates. To evaluate this proposed relationship, I used three-dimensional morphometric methods to quantify TMJ shape across a sample of 13 platyrrhine species. A broad interspecific analysis of this sample found strong relationships among TMJ size, TMJ shape, and diet, suggesting that both size and diet are significant factors influencing TMJ morphology in New World primates. However, it is likely that at least some of these differences are related to a division of dietary categories along clade lines. A series of hypotheses related to load resistance capabilities and range of motion in the TMJ were then tested among small groups of closely related taxa with documented dietary differences. These pairwise analyses indicate that some aspects of TMJ morphology can be used to differentiate among closely related species with different diets. However, not all of my predictions were upheld. The anteroposterior dimensions of the TMJ were most strongly consistent with hypothesized differences in ingestive/masticatory behaviors and jaw gape, whereas the predictions generated for variation in entoglenoid and articular tubercle height were not upheld. These results imply that while some features can be reliably associated with increased load resistance and facilitation of wider jaw gapes in the masticatory apparatus, other features are less strongly correlated with masticatory function. PMID:21920583

  15. Neocartilage integration in temporomandibular joint discs: physical and enzymatic methods

    PubMed Central

    Murphy, Meghan K.; Arzi, Boaz; Prouty, Shannon M.; Hu, Jerry C.; Athanasiou, Kyriacos A.

    2015-01-01

    Integration of engineered musculoskeletal tissues with adjacent native tissues presents a significant challenge to the field. Specifically, the avascularity and low cellularity of cartilage elicit the need for additional efforts in improving integration of neocartilage within native cartilage. Self-assembled neocartilage holds significant potential in replacing degenerated cartilage, though its stabilization and integration in native cartilage require further efforts. Physical and enzymatic stabilization methods were investigated in an in vitro model for temporomandibular joint (TMJ) disc degeneration. First, in phase 1, suture, glue and press-fit constructs were compared in TMJ disc intermediate zone defects. In phase 1, suturing enhanced interfacial shear stiffness and strength immediately; after four weeks, a 15-fold increase in stiffness and a ninefold increase in strength persisted over press-fit. Neither suture nor glue significantly altered neocartilage properties. In phase 2, the effects of the enzymatic stabilization regimen composed of lysyl oxidase, CuSO4 and hydroxylysine were investigated. A full factorial design was employed, carrying forward the best physical method from phase 1, suturing. Enzymatic stabilization significantly increased interfacial shear stiffness after eight weeks. Combined enzymatic stabilization and suturing led to a fourfold increase in shear stiffness and threefold increase in strength over press-fit. Histological analysis confirmed the presence of a collagen-rich interface. Enzymatic treatment additionally enhanced neocartilage mechanical properties, yielding a tensile modulus over 6 MPa and compressive instantaneous modulus over 1200 kPa at eight weeks. Suturing enhances stabilization of neocartilage, and enzymatic treatment enhances functional properties and integration of neocartilage in the TMJ disc. Methods developed here are applicable to other orthopaedic soft tissues, including knee meniscus and hyaline articular

  16. Direct sagital computed tomography of the temporomandibular joint

    SciTech Connect

    Manzione, J.V.; Seltzer, S.E.; Katzberg, R.W.; Hammerschlag, S.B.; Chiango, B.F.

    1983-01-01

    Temporomandibular joint dysfunction is a common clinical problem that has been reported to affect 4%-28% of adults. Temporomandibular joint arthrography has shown that many of these patients have intraarticular abnormalities involving the meniscus. A noninvasive test that could demonstrate the meniscus as well as bony abnormalities of the joint would be an important advance. In an attempt to develop such a noninvasive test, we have performed direct sagittal computed tomography (CT) on cadaver temporomandibular joints and have correlated the images with anatomic sections. We are currently applying this technique clinically and report one representative example in which direct sagittal computed tomography of the temporomandibular joint accurately demonstrated an anteriorly displaced meniscus.

  17. Extra and Intra-articular Synovial Chondromatosis.

    PubMed

    Chaudhary, R K; Banskota, B; Rijal, S; Banskota, A K

    2015-01-01

    Synovial chondromatosis is not so rare intra-articular condition secondary to synovial metaplasia, that affects the knee joint. Extra-articular synovial chondromatosis however is an extremely rare condition that usually involves the synovial sheath or bursa of the foot or hand. We present two cases of synovial chondromatosis, one intra and one extra-articular. The first case was a 25 year old lady who presented with pain, swelling and restricted range of motion of left knee and was found to have an intra-articular synovial chondromatosis which was treated successfully by joint debridement. The second case was that of a 22 year old man who presented with right knee pain and was diagnosed to have an extra-articular synovial chondromatosis of his right medial hamstring tendon sheath, excision of which resulted in complete relief of symptoms. PMID:27549506

  18. Imaging of the temporomandibular joint: An update

    PubMed Central

    Bag, Asim K; Gaddikeri, Santhosh; Singhal, Aparna; Hardin, Simms; Tran, Benson D; Medina, Josue A; Curé, Joel K

    2014-01-01

    Imaging of the temporomandibular joint (TMJ) is continuously evolving with advancement of imaging technologies. Many different imaging modalities are currently used to evaluate the TMJ. Magnetic resonance imaging is commonly used for evaluation of the TMJ due to its superior contrast resolution and its ability to acquire dynamic imaging for demonstration of the functionality of the joint. Computed tomography and ultrasound imaging have specific indication in imaging of the TMJ. This article focuses on state of the art imaging of the temporomandibular joint. Relevant normal anatomy and biomechanics of movement of the TMJ are discussed for better understanding of many TMJ pathologies. Imaging of internal derangements is discussed in detail. Different arthropathies and common tumors are also discussed in this article. PMID:25170394

  19. Radiation dose in temporomandibular joint zonography

    SciTech Connect

    Coucke, M.E.; Bourgoignie, R.R.; Dermaut, L.R.; Bourgoignie, K.A.; Jacobs, R.J. )

    1991-06-01

    Temporomandibular joint morphology and function can be evaluated by panoramic zonography. Thermoluminescent dosimetry was applied to evaluate the radiation dose to predetermined sites on a phantom eye, thyroid, pituitary, and parotid, and the dose distribution on the skin of the head and neck when the TMJ program of the Zonarc panoramic x-ray unit was used. Findings are discussed with reference to similar radiographic techniques.

  20. Predisposition for temporomandibular joint disorders: loose ligaments.

    PubMed

    Deodato, Francesco; Trusendi, Raffaello; Giorgetti, Roberto; Scalese, Marco U

    2006-07-01

    Loose ligaments are often a predisposing factor of temporomandibular joint (TMJ) disorders. This causal factor was analyzed in 701 subjects presenting at the TMJ and Posture Center of Siena University with TMJ pain or dysfunction. Along with the conventional jaw examination, a Carter and Wilkinson test as modified by Beighton was also done. We found a correlation among the parameters of age, gender, TMJ disorder, joint pain, muscle pain, and loose ligaments. PMID:16933458

  1. Laser arthroscopy of the temporomandibular joint.

    PubMed

    Gerard, N; Hendler, B H

    1995-04-01

    Laser surgery is very different than traditional surgery. The clinician must be familiar with the physical properties of the laser to use this instrument safely and properly. Various lasers are available for use in oral and maxillofacial surgery and dentistry, namely the carbon dioxide laser, the neodymium:yttrium-aluminum-garnet laser, and the holmium: yttrium-aluminum-garnet laser (Ho:YAG). Only the Ho:YAG laser has been used with effectiveness in temporomandibular joint arthroscopic surgery. PMID:8935004

  2. Temporomandibular Disorders: The Habitual Chewing Side Syndrome

    PubMed Central

    Santana-Mora, Urbano; López-Cedrún, José; Mora, María J.; Otero, Xosé L.; Santana-Penín, Urbano

    2013-01-01

    Background Temporomandibular disorders are the most common cause of chronic orofacial pain, but, except where they occur subsequent to trauma, their cause remains unknown. This cross-sectional study assessed chewing function (habitual chewing side) and the differences of the chewing side and condylar path and lateral anterior guidance angles in participants with chronic unilateral temporomandibular disorder. This is the preliminary report of a randomized trial that aimed to test the effect of a new occlusal adjustment therapy. Methods The masticatory function of 21 randomly selected completely dentate participants with chronic temporomandibular disorders (all but one with unilateral symptoms) was assessed by observing them eat almonds, inspecting the lateral horizontal movement of the jaw, with kinesiography, and by means of interview. The condylar path in the sagittal plane and the lateral anterior guidance angles with respect to the Frankfort horizontal plane in the frontal plane were measured on both sides in each individual. Results Sixteen of 20 participants with unilateral symptoms chewed on the affected side; the concordance (Fisher’s exact test, P = .003) and the concordance-symmetry level (Kappa coefficient κ = 0.689; 95% confidence interval [CI], 0.38 to 0.99; P = .002) were significant. The mean condylar path angle was steeper (53.47(10.88) degrees versus 46.16(7.25) degrees; P = .001), and the mean lateral anterior guidance angle was flatter (41.63(13.35) degrees versus 48.32(9.53) degrees P = .036) on the symptomatic side. Discussion The results of this study support the use of a new term based on etiology, “habitual chewing side syndrome”, instead of the nonspecific symptom-based “temporomandibular joint disorders”; this denomination is characterized in adults by a steeper condylar path, flatter lateral anterior guidance, and habitual chewing on the symptomatic side. PMID:23593156

  3. Modeling the biomechanics of articular eminence function in anthropoid primates

    PubMed Central

    Terhune, Claire E

    2011-01-01

    One of the most prominent features of the cranial component of the temporomandibular joint (TMJ) is the articular eminence (AE). This bar of bone is the primary surface upon which the condyle translates and rotates during movements of the mandible, and is therefore the primary point at which forces are transmitted from the mandible to the cranium during loading of the masticatory apparatus. The shape of the AE is highly variable across primates, and the raised eminence of humans has often been considered a defining feature of the human TMJ, yet few data exist to address whether this variation is functionally significant. This study used a broad interspecific sample of anthropoid primates to elaborate upon and test the predictions of a previously proposed model of AE function. This model suggests that AE inclination acts to resist non-normal forces at the TMJ, thereby maximizing bite forces (BFs). AE inclination was predicted to covary with two specific features of the masticatory apparatus: height of the TMJ above the occlusal plane; and inclination of the masticatory muscles. A correlate of this model is that taxa utilizing more resistant food objects should also exhibit relatively more inclined AEs. Results of the correlation analyses found that AE inclination is strongly correlated with height of the TMJ above the occlusal plane, but less so with inclination of the masticatory muscles. Furthermore, pairwise comparisons of closely related taxa with documented dietary differences found that the AE is consistently more inclined in taxa that utilize more resistant food items. These data preliminarily suggest that variation in AE morphology across anthropoid primates is functionally related to maximizing BFs, and add to the growing dataset of masticatory morphologies linked to feeding behavior. PMID:21923720

  4. Orthodontics and temporomandibular disorders: a curriculum proposal for postgraduate programs.

    PubMed

    Greene, Charles S; Stockstill, John; Rinchuse, Donald; Kandasamy, Sanjivan

    2012-07-01

    In a previous article, we reported the results of a survey of American and Canadian orthodontic postgraduate programs to determine how the topics of occlusion, temporomandibular joint, and temporomandibular disorders were currently being taught. Based on the finding of considerable diversity among those programs, we decided to write a curriculum proposal for temporomandibular disorders that would be compatible with and satisfy the current curriculum guidelines for postgraduate orthodontic programs. These guidelines arose from a combination of the requirements published by the American Dental Association's Commission on Dental Accreditation and the written guide (July 2010) of the American Board of Orthodontics for the its clinical examination. The proposed curriculum, based on the latest scientific evidence in the temporomandibular disorder field, gives program directors a template for covering these subjects thoroughly. At the same time, they can focus on related orthodontic issues, so that their future graduates will be prepared to deal with patients who either have or later develop temporomandibular disorder problems. PMID:22748986

  5. Vertical Craniofacial Morphology and its Relation to Temporomandibular Disorders

    PubMed Central

    Bavia, Paula Furlan

    2016-01-01

    ABSTRACT Objectives This study investigated the association between craniofacial morphology and temporomandibular disorders in adults. The influence of different craniofacial morphologies on painful temporomandibular disorders was also evaluated. Material and Methods A total of 200 subjects were selected, including 100 with temporomandibular disorders (TMD) and 100 without TMD (control), diagnosed by research diagnostic criteria for temporomandibular disorders. All subjects were submitted to lateral cephalometric radiographs, and classified as brachyfacial, mesofacial, or dolichofacial by Ricketts’ analysis. Data were analysed by Tukey-Kramer and Chi-square tests. Results No association between craniofacial morphology and TMD was found (P = 0.6622). However, brachyfacial morphology influences the presence of painful TMD (P = 0.0077). Conclusions Craniofacial morphology is not related to temporomandibular disorders in general. PMID:27489610

  6. Extra-articular Manifestations in Rheumatoid Arthritis

    PubMed Central

    Cojocaru, Manole; Cojocaru, Inimioara Mihaela; Silosi, Isabela; Vrabie, Camelia Doina; Tanasescu, R

    2010-01-01

    ABSTRACT Rheumatoid arthritis (RA) is a systemic autoimmune disease whose main characteristic is persistent joint inflammation that results in joint damage and loss of function. Although RA is more common in females, extra-articular manifestations of the disease are more common in males. The extra-articular manifestations of RA can occur at any age after onset. It is characterised by destructive polyarthritis and extra-articular organ involvement, including the skin, eye, heart, lung, renal, nervous and gastrointestinal systems. The frequence of extra-articular manifestations in RA differs from one country to another. Extra-articular organ involvement in RA is more frequently seen in patients with severe, active disease and is associated with increased mortality. Incidence and frequence figures for extra-articular RA vary according to study design. Extra-articular involvement is more likely in those who have RF and/or are HLA-DR4 positive. Occasionally, there are also systemic manifestations such as vasculitis, visceral nodules, Sjögren's syndrome, or pulmonary fibrosis present. Nodules are the most common extra-articular feature, and are present in up to 30%; many of the other classic features occur in 1% or less in normal clinic settings. Sjögren's syndrome, anaemia of chronic disease and pulmonary manifestations are relatively common – in 6-10%, are frequently present in early disease and are all related to worse outcomes measures of rheumatoid disease in particular functional impairment and mortality. The occurrence of these systemic manifestations is a major predictor of mortality in patients with RA. This paper focuses on extra-articular manifestations, defined as diseases and symptoms not directly related to the locomotor system. PMID:21977172

  7. Interaction of strain and interleukin-1 in articular cartilage: effects, on proteoglycan synthesis in chondrocytes

    PubMed Central

    Gassner, Robert J.; Buckley, Michael J.; Studer, Rebecca K.; Evans, Chris H.; Agarwal, Sudha

    2016-01-01

    In temporomandibular joint disorders, the release of proinflammatory cytokines such as interleukin-1 (IL-1) initiates an inflammatory process disrupting cartilage homeostasis, ultimately leading to cartilage destruction. Additionally, mechanical stimuli affect articular chondrocyte metabolism. While articular chondrocytes generate nitric oxide (NO) in the presence of IL-1 proteoglycan synthesis is consecutively suppressed. The purpose of this study was to assess the effects of proinflammatory cytokines and mechanical strain in the form of cyclic tensile stretch on proteoglycan synthesis in chondrocytes, as compared to the NO competitive inhibitor L-N-monomethyl arginine (LMA), and to assess whether this effect is secondarily related to the activity of growth factors such as transforming growth factor beta (TGF-β). Lapine articular chondrocytes were exposed to one of four different treatment regimens: no cyclic tensile stretch, IL-1, cyclic tensile stretch, or IL-1 plus cyclic tensile stretch. NO production was determined as medium nitrite accumulation. TGF-β-bioactivity in chondrocyte conditioned medium was measured with the mink-lung epithelial cell bioassay. Proteoglycan synthesis was measured as the incorporation of 35-[S]-sodium sulfate into macromolecules separated from unincorporated label by gel filtration on PD-10 columns. In resting chondrocyte cultures, only baseline levels of NO were measured and the application of stretch for 24 h did not affect NO production. Addition of IL-1 provoked a large increase in NO synthesis which was abrogated in the presence of LMA. Application of stretch decreased the IL-1 induced NO synthesis, but did not modify the effect of LMA (being a competitive inhibitor of the inducible NO synthase) inhibiting IL-1 induced NO production. Glucosaminoglycan production was noted as proteoglycan synthesis showing almost no effect of cyclic stretch alone in comparison to the control condition, which correlates with the missing NO

  8. Immunohistochemical expression of types I and III collagen antibodies in the temporomandibular joint disc of human foetuses

    PubMed Central

    de Moraes, L.O.C.; Lodi, F.R.; Gomes, T.S.; Marques, S.R.; Oshima, C.T.F.; Lancellotti, C.L.P.; Rodríguez-Vázquez, J.F.; Mérida-Velasco, J.R.; Alonso, L.G.

    2011-01-01

    The objective was to study the morphology of the articular disc and analyse the immunohistochemical expression of types I and III collagen markers in the temporomandibular joint (TMJ) disc of human foetuses of different gestational ages. Twenty TMJ from human foetuses supplied by Universidade Federal de Uberaba with gestational ages from 17 to 24 weeks were studied. The gestational age of the foetuses was determined by measuring the crown-rump (CR) length. Macroscopically, the foetuses were fixed in 10% formalin solution and dissected by removing the skin and subcutaneous tissue and exposing the deep structures. Immunohistochemical markers of type I and III were used to characterize the existence of collagen fibres. Analysis of the immunohistochemical markers of types I and III collagen revealed the presence of heterotypical fibril networks. PMID:22073371

  9. Influence of unilateral disc displacement on the stress response of the temporomandibular joint discs during opening and mastication

    PubMed Central

    Pérez del Palomar, A; Doblaré, M

    2007-01-01

    The temporomandibular joint plays a crucial role in human mastication acting as a guide of jaw movements. During these movements, the joint is subjected to loads which cause stresses and deformations in its cartilaginous structures. A perfect balance between the two sides of the joint is essential to maintain the physiological stress level within the tissues. Therefore, it has been suggested that a derangement of the joint is a contributing factor in the development of mandibular asymmetry, especially if problems of the temporomandibular joint start in childhood or adolescence. To analyze the movement of the mandible and the stresses undergone by the discs, two finite element models of the human temporomandibular joint including the masticatory system were developed, one corresponding to a healthy joint and the other with a unilateral anterior disc displacement with their movement controlled by muscle activation. A fibre-reinforced porohyperelastic model was used to simulate the behaviour of the articular discs. The stress distribution was analyzed in both models during free opening and closing, and during the introduction of a resistant force between incisors or molars. It was found that a slight unilateral anterior disc displacement does not lead to mandibular asymmetry but to a slight decrease of the maximum gape. With the introduction of a restriction between incisors, the maximum stresses moved to the anterior band in contrast to what happened if the restriction was imposed between molars where maximum stresses were located more posteriorly. Finally, the presence of a unilateral displacement of the disc involved a strong change in the overall behaviour of the joint including also the healthy side, where the maximum stresses moved to the posterior part. PMID:17725577

  10. Transcriptional regulation of Proteoglycan 4 (PRG4) by 17β-estradiol in immortalized baboon temporomandibular joint disc cells

    PubMed Central

    McDaniel, Jennifer S.; Babu, Ramya Akula Suresh; Navarro, Mary M.; LeBaron, Richard G.

    2015-01-01

    Temporomandibular joint disorders (TMDs) affect a significant portion of the U.S. population with the majority seeking treatment being women of childbearing age. Due to this striking sexual dimorphism it has been postulated that there is a role for sex hormones in the maintenance of normal temporomandibular joint (TMJ) function. Proteoglycan 4 (PRG4) is a secreted lubricating molecule required for maintaining low frictional levels within articular joints, however its role in the TMJ is not well characterized. In this study we describe the development of immortalized baboon cells isolated from specific regions of the TMJ disc and their use in the investigation of PRG4 expression and localization patterns in the TMJ. We identified conserved estrogen response elements within the 5′ flanking region of the PRG4 gene of several species, and found that treatment of baboon TMJ disc cells with estrogen led to reduced PRG4 promoter activity and mRNA expression in vitro. The observed negative regulation of PRG4 by estrogen could lead to increased friction and degradation of joint components over time. This study, for the first time, provides evidence of the regulatory potential of estrogen on PRG4 gene expression and suggests a novel etiology for the gender disparity observed among TMD patients. PMID:24621258

  11. Morphological Study of the Articular Disc and Capillary of the Retrodiscal Tissue in a Type 2 Spontaneous Diabetes Mellitus Rat Model.

    PubMed

    Uemura, Mamoru; Toda, Isumi; Kawashima, Wataru; Yoshimoto, Gaku; Fang, Yi-Ru; Xu, Yuan Jin; Liu, Yuan; Zhang, Lei; Takemura, Akimichi

    2016-01-01

    The objective of this study was to evaluate morphological changes at the articular disc of the temporomandibular joint and capillary of the retrodiscal tissue in a rat model for type 2 spontaneous diabetes mellitus (DM) (i.e., Goto-Kakizaki [GK] rats) compared to normal Wistar rats. A total of 20 experimental rats were used in this study; the rats were categorized into the normal (n = 10 male 8-week-old Wistar rats) and DM (n = 10 male 8-week-old GK rats) groups. Hematoxylin-eosin stained specimens were obtained from 5 rats from each group. Image analyses of the hematoxylin-eosin stained specimens were conducted using light micrographs, which allowed comparisons of the thickness of the anterior, central, and posterior parts of the articular disc. Afterwards, the microvascular corrosion cast specimens were obtained from 5 rats from each group. The diameter of the capillary of the retrodiscal tissue was determined by analyzing scanning electron micrographs of the microvascular corrosion cast specimens. Student's t-test was used to test for statistical significant differences between the 2 groups. Differences were considered significant when p < 0.01. We found that the thickness of the anterior, central, and posterior parts of the articular disc, and the diameter of the capillary of the retrodiscal tissue was significantly lower in the DM vs. normal group. Therefore, we consider that DM-associated the hyperglycemia causes atrophy of the articular disc and microangiopathy of the capillary of the retrodiscal tissue in GK rats. PMID:27319300

  12. Supporting Biomaterials for Articular Cartilage Repair

    PubMed Central

    Duarte Campos, Daniela Filipa; Drescher, Wolf; Rath, Björn; Tingart, Markus

    2012-01-01

    Orthopedic surgeons and researchers worldwide are continuously faced with the challenge of regenerating articular cartilage defects. However, until now, it has not been possible to completely mimic the biological and biochemical properties of articular cartilage using current research and development approaches. In this review, biomaterials previously used for articular cartilage repair research are addressed. Furthermore, a brief discussion of the state of the art of current cell printing procedures mimicking native cartilage is offered in light of their use as future alternatives for cartilage tissue engineering. Inkjet cell printing, controlled deposition cell printing tools, and laser cell printing are cutting-edge techniques in this context. The development of mimetic hydrogels with specific biological properties relevant to articular cartilage native tissue will support the development of improved, functional, and novel engineered tissue for clinical application. PMID:26069634

  13. Characterization of cutaneous and articular sensory neurons

    PubMed Central

    da Silva Serra, Ines; Husson, Zoé; Bartlett, Jonathan D.

    2016-01-01

    Background A wide range of stimuli can activate sensory neurons and neurons innervating specific tissues often have distinct properties. Here, we used retrograde tracing to identify sensory neurons innervating the hind paw skin (cutaneous) and ankle/knee joints (articular), and combined immunohistochemistry and electrophysiology analysis to determine the neurochemical phenotype of cutaneous and articular neurons, as well as their electrical and chemical excitability. Results Immunohistochemistry analysis using RetroBeads as a retrograde tracer confirmed previous data that cutaneous and articular neurons are a mixture of myelinated and unmyelinated neurons, and the majority of both populations are peptidergic. In whole-cell patch-clamp recordings from cultured dorsal root ganglion neurons, voltage-gated inward currents and action potential parameters were largely similar between articular and cutaneous neurons, although cutaneous neuron action potentials had a longer half-peak duration (HPD). An assessment of chemical sensitivity showed that all neurons responded to a pH 5.0 solution, but that acid-sensing ion channel (ASIC) currents, determined by inhibition with the nonselective acid-sensing ion channel antagonist benzamil, were of a greater magnitude in cutaneous compared to articular neurons. Forty to fifty percent of cutaneous and articular neurons responded to capsaicin, cinnamaldehyde, and menthol, indicating similar expression levels of transient receptor potential vanilloid 1 (TRPV1), transient receptor potential ankyrin 1 (TRPA1), and transient receptor potential melastatin 8 (TRPM8), respectively. By contrast, significantly more articular neurons responded to ATP than cutaneous neurons. Conclusion This work makes a detailed characterization of cutaneous and articular sensory neurons and highlights the importance of making recordings from identified neuronal populations: sensory neurons innervating different tissues have subtly different properties

  14. Imaging Approach to Temporomandibular Joint Disorders.

    PubMed

    Morales, H; Cornelius, R

    2016-03-01

    Internal derangement is the most common temporomandibular joint disorder. Degenerative osteoarthritis and trauma are next in frequency. Less common pathology includes rheumatoid arthritis, synovial chondromatosis, calcium pyrophosphate dehydrate deposition disease, pigmented villonodular synovitis, tumors, infection, and osteonecrosis. We provide a systematic approach to facilitate interpretation based on major anatomic structures: disc-attachments, joint space, condyle, and lateral pterygoid muscle. Relevant graphic anatomy and state of the art imaging are discussed in correlation with current clinical and therapeutic highlights of pathologic entities affecting the joint. PMID:26374243

  15. Intrauterine Temporomandibular Joint Dislocation: Prenatal Sonographic Evaluation

    PubMed Central

    Çil, Ahmet Said; Bozkurt, Murat; Bozkurt, Duygu Kara

    2014-01-01

    Congenital temporomandibular joint (TMJ) diseases are very rare disorders and are usually diagnosed in childhood. Developmental disorders of the TMJ such as hypoplasia, hyperplasia, and aplasia of the TMJ compartments are characterized by TMJ dysfunction. In childhood, these patients experience recurrent dislocation, pain, and malocclusion. We present the case of a 25-week fetus with unilateral TMJ dislocation with fluid retention in the joint diagnosed by ultrasonography. To the best of our knowledge, this is the first case of TMJ dislocation diagnosed by ultrasonographic evaluation during the prenatal period. PMID:23669613

  16. Myogenous temporomandibular disorders: diagnostic and management considerations.

    PubMed

    Fricton, James

    2007-01-01

    Myogenous temporomandibular disorders (or masticatory myalgia) are characterized by pain and dysfunction that arise from pathologic and functional processes in the masticatory muscles. There are several distinct muscle disorder subtypes in the masticatory system, including myofascial pain, myositis, muscle spasm, and muscle contracture. The major characteristics of masticatory myalgia include pain, muscle tenderness, limited range of motion, and other symptoms (eg, fatigability, stiffness, subjective weakness). Comorbid conditions and complicating factors also are common and are discussed. Management follows with stretching, posture, and relaxation exercises, physical therapy, reduction of contributing factors, and as necessary, muscle injections. PMID:17185060

  17. Quantitative Radiological Diagnosis Of The Temporomandibular Joint

    NASA Astrophysics Data System (ADS)

    Jordan, Steven L.; Heffez, Leslie B.

    1989-05-01

    Recent impressive technological advances in imaging techniques for the human temporomandibular (tm) joint, and in enabling geometric algorithms have outpaced diagnostic analyses. The authors present a basis for systematic quantitative diagnoses that exploit the imaging advancements. A reference line, coordinate system, and transformations are described that are appropriate for tomography of the tm joint. These yield radiographic measurements (disk displacement) and observations (beaking of radiopaque dye and disk shape) that refine diagnostic classifications of anterior displacement of the condylar disk. The relevance of these techniques has been clinically confirmed. Additional geometric invariants and procedures are proposed for future clinical verification.

  18. Intrauterine temporomandibular joint dislocation: prenatal sonographic evaluation.

    PubMed

    Çil, Ahmet Said; Bozkurt, Murat; Bozkurt, Duygu Kara

    2014-09-01

    Congenital temporomandibular joint (TMJ) diseases are very rare disorders and are usually diagnosed in childhood. Developmental disorders of the TMJ such as hypoplasia, hyperplasia, and aplasia of the TMJ compartments are characterized by TMJ dysfunction. In childhood, these patients experience recurrent dislocation, pain, and malocclusion. We present the case of a 25-week fetus with unilateral TMJ dislocation with fluid retention in the joint diagnosed by ultrasonography. To the best of our knowledge, this is the first case of TMJ dislocation diagnosed by ultrasonographic evaluation during the prenatal period. PMID:23669613

  19. Articular cartilage: structure and regeneration.

    PubMed

    Becerra, José; Andrades, José A; Guerado, Enrique; Zamora-Navas, Plácido; López-Puertas, José M; Reddi, A Hari

    2010-12-01

    Articular cartilage (AC) has no or very low ability of self-repair, and untreated lesions may lead to the development of osteoarthritis. One method that has been proven to result in long-term repair or isolated lesions is autologous chondrocyte transplantation. However, first generation of these cells' implantation has limitations, and introducing new effective cell sources can improve cartilage repair. AC provides a resilient and compliant articulating surface to the bones in diarthrodial joints. It protects the joint by distributing loads applied to it, so preventing potentially damaging stress concentrations on the bone. At the same time it provides a low-friction-bearing surface to enable free movement of the joint. AC may be considered as a visco- or poro-elastic fiber-composite material. Fibrils of predominantly type II collagen provide tensile reinforcing to a highly hydrated proteoglycan gel. The tissue typically comprises 70% water and it is the structuring and retention of this water by the proteoglycans and collagen that is largely responsible for the remarkable ability of the tissue to support compressive loads. PMID:20836752

  20. Diagnostic concordance between MRI and electrovibratography of the temporomandibular joint of subjects with disc displacement disorders

    PubMed Central

    Deregibus, A; Castroflorio, T; De Giorgi, I; Burzio, C; Debernardi, C

    2013-01-01

    Objectives: The aim of this study is to evaluate the diagnostic concordance of MRI and electrovibratography (EVG) of the temporomandibular joint (TMJ) in the diagnosis of articular disc displacement with reduction (ADDwR) and articular disc displacement without reduction (ADDw/oR). Methods: 50 patients (12 males, 38 females; mean age 37.46 ± 15.64 years) with a hypothesis of disc displacement were selected. For each patient an MRI of the TMJ was performed. MRIs were evaluated sorting the 100 TMJs by kind of pathology (no pathology, ADDwR, ADDw/oR, and joint hypermobility). Afterwards, the patients had an EVG exam. The EVG exams were performed with vibration transducers over each TMJ, enabling simultaneous, bilateral recording of vibrations emanating from joint sounds during the opening and closing movements. The presence of a sound peak was compared with the MRI diagnosis of ADDwR, while a multipeak aspect was compared with ADDw/oR diagnosis using Cohen's kappa test. Results: The presence of a peak-shaped track has high specificity for ADDwR (90.27%). The Cohen's kappa calculated for the ADDwR was 0.5615 (good–moderate). The presence of a multipeak-shaped track has low specificity (65.22%) and sensitivity (70.42%). The Cohen's kappa calculated for the ADDw/oR was 0.2992 (poor). Conclusions: The present study recommends the use of EVG to support the clinical diagnosis of a disc displacement with reduction when MRI is not available or when subjects cannot be investigated by MRI. PMID:23420863

  1. Clinical, radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases.

    PubMed

    Helenius, L M J; Tervahartiala, P; Helenius, I; Al-Sukhun, J; Kivisaari, L; Suuronen, R; Kautiainen, H; Hallikainen, D; Lindqvist, C; Leirisalo-Repo, M

    2006-11-01

    The aim of this study was to investigate the condition of the temporomandibular joint (TMJ) in patients with different rheumatic diseases, and report correlations between the clinical, radiographic and magnetic resonance imaging (MRI) findings. The 67 patients were divided into four groups: 16 with rheumatoid arthritis (RA), 15 with mixed connective tissue disease (MCTD), 18 with ankylosing spondylitis (AS) and 18 with spondyloarthropathy (SPA). They were clinically examined, and panoramic tomography, lateral panoramic radiography and MRI of the TMJ were performed. MRI showed reduced articular cartilage in 25% (4/16) of RA, 0% (0/15) of MCTD, 17% (3/18) of AS and 17% (3/18) of SPA patients. Condylar changes included erosion, osteophytes and abnormal shape. Disc alterations included perforation, abnormal anterior position and decreased movement. These abnormalities were most frequent in RA patients, and least frequent in MCTD and SPA patients. Crepitation and reduced maximum opening of the mouth correlated with abnormalities of the disc and articular cartilage as shown by MRI. Severe condylar erosion in panoramic tomograms significantly correlated with MRI findings of condylar erosion (P<0.01), diminished thickness of condylar cartilage, abnormal condylar shape, and abnormal shape of the temporal surface of the TMJ (P< or =0.001). The presence of crepitation, limited mandibular movement and/or pain on movement of the jaw often indicated structural damage to the TMJ. Panoramic radiographs provide an alternative method to MRI but, to obtain a more detailed anatomic picture, MRI is recommended for patients with acute unexplained pain or as part of preoperative work up. A panoramic recording is not indicated when MRI is planned. PMID:17052893

  2. Assessing the reliability of MRI-CBCT image registration to visualize temporomandibular joints

    PubMed Central

    Jaremko, J L; Alsufyani, N; Jibri, Z; Lai, H; Major, P W

    2015-01-01

    Objectives: To evaluate image quality of two methods of registering MRI and CBCT images of the temporomandibular joint (TMJ), particularly regarding TMJ articular disc–condyle relationship and osseous abnormality. Methods: MR and CBCT images for 10 patients (20 TMJs) were obtained and co-registered using two methods (non-guided and marker guided) using Mirada XD software (Mirada Medical Ltd, Oxford, UK). Three radiologists independently and blindly evaluated three types of images (MRI, CBCT and registered MRI-CBCT) at two times (T1 and T2) on two criteria: (1) quality of MRI-CBCT registrations (excellent, fair or poor) and (2) TMJ disc–condylar position and articular osseous abnormalities (osteophytes, erosions and subcortical cyst, surface flattening, sclerosis). Results: 75% of the non-guided registered images showed excellent quality, and 95% of the marker-guided registered images showed poor quality. Significant difference was found between the non-guided and marker-guided registration (χ2 = 108.5; p < 0.01). The interexaminer variability of the disc position in MRI [intraclass correlation coefficient (ICC) = 0.50 at T1, 0.56 at T2] was lower than that in MRI-CBCT registered images [ICC = 0.80 (0.52–0.92) at T1, 0.84 (0.62–0.93) at T2]. Erosions and subcortical cysts were noticed less frequently in the MRI-CBCT images than in CBCT images. Conclusions: Non-guided registration proved superior to marker-guided registration. Although MRI-CBCT fused images were slightly more limited than CBCT alone to detect osseous abnormalities, use of the fused images improved the consistency among examiners in detecting disc position in relation to the condyle. PMID:25734241

  3. COMPUTED TOMOGRAPHIC APPEARANCE OF THE TEMPOROMANDIBULAR JOINT IN 1018 ASYMPTOMATIC HORSES: A MULTI-INSTITUTION STUDY.

    PubMed

    Carmalt, James L; Kneissl, Sibylle; Rawlinson, Jennifer E; Zwick, Timo; Zekas, Lisa; Ohlerth, Stefanie; Bienert-Zeit, Astrid

    2016-05-01

    Published descriptions of nonseptic arthritis of the equine temporomandibular joint (TMJ) are rare and large studies investigating variations in the TMJ for asymptomatic horses are lacking. The objectives of this cross-sectional, retrospective, multi-institutional study were to describe anatomical variations in the TMJ detected using computed tomography (CT) in an equid population asymptomatic for TMJ disease and determine whether these variations were associated with patient signalment, reason for CT examination, or CT slice width. Medical records at eight hospitals were searched for horses that had head/neck CT scans and no clinical signs of TMJ disease. Age, breed, sex, clinical presentation, and CT slice width data were recorded. Alterations in CT contour and density of the mandibular condyles, mandibular fossae, and TMJ intra-articular discs were described for each horse. Generalized logistic regression was used to test associations between anatomical variations and horse age. A total of 1018 horses were sampled. Anatomical variations were found in TMJ CT images for 40% of horses and 29% of joints. These were dichotomous with regard to age. Horses <1 year old commonly had alterations in the shape and density of the mandibular condyle. Older horses commonly had spherical hypodensities within the mandibular condyles consistent with bone cysts; and hyperdense regions of the intra-articular disc consistent with dystrophic mineralization. Findings indicated that TMJ anatomic variations were common in CT images of younger and older horses asymptomatic for TMJ disease. Future studies are needed to more definitively characterize these CT variations using gross pathology and histopathology. PMID:26773281

  4. Inhibition of β-Catenin Signaling in Articular Chondrocytes Results in Articular Cartilage Destruction

    PubMed Central

    Zhu, Mei; Chen, Mo; Zuscik, Michael; Wu, Qiuqian; Wang, Yong-Jun; Rosier, Randy N.; O’Keefe, Regis J.; Chen, Di

    2009-01-01

    Objective Osteoarthritis is a degenerative joint disease whose molecular mechanism is currently unknown. Wnt/β-catenin signaling has been demonstrated to play a critical role in the development and function of articular chondrocytes. To determine the role of β-catenin signaling in articular chondrocyte function, we generated Col2a1-ICAT–transgenic mice to inhibit β-catenin signaling in chondrocytes. Methods The expression of the ICAT transgene was determined by immunostaining and Western blot analysis. Histologic analyses were performed to determine changes in articular cartilage structure and morphology. Cell apoptosis was determined by TUNEL staining and the immunostaining of cleaved caspase 3 and poly(ADP-ribose) polymerase (PARP) proteins. Expression of Bcl-2, Bcl-xL, and Bax proteins and caspase 9 and caspase 3/7 activities were examined in primary sternal chondrocytes isolated from 3-day-old neonatal Col2a1-ICAT–transgenic mice and their wild-type littermates and in primary chicken and porcine articular chondrocytes. Results Expression of the ICAT transgene was detected in articular chondrocytes of the transgenic mice. Associated with this, age-dependent articular cartilage destruction was observed in Col2a1-ICAT– transgenic mice. A significant increase in cell apoptosis in articular chondrocytes was identified by TUNEL staining and the immunostaining of cleaved caspase 3 and PARP proteins in these transgenic mice. Consistent with this, Bcl-2 and Bcl-xL expression were decreased and caspase 9 and caspase 3/7 activity were increased, suggesting that increased cell apoptosis may contribute significantly to the articular cartilage destruction observed in Col2a1-ICAT–transgenic mice. Conclusion Inhibition of β-catenin signaling in articular chondrocytes causes increased cell apoptosis and articular cartilage destruction in Col2a1-ICAT–transgenic mice. PMID:18576323

  5. Temporomandibular disorders. Part 2: conservative management

    PubMed Central

    Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

    2014-01-01

    Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables. PMID:24976744

  6. Articular chondrocyte metabolism and osteoarthritis

    SciTech Connect

    Leipold, H.R.

    1989-01-01

    The three main objectives of this study were: (1) to determine if depletion of proteoglycans from the cartilage matrix that occurs during osteoarthritis causes a measurable increase of cartilage proteoglycan components in the synovial fluid and sera, (2) to observe what effect intracellular cAMP has on the expression of matrix components by chondrocytes, and (3) to determine if freshly isolated chondrocytes contain detectable levels of mRNA for fibronectin. Canine serum keratan sulfate and hyaluronate were measured to determine if there was an elevation of these serum glycosaminoglycans in a canine model of osteoarthritis. A single intra-articular injection of chymopapain into a shoulder joint increased serum keratan sulfate 10 fold and hyaluronate less than 2 fold in 24 hours. Keratan sulfate concentrations in synovial fluids of dogs about one year old were unrelated to the presence of spontaneous cartilage degeneration in the joints. High keratan sulfate in synovial fluids correlated with higher keratan sulfate in serum. The mean keratan sulfate concentration in sera of older dogs with osteoarthritis was 37% higher than disease-free controls, but the difference between the groups was not statistically significant. Treatment of chondrocytes with 0.5 millimolar (mM) dibutyryl cAMP (DBcAMP) caused the cells to adopt a more rounded morphology. There was no difference between the amount of proteins synthesized by cultures treated with DBcAMP and controls. The amount of fibronectin (FN) in the media of DBcAMP treated cultures detected by an ELISA was specifically reduced, and the amount of {sup 35}S-FN purified by gelatin affinity chromatography decreased. Moreover, the percentage of FN containing the extra domain. A sequence was reduced. Concomitant with the decrease in FN there was an increase in the concentration of keratan sulfate.

  7. Intra-articular therapy in osteoarthritis

    PubMed Central

    Uthman, I; Raynauld, J; Haraoui, B

    2003-01-01

    The medical literature was reviewed from 1968–2002 using Medline and the key words "intra-articular" and "osteoarthritis" to determine the various intra-articular therapies used in the treatment of osteoarthritis. Corticosteroids and hyaluronic acid are the most frequently used intra-articular therapies in osteoarthritis. Other intra-articular substances such as orgotein, radiation synovectomy, dextrose prolotherapy, silicone, saline lavage, saline injection without lavage, analgesic agents, non-steroidal anti-inflammatory drugs, glucosamine, somatostatin, sodium pentosan polysulfate, chloroquine, mucopolysaccharide polysulfuric acid ester, lactic acid solution, and thiotepa cytostatica have been investigated as potentially therapeutic in the treatment of arthritic joints. Despite the lack of strong, convincing, and reproducible evidence that any of the intra-articular therapies significantly alters the progression of osteoarthritis, corticosteroids and hyaluronic acid are widely used in patients who have failed other therapeutic modalities for lack of efficacy or toxicity. As a practical approach for a knee with effusion, steroid injections should be considered while the presence of symptomatic "dry" knees may favour the hyaluronic acid approach. The virtual absence of serious side effects, coupled with the perceived benefits, make these approaches attractive. PMID:12954956

  8. Temporomandibular joint: true sagittal computed tomography with meniscus visualization

    SciTech Connect

    Sartorix, D.J.; Neumann, C.H.; Riley, R.W.

    1984-01-01

    Accessory patient support equipment was constructed that allows patient positioning for true sagittal projection of the temporomandibular joint using a GE 8800 CT/T scanner. Range of motion abnormalities, osseous alterations of the mandibular condyle and temporal bone, joint-space narrowing, and meniscal configuration may be demonstrated. The technique has potential advantages over other CT projections and sagittal reconstruction for evaluation of temporomandibular joint dysfunction.

  9. Prevalence of temporomandibular dysfunction in children and adolescents

    PubMed Central

    de Sena, Marina Fernandes; de Mesquita, Késsia Suênia F.; Santos, Fernanda Regina R.; Silva, Francisco Wanderley G. P.; Serrano, Kranya Victoria D.

    2013-01-01

    OBJECTIVE: To review the prevalence of temporomandibular disorders (TMD) in children and adolescents, verifying the methodological variations. DATA SOURCES: Research conducted in Medline, PubMed, Lilacs and BBO databases, including manuscripts (except reviews and case reports) published from 1990 to 2012. The descriptors were "temporomandibular joint syndrome", "temporomandibular joint dysfunction syndrome", "temporomandibular joint disorders", "prevalence studies", and "cross-sectional studies"; the words "dysfunction", "disorder", "temporomandibular", "children", "adolescents", "prevalence", "frequency", and "transversal" were used. DATA SYNTHESIS: Seventeen articles were selected, and the TMD frequency varied from 16 to 68%. Regarding the methodological criteria, only three articles (18%) reported sample size determination, three (18%) clearly described the sample selection process by stratified selection technique, and nine studies (53%) carried out the calibration of the examiners. The diagnostic criteria used in the studies were: Helkimo index (n=2; 12%), Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (n=4; 24%), the jaw index (n=1; 6%), clinical protocols (n=10; 59%), and anamnestic questionnaires (n=6; 35%). CONCLUSIONS: The TMD prevalence in children and adolescents varies in the literature. Appropriate and standardized methods are needed to identify, with greater validity, the presence of TMD in this population, allowing a better understanding of the pathological aspects in order to address more effective preventive and therapeutic procedures. PMID:24473961

  10. A retrospective study of temporomandibular joint ankylosis secondary to surgical treatment of mandibular condylar fractures.

    PubMed

    Xiang, Guo-lin; Long, Xing; Deng, Mo-hong; Han, Qian-chao; Meng, Qing-gong; Li, Bo

    2014-03-01

    We investigated the incidence of ankylosis of the temporomandibular joint (TMJ) after open operations for fractures of the mandibular condyle, and analysed possible risk factors in a total of 385 patients with 492 condylar fractures who had been operated on in our department from 2001 to 2010. Sixteen patients developed postoperative ankylosis of the TMJ with 26 joints (5%) affected during a follow-up of 6 months-10 years. Of the 492 condylar fractures, the most common ones that were associated with postoperative ankylosis were those of the condylar head (20/248), followed by the condylar neck (6/193). Subcondylar fractures did not cause postoperative ankylosis (0/51). Among the 16 patients with postoperative ankylosis, 13 had associated anterior mandibular fractures. Long-screw (bicortical screw) fixation of fractures of the condylar head seemed to be associated with a lower incidence of postoperative ankylosis than fixation by miniplate and wire or removal of the fractured fragment. The articular discs were damaged in all ankylosed joints, and the remaining fractured fragment was found in 10 ankylosed joints after fractures of the condylar head. The results suggest that fractures of the condylar head are more prone to lead to postoperative ankylosis of the TMJ, and that the possible risk factors seem to include the technique used for fixation and damage to the disc, together with an anterior mandibular fracture with the fractured fragment remaining. PMID:24485809

  11. HLA analysis in patients with degenerative diseases of the temporomandibular joint.

    PubMed

    Learreta, Jorge A; Bono, Andrea E; Durst, Andreas C

    2011-01-01

    The aim of this study was to determine the presence of HLA alleles, specifically HLA-DR alleles, and to correlate them with clinical and radiological features of patients with degenerative processes (DP) of the temporomandibular joint (TMJ). The final goal was to determine which allele can be used to identify patients having more aggressive forms of the articular pathologies. Thirty-two (32) Caucasian patients with DP of the TMJ were included in the study. The SSOP (Luminex Corp., Austin, TX) method was used to determine class II HLA alleles. The presence of HLA-II DR in patients with DP of the TMJ was 98%. The presence of HLA was significantly higher in patients with DP of the TMJ than in healthy subjects (66%) (p=0.003). HLA DR52 was significantly more frequent in patients than in healthy individuals (40.62% vs. 13.79%, p = 0.041). While the percentage of DR11 positive individuals was also higher among patients than among healthy control subjects, the association with DP of the TMJ was not significant (p=0.220). Patients having the DR52 allele had higher deformation or DP. It was concluded that HLA-DR54 and DR11 alleles are associated with a higher susceptibility to DP of the TMJ, and HLA-DR54 and DR52 are associated with a higher severity of DP. PMID:21370767

  12. Removal of a Solitary Synovial Chondromatosis of the Temporomandibular Joint Using Arthroscopy.

    PubMed

    Pastore, Gabriel Pires; Goulart, Douglas Rangel; Pastore, Patrícia Radaic; Prati, Alexandre Javaroni

    2016-06-01

    The diagnosis of synovial chrondromatosis of temporomandibular joint (TMJ) requires a combined assessment consisting of clinical, radiologic, and histopathologic examinations. The purpose of this study is to report in 1 patient the removal of a single large cartilaginous nodule floating in the upper joint compartment using arthroscopy. A 30-year-old woman was referred to our department complaining about pain in preauricular area and restricted mouth opening. Imaging of magnetic resonance reveals anterior disc displacement and right joint effusion. Arthroscopy of TMJ was performed for diagnosis and treatment. During the arthroscopy a large loose body was identified and removed with a biopsy forceps; lavage was conducted with ringer solution. Hyaluronic acid was injected in TMJ at surgery, 1 and 3 months after surgery. Postoperative magnetic resonance imaging showed articular disc on position and no effusion. The patient was followed up of 1 year without sign and symptoms. Arthroscopic procedure of TMJ was effective in diagnosis and removal of a solitary loose body of synovial chrondromatosis. Viscosupplementation appers to offer benefits in controlling pain and functional improvements. PMID:27244213

  13. Arthroscopic eminoplasty for habitual dislocation of the temporomandibular joint: preliminary study.

    PubMed

    Segami, N; Kaneyama, K; Tsurusako, S; Suzuki, T

    1999-12-01

    A unique surgical technique, arthroscopic eminoplasty was undertaken in 16 joints of 11 patients with habitual dislocation of the temporomandibular joint (TMJ). There were 10 joints with subluxation and 6 joints with complete dislocation in 4 male and 7 female patients with a mean age of 33 +/- 20 years. The procedure consisted of conventional diagnostic arthroscopy, followed by shaving of approximately 3 to 5 mm in height of the articular eminence with an electric motorized shaver with bone files, depending on the bone thickness as detected by preoperative imaging. The arthroscopic eminoplasty was accomplished without any peri- or postoperative complication. During the postoperative follow-up period of 19 months on average (6-36 months), all patients were free of dislocation of the TMJ, except for one joint. The patients could open their mouth 42 +/- 6 mm without arthralgia 2 weeks after surgery, and finally 47 +/- 7 mm without any subjective symptom but small joint noises (clicking or crepitus) in 10 joints. On postoperative radiographs only minor changes of the mandibular condyle were apparent in four joints. Arthroscopic eminoplasty might become a significant procedure for habitual dislocation of the TMJ and seems to produce results comparable to open arthrotomy. Further study will be required to assess this method as an acceptable modality in the future. PMID:10870759

  14. Injecting vascular endothelial growth factor into the temporomandibular joint induces osteoarthritis in mice

    PubMed Central

    Shen, Pei; Jiao, ZiXian; Zheng, Ji Si; Xu, Wei Feng; Zhang, Shang Yong; Qin, An; Yang, Chi

    2015-01-01

    It is unclear whether vascular endothelial growth factor (VEGF) can initiate osteoarthritis (OA) in the temporomandibular joint (TMJ). In this study we evaluated the effects of intra-articular injection of exogenous VEGF in the TMJ in mice on the early stage. Forty-eight male Sprague-Dawley mice were equally divided into 3 groups. In the vegf group, the mice received an injection of VEGF solution (50 μL) in the TMJ once a week over a period of 4 weeks. In the sham group, the mice received an injection of saline (50 μL). The control group did not receive any injection. Four mice from each group were sacrificed at 1, 2, 4, and 8 weeks. Gradual prominent cartilage degeneration was observed in the vegf group. Additionally, this group showed higher expressions of metalloproteinase (MMP)-9, MMP-13, receptor activator of nuclear factor-kappa-B ligand (RANKL), and a higher number of apoptotic chondrocytes and VEGF receptor 2 (VEGFR2)-positive chondrocytes. Micro-computed tomography (CT) revealed prominent subchondral bone resorption in the vegf group, with a high number of osteoclasts in the subchondral bone. In vitro study demonstrated that VEGF can promote osteoclast differentiation. In conclusion, our study found that VEGF can initiate TMJ OA by destroying cartilage and subchondral bone. PMID:26531672

  15. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

    PubMed

    Cömert Kiliç, S; Kiliç, N; Sümbüllü, M A

    2015-10-01

    The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA. PMID:26194774

  16. Congenital deformities and developmental abnormalities of the mandibular condyle in the temporomandibular joint.

    PubMed

    Kaneyama, Keiseki; Segami, Natsuki; Hatta, Toshihisa

    2008-09-01

    The temporomandibular joint (TMJ) consists of the mandibular condyle and the articular eminence of the temporal bone. The morphological development of the TMJ during prenatal life lags behind other joints in terms of both the timing of its appearance and its progress. At birth, the joint is still largely underdeveloped. There are many causes of the various growth disturbances and abnormalities of the mandibular condyle and related structures. Growth disturbances in the development of the mandibular condyle may occur in utero late in the first trimester and may result in disorders such as aplasia or hypoplasia of the mandibular condyle. Meanwhile, hyperplasia of the mandibular condyle is not visible at birth and seems to be gradually acquired during growth. In the present review article, the congenital abnormalities of the mandibular condyle are classified morphologically into three major groups and two subgroups from a clinical standpoint: (1) hypoplasia or aplasia of the mandibular condyle, including (i) primary condylar aplasia and hypoplasia, (ii) secondary condylar hypoplasia; (2) hyperplasia; and (3) bifidity. In addition, the molecular-based etiology of anomalies of the mandibular condyle is also discussed. PMID:18778456

  17. Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice

    PubMed Central

    CALDAS, Waleska; CONTI, Ana Cláudia de Castro Ferreira; JANSON, Guilherme; Paulo César Rodrigues, CONTI

    2016-01-01

    ABSTRACT The relationship between Temporomandibular Disorders (TMD) and malocclusion is an extremely critical issue in dentistry. Contrary to the old concept that malocclusion causes TMD, occlusal changes, especially those observed as sudden, may be secondary and reflect joint or muscle disorders due to the obvious connection between these structures and the dental occlusion. Objectives The aim of this article is to present the most commonly occlusal changes secondary to TMD. Methods The clinical presentation of these conditions is discussed. Details regarding diagnosis, treatment, and follow-up of patients presenting TMD prior or during treatment are also presented. Conclusions All plans for irreversible therapy should be preceded by a meticulous analysis of TMD signs and symptoms in such a way that patients are not submitted to irreversible treatment, based on an untrue occlusal relationship, secondary to articular and/or muscular disorders. When present, TMD symptoms must always be controlled to reestablish a “normal” occlusion and allow proper treatment strategy. PMID:27556214

  18. Ear pain following temporomandibular surgery originating from the temporomandibular joint or the cranial nervous tissue? A case report.

    PubMed

    Geerse, Wouter K; von Piekartz, Harry J M

    2015-02-01

    A patient presenting with local pain and limitation of movement in the temporomandibular region following surgery of the left temporomandibular joint (TMJ) is described. Manual techniques like distraction of the TMJ combined with motor control exercises to restore TMJ function were not sufficient to relieve the patient's symptoms and her orofacial functions. However, during manual assessment and treatment of cranial nervous tissue, in this case the auriculotemporal nerve and its interface, pain was relieved and orofacial functions improved. PMID:24948551

  19. Temporomandibular disorders. A case-control study

    PubMed Central

    Bagán, Jose V.; Sanchis, Jose M.; Carbonell, Enrique

    2012-01-01

    Objective: To compare the risk factors and clinical manifestations of patients with temporomandibular disorders (TMDs) diagnosed according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) (axis I) versus an age and gender matched control group. Study Design: A total of 162 patients explored according to the RDC/TMD (mean age 40.6±18.8 years, range 7-90; 11.1% males and 88.9% females) were compared with 119 controls, measuring differences in TMD risk factors (sleep disturbances, stress, psychoactive medication, parafunctions, loss of posterior support, ligament hyperlaxity) and clinical variables (joint sounds, painful muscle and joint palpation, maximum aperture). Results: Myofascial pain (MFP) (single or multiple diagnoses) was the most frequent diagnosis (42%). The most common diagnostic combination was MFP plus arthralgia (16.0%). Statistically significant differences were observed in clenching (OR 2.3; 95%CI: 1.4-3.8) and in maximum active aperture (MAA) on comparing the two groups both globally (TMD vs. controls) (patients 36.7±8.6 mm, controls 43.1±5.8 mm; F=45.41, p = 0.000) and on comparing according to diagnostic categories. MFP explained most of the observed differences in the risk factors: stress perception (OR=1.98;I.C.:1.01-3.89), psychoactive medication (OR=2.21; I.C.:1.12-4.37), parafunctions (OR=2.14;I.C.:1.12-4.11), and ligament laxity (OR=2.6;I.C.:1.01-6.68). Joint sounds were more frequent in patients with MFP (39.7% vs. 24.0%; χ2=4.66; p=0.03), and painful joint palpation was more common in patients with disc displacement with reduction (DDWR)(15.9% vs. 5.0%; χ2 = 5.2; p = 0.02) and osteoarthrosis (20.8% vs. 5.0%; χ2 = 7.0; p = 0.008). Conclusions: There is a high prevalence of signs and symptoms of TMDs in the general population. Significant differences are observed in clenching and MAA between patients and controls considered both globally and for each diagnostic category individually. The analyzed risk

  20. Simulaciones hidrodinámicas de flujos complejos

    NASA Astrophysics Data System (ADS)

    María Ibáñez Cabanell, José

    Son muchos los escenarios astrofísicos en que los procesos hidrodinámicos juegan un papel clave. En la complejidad que encierra la descripción de dichos procesos destaca el de la correcta simulación de flujos complejos donde la presencia de ondas de choque fuertes que, eventualmente, interaccionan entre ellas o también la presencia de inestabilidades (Kelvin-Helmholtz, Rayleigh-Taylor, etc.) suponen un verdadero desafío numérico. Los códigos hidrodinámicos basados en la solución de un problema de valores iniciales discontinuo (problema de Riemann) son, en la actualidad, los más robustos en el campo de la dinámica de fluidos computacional. En esta charla se dará un resumen de los fundamentos de dichas técnicas numéricas (esquemas de alta resolución de captura de choques) y se ilustrará su potencialidad mostrando una amplia gama de resultados en diferentes aplicaciones astrofísicas.

  1. Relationship between oral tori and temporomandibular disorders.

    PubMed

    Sirirungrojying, S; Kerdpon, D

    1999-04-01

    The aim of the study was to compare the presence of oral tori and parafunctional activity (clenching, grinding teeth and/or bruxism) between temporomandibular disorder (TMD) patients and control subjects. Fifty-nine TMD and 353 control subjects were included. The groups were similar in sex and age distribution. There was no significant difference in prevalence of torus palatinus (TP) between TMD and control group (P = 0.2), while torus mandibularis (TM) was more common in TMD than in control group (P < 0.0005). Parafunctional habit was more common in TMD patients than in the control group (P < 0.0005). There was no significant association between size of TM and Helkimo's dysfunction index (P = 0.4). The results show that the prevalence of TM and parafunctional activity was higher in TMD than control patients. TM might be useful as an indicator of increased risk of TMD in some patients. PMID:10858740

  2. Absorbed doses from temporomandibular joint radiography

    SciTech Connect

    Brooks, S.L.; Lanzetta, M.L.

    1985-06-01

    Thermoluminescent dosimeters were used in a tissue-equivalent phantom to measure doses of radiation absorbed by various structures in the head when the temporomandibular joint was examined by four different radiographic techniques--the transcranial, transorbital, and sigmoid notch (Parma) projections and the lateral tomograph. The highest doses of radiation occurred at the point of entry for the x-ray beam, ranging from 112 mrad for the transorbital view to 990 mrad for the sigmoid notch view. Only the transorbital projection a radiation dose to the lens of the eye. Of the four techniques evaluated, the lateral tomograph produced the highest doses to the pituitary gland and the bone marrow, while the sigmoid notch radiograph produced the highest doses to the parotid gland.

  3. Association between temporomandibular disorders and obesity.

    PubMed

    Rhim, Eunmi; Han, Kyungdo; Yun, Kyoung-In

    2016-08-01

    Psychological stress can induce altered eating patterns, and studies have indicated that there is a correlation between temporomandibular disorder (TMD) and psychological stress. This study investigated the relationship between TMD and body mass index (BMI) in a large representative sample of the South Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES). Men and women with TMD showed decreased prevalence of abdominal obesity. Women with TMD had lower age, lower BMI, lower metabolic syndromic waist circumference, lower prevalence of metabolic syndrome, and lower prevalence of diabetes compared with the group without TMD. However, males with TMD didn't show any statistically significant difference between BMI, and metabolic syndromic waist circumference compared with the group without TMD, although there were similar tendencies in the female subject groups. Overall, TMD was associated with decreased BMI and abdominal obesity in women. PMID:27349686

  4. [Interdisciplinary treatment of temporomandibular inflammation in children with juvenile idiopathic arthritis].

    PubMed

    Gönner-Ozkan, V; Meyer, P; Tzaribachev, N

    2010-03-01

    Involvement of the temporomandibular joints in children with juvenile idiopathic arthritis usually leads to destruction of the mandibular condyles with consistent growth disturbances and facial anomalies. Due to its frequently silent course, temporomandibular arthritis tends to be a diagnostic and therapeutic challenge. In addition to drug therapy, orthodontics and physiotherapy are essential to prevent further progression and restore lost temporomandibular function. PMID:20107815

  5. Extraction Techniques for the Decellularization of Tissue Engineered Articular Cartilage Constructs

    PubMed Central

    Elder, Benjamin D.; Eleswarapu, Sriram V.; Athanasiou, Kyriacos A.

    2009-01-01

    Several prior studies have been performed to determine the feasibility of tissue decellularization to create a non-immunogenic xenogenic tissue replacement for bladder, vasculature, heart valves, knee meniscus, temporomandibular joint disc, ligament, and tendon. However, limited work has been performed with articular cartilage, and no studies have examined the decellularization of tissue engineered constructs. The objective of this study was to assess the effects of different decellularization treatments on articular cartilage constructs, engineered using a scaffoldless approach, after 4 wks of culture, using a two-phased approach. In the first phase, five different treatments were examined: 1) 1% SDS, 2) 2% SDS, 3) 2% Tributyl phosphate, 4) 2% Triton X-100, and 5) Hypotonic followed by hypertonic solution. These treatments were applied for either 1 h or 8 h, followed by a 2 h wash in PBS. Following this wash, the constructs were assessed histologically, biochemically for cellularity, GAG, and collagen content, and biomechanically for compressive and tensile properties. In phase II, the best treatment from phase I was applied for 1, 2, 4, 6, or 8 h in order to optimize the application time. Treatment with 2% SDS for 1 h or 2 h significantly reduced the DNA content of the tissue, while maintaining the biochemical and biomechanical properties. On the other hand, 2% SDS for 6 h or 8 h resulted in complete histological decellularization, with complete elimination of cell nuclei on histological staining, although GAG content and compressive properties were significantly decreased. Overall, 2% SDS, for 1 or 2 h, appeared to be the most effective agent for cartilage decellularization, as it resulted in decellularization while maintaining the functional properties. The results of this study are exciting as they indicate the feasibility of creating engineered cartilage that may be non-immunogenic as a replacement tissue. PMID:19395023

  6. Pneumatized Articular Eminence and Assessment of Its Prevalence and Features on Panoramic Radiographs

    PubMed Central

    Khojastepour, Leila; Ezoddini, Fatemeh; Zeighami, Noshafarin

    2015-01-01

    Objectives: Pneumatized articular eminence or tubercle (PAT) is an air cell cavity in the zygomatic process of the temporal bone. Pneumatization of articular eminence may be seen incidentally on panoramic radiographs (PRs) as a unilocular or multilocular radiolucent defect. The aim of this study was to assess the prevalence and the pattern of PAT on PR in an Iranian population. Materials and Methods: A total of 3,098 PRs belonging to 1,735 females and 1,363 males were retrospectively investigated for the presence and radiographic features of PAT. All PRs were taken for routine dental examination. Chi-square test, univariate odds ratio (OR) and corresponding 95% confidence interval (95% CI) and binary logistic regression were used for statistical analysis. Results: Overall, PAT was found in 2.1 % of cases including 41 females and 23 males (with a mean age of 33.23±12.43 and 35.64±13.24 years, respectively, range 19–69 years). There were 40 unilateral and 24 bilateral cases (total: 88 PATs) including 49 unilocular and 39 multilocular cases. There was no significant difference in PAT between males and females or different age groups (P>0.05 and all CIs included 1.00). Binary logistic regression indicated that there was no relationship between the presence of PAT and age or sex. Conclusion: Knowledge about this anatomical variation is helpful for clinicians who are planning to perform temporomandibular joint surgery. They should assess the radiographic imaging thoroughly before the surgery. It can also provide valuable information to understand the differential diagnosis of pathological entities in this region. PMID:26622277

  7. Contour mapping of the TMJ temporal component and the relationship to articular soft tissue thickness and disk displacement.

    PubMed

    Pullinger, A G; Bibb, C A; Ding, X; Baldioceda, F

    1993-11-01

    The osseous architecture of central sagittal histologic sections of the temporal component of 51 temporomandibular joints of young adults at autopsy was studied to determine if this predicted the thickness of the overlying articular soft tissue and disk displacement. Geometric groupings of fossa-eminence shapes were generated using a hierarchical cluster analysis of the osseous fossa-eminence sigmoid curve, size, and slope. Six cluster groups were evolved and tested for relationship to soft tissue thickness measured at the eminence crest, mid-point of the eminence slope, closed pack location of the condyle, the inflection point, and the depth of the fossa. Soft tissue thickness at the inflection point and depth of the fossa was remarkably constant between cluster groups. Increased soft tissue thickness at the eminence crest and lower part of the posterior slope was weakly correlated to a flatter eminence slope and curve, explaining 10% to 20% of the variance (r2). There were no relationships between the parameters studied to the fossa curvature. An ANOVA showed no statistical difference in the posterior slope angle between the categories of disk position (p = 0.715) or to the six cluster groupings. The results suggest that the osseous contours seen on radiographs may not accurately predict the actual articular surface of the temporal component. PMID:8247506

  8. Intra-articular risks of suprapatellar nailing.

    PubMed

    Beltran, Michael J; Collinge, Cory A; Patzkowski, Jeanne C; Masini, Brendan D; Blease, Robert E; Hsu, Joseph R

    2012-12-01

    To determine the risks to local anatomy near the starting point for tibial nailing during suprapatellar nailing, 15 fresh-frozen hemipelvis specimens were nailed using a suprapatellar technique. After nail passage, the menisci and articular surfaces, anterior cruciate ligament (ACL) insertion, intermeniscal ligament, and fat pad were assessed for injury. The distance from the entry portal to the menisci, articular surfaces, and ACL insertion was determined. Medial meniscus injury occurred in 1 (6.7%) specimen and medial articular injury in 2 (13%). Nails passed through the fat pad in all specimens; intermeniscal ligament injury occurred in 3 (20%) specimens. The ACL insertion and lateral structures were not injured in any specimen. The distance from the entry portal margin to the lateral and medial menisci was 6.46±2.47 mm and 4.74±3.17 mm, respectively. The distances to the lateral and medial articular margins measured 10.33±3.62 mm and 6.54±3.57 mm, respectively. The distance to the ACL insertion averaged 5.80±3.94 mm. Suprapatellar nailing is associated with a risk of injury to anterior knee structures comparable to other nailing techniques. Additional clinical studies are warranted to further define the role of this technique in the management of tibial fractures. PMID:23550286

  9. Body Weight Independently Affects Articular Cartilage Catabolism

    PubMed Central

    Denning, W. Matt; Winward, Jason G.; Pardo, Michael Becker; Hopkins, J. Ty; Seeley, Matthew K.

    2015-01-01

    Although obesity is associated with osteoarthritis, it is unclear whether body weight (BW) independently affects articular cartilage catabolism (i.e., independent from physiological factors that also accompany obesity). The primary purpose of this study was to evaluate the independent effect of BW on articular cartilage catabolism associated with walking. A secondary purpose was to determine how decreased BW influenced cardiovascular response due to walking. Twelve able-bodied subjects walked for 30 minutes on a lower-body positive pressure treadmill during three sessions: control (unadjusted BW), +40%BW, and -40%BW. Serum cartilage oligomeric matrix protein (COMP) was measured immediately before (baseline) and after, and 15 and 30 minutes after the walk. Heart rate (HR) and rate of perceived exertion (RPE) were measured every three minutes during the walk. Relative to baseline, average serum COMP concentration was 13% and 5% greater immediately after and 15 minutes after the walk. Immediately after the walk, serum COMP concentration was 14% greater for the +40%BW session than for the -40%BW session. HR and RPE were greater for the +40%BW session than for the other two sessions, but did not differ between the control and -40%BW sessions. BW independently influences acute articular cartilage catabolism and cardiovascular response due to walking: as BW increases, so does acute articular cartilage catabolism and cardiovascular response. These results indicate that lower-body positive pressure walking may benefit certain individuals by reducing acute articular cartilage catabolism, due to walking, while maintaining cardiovascular response. Key points Walking for 30 minutes with adjustments in body weight (normal body weight, +40% and -40% body weight) significantly influences articular cartilage catabolism, measured via serum COMP concentration. Compared to baseline levels, walking with +40% body weight and normal body weight both elicited significant increases in

  10. Temporomandibular joint disorders and maxillomandibular malformations: role of condylar "repositionin" plate.

    PubMed

    Mazzone, Noemi; Matteini, Claudio; Incisivo, Veronica; Belli, Evaristo; Evaristo, Belli

    2009-05-01

    Even if the relationship between condylar position and/or temporomandibular disorders (TMDs) and dentofacial deformity is controversial in literature, several patients presenting malocclusion refer to pain and TMDs as the main trouble. There are also various opinions concerning the alterations or improvements of temporomandibular joint symptoms after orthognathic surgery. In agreement with the experience of Universität Würzburg, the purpose of this study was to evaluate the validity of splint technique to reproduce centric condyle positioning in bimaxillary osteotomy surgeries for the patients with skeletal-facial disorders and coexisting TMDs. The present study is based on a sample of patients with maxillomandibular malocclusion and coexisting TMDs who underwent bimaxillary osteotomy surgeries with splint technique. All patients underwent a protocol consisting of various steps: Pretreatment evaluation consisted of a questionnaire on subjective symptoms, clinical examinations, photographs of the occlusion, plaster casts, bite registrations, examination of the posture; instrumental examinations; panoramic, teleradiography, and cephalometric analysis; stratigraphy of TMD; and electromyography. Presurgical treatment consisted of therapy by modified Farrar splint associated with a pharmacologic therapy for the acute symptoms; orthodontic treatment associated with a global reeducation of the posture and a pompage of the masticatory muscles; and manufacturing of an occlusal splint in the most posterior asymptomatic position. Surgical treatment consisted of bimaxillary osteotomies performed after registering condyle position by a "repositioning" plate. The condyle position is guided by the intermaxillary fixation with the interposition of the occlusal splint. Surgery on maxillary is performed through Le Fort I osteotomy and fixation. Later, sagittal splint osteotomy of mandible is performed. Position of ramus and TMD complex is guided by the positioning of the plates

  11. Surgical treatment of temporomandibular joint ankyloses: meniscus conservation and relocation.

    PubMed

    Rinna, Claudio; Reale, Gabriele; Calvani, Francesco; Cascone, Piero

    2013-03-01

    Ankylosis of the temporomandibular joint is a serious complication, mainly after trauma and local or systemic infection. In rare cases, ankylosis is associated with systemic disease such as ankylosing spondylitis, rheumatoid arthritis, and psoriasis. According to the functional restriction and the provoked disturbances of facial growth in the youth, an early and effective therapy is desirable. There is a wide variety of surgical approaches to temporomandibular joint ankylosis, ranging from chondro-osseous grafts to prothesis. In the article the authors present the clinical case of a 60-year-old patient who, at the age of 6, accidentally fell from a height of about 2 m. In 60 years old, after removing the temporomandibular ankylosis with surgical technique, patient showed a marked improvement of mandibular kinetics. PMID:23524812

  12. An Interesting Case of Gunshot Injury to the Temporomandibular Joint

    PubMed Central

    Pires, Mário Sergio Medeiros; Giongo, Caroline Comis; Antonello, Guilherme de Marco; Couto, Ricardo Torres do; Filho, Ruy de Oliveira Veras; Junior, Otacílio Luiz Chagas

    2014-01-01

    The head and face are relatively common sites of gunshot injury, and the temporomandibular joint is often affected. These wounds usually produce major deformity and functional impairment, particularly when the temporomandibular joint is affected or when structures such as the facial nerve are damaged. Complications may include mandibular displacement at maximum mouth opening and in protrusion, limited mouth opening, limited lateral movement of the jaw, anterior open bite, and, more rarely, temporomandibular ankylosis. Projectiles that strike the mandible usually cause comminuted fractures; maxillary wounds, in turn, are most commonly perforating. The present report describes a case of gunshot injury in which the projectile lodged within the mandibular fossa but did not cause any fractures. Oral and maxillofacial trauma surgeons must be aware of the different types of gunshot injury, as they produce distinct patterns of tissue destruction due to projectile trajectory and release of kinetic energy into surrounding tissue. PMID:25709756

  13. Alterations in intermediate filaments expression in disc cells from the rat temporomandibular joint following exposure to continuous compressive force

    PubMed Central

    Magara, Jin; Nozawa-Inoue, Kayoko; Suzuki, Akiko; Kawano, Yoshiro; Ono, Kazuhiro; Nomura, Shuichi; Maeda, Takeyasu

    2012-01-01

    The articular disc in the temporomandibular joint (TMJ) that serves in load relief and stabilizing in jaw movements is a dense collagenous tissue consisting of extracellular matrices and disc cells. The various morphological configurations of the disc cells have given us diverse names, such as fibroblasts, chondrocyte-like cells and fibrochondrocytes; however, the characteristics of these cells have remained to be elucidated in detail. The disc cells have been reported to exhibit heterogeneous immunoreaction patterns for intermediate filaments including glial fibrillary acidic protein (GFAP), nestin and vimentin in the adult rat TMJ. Because these intermediate filaments accumulate in the disc cells as tooth eruption proceeds during postnatal development, it might be surmised that the expression of these intermediate filaments in the disc cells closely relates to mechanical stress. The present study was therefore undertaken to examine the effect of a continuous compressive force on the immunoexpression of these intermediate filaments and an additional intermediate filament – muscle-specific desmin – in the disc cells of the TMJ disc using a rat experimental model. The rats wore an appliance that exerts a continuous compressive load on the TMJ. The experimental period with the appliance was 5 days as determined by previous studies, after which some experimental animals were allowed to survive another 5 days after removal of the appliance. Histological observations demonstrated that the compressive force provoked a remarkable acellular region and a decrease in the thickness of the condylar cartilage of the mandible, and a sparse collagen fiber distribution in the articular disc. The articular disc showed a significant increase in the number of desmin-positive cells as compared with the controls. In contrast, immunopositive cells for GFAP, nestin and vimentin remained unchanged in number as well as intensity. At 5 days after removal of the appliance, both the disc

  14. Mouse genetic models for temporomandibular joint development and disorders

    PubMed Central

    Suzuki, A; Iwata, J

    2016-01-01

    The temporomandibular joint (TMJ) is a synovial joint essential for hinge and sliding movements of the mammalian jaw. Temporomandibular joint disorders (TMD) are dysregulations of the muscles or the TMJ in structure, function, and physiology, and result in pain, limited mandibular mobility, and TMJ noise and clicking. Although approximately 40–70% adults in the USA have at least one sign of TMD, the etiology of TMD remains largely unknown. Here, we highlight recent advances in our understanding of TMD in mouse models. PMID:26096083

  15. Articular synovial chondromatosis of the finger.

    PubMed

    Sano, Kazufumi; Hashimoto, Tomohisa; Kimura, Kazumasa; Ozeki, Satoru

    2014-10-01

    A 40-year-old woman presented with a six-month history of synovial chondromatosis of the metacarpophalangeal joint of the right ring finger, which was resected through both dorsal and volar incisions. To our knowledge there have been only 17 reported cases of articular synovial chondromatosis of the digital joint so far. We present a case affecting the metacarpophalangeal joint with a review of scattered information found in other 17 reports. PMID:23596991

  16. Surface of articular cartilage: immunohistological studies.

    PubMed

    Duance, V C

    1983-10-01

    Using several physical techniques the surface of articular cartilage has been reported to be structurally different from the deeper layers. In this paper using immunohistochemical methods, the surface has been shown to contain a characteristically different collagen, Type I in contrast to Type II which is the major collagen of cartilage. These results support previous proposals for a surface layer, or lamina splendens, the presence of which would be of considerable importance in understanding the degradation of cartilage in arthritides. PMID:6678620

  17. Septic Arthritis in the Temporomandibular Joint

    PubMed Central

    Al-Khalisy, Hassan Mahdi; Nikiforov, Ivan; Mansoora, Qurat; Goldman, John; Cheriyath, Pramil

    2015-01-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare event that has only been reported a few dozen times worldwide. This case is remarkable for septic arthritis of the TMJ joint in an otherwise healthy male. Case Report: A 24-year-old male presented to the emergency department with periauricular swelling, erythema, fever, myalgia's and generalized joint pain. He had previously sought medical attention and was placed on ciprofloxacin. However, he developed facial swelling and a rash and had to discontinue the antibiotic. On physical exam the patient had a large swelling and tenderness in his left periauricular area, with erythema and deviation of the right mandible which limited his ability to open the mouth. A computed tomography showed mild asymmetric soft tissue swelling in the left pharyngeal region but did not show joint effusion. Subsequent magnetic resonance imaging did show effusion of the joint space. The effusion was drained, and the synovial fluid was submitted for gram stain, culture, and sensitivity. The cultures grew menthicillin sensitive Staphyloccocus Aureus. The patient was discharged to complete a two week course of intravenous (IV) Ceftriaxone and IV Vancomycin via home infusion. Conclusion: Septic Arthritis of the TMJ is a rare event with very specific clinical symptoms. Due to the low sensitivity of the computed tomography scan, magnetic resonance imaging should be considered when computed tomography scan is negative for TMJ effusion. PMID:26713295

  18. [Total temporomandibular joint replacement with alloplastic prosthesis].

    PubMed

    García-Huerta, Marco Antonio; Romero-Flores, Jovita; Mena-Gómez, Eddy

    2012-01-01

    Three total temporomandibular joint (TMJ) replacement surgeries were performed on two patients with TMJ ankylosis using W. Lorenz system. The first surgery was performed on a female patient with osseous ankylosis who had no mandibular movement since she was 18 months old. The second surgery was on a patient with fibrous ankylosis who had an interincisive opening distance of 12 mm. Her condition was the result of a three year old subcondylar fracture which didn't receive any treatment. The first patient had total replacement of both TMJs, while the other just one TMJ. The follow up until today has been of eight months with an interincisive opening of 29 mm in the first patient and 34 mm in the other. There has not been any mandibular deviation during opening, nor postoperative pain in both cases. Facial nerve affection was not permanent in both patients. For all of this, we can conclude that total TMJ replacement is an effective treatment with stable results in patients with TMJ ankylosis. PMID:23234748

  19. Temporomandibular disorders and bruxism. Part I.

    PubMed

    Kevilj, R; Mehulic, K; Dundjer, A

    2007-01-01

    Correct functioning of the entire stomatognathic system is achieved by a compatible relationship of all its parts. Four determinants, by their mutual harmonious activity, dictate the function of the entire system: the teeth, periodontium with supporting structure, muscles, temporomandibular joint (TMJ) and CNS. In such a complex system a disorder of any integrative part causes disturbances also in other parts of the system. Changed functions can arise through organic disorder, and also iatrogenically by inadequate conservative, prosthetic, surgical or orthodontic therapy. For this reason it is often difficult to recognise the primary cause. The first responses of the system to the disorder are adaptive mechanisms which occur within one or more integrative parts, and depending on their intensity and duration symptoms grow more prominent. Tissue response can be ortho- or parafunctional. Attempts are made to exclude psychoemotional influences and the obstacle eliminated by either abrasion, clenching or grinding of the teeth. If the obstacle is not eliminated by abrasion, the cause of such functional disorder becomes the trigger for parafunctional activity. From a review of the relevant literature it can be concluded that parafunctional activity is caused by changed occlusion, with determined psychological habits of the patient and specific tissue response of the stomatognathic system. Therefore, therapy of these disorders is made more difficult and includes a multidisciplinary approach. PMID:17912197

  20. Temporomandibular joint replacement: a New Zealand perspective.

    PubMed

    Murdoch, B; Buchanan, J; Cliff, J

    2014-05-01

    Alloplastic total temporomandibular joint replacement (TMJ TJR) has been performed in New Zealand utilizing the TMJ Concepts patient-fitted system since 2000. The data analysed in this study were collected retrospectively from questionnaires sent to all maxillofacial surgeons in New Zealand who had implanted TMJ Concepts devices between 2000 and 2011. A total of 63 devices were implanted in 42 patients (13 males, 29 females) during this 12-year period. The primary indication for TMJ TJR was end-stage joint disease resulting from ankylosis and arthritis. The mean age of the patients was 47 years (range 7-80 years). The most common complication reported was transient facial nerve impairment in 4.8% of the patients. Objective results, measured as the maximal incisional opening, improved by a mean of 17.3mm (P<0.01); 90% of patients reported improved quality of life. New Zealand oral and maxillofacial surgeons have concluded that TMJ TJR using the TMJ Concepts prosthesis is a reliable treatment option for the management of end-stage TMJ disease. PMID:24332584

  1. Sleep bruxism and myofascial temporomandibular disorders

    PubMed Central

    Raphael, Karen G.; Sirois, David A.; Janal, Malvin N.; Wigren, Pia E.; Dubrovsky, Boris; Nemelivsky, Lena V.; Klausner, Jack J.; Krieger, Ana C.; Lavigne, Gilles J.

    2015-01-01

    Background Many dentists believe that sleep bruxism (SB) is a pathogenic factor in myofascial temporomandibular disorder (TMD), but almost all supportive data rely on patients’ self-reports rather than on direct observation. Methods The authors administered a structured self-report interview to determine whether a large and well-characterized sample of patients with myofascial TMD (124 women) experienced SB more often than did matched control participants (46 women). The authors then used data from a two-night laboratory-based polysomnographic (PSG) study to determine whether the case participants exhibited more SB than the control participants. Results The results of independent sample t tests and χ2 analyses showed that, although self-reported rates of SB were significantly higher in case participants (55.3 percent) than in control participants (15.2 percent), PSG-based measures showed much lower and statistically similar rates of SB in the two groups (9.7 percent and 10.9 percent, respectively). Grinding noises were common in both case participants (59.7 percent) and control participants (78.3 percent). Conclusions Most case participants did not exhibit SB, and the common belief that SB is a sufficient explanation for myofascial TMD should be abandoned. Clinical Implications Although other reasons to consider treating SB may exist, misplaced concern about SB’s sustaining or exacerbating a chronic myofascial TMD condition should not be used to justify SB treatment. PMID:23115152

  2. Osteochondritis dissecans of the temporomandibular joint.

    PubMed

    Campos, P S F; Freitas, C E; Pena, N; Gonzalez, M O D; Almeida, S M; Mariz, A C R; Lorens, F G L

    2005-05-01

    A case is reported of a 43-year-old female patient presenting bilateral osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ), in different stages for each side, associated with avascular necrosis (AVN) of the right condyle. Additionally observed was anterior disk displacement without reduction for both sides. We have proposed an adaptation of the previous classification of OCD for cases affecting the TMJ. We have also stressed the fundamental role of panoramic radiography on the diagnosis of stage 3 and stage 4 OCD of the TMJ. In relation to MRI, we have recommended sagittal (slice thickness of 2 mm) and coronal (slice thickness of 1 mm) fast spin-echo proton density-weighted sequences to better identify bone lesions (stage 1 and 2) and also localize osteochondral loose bodies; and coronal (slice thickness of 1 mm) fat-suppressed fast spin-echo T2 weighted sequence to better evaluate OCD (stable or unstable) and the features of the occasionally associated AVN (acute or chronic). PMID:15897292

  3. Assessment of temporomandibular injury and orofacial pain.

    PubMed

    Talley, R L

    1995-01-01

    Every individual has physical faults which makes him less than a perfect biological specimen. This is the foundation for the legal "eggshell principal." Most of us do not have perfect skeletal formation, muscular adaptation, neurological or vascular systems. Additionally, we may not have complete symmetry and ideal form to our cranium or mandible. Our dentitions are imperfect. All of these imperfections play a role in every injury. The variances of normal that are seen in any medical or dental population, must be accepted; therefore, a given injury can have tremendously varied sequelae, depending on the person receiving it. The patho-physiology resultant from an accident may not parallel the severity of the motor vehicle accident, fall or blow. Prompt and proper evaluation of the individual-turned-patient is imperative. Referral to a dentist, competent in providing the necessary evaluation of the injury, is the responsibility of those individuals attending to the injured person's physical, emotional, and financial trauma. Their physician, dentist, attorney or counselor should take the responsibility of providing proper referral. The four most dangerous words in medicine and dentistry today are: "It Will Go Away." People often develop serious sequelae by assuming that their problem will "go away" by just leaving it alone long enough or by simply ignoring it. With proper evaluation and management, most trauma related temporomandibular injuries can be corrected or at least be properly managed. PMID:9526244

  4. Inflammatory pseudotumour of the temporomandibular joint.

    PubMed

    Ghavami, Y; Yau, A Y; Ziai, K; Maducdoc, M M; Djalilian, H R

    2015-01-01

    Head and neck inflammatory pseudotumors (IPs) are rare, idiopathic, non-neoplastic lesions that most commonly affect the orbit, but may involve other areas such as the larynx, oropharynx, paranasal sinuses, and meninges. We report the case of a 55-year-old man who presented with progressive left-sided hearing loss, aural fullness, and otalgia. Computed tomography and magnetic resonance imaging (MRI) detected a soft-tissue mass in the left temporomandibular joint (TMJ). Histopathologic examination showed overlying squamous epithelium with hyperkeratosis, parakeratosis, subepithelial fibrosis, and chronic inflammatory infiltrate, which were consistent with an IP. Radiologic images and MRI indicated an ill-defined soft tissue involving the roof and posterior aspect of the TMJ, extending into the anterior external auditory canal. Our case was treated with a 2-week course of high dose prednisone (1 mg/kg) and a 2-week taper with resolution of symptoms. Two years after treatment, the patient shows no evidence of recurrence on MRI. PMID:26891541

  5. Hereditary uricemia and articular gout in chickens.

    PubMed

    Cole, R K; Austic, R E

    1980-05-01

    Ten generations of selection for uricemia and articular gout have led to the development of the HUA line which is characterized by a threefold increase in plasma level of uric acid when compared to the control LUA line, even when fed diets containing normal levels of protein. Articular gout results in many cases, especially among adult males fed a normal breeder diet. Restriction protein level of the diet delays or prevents the development of articular gout in mature males of the HUA line. The data suggest that relatively few genes are responsible for the defect in renal transport of uric acid which underlies the uricemia and gout. The association of lower levels of uric acid with dominant white plumage color suggests a linkage of a major recessive gene for the I gene. Ambient temperature, because of its effect on food consumption, influences the level of uric acid in blood plasma. The HUA line and its control (LUA line), both sex-linked dwarfs, would appear to provide an excellent animal model for the experimental study of gout in man. PMID:7393846

  6. Vitrification of intact human articular cartilage.

    PubMed

    Jomha, Nadr M; Elliott, Janet A W; Law, Garson K; Maghdoori, Babak; Forbes, J Fraser; Abazari, Alireza; Adesida, Adetola B; Laouar, Leila; Zhou, Xianpei; McGann, Locksley E

    2012-09-01

    Articular cartilage injuries do not heal and large defects result in osteoarthritis with major personal and socioeconomic costs. Osteochondral transplantation is an effective treatment for large joint defects but its use is limited by the inability to store cartilage for long periods of time. Cryopreservation/vitrification is one method to enable banking of this tissue but decades of research have been unable to successfully preserve the tissue while maintaining cartilage on its bone base - a requirement for transplantation. To address this limitation, human knee articular cartilage from total knee arthroplasty patients and deceased donors was exposed to specified concentrations of 4 different cryoprotective agents for mathematically determined periods of time at lowering temperatures. After complete exposure, the cartilage was immersed in liquid nitrogen for up to 3 months. Cell viability was 75.4 ± 12.1% determined by membrane integrity stains and confirmed with a mitochondrial assay and pellet culture documented production of sulfated glycosaminoglycans and collagen II similar to controls. This report documents successful vitrification of intact human articular cartilage on its bone base making it possible to bank this tissue indefinitely. PMID:22698720

  7. Various Spectrum of MRI Findings in Articular and Para-articular Tuberculosis: Pictorial Assay.

    PubMed

    Panchal, Hiten; Chiripal, Priyanka

    2015-12-01

    Tuberculosis continues to be a health-related issue in India. Musculoskeletal tuberculosis is noted to occur dramatically as isolates, primarily accounting for large numbers of extra-pulmonary tuberculosis since early diagnosis is always a priority; with good prognosis, it is a curable disease. Delayed treatment is associated with severe morbidity. Musculoskeletal tuberculosis accounts for a large number of extra-pulmonary tuberculosis. In this article, we describe various articular and para-articular MRI spectrum findings that are seen in patients with tuberculosis. MRI is the perfect modality to study the extent of involvement and its related complications. PMID:26730089

  8. Duplex Doppler ultrasound study of the temporomandibular joint

    PubMed Central

    Stagnitti, A.; Marini, A.; Impara, L.; Drudi, F.M.; Lo mele, L.; Lillo Odoardi, G.

    2012-01-01

    Introduction The anatomy and physiology of the temporomandibular joint can be studied clinically and by diagnostic imaging. Magnetic resonance imaging (MRI), radiography (X-ray) and computed tomography (CT) have thus for many years contributed to the study of the kinetics in the mandibular condyle. However, also duplex Doppler ultrasound (US) examination is widely used in the study of structures during movement, particularly vascular structures. Materials and methods A total of 30 patients were referred by the Department of Orthodontics to the Department of Radiological, Oncological and Pathological Sciences, University of Rome “La Sapienza”. All patients underwent duplex Doppler ultrasound (US) examination of the temporomandibular joint using Toshiba APLIO SSA-770A equipment and duplex Doppler multi-display technique, which allows simultaneous display of US images and color Doppler signals. A linear phased array probe with crystal elements was used operating at a basic frequency of 6 MHz during pulsed Doppler spectral analysis and 7.5 MHz during US imaging. Results In normal patients a regular alternation in the spectral Doppler waveforms was obtained, while in patients with temporomandibular joint meniscus dysfunction there was no regularity in the sum of the Fourier series with an unsteady waveform pattern related to irregular movements of the temporomandibular joint. Conclusions In all cases duplex Doppler US examination proved able to differentiate between normal and pathological patients and among the latter this technique permitted identification of the most significant aspects of the dysfunctional diseases. PMID:23397016

  9. Case-Based Learning for Orofacial Pain and Temporomandibular Disorders.

    ERIC Educational Resources Information Center

    Clark, Glenn T.; And Others

    1993-01-01

    The use of interactive computer-based simulation of cases of chronic orofacial pain and temporomandibular joint disfunction patients for clinical dental education is described. Its application as a voluntary study aid in a third-year dental course is evaluated for effectiveness and for time factors in case completion. (MSE)

  10. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... reconstruct the temporomandibular joint. (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food... approved PMA or a declared completed PDP in effect before being placed in commercial distribution....

  11. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... reconstruct the temporomandibular joint. (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food... approved PMA or a declared completed PDP in effect before being placed in commercial distribution....

  12. [Temporomandibular ankylosis in Gabon (apropos of 13 case reports)].

    PubMed

    Rives, J M; Cantaloube, D; Kremer, A

    1988-01-01

    The authors report on 13 cases of temporomandibular ankylosis observed in Gabon. Based on an epidemiologic and etio-pathogenic study, they dwell on the existing therapy of this affection, i.e. broad osteotomy with silicone interposition followed by mechanotherapy prolonged in time. Prophylaxis is discussed in the framework of Primary Health Care. PMID:3405073

  13. Accurate 3D kinematic measurement of temporomandibular joint using X-ray fluoroscopic images

    NASA Astrophysics Data System (ADS)

    Yamazaki, Takaharu; Matsumoto, Akiko; Sugamoto, Kazuomi; Matsumoto, Ken; Kakimoto, Naoya; Yura, Yoshiaki

    2014-04-01

    Accurate measurement and analysis of 3D kinematics of temporomandibular joint (TMJ) is very important for assisting clinical diagnosis and treatment of prosthodontics and orthodontics, and oral surgery. This study presents a new 3D kinematic measurement technique of the TMJ using X-ray fluoroscopic images, which can easily obtain the TMJ kinematic data in natural motion. In vivo kinematics of the TMJ (maxilla and mandibular bone) is determined using a feature-based 2D/3D registration, which uses beads silhouette on fluoroscopic images and 3D surface bone models with beads. The 3D surface models of maxilla and mandibular bone with beads were created from CT scans data of the subject using the mouthpiece with the seven strategically placed beads. In order to validate the accuracy of pose estimation for the maxilla and mandibular bone, computer simulation test was performed using five patterns of synthetic tantalum beads silhouette images. In the clinical applications, dynamic movement during jaw opening and closing was conducted, and the relative pose of the mandibular bone with respect to the maxilla bone was determined. The results of computer simulation test showed that the root mean square errors were sufficiently smaller than 1.0 mm and 1.0 degree. In the results of clinical application, during jaw opening from 0.0 to 36.8 degree of rotation, mandibular condyle exhibited 19.8 mm of anterior sliding relative to maxillary articular fossa, and these measurement values were clinically similar to the previous reports. Consequently, present technique was thought to be suitable for the 3D TMJ kinematic analysis.

  14. Characterization of the Temporomandibular Joint of Southern Sea Otters (Enhydra lutris nereis)

    PubMed Central

    Lieske, Danielle; Vapniarsky, Natalia; Verstraete, Frank J. M.; Leale, Dustin M.; Young, Colleen; Arzi, Boaz

    2015-01-01

    The structure–function relationship of the temporomandibular joint (TMJ) of southern sea otter has largely not been described. This study aims to describe the histological, biochemical, and biomechanical features of the TMJ disk in the southern sea otter. The TMJ disks from fresh cadaver heads of southern sea otter adult males (n = 8) and females (n = 8) acquired from strandings were examined. Following macroscopical evaluation, the TMJs were investigated for their histological, mechanical, and biochemical properties. We found that the sea otter TMJ disks are, in general, similar to other carnivores. Macroscopically, the TMJ disk was highly congruent, and the mandibular head was encased tightly by the mandibular fossa with a thin disk separating the joint into two compartments. Histologically, the articular surfaces were lined with dense fibrous connective tissue that gradually transitioned into one to two cell thick layer of hyaline-like cartilage. The disk fibers were aligned primarily in the rostrocaudal direction and had occasional lacuna with chondrocyte-like cells. The disk was composed primarily of collagen type 1. Biochemical analysis indicates sulfated glycosaminoglycan content lower than other mammals, but significantly higher in male sea otters than female sea otters. Finally, mechanical analysis demonstrated a disk that was not only stronger and stiffer in the rostrocaudal direction than the mediolateral direction but also significantly stronger and stiffer in females than males. We conclude that the congruent design of the TMJ, thin disk, biochemical content, and mechanical properties all reflect a structure–function relationship within the TMJ disk that is likely designed for the sea otter’s hard diet and continuous food intake. PMID:26664997

  15. Characterization of the Temporomandibular Joint of Southern Sea Otters (Enhydra lutris nereis).

    PubMed

    Lieske, Danielle; Vapniarsky, Natalia; Verstraete, Frank J M; Leale, Dustin M; Young, Colleen; Arzi, Boaz

    2015-01-01

    The structure-function relationship of the temporomandibular joint (TMJ) of southern sea otter has largely not been described. This study aims to describe the histological, biochemical, and biomechanical features of the TMJ disk in the southern sea otter. The TMJ disks from fresh cadaver heads of southern sea otter adult males (n = 8) and females (n = 8) acquired from strandings were examined. Following macroscopical evaluation, the TMJs were investigated for their histological, mechanical, and biochemical properties. We found that the sea otter TMJ disks are, in general, similar to other carnivores. Macroscopically, the TMJ disk was highly congruent, and the mandibular head was encased tightly by the mandibular fossa with a thin disk separating the joint into two compartments. Histologically, the articular surfaces were lined with dense fibrous connective tissue that gradually transitioned into one to two cell thick layer of hyaline-like cartilage. The disk fibers were aligned primarily in the rostrocaudal direction and had occasional lacuna with chondrocyte-like cells. The disk was composed primarily of collagen type 1. Biochemical analysis indicates sulfated glycosaminoglycan content lower than other mammals, but significantly higher in male sea otters than female sea otters. Finally, mechanical analysis demonstrated a disk that was not only stronger and stiffer in the rostrocaudal direction than the mediolateral direction but also significantly stronger and stiffer in females than males. We conclude that the congruent design of the TMJ, thin disk, biochemical content, and mechanical properties all reflect a structure-function relationship within the TMJ disk that is likely designed for the sea otter's hard diet and continuous food intake. PMID:26664997

  16. Condylar bony changes in patients with temporomandibular disorders: a CBCT study

    PubMed Central

    2012-01-01

    Purpose Diagnosis of osteoarthritis most commonly depends on clinical and radiographic findings. The present study attempted to observe the bony changes in temporomandibular joint (TMJ) patients from all age groups. Materials and Methods The first-visit clinical records and cone beam computed tomography (CBCT) data of 440 TMJs from 220 consecutive TMJ patients were reviewed retrospectively. Results The most frequent condylar bony change observed was sclerosis (133 joints, 30.2%) followed by surface erosion (129 joints, 29.3%), flattening of the articular surface (112 joints, 25.5%), and deviation in form (58 joints, 13.2%), which included 33 TMJs in a cane-shape, 16 with a lateral or medial pole depression, 6 with posterior condylar surface flattening, and 3 with a bifid-shaped condyle. Fifty-three joints (12.0%) showed hypoplastic condyles but only 1 joint showed hyperplasia. Osteophyte was found in 35 joints (8.0%) and subcortical cyst in 24 joints (5.5%), 5 of which had surface erosion as well. One hundred nineteen joints (27.0%) had only one kind of condylar bony change, 66 joints (15.0%) had two, 52 joints (11.8%) had three, 12 joints (5.0%) had four, and 6 joints (1.4%) had five kinds of condylar bony changes at the same time. Eighty-five (65.9%) of 129 joints with surface erosion had pain recorded at the chief complaint. Conclusion With more widespread use of CBCT, more specific or detailed guidelines for osteoarthritis are needed. PMID:23301212

  17. Temporomandibular joint dysfunction in various rheumatic diseases.

    PubMed

    Aceves-Avila, F J; Chávez-López, M; Chavira-González, J R; Ramos-Remus, C

    2013-01-01

    Temporomandibular disorder (TMD) is an inclusive term in which those conditions disturbing the masticatory function are embraced. It has been estimated that 33% of the population have signs of TMD, but less than 5% of the population will require treatment. The objective of this study was to measure the frequency of TMD in rheumatoid arthritis (RA), osteoarthrosis (OA), ankylosing spondylitis (AS) and systemic lupus erythematosus, and to define the limitations in everyday's life that patients perceive when present. A six-month survey of consecutive outpatients in a rheumatology clinic in a teaching hospital in Mexico was carried out. We defined TMD as: 1) the presence of pain; 2) difficulty on mouth opening, chewing or speaking; 3) the presence of non-harmonic movements of the temporomaxilar joints. All three characteristics had to be present. Z test was used to define differences between proportions. We present the results of 171 patients. Overall, 50 patients had TMD according to our operational definition (29.24%). Up to 76% of the sample had symptoms associated with the condition. TMD is more frequent in OA and in AS (29.24% vs 38% OA, P=0.009; 39% AS; P=0.005). We found no association between the severity of TMD and the request for specific attention for the discomfort produced by the condition. Only 8 of 50 (16%) patients with TMD had requested medical help for their symptoms, and they were not the most severe cases. TMD is more frequent in RA and OA. Although it may produce severe impairment, patients seem to adapt easily. PMID:23884028

  18. Speech evaluation in children with temporomandibular disorders

    PubMed Central

    PIZOLATO, Raquel Aparecida; FERNANDES, Frederico Silva de Freitas; GAVIÃO, Maria Beatriz Duarte

    2011-01-01

    Objectives The aims of this study were to evaluate the influence of temporomandibular disorders (TMD) on speech in children, and to verify the influence of occlusal characteristics. Material and methods Speech and dental occlusal characteristics were assessed in 152 Brazilian children (78 boys and 74 girls), aged 8 to 12 (mean age 10.05 ± 1.39 years) with or without TMD signs and symptoms. The clinical signs were evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) (axis I) and the symptoms were evaluated using a questionnaire. The following groups were formed: Group TMD (n=40), TMD signs and symptoms (Group S and S, n=68), TMD signs or symptoms (Group S or S, n=33), and without signs and symptoms (Group N, n=11). Articulatory speech disorders were diagnosed during spontaneous speech and repetition of the words using the "Phonological Assessment of Child Speech" for the Portuguese language. It was also applied a list of 40 phonological balanced words, read by the speech pathologist and repeated by the children. Data were analyzed by descriptive statistics, Fisher's exact or Chi-square tests (α=0.05). Results A slight prevalence of articulatory disturbances, such as substitutions, omissions and distortions of the sibilants /s/ and /z/, and no deviations in jaw lateral movements were observed. Reduction of vertical amplitude was found in 10 children, the prevalence being greater in TMD signs and symptoms children than in the normal children. The tongue protrusion in phonemes /t/, /d/, /n/, /l/ and frontal lips in phonemes /s/ and /z/ were the most prevalent visual alterations. There was a high percentage of dental occlusal alterations. Conclusions There was no association between TMD and speech disorders. Occlusal alterations may be factors of influence, allowing distortions and frontal lisp in phonemes /s/ and /z/ and inadequate tongue position in phonemes /t/; /d/; /n/; /l/. PMID:21986655

  19. Changes in temporomandibular joint morphology in class II patients treated with fixed mandibular repositioning and evaluated through 3D imaging: a systematic review.

    PubMed

    Al-Saleh, M A Q; Alsufyani, N; Flores-Mir, C; Nebbe, B; Major, P W

    2015-11-01

    To estimate the effects of skeletal class II malocclusion treatment using fixed mandibular repositioning appliances on the position and morphology of the temporomandibular joint (TMJ). Two independent reviewers performed comprehensive electronic searches of MEDLINE, EMBASE, EBM reviews and Scopus (until May 5, 2015). The references of the identified articles were also manually searched. All studies investigating morphological changes of the TMJ articular disc, condyle and glenoid fossa with 3D imaging following non-surgical fixed mandibular repositioning appliances in growing individuals with class II malocclusions were included in the analysis. Of the 269 articles initially reviewed, only 12 articles used magnetic resonance imaging and two articles used computed tomography (CT) or cone-beam CT images. Treatment effect on condyle and glenoid fossa was discussed in eight articles. Treatment effect on TMJ articular disc position and morphology was discussed in seven articles. All articles showed a high risk of bias due to deficient methodology: inadequate consideration of confounding variables, blinding of image assessment, selection or absence of control group and outcome measurement. Reported changes in osseous remodelling, condylar and disc position were contradictory. The selected articles failed to establish conclusive evidence of the exact nature of TMJ tissue response to fixed mandibular repositioning appliances. PMID:26260422

  20. Effect of psychological stress on the structure of the temporomandibular joint and the expression of MMP-3 and TIMP-3 in the cartilage in rats.

    PubMed

    Huang, Xu; Liu, Haixia; Xiao, Peng; Wang, Yan; Zhang, Hongyu

    2014-10-01

    Our aim was to observe the effects of psychological stress on the structure of the temporomandibular joint (TMJ), and to evaluate the expression of matrix metallopeptidase-3 (MMP-3) and tissue inhibitor of metalloproteinase-3 (TIMP-3) in condylar chondrocytes in rats. The rats were divided into 3 groups of 12 according to the duration of psychological stress: 3 weeks or 6 weeks, and 6 weeks of recovery. A fourth group of 12 rats was used as controls. Each rat was evaluated by the open-field test and the weight measured. The results confirmed psychological stress in 24 of the 36 rats (67%). The tissues of the TMJ were stained with haematoxylin and eosin and pathological changes were studied under a light microscope. MMP-3 and TIMP-3 expression was investigated using the SP kit. The experimental groups showed thinning of articular cartilage, shedding of collagen fibres, cracks in the articular discs, and other structural changes that were aggravated with time, from three weeks to six weeks. The 6-week recovery group showed an improvement in these changes, which indicated the initiation of joint repair. The MMP-3 expression rate correlated with the degree of joint lesion, while the TIMP-3 rate showed an opposite trend and was highest in the 6-week recovery group. Our findings clearly indicate that psychological stress may play an important part in the development of TMJ diseases in rats; further studies should be made to extrapolate the results to other models before clinical use. PMID:25060974

  1. Effect of pumping with injection of sodium hyaluronate and the other factors related to outcome in patients with non-reducing disk displacement of the temporomandibular joint.

    PubMed

    Sato, S; Goto, S; Kasahara, T; Kawamura, H; Motegi, K

    2001-06-01

    We retrospectively examined the effect of pumping with injection of sodium hyaluronate into the temporomandibular joint (TMJ) and the other factors influencing outcome in patients with non-reducing disk displacement of the TMJ. Fifty-nine patients underwent pumping with injection of sodium hyaluronate into the TMJ. As control, 62 patients were observed without any treatment. Both groups were observed for 12 months. The relation between outcome and the following clinical characteristics was also studied: sex, age, range of motion for maximal mouth opening, TMJ pain, TMJ noise, tenderness of masticatory muscles, locking duration, intercuspal occlusions, angle of posterior slope of articular eminence and degenerative bony changes of the condyle. Logistic regression analysis revealed that pumping with injection of sodium hyaluronate was related to a good outcome. Clinical characteristics of presentation significantly related to a good outcome were a large maximal mouth opening, a short locking duration, and a steep posterior slope of articular eminence. We conclude that pumping with injection of sodium hyaluronate into the TMJ is an effective treatment method for non-reducing disk displacement of the TMJ and that some clinical characteristics also influence outcome. PMID:11420900

  2. Oral health status and temporomandibular disorders in multiple sclerosis patients.

    PubMed

    Kovac, Zoran; Uhac, Ivone; Buković, Dino; Cabov, Tomislav; Kovacević, Daniela; Grzić, Renata

    2005-12-01

    Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system. Certain clinical manifestations affect the oro-facial region. Three in particular should be of interest to the dentist: trigeminal neuralgia, sensory neuropathy of the trigeminal nerve and facial palsy. The aim of this study was to determine the oral health status, the frequency of subjective symptoms and temporomandibular disorders (TMD) subtype according to Research diagnostic criteria for temporomandibular disorders (RDC/TMD) among MS patients. Examinees in this study were 50 patients suffering from MS, who were at least once treated during their disease in the Clinic Hospital Center, Rijeka, Clinic for Neurology. All examinees had to meet the diagnostic criteria for clinically and laboratory confirmed MS, according to Poser. The results show the difference in mean DMFT (decayed, missing, filled teeth) between MS and the control group. The number of decayed and missing teeth was higher, but the number of filled teeth was significantly lower in MS group. Eighty-two per cent of the subjects with MS had a least one symptom of dysfunction compared with 24% of the subjects in the healthy control group. In the present study, pain, the pain during mouth opening, the difficulty with mouth opening and temporomandibular joint (TMJ) sounds were more commonly reported in the MS group than in the control group. This study shows a statistically significant excess of dental caries and temporomandibular disorders among MS patients compared with the control group. These results suggest that MS is a possible etiological factor in temporomandibular disorders. PMID:16417141

  3. [Improvement of outcomes by primary treatment for temporomandibular disorders].

    PubMed

    Aoyama, Shigeru; Kino, Koji; Iwaki, Hiroshi; Amagasa, Teruo

    2008-10-01

    The aim of this study was to survey the current state of the temporomandibular joint disorder treatment in our clinic and to confirm the therapeutic outcomes. The subjects in this study were recruited from among the patients with temporomandibular disorders who attended the Temporomandibular Disorder Special Clinic, Department of Oral Surgery, Hitachi Yokohama Hospital during one year period from February 2007 to January 2008. A total of 100 consecutive outpatients diagnosed with temporomandibular disorders were selected for the study. Pain intensity and the degree to which daily function was limited before and after treatment were evaluated using the Visual Analogue Scale (VAS). The Beck Depression Inventory-II (BDI-II) score was evaluated simultaneously, and the correlation with changes in symptom was evaluated. The median (25th, 75th percentiles) of pain intensity (VAS value) before treated was 45 (25.0, 65.0) and the degree of limitation of daily function (VAS value) was 15 (0.0, 50.0). The median (25th, 75th percentiles) of pain intensity at 4 weeks after was 10 (0.0, 30.0), and significantly lower than that before treatment (p = 0.000). The degree of limitation of daily function was 0 (0.0, 10.0), also significantly lower than that before treatment (p = 0.000). The BDI-II score decreased from 8 (2.0, 11.8) before treatment to 5 (2.0, 11.0, p = 0.024) and showed no significant correlation with the improvement in outcomes by primary treatment for temporomandibular disorders. PMID:19044015

  4. Distinguishing ankle and knee articular cartilage.

    PubMed

    Cole, Ada A; Margulis, Arkady; Kuettner, Klaus E

    2003-06-01

    Degenerative changes in the tall and femoral distal cartilages of more than 2,000 tissue donors were graded based on the appearance of articular cartilage and osteophytes. In the ankle and the knee the degenerative changes increased with age; however, the rate of degeneration in the ankle was slower than in the knee. The degenerative changes in the ankle were more severe in men than in women, were predominantly bilateral, and seemed to be correlated with weight. The slower rate of change in the ankle may be caused, in part, by the biochemical and biomechanical tissue properties that distinguish ankle cartilage from that of the knee. PMID:12911243

  5. Treatment of articular fractures with continuous passive motion.

    PubMed

    Onderko, Laura Lynn; Rehman, Saqib

    2013-07-01

    This article presents a review of the basic science and current research on the use of continuous passive motion therapy after surgery for an intra-articular fracture. This information is useful for surgeons in the postoperative management of intra-articular fractures in determining the best course of treatment to reduce complications and facilitate quicker recovery. PMID:23827837

  6. Correlation of stress and muscle activity of patients with different degrees of temporomandibular disorder

    PubMed Central

    Tosato, Juliana de Paiva; Caria, Paulo Henrique Ferreira; Gomes, Cid Andre Fidelis de Paula; Berzin, Fausto; Politti, Fabiano; Gonzalez, Tabajara de Oliveira; Biasotto-Gonzalez, Daniela Aparecida

    2015-01-01

    [Purpose] Temporomandibular disorder is one of the many different adverse health conditions that can be triggered by stress. Therefore, a biopsychosocial model has been proposed to characterize the multifactorial nature of temporomandibular disorder. The aim of the present study was investigate the correlation of salivary cortisol levels with the activities of the masseter and anterior temporal muscles of patients with different degrees of temporomandibular disorder. [Subjects and Methods] Forty-nine women between 18 and 40 years of age with a diagnosis of myogenous temporomandibular disorder based on the Research Diagnostic Criteria for temporomandibular disorders were evaluated using the Fonseca Index to determine the degree of the disorder. Salivary cortisol levels were determined and surface electromyography was used to evaluate electrical activity in the masticatory muscles. [Results] Positive correlations were found among the degree of temporomandibular disorder, electromyographic activity and salivary cortisol: as women with more severe temporomandibular disorder had greater electrical activity in the muscles analyzed, especially the anterior temporal muscle, and higher levels of cortisol. [Conclusion] Muscle activity was greater among individuals with severe temporomandibular disorder and positive correlations were found among electromyographic activity, salivary cortisol and the degree of temporomandibular disorder severity. PMID:25995595

  7. Rabbit model for osteoarthrosis of the temporomandibular joint as a basis for assessment of outcomes after intervention.

    PubMed

    Artuzi, Felipe Ernesto; Langie, Renan; Abreu, Maíra Cavallet de; Quevedo, Alexandre Silva; Corsetti, Adriana; Ponzoni, Deise; Puricelli, Edela

    2016-06-01

    Osteoarthritis can be induced in the temporomandibular joint (TMJ) by primary or secondary trauma, or overloading of the joint. We have therefore systematically evaluated the histological progression of experimental osteoarthritis induced by a high concentration of monosodium iodoacetate into the rabbit TMJ. These findings may contribute to the establishment of a protocol to investigate the benefits of treatment of osteoarthritis of the TMJ. We used 21 male New Zealand rabbits; the 15 in the test group were given an intra-articular injection of monosodium iodoacetate 10mg/ml into the right TMJ and were killed after 60 (n=5), 80 (n=5), and 100 days (n=5). The six in the control group were given an injection of saline into the right TMJ. The assessment system for osteoarthritis based on six grades was used for the histological analysis of severity. The model was effective in producing histological changes in the cartilage consistent with those found in osteoarthritis at all time points. The within-group analysis indicated that the disease did not progress after 60 days. The successful induction of osteoarthritis in this way, its stabilisation after 60 days, and the appropriate size of the animal suggest that this experimental model is ideal for future studies of the effectiveness of treatment in osteoarthritis of the TMJ. PMID:26872897

  8. Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle.

    PubMed

    Campos, M I G; Campos, P S F; Cangussu, M C T; Guimarães, R C; Line, S R P

    2008-06-01

    The aim of this study was to investigate temporomandibular joint (TMJ) pain and magnetic resonance imaging characteristics in 104 TMJs with and 58 without degenerative changes of the condyle, such as osteophytes, erosion, avascular necrosis, subcondral cyst and intra-articular loose bodies. TMJ images were also assessed for flattening, retropositioning and hypomobility of condyle and disc displacement. Comparison of the TMJ side-related data showed a significant relationship between disc displacement without reduction (DDwoR) and the presence of degenerative bony changes (p=0.00). Flattening, retropositioning and hypomobility of condyle showed no significant difference in relation to the presence or absence of degenerative bony changes. Retropositioning of the condyle was significantly associated to disc displacement with reduction (DDwR) (p=0.00), while condylar hypomobility was significantly more frequent in TMJ with DDwoR (p<0.05). Independent of the presence or type of DD, TMJ pain was more frequent in the presence of degenerative bony changes. When considering only DDwR, TMJ pain was significantly associated to a degenerative condition (p=0.03). When there were no degenerative bony changes, TMJ pain was significantly more frequent in DDwoR (p=0.04). Despite the present findings, the absence of symptoms in some patients with condylar bony changes suggests that the diagnosis of osteoarthritis should be established by evaluation of magnetic resonance images in association with clinical examination. PMID:18440778

  9. Low-level laser therapy stimulates tissue repair and reduces the extracellular matrix degradation in rats with induced arthritis in the temporomandibular joint.

    PubMed

    Lemos, George Azevedo; Rissi, Renato; de Souza Pires, Ivan Luiz; de Oliveira, Letícia Prado; de Aro, Andrea Aparecida; Pimentel, Edson Rosa; Palomari, Evanisi Teresa

    2016-08-01

    The objective of this study was to characterize morphological and biochemistry action of low-level laser therapy (LLLT) on induced arthritis in the temporomandibular joint (TMJ) of rats. Twenty-four male Wistar rats were randomly divided into groups with 12 animals each: (AG) group with arthritis induced in the left TMJ and (LG) group with arthritis induced in the left TMJ and treated with LLLT (830 nm, 30 mW, 3 J/cm(2)). Right TMJs in the AG group were used as noninjected control group (CG). Arthritis was induced by intra-articular injection of 50 μl Complete Freund's Adjuvant (CFA) and LLLT began 1 week after arthritis induction. Histopathological analysis was performed using sections stained with hematoxylin-eosin, Toluidine Blue, and picrosirius. Biochemical analysis was determined by the total concentration of sulfated glycosaminoglycans (GAGs) and evaluation of matrix metalloproteinases (MMP-2 and MMP-9). Statistical analysis was performed using paired and unpaired t tests, with p < 0.05. Compared to AG, LG had minor histopathological changes in the TMJ, smaller thickness of the articular disc in the anterior (p < 0.0001), middle (p < 0.0001) and posterior regions (p < 0.0001), high birefringence of collagen fibers in the anterior (p < 0.0001), middle (p < 0.0001) and posterior regions (p < 0.0001) on the articular disc, and statistically lower activity of MMP-2 latent (p < 0.0001), MMP-2 active (P = 0.02), MMP-9 latent (p < 0.0001), and MMP-9 active (p < 0.0001). These results suggest that LLLT can increase the remodeling and enhancing tissue repair in TMJ with induced arthritis. PMID:27147076

  10. Toward patient-specific articular contact mechanics

    PubMed Central

    Ateshian, Gerard A.; Henak, Corinne R.; Weiss, Jeffrey A.

    2015-01-01

    The mechanics of contacting cartilage layers is fundamentally important to understanding the development, homeostasis and pathology of diarthrodial joints. Because of the highly nonlinear nature of both the materials and the contact problem itself, numerical methods such as the finite element method are typically incorporated to obtain solutions. Over the course of five decades, we have moved from an initial qualitative understanding of articular cartilage material behavior to the ability to perform complex, three-dimensional contact analysis, including multiphasic material representations. This history includes the development of analytical and computational contact analysis methods that now provide the ability to perform highly nonlinear analyses. Numerical implementations of contact analysis based on the finite element method are rapidly advancing and will soon enable patient-specific analysis of joint contact mechanics using models based on medical image data. In addition to contact stress on the articular surfaces, these techniques can predict variations in strain and strain through the cartilage layers, providing the basis to predict damage and failure. This opens up exciting areas for future research and application to patient-specific diagnosis and treatment planning applied to a variety of pathologies that affect joint function and cartilage homeostasis. PMID:25698236

  11. PRP and Articular Cartilage: A Clinical Update

    PubMed Central

    Rossi, Roberto; Castoldi, Filippo; Michielon, Gianni

    2015-01-01

    The convincing background of the recent studies, investigating the different potentials of platelet-rich plasma, offers the clinician an appealing alternative for the treatment of cartilage lesions and osteoarthritis. Recent evidences in literature have shown that PRP may be helpful both as an adjuvant for surgical treatment of cartilage defects and as a therapeutic tool by intra-articular injection in patients affected by osteoarthritis. In this review, the authors introduce the trophic and anti-inflammatory properties of PRP and the different products of the available platelet concentrates. Then, in a complex scenario made of a great number of clinical variables, they resume the current literature on the PRP applications in cartilage surgery as well as the use of intra-articular PRP injections for the conservative treatment of cartilage degenerative lesions and osteoarthritis in humans, available as both case series and comparative studies. The result of this review confirms the fascinating biological role of PRP, although many aspects yet remain to be clarified and the use of PRP in a clinical setting has to be considered still exploratory. PMID:26075244

  12. [Articular chondrocalcinosis after 80 years of age].

    PubMed

    Memin, Y; Monville, C; Ryckewaert, A

    1978-02-01

    In 108 women over 80 (mean age 88,4 years, extremes 80 and 99 years) hospitalized in a geriatric service for various reasons, radiograms were made of both knees in the frontal aspect on standard film to detect calcinosis of the meniscus and chondrocalcinosis of the joint. In 25 women (23.1%) the radiographs revealed calcinosis of the meniscus with or without chondrocalcinosis. In these 25 cases a lateral X-ray was also made of the two knees, frontal X-rays were made of the pelvis, thumbs and shoulders. In 22 cases (88%) these revealed calcification of the fibrocartilages or articular cartilages in joints other than the knee. Seven of the 25 women had at least one attack of articular inflammation (especially of the knee) resembling a pseudo-gout crisis. The frequency of chronic arthropathies resembling arthroses was high in the 25 patients with chondrocalcinosis: 8 (32%) had an internal or external femoro-tibial arthrosis, as against 11 of the 83 patients (13%) of the same age without chondrocalcinosis, a significant difference. Eleven of the 25 women had signs of femororotular arthrosis on the lateral X-rays of the knees, 5 had coxarthrosis (with in 3 cases a radiological image of fibrocartilaginous or coxofemoral cartilaginous calcification). One women had chronic radiocarpal arthropathy evocative or chondrocalcinosis. Ten had a scaphotrapezoidal arthrosis, 5 arthrosis of the shoulder, 3 with radiological aspect of glenohumeral chondrocalcinosis. PMID:644241

  13. Imaging of articular cartilage: current concepts

    PubMed Central

    RONGA, MARIO; ANGERETTI, GLORIA; FERRARO, SERGIO; DE FALCO, GIOVANNI; GENOVESE, EUGENIO A.; CHERUBINO, PAOLO

    2014-01-01

    Magnetic resonance imaging (MRI) is the gold standard method for non-invasive assessment of joint cartilage, providing information on the structure, morphology and molecular composition of this tissue. There are certain minimum requirements for a MRI study of cartilage tissue: machines with a high magnetic field (> 1.5 Tesla); the use of surface coils; and the use of T2-weighted, proton density-weighted fast-spin echo (T2 FSE-DP) and 3D fat-suppressed T1-weighted gradient echo (3D-FS T1W GRE) sequences. For better contrast between the different joint structures, MR arthography is a method that can highlight minimal fibrillation or fractures of the articular surface and allow evaluation of the integrity of the native cartilage-repair tissue interface. To assess the biochemical composition of cartilage and cartilage repair tissue, various techniques have been proposed for studying proteoglycans [dGEMRIC, T1rho mapping, sodium (23Na) imaging MRI, etc.], collagen, and water distribution [T2 mapping, “magnetisation transfer contrast”, diffusion-weighted imaging (DWI), and so on]. Several MRI classifications have been proposed for evaluating the processes of joint degeneration (WORMS, BLOKS, ICRS) and post-surgical maturation of repair tissue (MOCART, 3D MOCART). In the future, isotropic 3D sequences set to improve image quality and facilitate the diagnosis of disorders of articular structures adjacent to cartilage. PMID:25606557

  14. Bite force and temporomandibular disorder in juvenile chronic arthritis.

    PubMed

    Wenneberg, B; Kjellberg, H; Kiliaridis, S

    1995-08-01

    The aim of this study was to investigate the functional condition of the stomatognathic system in children suffering from juvenile chronic arthritis, with respect to bite force and temporomandibular disorder in relation to radiographic abnormalities of the mandibular condyle, occlusal factors and systemic disease parameters. Thirty-five children with juvenile chronic arthritis were compared to 89 healthy children with an Angle Class I occlusion and 62 children with an Angle Class II malocclusion. Subjective symptoms and clinical signs of temporomandibular disorder and radiographic mandibular condylar changes were more common in children with juvenile chronic arthritis than in the two comparison groups. Maximal molar and incisal bite forces and maximal molar bite force endurance times were also significantly reduced in children with juvenile chronic arthritis. It is concluded that the differences between the groups are caused mainly by the systemic inflammatory disease itself, but a functional influence of weakened masticatory muscles cannot be excluded. PMID:7472737

  15. Rationale of arthroscopic surgery of the temporomandibular joint

    PubMed Central

    Murakami, KenIchiro

    2013-01-01

    Arthroscopic surgery has been widely used for treatment of temporomandibular joint (TMJ) internal derangements and diseases for the last 40 years. Although 626 articles have been hit by Pubmed search in terms of “TMJ arthroscopic surgery”, this review article is described based on distinguished publishing works and on my experiences with TMJ arthroscopic surgery and related research with an aim to analyse the rationale of arthroscopic surgeries of the temporomandibular joint. With arthrocentesis emerging as an alternative, less invasive, treatment for internal derangement with closed lock, the primary indication of arthroscopic surgery seems to be somewhat limited. However, the value of endoscopic inspection and surgery has its position for both patient and physician with its long-term reliable results. PMID:25737901

  16. [Can orthodontic treatment generate temporomandibular disorders and pain? A review].

    PubMed

    Gebeile-Chauty, Sarah; Robin, Olivier; Messaoudi, Yassine; Aknin, Jean-Jacques

    2010-03-01

    While considered for years to play the primary role in the etiology of temporo-mandibular joint disturbances (TMD), occlusal discrepancies are now considered to be just one causative factor among many. Recent studies, literature reviews or meta-analyses, and longitudinal studies with follow-up of children treated for many years all conclude that there is no risk of orthodontic treatment giving rise to episodes of temporo-mandibular disorders. The signs of TMD appearing during the course of orthodontic treatment should be considered in the context of the epidemiology of the disorder, which is characterized by a strong increase in its occurrence during adolescence. In conclusion, it should be stated that if orthodontic treatment can no longer be considered as one of the etiopathogenic factors in the TMD complex, there are no scientific arguments to justify the converse, that there are indications for orthodontic treatment whose sole goal would be the treatment of TMD. PMID:20359451

  17. Body posture evaluations in subjects with internal temporomandibular joint derangement.

    PubMed

    Munhoz, Wagner Cesar; Marques, Amélia Pasqual

    2009-10-01

    The aim of this study was to verify possible relationships between global body posture and temporomandibular joint internal derangement (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Body posture was assessed using the analysis of muscle chains on several photographs. Results show a higher frequency of lifted shoulders (p=0.04) and of changes in the antero-internal hip chain (p=0.02) in the test group, but no further differences were found significant between the control and test groups. The test group was then divided into three subgroups according to the Helkimo index of temporomandibular disorder severity. Again, no significant differences were found between the subgroups. However, there was a trend noticed in the group with the most severe dysfunction, to present a forward head and shoulders posture. Results are discussed in light of previous studies using the same sample. PMID:19891257

  18. Oral splint for temporomandibular joint disorders with revolutionary fluid system

    PubMed Central

    Srivastava, Rahul; Jyoti, Bhuvan; Devi, Parvathi

    2013-01-01

    Temporomandibular joint (TMJ) diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal movements of speech, facial expression, eating, chewing, and swallowing. The conventional soft occlusal splint therapy is a much safer and effective mode of a conservative line of therapy in comparison to the surgical therapy for temporomandibular joint disorders (TMD). The purpose of this article is to review the Aqualizer™, an hydrostatic oral splint, as accurate, effective treatment and differential diagnostic tool in TMD that allow treating the patient's pain quickly and accurately saving valuable treatment time. The review article has been prepared doing a literature review from the world-wide web and pubmed/medline. PMID:24019797

  19. Current concepts in the pathogenesis of traumatic temporomandibular joint ankylosis

    PubMed Central

    2014-01-01

    Traumatic temporomandibular joint (TMJ) ankylosis can be classified into fibrous, fibro-osseous and bony ankylosis. It is still a huge challenge for oral and maxillofacial surgeons due to the technical difficulty and high incidence of recurrence. The poor outcome of disease may be partially attributed to the limited understanding of its pathogenesis. The purpose of this article was to comprehensively review the literature and summarise results from both human and animal studies related to the genesis of TMJ ankylosis. PMID:25189735

  20. Temporomandibular Myofacial Pain Treated with Botulinum Toxin Injection

    PubMed Central

    Mor, Niv; Tang, Christropher; Blitzer, Andrew

    2015-01-01

    This article reviews the diagnoses and treatment of temporomandibular disorders (TMD) and outlines of the role of botulinum toxin (BoNT) in the treatment of myofacial TMD. This manuscript includes a brief history of the use of BoNT in the treatment of pain, the mechanism of action of BoNT, and the techniques for injections, adverse effects and contraindications when using BoNT to treat mayofacial pain caused by TMD. PMID:26213970

  1. Regional 3D superimposition to assess temporomandibular joint condylar morphology

    PubMed Central

    Schilling, J; Gomes, L C R; Benavides, E; Nguyen, T; Paniagua, B; Styner, M; Boen, V; Gonçalves, J R; Cevidanes, L H S

    2014-01-01

    Objectives: To investigate the reliability of regional three-dimensional registration and superimposition methods for assessment of temporomandibular joint condylar morphology across subjects and longitudinally. Methods: The sample consisted of cone beam CT scans of 36 patients. The across-subject comparisons included 12 controls, mean age 41.3 ± 12.0 years, and 12 patients with temporomandibular joint osteoarthritis, mean age 41.3 ± 14.7 years. The individual longitudinal assessments included 12 patients with temporomandibular joint osteoarthritis, mean age 37.8 ± 16.7 years, followed up at pre-operative jaw surgery, immediately after and one-year post-operative. Surface models of all condyles were constructed from the cone beam CT scans. Two previously calibrated observers independently performed all registration methods. A landmark-based approach was used for the registration of across-subject condylar models, and temporomandibular joint osteoarthritis vs control group differences were computed with shape analysis. A voxel-based approach was used for registration of longitudinal scans calculated x, y, z degrees of freedom for translation and rotation. Two-way random intraclass correlation coefficients tested the interobserver reliability. Results: Statistically significant differences between the control group and the osteoarthritis group were consistently located on the lateral and medial poles for both observers. The interobserver differences were ≤0.2 mm. For individual longitudinal comparisons, the mean interobserver differences were ≤0.6 mm in translation errors and 1.2° in rotation errors, with excellent reliability (intraclass correlation coefficient >0.75). Conclusions: Condylar registration for across-subjects and longitudinal assessments is reliable and can be used to quantify subtle bony differences in the three-dimensional condylar morphology. PMID:24170802

  2. Diagnosis of temporomandibular joint (TMJ) ankylosis in children.

    PubMed

    Shetty, Priya; Thomas, Ann; Sowmya, B

    2014-01-01

    Temporomandibular joint (TMJ) ankylosis involves fusion of the mandibular condyle with the base of the skull. It results in functional, esthetic, and psychosocial limitations, if it affects children at an early age. Hence, it is important to recognize and diagnose the pathology and provide immediate treatment alternatives to improve the patient condition. In this case report, we highlight the diagnostic perspective of TMJ ankylosis in children, and the use of 3D computed tomography as an effective diagnostic aid. PMID:25001450

  3. Dislocation of the Temporomandibular Joint and Relocation Procedures.

    PubMed

    White, Thomas; Hedderick, Viki; Ramponi, Denise R

    2016-01-01

    Temporomandibular joint (TMJ) dislocation requires prompt medical attention due to the crucial impact of airway, nutrition acquisition, and communication. Recognition of this injury by the practitioner, based on clinical presentation and history, is paramount for identification of accurate diagnosis and prompt treatment of TMJ dislocation. Relocation or reduction methods vary on the basis of the severity of the injury and whether it is an acute or chronic dislocation. PMID:27482989

  4. [Diagnosis and treatment of temporo-mandibular disorders in orthodontics].

    PubMed

    Bocquet, Emmanuelle; Moreau, Alexis; Danguy, Michel; Danguy, Chantal

    2010-03-01

    Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy. PMID:20359450

  5. Temporomandibular disorders in fibromyalgia patients: are there different pain onset?

    PubMed

    Fujarra, Fábio J C; Kaziyama, Helena Hideko Seguchi; Siqueira, Silvia Regina D T de; Yeng, Lin Tchia; Camparis, Cinara M; Teixeira, Manoel Jacobsen; Siqueira, José Tadeu Tesseroli de

    2016-03-01

    Objective To identify temporomandibular disorders (TMD) symptoms in two groups of fibromyalgia patients according to the temporal relation between the onset of facial pain (FP) and generalized body pain (GBP). Cross-sectional study design: Fifty-three consecutive women with fibromyalgia and FP were stratified according to the onset of orofacial pain: Group-A (mean age 47.30 ± 14.20 years old), onset of FP preceded GBP; Group-B (mean age 51.33 ± 11.03 years old), the FP started concomitant or after GBP. Clinical assessment Research Diagnostic Criteria for Temporomandibular Disorders and the Visual Analogue Scale. Results Myofascial pain with mouth opening limitation (p = 0.038); right disc displacement with reduction (p = 0.012) and jaw stiffness (p = 0.004) were predominant in Group A. Myofascial pain without mouth opening limitation (p = 0.038) and numbness/burning were more common in Group B. Conclusion All patients had temporomandibular joint symptoms, mainly muscle disorders. The prevalence of myofascial pain with limited mouth opening and right TMJ disc displacement with reduction were higher in Group A. PMID:27050847

  6. Management of the Temporomandibular Joint after Ablative Surgery

    PubMed Central

    Bredell, Marius; Grätz, Klaus; Obwegeser, Joachim; Gujer, Astrid Kruse

    2014-01-01

    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. PMID:25379124

  7. Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series

    PubMed Central

    Pavia, Steven; Fischer, Rebecca; Roy, Richard

    2015-01-01

    Objective The purpose of this study is to describe chiropractic treatment of 14 patients who presented with signs and symptoms of temporomandibular joint dysfunction (TMD). Methods This is a retrospective case series of 14 patients, including 13 adults and 1 child. The majority of these patients were undergoing chiropractic care for spine-related conditions when they presented with additional TMD signs and symptoms. They were evaluated and treated with Activator Methods International published protocols relative to the temporomandibular joint before the addition of treatment to the suprahyoid muscles. Results All pre- and postadjustment assessments were recorded using a numeric pain scale. The resulting average showed a reduction in the patients’ pain scores from the initial visit of 8.3 ± 1.6 to the last visit at 1.4 ± 1.1 with an 80.9% ± 15.4% improvement. The average number of visits was 13.6 ± 8.2. Conclusion All patients selected for this case series showed a reduction of temporomandibular dysfunction symptoms. PMID:26793040

  8. Risk factors for temporomandibular disorder: Binary logistic regression analysis

    PubMed Central

    Magalhães, Bruno G.; de-Sousa, Stéphanie T.; de Mello, Victor V C.; da-Silva-Barbosa, André C.; de-Assis-Morais, Mariana P L.; Barbosa-Vasconcelos, Márcia M V.

    2014-01-01

    Objectives: To analyze the influence of socioeconomic and demographic factors (gender, economic class, age and marital status) on the occurrence of temporomandibular disorder. Study Design: One hundred individuals from urban areas in the city of Recife (Brazil) registered at Family Health Units was examined using Axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) which addresses myofascial pain and joint problems (disc displacement, arthralgia, osteoarthritis and oesteoarthrosis). The Brazilian Economic Classification Criteria (CCEB) was used for the collection of socioeconomic and demographic data. Then, it was categorized as Class A (high social class), Classes B/C (middle class) and Classes D/E (very poor social class). The results were analyzed using Pearson’s chi-square test for proportions, Fisher’s exact test, nonparametric Mann-Whitney test and Binary logistic regression analysis. Results: None of the participants belonged to Class A, 72% belonged to Classes B/C and 28% belonged to Classes D/E. The multivariate analysis revealed that participants from Classes D/E had a 4.35-fold greater chance of exhibiting myofascial pain and 11.3-fold greater chance of exhibiting joint problems. Conclusions: Poverty is a important condition to exhibit myofascial pain and joint problems. Key words:Temporomandibular joint disorders, risk factors, prevalence. PMID:24316706

  9. Value of the nuclear medical scan in the diagnosis of temporomandibular joint disease

    SciTech Connect

    Craemer, T.D.; Ficara, A.J.

    1984-10-01

    A total of 125 patients with temporomandibular joint complaints underwent nuclear medical scans of their joints as part of their diagnostic work-ups. The scan results were compared with the radiographic and arthrogram findings of these patients. The results suggest that the nuclear medical scan is not a highly reliable diagnostic aid for the majority of temporomandibular joint patients.

  10. Bilateral Temporomandibular Joint Replacement Using Computer-Assisted Surgical Simulation and Three-Dimensional Printing.

    PubMed

    Ryu, Jaeyoung; Cho, Jinyong; Kim, Hyeon Min

    2016-07-01

    The dental occlusion is the important reference for replacement of the temporomandibular joint. If a patient does not have normal occlusion, few considerations are needed for temporomandibular joint replacement. The custom-made prosthesis, typically fabricated with a stereolithographic model, is probably the optimized solution currently available. However the ready-made stock from Biomet Microfixation System (Jacksonville, FL) is the only available product, which is authorized by the government ministry in South Korea, for replacement of the temporomandibular joint. This report presents a patient with the problems that were retrognathic "bird face" profile subsequent to severe bilateral condylar resorption and temporomandibular joint ankylosis without enough natural teeth for occlusion. Bilateral temporomandibular joint replacement using the ready-made prosthesis was done by reestablishing the mandibular position with new occlusion and improved facial profile via the virtual surgical planning and stereolithographic model simulation. PMID:27315318

  11. Tissue Engineering of Articular Cartilage with Biomimetic Zones

    PubMed Central

    Klein, Travis J.; Malda, Jos; Sah, Robert L.

    2009-01-01

    Articular cartilage damage is a persistent and increasing problem with the aging population, and treatments to achieve biological repair or restoration remain a challenge. Cartilage tissue engineering approaches have been investigated for over 20 years, but have yet to achieve the consistency and effectiveness for widespread clinical use. One of the potential reasons for this is that the engineered tissues do not have or establish the normal zonal organization of cells and extracellular matrix that appears critical for normal tissue function. A number of approaches are being taken currently to engineer tissue that more closely mimics the organization of native articular cartilage. This review focuses on the zonal organization of native articular cartilage, strategies being used to develop such organization, the reorganization that occurs after culture or implantation, and future prospects for the tissue engineering of articular cartilage with biomimetic zones. PMID:19203206

  12. Simultaneous magnetic resonance imaging and consolidation measurement of articular cartilage.

    PubMed

    Wellard, Robert Mark; Ravasio, Jean-Philippe; Guesne, Samuel; Bell, Christopher; Oloyede, Adekunle; Tevelen, Greg; Pope, James M; Momot, Konstantin I

    2014-01-01

    Magnetic resonance imaging (MRI) offers the opportunity to study biological tissues and processes in a non-disruptive manner. The technique shows promise for the study of the load-bearing performance (consolidation) of articular cartilage and changes in articular cartilage accompanying osteoarthritis. Consolidation of articular cartilage involves the recording of two transient characteristics: the change over time of strain and the hydrostatic excess pore pressure (HEPP). MRI study of cartilage consolidation under mechanical load is limited by difficulties in measuring the HEPP in the presence of the strong magnetic fields associated with the MRI technique. Here we describe the use of MRI to image and characterize bovine articular cartilage deforming under load in an MRI compatible consolidometer while monitoring pressure with a Fabry-Perot interferometer-based fiber-optic pressure transducer. PMID:24803188

  13. Simultaneous Magnetic Resonance Imaging and Consolidation Measurement of Articular Cartilage

    PubMed Central

    Wellard, Robert Mark; Ravasio, Jean-Philippe; Guesne, Samuel; Bell, Christopher; Oloyede, Adekunle; Tevelen, Greg; Pope, James M.; Momot, Konstantin I.

    2014-01-01

    Magnetic resonance imaging (MRI) offers the opportunity to study biological tissues and processes in a non-disruptive manner. The technique shows promise for the study of the load-bearing performance (consolidation) of articular cartilage and changes in articular cartilage accompanying osteoarthritis. Consolidation of articular cartilage involves the recording of two transient characteristics: the change over time of strain and the hydrostatic excess pore pressure (HEPP). MRI study of cartilage consolidation under mechanical load is limited by difficulties in measuring the HEPP in the presence of the strong magnetic fields associated with the MRI technique. Here we describe the use of MRI to image and characterize bovine articular cartilage deforming under load in an MRI compatible consolidometer while monitoring pressure with a Fabry-Perot interferometer-based fiber-optic pressure transducer. PMID:24803188

  14. A literature review of lasers and articular cartilage.

    PubMed

    Vangsness, C T; Ghaderi, B

    1993-05-01

    Articles from the English literature concerning lasers and articular cartilage were reviewed. Different experimental methods and laser systems were analyzed. Many studies lacked scientific validity. Future investigations with sound biologic foundations are recommended. PMID:8327386

  15. Follistatin Alleviates Synovitis and Articular Cartilage Degeneration Induced by Carrageenan

    PubMed Central

    Yamada, Jun; Abula, Kahaer; Inoue, Makiko; Sekiya, Ichiro; Muneta, Takeshi

    2014-01-01

    Activins are proinflammatory cytokines which belong to the TGFβ superfamily. Follistatin is an extracellular decoy receptor for activins. Since both activins and follistatin are expressed in articular cartilage, we hypothesized that activin-follistatin signaling participates in the process of joint inflammation and cartilage degeneration. To test this hypothesis, we examined the effects of follistatin in a carrageenan-induced mouse arthritis model. Synovitis induced by intra-articular injection of carrageenan was significantly alleviated by preinjection with follistatin. Macrophage infiltration into the synovial membrane was significantly reduced in the presence of follistatin. In addition, follistatin inhibited proteoglycan erosion induced by carrageenan in articular cartilage. These data indicate that activin-follistatin signaling is involved in joint inflammation and cartilage homeostasis. Our data suggest that follistatin can be a new therapeutic target for inflammation-induced articular cartilage degeneration. PMID:25574420

  16. Fractures of the articular processes of the cervical spine

    SciTech Connect

    Woodring, J.H.; Goldstein, S.J.

    1982-08-01

    Fractures of the articular processes occurred in 16 (20.8%) of 77 patients with cervical spine fractures as demonstrated by multidirectional tomography. Plain films demonstrated the fractures in only two patients. Acute cervical radiculopathy occurred in five of the patients with articular process fractures (superior process, two cases; inferior process, three cases). Persistent neck pain occurred in one other patient without radiculopathy. Three patients suffered spinal cord damage at the time of injury, which was not the result of the articular process fracture itself. In the other seven cases, no definite sequelae occurred. However, disruption of the facet joint may predispose to early degenerative joint disease and chronic pain; unilateral or bilateral facet dislocation was present in five patients. In patients with cervical trauma who develop cervical radiculopathy, tomography should be performed to evaluate the articular processes.

  17. Extra-Articular Ganglion Cysts around the Knee Joint

    PubMed Central

    Park, Sang-Eun; Panchal, Karnav; Kim, Young-Yul; Ji, Jong-Hun; Park, Sung-Ryeoll; Park, Min-Kyu

    2015-01-01

    Purpose The purpose of this study was to report clinical results of open excision of extra-articular ganglion cysts around the knee joint combined with arthroscopic management of intra-articular pathologies if present. Materials and Methods Of the total 107 cases of cystic lesions around the knee, 23 cases of extra-articular ganglion cysts were reviewed between January 2006 and July 2011. There were 13 males and 10 females with a mean age of 48 years (range, 30 to 73 years). The mean follow-up duration was 40 months (range, 30 to 60 months). Preoperative magnetic resonance imaging (MRI) scan was done in all cases. Open surgical excision of the cyst was performed after arthroscopic management of intra-articular pathologies in all but 1 case. At the last follow-up, Lysholm and International Knee Documentation Committee (IKDC) scores were evaluated and MRI was conducted to detect recurrence. Results The mean Lysholm and IKDC scores showed significant improvement (p=0.005 and 0.013, respectively).The location of the cysts was anterior in 9, lateral in 7, medial in 6, and posterosuperior in 1. Intra-articular pathologies were found in 16/23 cases (69.6%). In 10/23 cases (43%), the cyst was connected to the knee joint. Three months postoperative MRI did not show any recurrence of ganglion cysts except for 1 case. Conclusions In the treatment of extra-articular ganglion cysts, MRI can be useful for detecting intra-articular lesions and connecting orifices, and arthroscopic management of intra-articular pathologies with open excision of the cyst should be considered as a viable treatment option. PMID:26672721

  18. ACTIVATION OF B-CATENIN SIGNALLING LEADS TO TEMPOROMANDIBULAR JOINT DEFECTS

    PubMed Central

    Wang, M.; Li, S.; Xie, W.; Shen, J.; Im, H-J.; Holz, J.D.; Wang, M.; Diekwisch, T.G.H.; Chen, D.

    2014-01-01

    Despite extensive research in knee and hip osteoarthritis (OA), the underlying mechanism of temporomandibular joint (TMJ) disorder remains largely unknown. The purpose of this study was to determine whether the constitutive activation of β-catenin in the middle and deep layers of the articular cartilage can compromise the homeostasis of this tissue in the TMJ. Co12CreERT2 transgenic mice were bred with RosamT/mG reporter mice to determine Cre recombination efficiency. Co12CreERT2 mice were then crossed with β-cateninflox (ex3)/+ mice to generate β-catenin conditional activation mice, β-catenin(ex3)Co12ER. TMJ samples were harvested when the mice were 1-, 3- or 6-month-old and evaluated using histology, histomorphometry and immunohistochemistry. β-catenin(ex3)Co12ER mice were further crossed with Mmp13flox/flox and Adamts5−/− mice to generate β-catenin(ex3)/Mmp13)Co12ER and β-catenin(ex3)Co12ER)/Adamts5−/− double mutant mice to investigate the role of Mmp13 and Adamts5 in the development of TMJ disorder. High levels of Cre-recombination were seen in Co12CreERT2;RosamT/mG mice. Progressive TMJ defects developed in 1-, 3- and 6-month-old β-catenin(ex3)Co12ER mice, as revealed by histology and histomorphometry. Results further demonstrated that the defects observed in β-catenin(ex3)Co12ER mice were significantly decelerated after deletion of the Mmp13 or Adamts5 gene in (β-catenin(ex3)/Mmp13)co12ER or β-catenin(ex3)Co12ER/ Adamts5−/− double mutant mice. In summary, we found that β-catenin is a critical gene in the induction of TMJ cartilage degeneration, and over-expressing β-catenin in TMJ cartilage leads to defects assembling an OA-like phenotype. Deletion of Mmp13 and Adamts5 in β-catenin(ex3)Co12ER mice ameliorates the development of TMJ defects. This study suggests that Mmp13 and Adamts5 could be potential therapeutic targets for the treatment of TMJ disorders. PMID:25340802

  19. Activation of β-catenin signalling leads to temporomandibular joint defects.

    PubMed

    Wang, M; Li, S; Xie, W; Shen, J; Im, H J; Holz, J D; Wang, M; Diekwisch, T G; Chen, D

    2014-01-01

    Despite extensive research in knee and hip osteoarthritis (OA), the underlying mechanism of temporomandibular joint (TMJ) disorder remains largely unknown. The purpose of this study was to determine whether the constitutive activation of β-catenin in the middle and deep layers of the articular cartilage can compromise the homeostasis of this tissue in the TMJ. Col2CreERT2 transgenic mice were bred with RosamT/mG reporter mice to determine Cre recombination efficiency. Col2CreERT2 mice were then crossed with β-cateninflox(ex3)+ mice to generate β-catenin conditional activation mice, β-catenin(ex3)Col2ER. TMJ samples were harvested when the mice were 1-, 3- or 6-month-old and evaluated using histology, histomorphometry and immunohistochemistry. β-catenin(ex3)Col2ER mice were further crossed with Mmp13flox/flox and Adamts5-/- mice to generate (β-catenin(ex3)/Mmp13)Col2ER and β-catenin(ex3)Col2ER)/Adamts5-/- double mutant mice to investigate the role of Mmp13 and Adamts5 in the development of TMJ disorder. High levels of Cre-recombination were seen in Col2CreERT2;RosamT/mGmice. Progressive TMJ defects developed in 1-, 3- and 6-month-old β-catenin(ex3)Col2ER mice, as revealed by histology and histomorphometry. Results further demonstrated that the defects observed in β-catenin(ex3)Col2ER mice were significantly decelerated after deletion of the Mmp13 or Adamts5 gene in (β-catenin(ex3)/Mmp13)Col2ER or β-catenin(ex3)Col2ER/Adamts5-/- double mutant mice. In summary, we found that β-catenin is a critical gene in the induction of TMJ cartilage degeneration, and over-expressing β-catenin in TMJ cartilage leads to defects assembling an OA-like phenotype. Deletion of Mmp13 and Adamts5 in β-catenin(ex3)Col2ER mice ameliorates the development of TMJ defects. This study suggests that Mmp13 and Adamts5 could be potential therapeutic targets for the treatment of TMJ disorders. PMID:25340802

  20. Articular cartilage: from formation to tissue engineering.

    PubMed

    Camarero-Espinosa, Sandra; Rothen-Rutishauser, Barbara; Foster, E Johan; Weder, Christoph

    2016-05-26

    Hyaline cartilage is the nonlinear, inhomogeneous, anisotropic, poro-viscoelastic connective tissue that serves as friction-reducing and load-bearing cushion in synovial joints and is vital for mammalian skeletal movements. Due to its avascular nature, low cell density, low proliferative activity and the tendency of chondrocytes to de-differentiate, cartilage cannot regenerate after injury, wear and tear, or degeneration through common diseases such as osteoarthritis. Therefore severe damage usually requires surgical intervention. Current clinical strategies to generate new tissue include debridement, microfracture, autologous chondrocyte transplantation, and mosaicplasty. While articular cartilage was predicted to be one of the first tissues to be successfully engineered, it proved to be challenging to reproduce the complex architecture and biomechanical properties of the native tissue. Despite significant research efforts, only a limited number of studies have evolved up to the clinical trial stage. This review article summarizes the current state of cartilage tissue engineering in the context of relevant biological aspects, such as the formation and growth of hyaline cartilage, its composition, structure and biomechanical properties. Special attention is given to materials development, scaffold designs, fabrication methods, and template-cell interactions, which are of great importance to the structure and functionality of the engineered tissue. PMID:26923076

  1. The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications

    PubMed Central

    Caradonna, Carola; Caradonna, Domenico; Anastasi, Giuseppe; Milardi, Demetrio; Favaloro, Angelo; De Pietro, Anita; Angileri, Tommaso Maurizio; Caradonna, Luigi; Cutroneo, Giuseppina

    2013-01-01

    Purpose The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Materials and Methods Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. Results The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. Conclusion The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint. PMID:23525363

  2. Dental and Temporomandibular Joint Pathology of the Eastern Pacific Harbour Seal (Phoca vitulina richardii).

    PubMed

    Aalderink, M T; Nguyen, H P; Kass, P H; Arzi, B; Verstraete, F J M

    2015-05-01

    .2%) in seven animals. Periapical lesions were found in four skulls (2.1% of the total number of specimens). None of the specimens showed signs of enamel hypoplasia. More than half (55.6%) of alveoli, either with or without teeth, showed signs of alveolar bony changes consistent with periodontitis. A total of 178 specimens (91.8%) had at least one tooth associated with mild periodontitis. Lesions consistent with temporomandibular joint osteoarthritis (TMJ-OA) were found in 67 specimens (34.5%). The most common articular surface to be affected was the left mandibular fossa of the temporal bone, with lesions in 44 cases (32.8% of all lesions). In 13 specimens (6.7%) all articular surfaces were affected. Both periodontal disease and TMJ-OA were significantly more common in adults than in juveniles (P <0.0001). Although the significance of the high incidence of periodontitis and TMJ-OA in the Eastern Pacific harbor seal remains unknown, the occurrence and severity of these diseases as found in this study may play an important role in the morbidity and mortality of this species. PMID:25824118

  3. A possible barrier function of the articular surface.

    PubMed

    Takada, N; Wada, I; Sugimura, I; Sakuma, E; Maruyama, H; Matsui, N

    1999-12-01

    Since MacConaill first reported the existence of a thin additional layer of the articular cartilage and named it the lamina splendens, there have been various opinions as to the role of this layer in the lubrication of the articular surface. We studied the superficial portion of the articular cartilage in the 20 day-old and 30 day-old rats using light and transmission electron microscopy. Furthermore, we studied the articular cartilage of the rat whose "cover layer" had been removed mechanically. Also, intraarticular latex beads injection, intraarticular dye injection using lithium carmine and supravital staining experiments were performed. On day 20, dye injected intraarticularly was clearly observed by light microscopy in chondrocytes situated in the deeper layers. The dye injected in the 30 day-old rats, however, was not seen in the chondrocytes but was found only in the superficial layer. Dye was found in the chondrocytes when supravital staining was performed in the articular cartilage of 30 day-old rats after mechanical removal of the cover layer. By transmission electron microscopy, a superficial layer consisted of fine filamentous structures was observed on the articular surface of the 30 day-old rats. The cover layer was destroyed by intraarticular injected latex beads in 30 day-old rats. These findings strongly support the idea that the cover layer acts as a barrier against substances which invade from the surface of the articular cartilage. The development period of the cover layer coincides with the initiation of weight bearing, and joint cartilage debris and pressure changes might further promote maturation. PMID:10659579

  4. A conservative surgical approach to temporomandibular joint ankylosis.

    PubMed

    Guarda-Nardini, Luca; Cocilovo, Francesco; Olivo, Marco; Ferronato, Giuseppe; Manfredini, Daniele

    2014-05-01

    The current article describes a case of a patient with temporomandibular joint (TMJ) ankylosis undergoing surgery performed with a tailored technique for condylar reshaping. A patient with posttraumatic bilateral TMJ ankylosis underwent interpositional arthroplasty with temporalis fascia, and focus was put on the need to maintain the vertical height of the mandible. The postoperative course was uneventful, and positive outcomes were kept during a 1-year follow-up span. The adoption of surgical strategies aiming at restoring a condylar shape as similar as possible to the natural one may be important in the light of the search for surgeries providing and/or recreating normal function of the TMJ. PMID:24705240

  5. Bilateral Traumatic Temporomandibular Joint Luxation in a Rat

    PubMed Central

    Shientag, Lisa J; Rosenthal, Karen L; Chandler, Heidi K; Wheeler, Suzanne M

    2011-01-01

    Bilateral temporomandibular joint (TMJ) luxation was diagnosed postmortem in a female, 6-mo-old CD rat (Rattus norvegicus) after probable head entrapment and subsequent disentanglement from a protective jacket. Clinical antemortem signs included inability to close her mouth, prehend food and drink water, anxiety, and linear skin erosions extending down the right and left commissures of the mouth. Radiography revealed rostral displacement of the mandible with concomitant malocclusion. The combination of clinical signs, acute nature of the presentation, and torn appearance of the protective jacket were strongly indicative of a traumatic etiology. To our knowledge, this is the first reported case of TMJ luxation in a rat. PMID:22330578

  6. Clinical assessment of patients with orofacial pain and temporomandibular disorders.

    PubMed

    Stern, Ilanit; Greenberg, Martin S

    2013-07-01

    Accurate diagnosis of chronic pain disorders of the mouth, jaws, and face is frequently complex. It is common for patients with chronic orofacial pain to consult multiple clinicians and receive ineffective treatment before a correct diagnosis is reached. This problem is a significant public health concern. Clinicians can minimize error by starting the diagnostic procedure with a careful, accurate history and thorough head and neck examination followed by a thoughtfully constructed differential diagnosis. The possibility that the patient has symptoms of a life-threatening underlying disease rather than a more common dental, sinus, or temporomandibular disorder must always be considered. PMID:23809299

  7. Component Approach to the Temporomandibular Joint and Coronoid Process

    PubMed Central

    Pfaff, Miles J.; Clune, James; Steinbacher, Derek

    2014-01-01

    Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar. PMID:25383157

  8. Component approach to the temporomandibular joint and coronoid process.

    PubMed

    Pfaff, Miles J; Clune, James; Steinbacher, Derek

    2014-12-01

    Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar. PMID:25383157

  9. Neurology of the temporomandibular joints: an experimental study.

    PubMed Central

    Clark, R. K.

    1976-01-01

    Experiments on anaesthetized cats are described in which the reflex effects of stimulation of the mechanoreceptors in the temporomandibular joints on the ipsilateral and contralateral mandibular muscles were studied. The effects on this reflex activity and on dynamic manidublar muscle activity of the production of temporary and permanent dysfunction of the mechanoreceptors in different regions of the joint capsule were also studied. The significance of the findings in relation to the maintenance of normal jaw posture and the disturbance of mandibular muscular function by trauma, disease, and malocclusion is discussed. PMID:1259326

  10. Intra-articular injection of Torin 1 reduces degeneration of articular cartilage in a rabbit osteoarthritis model

    PubMed Central

    Cheng, N-T.; Cui, Y-P.

    2016-01-01

    Objectives Recent studies have shown that systemic injection of rapamycin can prevent the development of osteoarthritis (OA)-like changes in human chondrocytes and reduce the severity of experimental OA. However, the systemic injection of rapamycin leads to many side effects. The purpose of this study was to determine the effects of intra-articular injection of Torin 1, which as a specific inhibitor of mTOR which can cause induction of autophagy, is similar to rapamycin, on articular cartilage degeneration in a rabbit osteoarthritis model and to investigate the mechanism of Torin 1’s effects on experimental OA. Methods Collagenase (type II) was injected twice into both knees of three-month-old rabbits to induce OA, combined with two intra–articular injections of Torin 1 (400 nM). Degeneration of articular cartilage was evaluated by histology using the Mankin scoring system at eight weeks after injection. Chondrocyte degeneration and autophagosomes were observed by transmission electron microscopy. Matrix metallopeptidase-13 (MMP-13) and vascular endothelial growth factor (VEGF) expression were analysed by quantitative RT-PCR (qPCR).Beclin-1 and light chain 3 (LC3) expression were examined by Western blotting. Results Intra-articular injection of Torin 1 significantly reduced degeneration of the articular cartilage after induction of OA. Autophagosomes andBeclin-1 and LC3 expression were increased in the chondrocytes from Torin 1-treated rabbits. Torin 1 treatment also reduced MMP-13 and VEGF expression at eight weeks after collagenase injection. Conclusion Our results demonstrate that intra-articular injection of Torin 1 reduces degeneration of articular cartilage in collagenase-induced OA, at least partially by autophagy activation, suggesting a novel therapeutic approach for preventing cartilage degeneration and treating OA. Cite this article: N-T. Cheng, A. Guo, Y-P. Cui. Intra-articular injection of Torin 1 reduces degeneration of articular cartilage in a

  11. Magnetic resonance imaging of the temporomandibular joint in children with juvenile idiopathic arthritis.

    PubMed

    Meyers, Arthur B; Laor, Tal

    2013-12-01

    For more than a century, it has been known that juvenile idiopathic arthritis (JIA) can affect the temporomandibular joint. With advances in medical imaging in more recent decades, there has been an increase in awareness of the spectrum of pathology that can affect the temporomandibular joint in children with JIA. This pathology can lead to symptoms ranging from decreased chewing ability, jaw and facial pain, headaches and malocclusion to craniofacial morphological changes such as a retrognathic mandible. The purpose of this review is to suggest an MR imaging protocol for the temporomandibular joint and to illustrate normal and abnormal appearances of the joint in children with JIA. PMID:24257698

  12. The Functions of BMP3 in Rabbit Articular Cartilage Repair.

    PubMed

    Zhang, Zhe; Yang, Wenyu; Cao, Yiting; Shi, Yanping; Lei, Chen; Du, Bo; Li, Xuemin; Zhang, Qiqing

    2015-01-01

    Bone morphogenetic proteins (BMPs) play important roles in skeletal development and repair. Previously, we found fibroblast growth factor 2 (FGF2) induced up-regulation of BMP2, 3, 4 in the process of rabbit articular cartilage repair, which resulted in satisfactory repair effects. As BMP2/4 show a clearly positive effect for cartilage repair, we investigated the functions of BMP3 in rabbit articular cartilage repair. In this paper, we find that BMP3 inhibits the repair of partial-thickness defect of articular cartilage in rabbit by inducing the degradation of extracellular matrix, interfering with the survival of chondrocytes surrounding the defect, and directly inhibiting the expression of BMP2 and BMP4. Meanwhile BMP3 suppress the repair of full-thickness cartilage defect by destroying the subchondral bone through modulating the proliferation and differentiation of bone marrow stem cells (BMSCs), and directly increasing the expression of BMP4. Although BMP3 has different functions in the repair of partial and full-thickness defects of articular cartilage in rabbit, the regulation of BMP expression is involved in both of them. Together with our previous findings, we suggest the regulation of the BMP signaling pathway by BMP3 is essential in articular cartilage repair. PMID:26528966

  13. Targeting TGFβ Signaling in Subchondral Bone and Articular Cartilage Homeostasis

    PubMed Central

    Zhen, Gehau; Cao, Xu

    2014-01-01

    Osteoarthritis (OA) is the most common degenerative joint disease, and there is no disease-modifying therapy for OA currently available. Targeting of articular cartilage alone may not be sufficient to halt this disease progression. Articular cartilage and subchondral bone act as a functional unit. Increasing evidence indicates that transforming growth factor β (TGFβ) plays a crucial role in maintaining homeostasis of both articular cartilage and subchondral bone. Activation of extracellular matrix latent TGFβ at the appropriate time and location is the prerequisite for its function. Aberrant activation of TGFβ in the subchondral bone in response to abnormal mechanical loading environment induces formation of osteroid islets at onset of osteoarthritis. As a result, alteration of subchondral bone structure changes the stress distribution on the articular cartilage and leads to its degeneration. Thus, inhibition of TGFβ activity in the subchondral bone may provide a new avenue of treatment for OA. In this review, we will respectively discuss the role of TGFβ in homeostasis of articular cartilage and subchondral bone as a novel target for OA therapy. PMID:24745631

  14. Remobilization does not fully restore immobilization induced articular cartilage atrophy.

    PubMed

    Haapala, J; Arokoski, J P; Hyttinen, M M; Lammi, M; Tammi, M; Kovanen, V; Helminen, H J; Kiviranta, I

    1999-05-01

    The recovery of articular cartilage from immobilization induced atrophy was studied. The right hind limbs of 29-week-old beagle dogs were immobilized for 11 weeks and then remobilized for 50 weeks. Cartilage from the immobilized knee was compared with tissue from age matched control animals. After the immobilization period, uncalcified articular cartilage glycosaminoglycan concentration was reduced by 20% to 23%, the reduction being largest (44%) in the superficial zone. The collagen fibril network showed no significant changes, but the amount of collagen crosslinks was reduced (13.5%) during immobilization. After remobilization, glycosaminoglycan concentration was restored at most sites, except for in the upper parts of uncalcified cartilage in the medial femoral and tibial condyles (9% to 17% less glycosaminoglycans than in controls). The incorporation of 35SO4 was not changed, and remobilization also did not alter the birefringence of collagen fibrils. Remobilization restored the proportion of collagen crosslinks to the control level. The changes induced by joint unloading were reversible at most sites investigated, but full restoration of articular cartilage glycosaminoglycan concentration was not obtained in all sites, even after remobilization for 50 weeks. This suggests that lengthy immobilization of a joint can cause long lasting articular cartilage proteoglycan alterations at the same time as collagen organization remains largely unchanged. Because proteoglycans exert strong influence on the biomechanical properties of cartilage, lengthy immobilization may jeopardize the well being of articular cartilage. PMID:10335301

  15. The Functions of BMP3 in Rabbit Articular Cartilage Repair

    PubMed Central

    Zhang, Zhe; Yang, Wenyu; Cao, Yiting; Shi, Yanping; Lei, Chen; Du, Bo; Li, Xuemin; Zhang, Qiqing

    2015-01-01

    Bone morphogenetic proteins (BMPs) play important roles in skeletal development and repair. Previously, we found fibroblast growth factor 2 (FGF2) induced up-regulation of BMP2, 3, 4 in the process of rabbit articular cartilage repair, which resulted in satisfactory repair effects. As BMP2/4 show a clearly positive effect for cartilage repair, we investigated the functions of BMP3 in rabbit articular cartilage repair. In this paper, we find that BMP3 inhibits the repair of partial-thickness defect of articular cartilage in rabbit by inducing the degradation of extracellular matrix, interfering with the survival of chondrocytes surrounding the defect, and directly inhibiting the expression of BMP2 and BMP4. Meanwhile BMP3 suppress the repair of full-thickness cartilage defect by destroying the subchondral bone through modulating the proliferation and differentiation of bone marrow stem cells (BMSCs), and directly increasing the expression of BMP4. Although BMP3 has different functions in the repair of partial and full-thickness defects of articular cartilage in rabbit, the regulation of BMP expression is involved in both of them. Together with our previous findings, we suggest the regulation of the BMP signaling pathway by BMP3 is essential in articular cartilage repair. PMID:26528966

  16. Leptin plays a catabolic role on articular cartilage.

    PubMed

    Bao, Jia-peng; Chen, Wei-ping; Feng, Jie; Hu, Peng-fei; Shi, Zhong-li; Wu, Li-dong

    2010-10-01

    Leptin has been shown to play a crucial role in the regulation of body weight. There is also evidence that this adipokine plays a key role in the process of osteoarthritis. However, the precise role of leptin on articular cartilage metabolism is not clear. We investigate the role of leptin on articular cartilage in vivo in this study. Recombinant rat leptin (100 μg) was injected into the knee joints of rats, 48 h later, messenger RNA (mRNA) expression and protein levels of basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF), matrix metalloproteinases 2 and 9 (MMP-2, MMP-9), cathepsin D, and collagen II from articular cartilage were analyzed by real-time quantitative polymerase chain reaction (PCR) and western blot. Two important aggrecanases ADAMTS-4 and -5 (a disintegrin and metalloproteinase with thrombospondin motifs 4 and 5) were also analyzed by real-time quantitative PCR. Besides, articular cartilage was also assessed for proteoglycan/GAG content by Safranin O staining. Leptin significantly increased both gene and protein levels of MMP-2, MMP-9, cathepsin D, and collagen II, while decreased bFGF markedly in cartilage. Moreover, the gene expression of ADAMTS-4 and -5 were markedly increased, and histologically assessed depletion of proteoglycan in articular cartilage was observed after treatment with leptin. These results strongly suggest that leptin plays a catabolic role on cartilage metabolism and may be a disadvantage factor involve in the pathological process of OA. PMID:19876764

  17. Effect of biomechanical disturbance of the temporomandibular joint on the prevalence of internal derangement in mandibular asymmetry.

    PubMed

    Buranastidporn, B; Hisano, M; Soma, K

    2006-06-01

    The aim of the present study was to elucidate the relationship between biomechanical changes of the temporomandibular joint (TMJ) and internal derangement (ID) symptoms in mandibular asymmetry. Posteroanterior cephalograms (PA) of 140 patients with TMJ ID associated with mandibular asymmetry were used to investigate the inclination of the frontal occlusal plane (FOP), and were analysed in conjunction with the results of a report providing information on ID symptoms. A three-dimensional (3D) finite element model (FEM) of the entire mandible was created to investigate the distribution of TMJ forces during clenching. The inclination of the FOP was modified to simulate various degrees of vertical asymmetry. The stresses on the TMJ on the ipsilateral and contralateral sides were analysed and their values were compared with those of the standard model. The results showed that the symptomatic sides were significantly related to the degree of inclination of the FOP. Increasing its angulation resulted in a decrease of the symptoms on the ipsilateral side and an increase of those on the contralateral side. The analysis showed that stress-distribution patterns and overall stresses of the articular disc were influenced by the angulation of inclination of the FOP. These mechanical changes exhibited a distinct relationship with the prevalence of ID in the patients. These results suggest that disturbances in the stresses either in amount or direction due to occlusal inclination can be responsible for ID. Therefore, an attempt to establish a flat occlusal plane is an important orthodontic treatment objective in maintaining the normal health and structure of the TMJ. PMID:16230327

  18. Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis?

    PubMed Central

    Assaf, AT; Kahl-Nieke, B; Feddersen, J; Habermann, CR

    2013-01-01

    Objectives: The purpose of this study was to determine the potential of high-resolution ultrasonography for the detection of temporomandibular joint (TMJ) changes in children with juvenile idiopathic arthritis (JIA). Methods: We investigated prospectively 20 children (17 female and 3 male; mean age 11.06 years, standard deviation 3.43 years) with TMJ disorders caused by JIA, over a period of 16 months. Using a 12 MHz array transducer, four images in each TMJ (160 images) were acquired. Each image was analysed with regard to five different aspects (condylar erosion, thickness of the condylar disc, synovial thickness, joint effusion and enlargement of the intra-articular space). Results: Diagnosis of JIA was ensured for every child and involvement of the TMJ was proven by MRI. Overall 287 changes (35.9%) were detected by using high-resolution ultrasonography. On 124 images (77.5%) condylar erosions were diagnosed; on 55 images (34.4%) synovial thickness was abnormal; on 48 images (30%) we could see higher thickness of the condylar disc; on 40 images (25%) irregularities of the bony surface were detected; and on 20 images (12.5%) we found joint effusion. Conclusion: High-resolution ultrasonography could be a sufficient diagnostic method, especially for the detection of condylar involvement in children with JIA, even if not all parts of the TMJ are visible for ultrasonography. High-resolution ultrasonography is a valuable tool in particular situations: (i) when MRI examination is not available; (ii) when children fear MRI examination; (iii) in more advanced stages of JIA; and (iv) for monitoring the progression of TMJ involvement and response of therapy. PMID:23439686

  19. Observing the development of the temporomandibular joint in embryonic and post-natal mice using various staining methods

    PubMed Central

    LIANG, WENNA; LI, XIHAI; GAO, BIZHEN; GAN, HUIJUAN; LIN, XUEJUAN; LIAO, LINGHONG; LI, CANDONG

    2016-01-01

    The temporomandibular joint (TMJ) is a specialized synovial joint that is essential for the movement and function of the mammalian jaw. The TMJ develops from two mesenchymal condensations, and is composed of the glenoid fossa that originates from the otic capsule by intramembranous ossification, the mandibular condyle of the temporal bone and a fibrocartilagenous articular disc derived from a secondary cartilaginous joint by endochondral ossification. However, the development of the TMJ remains unclear. In the present study, the formation and development of the mouse TMJ was investigated between embryonic day 13.5 and post-natal day 180 in order to elucidate the morphological and molecular alterations that occur during this period. TMJ formation appeared to proceed in three stages: Initiation or blastema stage; growth and cavitation stage; and the maturation or completion stage. In order to investigate the activity of certain transcription factors on TMJ formation and development, the expression of extracellular matrix (ECM), sex determining region Y-box 9, runt-related transcription factor 2, Indian hedgehog homolog, Osterix, collagen I, collagen II, aggrecan, total matrix metalloproteinase (MMP), MMP-9 and MMP-13 were detected in the TMJ using in situ and/or immunohistochemistry. The results indicate that the transcription factors, ECM and MMP serve critical functions in the formation and development of the mouse TMJ. In summary, the development of the mouse TMJ was investigated, and the molecular regulation of mouse TMJ formation was partially characterized. The results of the present study may aid the systematic understanding of the physiological processes underlying TMJ formation and development in mice. PMID:26893634

  20. Congenital Temporomandibular Joint Ankylosis: Case Report and Literature Review.

    PubMed

    Cheong, Ryan Chin Taw; Kassam, Karim; Eccles, Simon; Hensher, Robert

    2016-01-01

    Congenital temporomandibular joint (TMJ) ankylosis is an uncommon condition that presents itself at or soon after birth in the absence of acquired factors that could have contributed to the ankylosis such as infection and trauma. The experience of managing one such case is reported in light of a review of the literature on this condition. Key management principles include adequate removal of the ankylotic mass, costochondral grafting, and post-op physiotherapy. Most patients reported in the literature with the condition experienced relapse. This echoes our own experience where there was recurrence of the ankylosis. However, after removal of the ankylotic mass, the patient maintains a satisfactory maximal incisal opening (MIO) till the present day. The additional challenges faced in the congenital form in addition to the already complex management of acquired paediatric temporomandibular joint ankylosis are (1) much earlier insult to the TMJ, (2) reduced opportunity for neuromuscular development of the muscles of mastication, and (3) reduced compliance with postoperative physiotherapy programmes due to the younger age of these patients. PMID:27190665

  1. Congenital Temporomandibular Joint Ankylosis: Case Report and Literature Review

    PubMed Central

    Cheong, Ryan Chin Taw; Kassam, Karim; Eccles, Simon; Hensher, Robert

    2016-01-01

    Congenital temporomandibular joint (TMJ) ankylosis is an uncommon condition that presents itself at or soon after birth in the absence of acquired factors that could have contributed to the ankylosis such as infection and trauma. The experience of managing one such case is reported in light of a review of the literature on this condition. Key management principles include adequate removal of the ankylotic mass, costochondral grafting, and post-op physiotherapy. Most patients reported in the literature with the condition experienced relapse. This echoes our own experience where there was recurrence of the ankylosis. However, after removal of the ankylotic mass, the patient maintains a satisfactory maximal incisal opening (MIO) till the present day. The additional challenges faced in the congenital form in addition to the already complex management of acquired paediatric temporomandibular joint ankylosis are (1) much earlier insult to the TMJ, (2) reduced opportunity for neuromuscular development of the muscles of mastication, and (3) reduced compliance with postoperative physiotherapy programmes due to the younger age of these patients. PMID:27190665

  2. Optoelectronic pantography diagnostics of temporomandibular disorders in patients with bruxism.

    PubMed

    Mehulić, Ketij; Gospić, Renata Kevilj; Dundjer, Alenko; Skrinjarić, Tomislav; Stefancić, Sanja; Vojvodić, Denis; Perinić, Margareta

    2009-09-01

    Temporomandibular disorders (TMD) is a joint term that encompasses a number of clinical symptoms that involve the teeth, masticatory musculature and temporomandibular joints (TMJ). They are a frequent cause of orofacial medical conditions. The aetiology of disorders is complex and individual etiologic factors are not sufficiently defined. Bruxism, in its centric or eccentric form, is becoming a frequent problem for dentists. The purpose of this study is to show factors of the condyle leading in patients with bruxism by optoelectronic pantography, and to establish the possibility of using optoelectronic pantography in the diagnostic procedure of TMD. Patients were selected (N = 42), with incomplete sets of teeth, without prosthodontic appliances and with traces and symptoms of TMD. After completing the history questionnaire a clinical check up and plaster cast analysis patients with bruxism were selected (N = 22) and without bruxism (N = 20). During the study optoelectronic String-condylocomp LR3, Dentron, D-Höchberg (software JAWS 30) was used. This study showed the possibility of applying optoelectronic pantography in TMD diagnostics and compares history, clinical and condylographic parameters in TMD patients with and without bruxism. Optoelectronic pantography enables us, by using relatively easy methods, to determine a more accurate diagnosis, highly important when choosing therapeutic methods and control of the aforementioned disorders. PMID:19860114

  3. Deficient cytokine control modulates temporomandibular joint pain in rheumatoid arthritis.

    PubMed

    Ahmed, Neveen; Catrina, Anca I; Alyamani, Ahmed O; Mustafa, Hamid; Alstergren, Per

    2015-08-01

    The aim was to investigate how endogenous cytokine control of tumor necrosis factor (TNF) influences temporomandibular joint (TMJ) pain in relation to the role of anti-citrullinated peptide antibodies (ACPA) in patients with rheumatoid arthritis (RA). Twenty-six consecutive patients with TMJ RA were included. Temporomandibular joint pain intensity was assessed at rest, on maximum mouth opening, on chewing, and on palpation. Mandibular movement capacity and degree of anterior open bite (a clinical sign of structural destruction of TMJ tissues) were also assessed. Systemic inflammatory activity was assessed using the Disease Activity Score in 28 joints (DAS28) for rheumatoid arthritis. Samples of TMJ synovial fluid and blood were obtained and analyzed for TNF, its soluble receptor, soluble TNF receptor II (TNFsRII), and ACPA. A high concentration of TNF in relation to the concentration of TNFsRII in TMJ synovial fluid was associated with TMJ pain on posterior palpation on maximum mouth opening. The ACPA concentration correlated significantly to the TNF concentration, but not to the TNFsRII concentration, indicating that increased inflammatory activity is mainly caused by an insufficient increase in anti-inflammatory mediators. This study indicates that TMJ pain on palpation in patients with RA is related to a deficiency in local cytokine control that contributes to increased inflammatory activity, including sensitization to mechanical stimuli over the TMJ. PMID:26010823

  4. Effects of COX-2 inhibitor in temporomandibular joint acute inflammation.

    PubMed

    Schütz, T C B; Andersen, M L; Tufik, S

    2007-05-01

    Since it is recognized that cyclo-oxygenase-2 mediates nociception and the sleep-wake cycle as well, and that acute inflammation of the temporomandibular joint (TMJ) results in sleep disturbances, we hypothesized that cyclo-oxygenase-2 inhibitor would restore the sleep pattern in this inflammatory rat model. First, sleep was monitored after the injection of Freund's adjuvant (FA group) or saline (SHAM group) into the rats' temporomandibular joint. Second, etoricoxib was co-administered in these groups. The Freund's adjuvant group showed a reduction in sleep efficiency, in rapid eye movement (REM), and in non-REM sleep, and an increase in sleep and REM sleep latency when compared with the SHAM group, while etoricoxib substantially increased sleep quality in the Freund's adjuvant group. These parameters returned progressively to those found in the SHAM group. Etoricoxib improved the sleep parameters, suggesting the involvement of the cyclo-oxygenase-2 enzyme in acute inflammation of the TMJ, specifically in REM sleep. PMID:17452571

  5. Mood spectrum in patients with different painful temporomandibular disorders.

    PubMed

    Manfredini, Daniele; di Poggio, Adolfo Bandettini; Romagnoli, Mario; Dell'Osso, Liliana; Bosco, Mario

    2004-07-01

    The purpose of this study was to investigate for difference in the prevalence of mood disorders between patients with different painful temporomandibular disorders (TMD). After a sample size necessary for the study was calculated, 60 patients with a painful TMD were selected and divided into the following groups: myofascial pain (n=20), temporomandibular joint (TMJ) pain (n=18), combined myofascial and TMJ pain (n=22). Two distinct comparison groups were selected: subjects with a nonpainful TMD (n=25) and TMD-free subjects (n=29). All participants filled out a self-report validated instrument (MOODS-SR) to evaluate psychopathological symptoms related to mood disturbances. A one-way analysis of variance (ANOVA) with Bonferroni's post hoc test for multiple comparisons was performed to investigate for significant differences among the groups. The three groups of patients with painful TMD scored significantly higher than comparison groups in all MOODS-SR domains investigating depression, but no difference was shown between subjects with myofascial pain and those with TMJ pain. No significant differences among the groups emerged for the presence of manic symptoms, indicating that depressive disorders associated with TMD are not an expression of a more complex manic depressive illness. The study concluded that the presence of depressive symptoms in TMD patients seems to be related to the presence of a painful condition and seems to be unrelated to the location of pain. Furthermore, depressive disturbances in painful TMD patients affect the whole spectrum of depressive psychopathology. PMID:15293779

  6. Pseudotumor in the temporomandibular joint: A case report

    PubMed Central

    Yoshitake, Hiroyuki; Kayamori, Kou; Nakamura, Ryosuke; Wake, Sou; Harada, Kiyoshi

    2015-01-01

    Introduction Neoplastic disease in the temporomandibular joint (TMJ) is a rare condition and is difficult to differentiate from temporomandibular disorders (TMD) based on symptoms and simple X-ray examinations. Potential differential diagnoses include synovial chondromatosis and pseudotumor, both of which are also relatively rare in the TMJ. Presentation of case We report a case of pseudotumor of the TMJ that was difficult to differentiate from synovial chondromatosis in a 71-year-old woman with a chief complaint of pain in the left TMJ. MRI of the right TMJ initially led to diagnosis of synovial chondromatosis. Extirpation of the lesion was performed under general anesthesia. Histopathological findings of the resected specimen revealed inflammatory granulation tissue without cellular atypism. Discussion The pathological findings for the resected specimen were compatible with pseudotumor of the TMJ. These findings were not supportive of synovial chondromatosis or other tumor diseases. Conclusion This case illustrates the importance of careful examination of a mass lesion in the TMJ for differentiation from other TMJ-related diseases. PMID:26298241

  7. Temporomandibular Joint Hypermobility Manifestation Based on Clinical Observations

    PubMed Central

    Nosouhian, Saeid; Haghighat, Abbas; Mohammadi, Iman; Shadmehr, Elham; Davoudi, Amin; Badrian, Hamid

    2015-01-01

    Background: Joint range of motion might affected by some factors like laxity and increase joint mobility. Generalized joint hypermobility and temporomandibular joint hypermobility (TMJH) are reported as risk factors for temporomandibular disorders. The aim of this study was to survey the etiological factors of TMJH and its relations to habitual status. Materials and Methods: In this cross-sectional descriptive study, 69 patients with TMJH were involved. After profiling personal information and medical history, the patients were divided into three groups based on their maximum mouth opening (MMO) as follow: (Light) MMO of 50-55 mm, (moderate): MMO between 55 and 65 mm, (severe) MMO >65 mm. For subjective observations, patients were asked to fill the prepared questionnaire. The objective evaluations conducted by a specialist. Finally, all the data subjected Chi-Square test by using SPSS software version 22 at a significant level of 0.05. Results: TMJH was more common in women (74.2%). The light group had significant differences with other groups in the discomfort of TMJ and TMJ sound (P < 0.05). Furthermore, sever group manifested highest percentage of masticatory pains, significantly (P < 0.05). Conclusion: It can be concluded that pain in TMJ would have a correlation with MMO. PMID:26464530

  8. Masticatory function in temporomandibular dysfunction patients: electromyographic evaluation.

    PubMed

    Berretin-Felix, Giédre; Genaro, Katia Flores; Trindade, Inge Elly Kiemle; Trindade Júnior, Alceu Sergio

    2005-12-01

    Temporomandibular dysfunction (TMD) is a complex disturbance that involves the masticatory muscles and/or temporomandibular joint, causing damage to the masticatory function. This study evaluated the electromyographic activity of the masseter muscle during habitual mastication of bread, apple, banana, cashew nut and paraffin film (Parafilm M) in 25 adult subjects, of both gender, with TMD. The results were compared to those of a control group, composed of 15 adult subjects, of both sexes, free of signs and/or symptoms of TMD. The MYO-TRONICS Inc., K6-I computer software was used for electromyographic processing and analyzed the following parameters: duration of the act, duration of the masticatory cycle and number of cycles. No significant differences were found between subjects in the control group and individuals with TMD as to duration of the masticatory act and of the masticatory cycle, considering all materials used for mastication. The duration of the masticatory act and cycle was longer during mastication of paraffin film in both groups. The number of masticatory cycles was higher for mastication of apple in comparison to mastication of banana, in both groups. It can be concluded that the consistency of foods influences the duration parameters of the act, duration of the cycle and the number of masticatory cycles, and the behavior of the masticatory muscles in individuals with TMD during habitual mastication is similar to that verified in individuals without TMD. PMID:20865220

  9. Temporomandibular disorders. Part 1: anatomy and examination/diagnosis

    PubMed Central

    Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

    2014-01-01

    Temporomandibular disorders (TMD) are a heterogeneous group of diagnoses affecting the temporomandibular joint (TMJ) and surrounding tissues. A variety of methods for evaluating and managing TMD have been proposed within the physical therapy profession but these sources are not peer-reviewed and lack updates from scientific literature. The dental profession has provided peer-reviewed sources that lack thoroughness with respect to the neuromusculoskeletal techniques utilized by physical therapists. The subsequent void creates the need for a thorough, research informed, and peer-reviewed source regarding TMD evaluation and management for physical therapists. This paper is the first part in a two-part series that seeks to fill the current void by providing a brief but comprehensive outline for clinicians seeking to provide services for patients with TMD. Part one focuses on anatomy and pathology, arthro- and osteokinematics, epidemiology, history taking, and physical examination as they relate to TMD. An appreciation of the anatomical and mechanical features associated with the TMJ can serve as a foundation for understanding a patient’s clinical presentation. Performance of a thorough patient history and clinical examination can guide the clinician toward an improved diagnostic process. PMID:24976743

  10. Signs and symptoms of temporomandibular disorders in adolescent violin players.

    PubMed

    Kovero, O; Könönen, M

    1996-08-01

    Signs and symptoms of temporomandibular disorders (TMDs) and the frequency of radiologically observed abnormalities in the condyles of temporomandibular joints (TMJs) of adolescent violin players (VP group) were investigated in a group of 31 music students and in their age- and sex-matched controls (C group). All subjects underwent a routine clinical stomatognathic examination, a standardized interview, and radiography of the condyles. The VP group reported a higher frequency of the subjective symptoms: pain in the TMJ when chewing, a feeling of stiffness in the TMJ, and clenching of the teeth. Clinically, the VP group showed a greater range of maximal protrusion and of maximal laterotrusion to the right, and a greater frequency of deviation to the right on opening. They also showed more palpatory tenderness in the masticatory muscles and pain in the TMJ on maximal opening. The number of playing years and the number of weekly playing hours correlated with several signs and symptoms of TMDs. In terms of radiologic findings in the condyles of the TMJs there was no difference between the groups. It is concluded that intense violin playing may have a predisposing role in the etiology of TMDs in adolescence. PMID:8876740

  11. Headache attributed to temporomandibular disorders and masticatory myofascial pain.

    PubMed

    Hara, Kazuhiko; Shinozaki, Takahiro; Okada-Ogawa, Akiko; Matsukawa, Yumiko; Dezawa, Ko; Nakaya, Yuka; Chen, Jui-Yen; Noma, Noboru; Oka, Shunichi; Iwata, Koichi; Imamura, Yoshiki

    2016-01-01

    We investigated the temporal association between temporomandibular disorders (TMD)-related symptoms and headache during TMD treatment for patients who fulfilled the diagnostic criteria for headache attributed to TMD (HATMD) specified in the Diagnostic criteria for TMD (DC/TMD) and International classification of headache disorders (ICHD)-3 beta. The study enrolled 34 patients with HATMD induced by masticatory myofascial pain but not by temporomandibular arthralgia. Facial pain intensity, the pressure pain threshold of pericranial muscles, and maximum unassisted opening of the jaw were assessed at an initial examination and before and after physical therapy. The intensity and frequency of headache episodes and tooth contact ratio were also recorded before and after the intervention. Headache intensity and frequency significantly decreased, and these reductions were temporally related to improvements in facial pain intensity, maximum unassisted opening, and pressure pain threshold during TMD treatment. Linear regression analysis showed significant correlations between facial pain intensity and headache intensity and between tooth contact ratio and pressure pain threshold. Among patients who fulfilled the DC/TMD and ICHD-3 beta diagnostic criteria for HATMD, headache improved during TMD treatment, and the improvement was temporally related to amelioration of TMD symptoms. These findings suggest that sensitization in the central and peripheral nervous systems is responsible for HATMD. (J Oral Sci 58, 195-204, 2016). PMID:27349540

  12. Treatment of temporomandibular myofascial pain with deep dry needling

    PubMed Central

    Gonzalez-Perez, Luis M.; Granados-Nuñez, Mercedes; Urresti-Lopez, Francisco J.

    2012-01-01

    Objectives: The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain. Study Design: We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6,5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention. Results: We found a statistically significant relationship (p<0,01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline. Conclusions: Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle. Key words:Temporomandibular joint, myofascial pain, external pterygoid muscle, trigger point, deep dry needling. PMID:22549679

  13. Manual therapy of the mandibular accessory ligaments for the management of temporomandibular joint disorders.

    PubMed

    Cuccia, Antonino Marco; Caradonna, Carola; Caradonna, Domenico

    2011-02-01

    Temporomandibular joint disorders are characterized by chronic or acute musculoskeletal or myofascial pain with dysfunction of the masticatory system. Treatment modalities include occlusal splints, patient education, activity modification, muscle and joint exercises, myofascial therapy, acupuncture, and manipulative therapy. In the physiology of the temporomandibular joint, accessory ligaments limit the movement of the mandible. A thorough knowledge of the anatomy of accessory ligaments is necessary for good clinical management of temporomandibular joint disorders. Although general principles regarding the anatomy of the ligaments are relatively clear, very little substantiated information on the dimension, orientation, and function of the ligaments has been published, to the authors' knowledge. The authors review the literature concerning the accessory ligaments of the temporomandibular joint and describe treatment options, including manual techniques for mobilizing the accessory ligaments. PMID:21357496

  14. Dysfunctional Patients with Temporomandibular Disorders: Evaluating the Efficacy of a Tailored Treatment Protocol.

    ERIC Educational Resources Information Center

    Turk, Dennis C.; And Others

    1996-01-01

    Forty-eight dysfunctional patients with temporomandibular disorders (TMD) were randomly assigned to treatments consisting of an intraoral appliance, stress management, and either nondirective supportive counseling or cognitive therapy. Results support tailored treatment of dysfunctional TMD. (KW)

  15. Intra-articular Placement of an Intraosseous Catheter.

    PubMed

    Grabel, Zachary; DePasse, J Mason; Lareau, Craig R; Born, Christopher T; Daniels, Alan H

    2015-02-01

    Gaining vascular access is essential in the resuscitation of critically ill patients. Intraosseous (IO) placement is a fundamentally important alternative to intravenous (IV) access in conditions where IV access delays resuscitation or is not possible. This case report presents a previously unreported example of prehospital misplacement of an IO catheter into the intra-articular space of the knee joint. This report serves to inform civilian and military first responders, as well as emergency medicine physicians, of intra-articular IO line placement as a potential complication of IO vascular access. Infusion of large amounts of fluid into the joint space could damage the joint and be catastrophic to a patient who needs immediate IV fluids or medications. In addition, intra-articular IO placement could result in septic arthritis of the knee. PMID:25483729

  16. Radiography of rabbit articular cartilage with diffraction-enhanced imaging.

    PubMed

    Muehleman, Carol; Chapman, L Dean; Kuettner, Klaus E; Rieff, Joel; Mollenhauer, Juergen A; Massuda, Koichi; Zhong, Zhong

    2003-05-01

    Articular cartilage of synovial joints is not visible with conventional X-ray imaging. Hence, the gradual degeneration and destruction of articular cartilage, which is characteristic of degenerative joint diseases, is only detected at a late stage when the cartilage is lost and the joint space that it once occupied narrows. The development of an X-ray imaging technique that could detect both the degenerative cartilage and bone features of joint diseases is of special interest. Here we show, for the first time, that a high-contrast imaging technique, diffraction-enhanced X-ray imaging (DEI), allows the visualization of articular cartilage of both disarticulated and articulated rabbit knee joints. Furthermore, a single cartilage lesion can be visualized within an intact joint. The results suggest that DEI has the potential to be of use in the study of cartilage degeneration. PMID:12704696

  17. Three-dimensional collagen architecture in bovine articular cartilage.

    PubMed

    Jeffery, A K; Blunn, G W; Archer, C W; Bentley, G

    1991-09-01

    The three-dimensional architecture of bovine articular cartilage collagen and its relationship to split lines has been studied with scanning electron microscopy. In the middle and superficial zones, collagen was organised in a layered or leaf-like manner. The orientation was vertical in the intermediate zone, curving to become horizontal and parallel to the articular surface in the superficial zone. Each leaf consisted of a fine network of collagen fibrils. Adjacent leaves merged or were closely linked by bridging fibrils and were arranged according to the split-line pattern. The surface layer (lamina splendens) was morphologically distinct. Although ordered, the overall collagen structure was different in each plane (anisotropic) a property described in previous morphological and biophysical studies. As all components of the articular cartilage matrix interact closely, the three-dimensional organisation of collagen is important when considering cartilage function and the processes of cartilage growth, injury and repair. PMID:1894669

  18. Use magnetic resonance imaging to assess articular cartilage

    PubMed Central

    Wang, Yuanyuan; Wluka, Anita E.; Jones, Graeme; Ding, Changhai

    2012-01-01

    Magnetic resonance imaging (MRI) enables a noninvasive, three-dimensional assessment of the entire joint, simultaneously allowing the direct visualization of articular cartilage. Thus, MRI has become the imaging modality of choice in both clinical and research settings of musculoskeletal diseases, particular for osteoarthritis (OA). Although radiography, the current gold standard for the assessment of OA, has had recent significant technical advances, radiographic methods have significant limitations when used to measure disease progression. MRI allows accurate and reliable assessment of articular cartilage which is sensitive to change, providing the opportunity to better examine and understand preclinical and very subtle early abnormalities in articular cartilage, prior to the onset of radiographic disease. MRI enables quantitative (cartilage volume and thickness) and semiquantitative assessment of articular cartilage morphology, and quantitative assessment of cartilage matrix composition. Cartilage volume and defects have demonstrated adequate validity, accuracy, reliability and sensitivity to change. They are correlated to radiographic changes and clinical outcomes such as pain and joint replacement. Measures of cartilage matrix composition show promise as they seem to relate to cartilage morphology and symptoms. MRI-derived cartilage measurements provide a useful tool for exploring the effect of modifiable factors on articular cartilage prior to clinical disease and identifying the potential preventive strategies. MRI represents a useful approach to monitoring the natural history of OA and evaluating the effect of therapeutic agents. MRI assessment of articular cartilage has tremendous potential for large-scale epidemiological studies of OA progression, and for clinical trials of treatment response to disease-modifying OA drugs. PMID:22870497

  19. Cryoprotectant kinetic analysis of a human articular cartilage vitrification protocol.

    PubMed

    Shardt, Nadia; Al-Abbasi, Khaled K; Yu, Hana; Jomha, Nadr M; McGann, Locksley E; Elliott, Janet A W

    2016-08-01

    We recently published a protocol to vitrify human articular cartilage and a method of cryoprotectant removal in preparation for transplantation. The current study's goal was to perform a cryoprotectant kinetic analysis and theoretically shorten the procedure used to vitrify human articular cartilage. First, the loading of the cryoprotectants was modeled using Fick's law of diffusion, and this information was used to predict the kinetics of cryoprotectant efflux after the cartilage sample had been warmed. We hypothesized that diffusion coefficients obtained from the permeation of individual cryoprotectants into porcine articular cartilage could be used to provide a reasonable prediction of the cryoprotectant loading and of the combined cryoprotectant efflux from vitrified human articular cartilage. We tested this hypothesis with experimental efflux measurements. Osteochondral dowels from three patients were vitrified, and after warming, the articular cartilage was immersed in 3 mL X-VIVO at 4 °C in two consecutive solutions, each for 24 h, with the solution osmolality recorded at various times. Measured equilibrium values agreed with theoretical values within a maximum of 15% for all three samples. The results showed that diffusion coefficients for individual cryoprotectants determined from experiments with 2-mm thick porcine cartilage can be used to approximate the rate of efflux of the combined cryoprotectants from vitrified human articular cartilage of similar thickness. Finally, Fick's law of diffusion was used in a computational optimization to shorten the protocol with the constraint of maintaining the theoretical minimum cryoprotectant concentration needed to achieve vitrification. The learning provided by this study will enable future improvements in tissue vitrification. PMID:27221520

  20. Detection of degenerative disease of the temporomandibular joint by bone scintigraphy: concise communication

    SciTech Connect

    Goldstein, H.A.; Bloom, C.Y.

    1980-10-01

    Nine patients with facial pain were evaluated with limited bone scans. The scintigrams correlated with microscopy in all patients, although radiographs correlated with microscopy in only five patients. The degenerative disease process in the temporomandibular joint was more extensive in the patients with radiographic and scintigraphic abnormalities than in those with scintigraphic abnormalities alone. The limited bone scan appears useful in detecting early degenerative changes in the temporomandibular joint.

  1. Colo-articular fistula following a Girdlestone resection arthroplasty

    PubMed Central

    El-Daly, Ibraheim; Natarajan, Brenavan; Rajakulendran, Karthig; Symons, Sean

    2014-01-01

    Colo-articular fistulas are rare complications that are usually associated with inflammatory, infective or malignant bowel disease. We report the case of a 44-year-old male who was found to have a colo-articular fistula intra-operatively during the washout of a septic hip joint. The patient had no pre-existing bowel disease, but was an intravenous drug user, who had previously undergone a Girdlestone procedure for osteomyelitis of the proximal femur. The patient was managed through a multi-disciplinary team approach with subsequent debridement and formation of a transverse loop colostomy to control the faeculent fistulous discharge. PMID:24876512

  2. Corrective Osteotomies for Malunited Extra-Articular Calcaneal Fractures.

    PubMed

    Ketz, John; Clare, Michael; Sanders, Roy

    2016-03-01

    The most effective way to treat calcaneal malunions is avoidance. With any articular fracture, progressive arthrosis and dysfunction are common. By restoring the anatomy initially through reduction, late reconstructive options become less complicated. Numerous studies have shown that restoration of the anatomic alignment either through percutaneous or open techniques is effective. In patients with no or minimal articular degeneration, extrarticular joint-sparing procedures can be performed. This represents a small select group who may benefit from simple osteotomy procedures with associated soft tissue reconstruction, if needed. PMID:26915784

  3. Effects of surgically induced instability on rat knee articular cartilage.

    PubMed Central

    Williams, J M; Felten, D L; Peterson, R G; O'Connor, B L

    1982-01-01

    Degenerative lesions in the articular cartilage were present following transection of the anterior cruciate ligament in the rat. These lesions included surface disruptions, a reduction in matrix proteoglycans, and cellular changes and therefore were similar to lesions seen in dogs following transection of the anterior cruciate ligament as well as lesions seen in other mechanical derangement models. Lesions were more frequently encountered in animals that had been exercised on a treadmill. This suggests that the rat knee joint may be a useful small animal model in studying the effect of mechanical derangement on articular tissues. Images Figs. 1-2 Figs. 3-4 Figs. 5-6 PMID:7076535

  4. Postnatal development of collagen structure in ovine articular cartilage

    PubMed Central

    2010-01-01

    Background Articular cartilage (AC) is the layer of tissue that covers the articulating ends of the bones in diarthrodial joints. Across species, adult AC shows an arcade-like structure with collagen predominantly perpendicular to the subchondral bone near the bone, and collagen predominantly parallel to the articular surface near the articular surface. Recent studies into collagen fibre orientation in stillborn and juvenile animals showed that this structure is absent at birth. Since the collagen structure is an important factor for AC mechanics, the absence of the adult Benninghoff structure has implications for perinatal AC mechanobiology. The current objective is to quantify the dynamics of collagen network development in a model animal from birth to maturity. We further aim to show the presence or absence of zonal differentiation at birth, and to assess differences in collagen network development between different anatomical sites of a single joint surface. We use quantitative polarised light microscopy to investigate properties of the collagen network and we use the sheep (Ovis aries) as our model animal. Results Predominant collagen orientation is parallel to the articular surface throughout the tissue depth for perinatal cartilage. This remodels to the Benninghoff structure before the sheep reach sexual maturity. Remodelling of predominant collagen orientation starts at a depth just below the future transitional zone. Tissue retardance shows a minimum near the articular surface at all ages, which indicates the presence of zonal differentiation at all ages. The absolute position of this minimum does change between birth and maturity. Between different anatomical sites, we find differences in the dynamics of collagen remodelling, but no differences in adult collagen structure. Conclusions The collagen network in articular cartilage remodels between birth and sexual maturity from a network with predominant orientation parallel to the articular surface to a

  5. Damage Control Mechanisms in Articular Cartilage

    PubMed Central

    Martin, James A; Scherb, MB; Lembke, Lois A; Buckwalter, Joseph

    2000-01-01

    Articular chondrocytes maintain cartilage throughout life by replacing lost or damaged matrix with freshly synthesized material. Synthesis activity is regulated, rapidly increasing to well above basal levels in response to cartilage injury. Such responses suggest that synthesis activity is linked to the rate of matrix loss by endogenous "damage control" mechanisms. As a major stimulator of matrix synthesis in cartilage, insulin-like growth factor I (IGF-I) is likely to play a role in such mechanisms. Although IGF-I is nearly ubiquitous, its bioavailability in cartilage is controlled by IGF-I binding proteins (IGFBPs) secreted by chondrocytes. IGFBPs are part of a complex system, termed the IGF-I axis, that tightly regulates IGF-I activities. For the most part, IGFBPs block IGF-I activity by sequestering IGF-I from its cell surface receptor. We recently found that the expression of one binding protein, IGFBP-3, increases with chondrocyte age, paralleling an age-related decline in synthesis activity. In addition, IGFBP-3 is overexpressed in osteoarthritic cartilage, leading to metabolic disturbances that contribute to cartilage degeneration. These observations indicate that IGFBP-3 plays a crucial role in regulating matrix synthesis in cartilage, and suggest that cartilage damage control mechanisms may fail due to age-related changes in IGFBP-3 expression or distribution. Our investigation of this hypothesis began with immunolocalization studies to determine the tissue distribution of IGFBP-3 in human cartilage. We found that IGFBP-3 accumulated around chondrocytes in the pericellular/territorial matrix, where it co-localized with fibronectin, but not with the other matrix proteins tenascin-C and type VI collagen. This result suggested that the IGFBP-3 distribution is determined by binding to fibronectin. Binding studies using purified proteins demonstrated that IGFBP-3 does in fact bind to fibronectin, but not to tenascin-C or type VI collagen. Finally, we

  6. Change of range of motion of the temporomandibular joint after correction of mild scoliosis.

    PubMed

    Park, Yongnam; Bae, Youngsook

    2014-08-01

    [Purpose] This study aimed to verify the change in range of motion of the temporomandibular joint on correction of scoliosis. [Subjects and Methods] This study examined 31 male and female participants in their 20s and 30s with a spinal curve degree of 10° or greater. The subjects performed therapeutic exercise based on the pilates exercise system, which is known to be effective in mitigating the spinal curve for patients with scoliosis. All participants completed an 8-week therapeutic exercise regimen to alleviate the scoliosis in which exercise was performed, the exercise was done three times a week for 8 weeks and each session lasted 60 minutes. Among them, 19 participants were selected as an experiment group, whose symptoms were mitigated significantly, and 12 participants who did not undergo the exercise were identified as a control group. All subject was assessed for spinal curve degree, apparent leg length discrepancy, and deviation and range of motion of the temporomandibular joint before and after the study. [Results] In the experimental group, the apparent leg length discrepancy and the deviation of the temporomandibular joint were significantly decreased after the exercise, and the ROM in the temporomandibular joint was significantly increased. In intergroup comparisons, all variables showed a significant difference. [Conclusion] The findings suggest that as the spinal curve degree decreases significantly, the range of motion and deviation in the temporomandibular joint showed a significant change, indicating that mild scoliosis may be a negative factor affecting the deviation and range of motion of the temporomandibular joint. PMID:25202172

  7. How muscle relaxation and laterotrusion resolve open locks of the temporomandibular joint. Forward dynamic 3D-modeling of the human masticatory system.

    PubMed

    Tuijt, M; Koolstra, J H; Lobbezoo, F; Naeije, M

    2016-01-25

    Patients with symptomatic hypermobility of the temporomandibular joint report problems with the closing movement of their jaw. Some are even unable to close their mouth opening wide (open lock). Clinical experience suggests that relaxing the jaw muscles or performing a jaw movement to one side (laterotrusion) might be a solution. The aim of our study was to assess the potential of these strategies for resolving an open lock and we hypothesised that both strategies work equally well in resolving open locks. We assessed the interplay of muscle forces, joint reaction forces and their moments during closing of mouth, following maximal mouth opening. We used a 3D biomechanical model of the masticatory system with a joint shape and muscle orientation that predispose for an open lock. In a forward dynamics approach, the effect of relaxation and laterotrusion strategies was assessed. Performing a laterotrusion movement was predicted to release an open lock for a steeper anterior slope of the articular eminence than relaxing the jaw-closing muscles, herewith we rejected our hypothesis. Both strategies could provide a net jaw closing moment, but only the laterotrusion strategy was able to provide a net posterior force for steeper anterior slope angles. For both strategies, the temporalis muscle appeared pivotal to retrieve the mandibular condyles to the glenoid fossa, due to its' more dorsally oriented working lines. PMID:26726782

  8. Current Concepts of Articular Cartilage Restoration Techniques in the Knee

    PubMed Central

    Camp, Christopher L.; Stuart, Michael J.; Krych, Aaron J.

    2014-01-01

    Context: Articular cartilage injuries are common in patients presenting to surgeons with primary complaints of knee pain or mechanical symptoms. Treatment options include comprehensive nonoperative management, palliative surgery, joint preservation operations, and arthroplasty. Evidence Acquisition: A MEDLINE search on articular cartilage restoration techniques of the knee was conducted to identify outcome studies published from 1993 to 2013. Special emphasis was given to Level 1 and 2 published studies. Study Design: Clinical review. Level of Evidence: Level 3. Results: Current surgical options with documented outcomes in treating chondral injuries in the knee include the following: microfracture, osteochondral autograft transfer, osteochondral allograft transplant, and autologous chondrocyte transplantation. Generally, results are favorable regarding patient satisfaction and return to sport when proper treatment algorithms and surgical techniques are followed, with 52% to 96% of patients demonstrating good to excellent clinical outcomes and 66% to 91% returning to sport at preinjury levels. Conclusion: Clinical, functional, and radiographic outcomes may be improved in the majority of patients with articular cartilage restoration surgery; however, some patients may not fully return to their preinjury activity levels postoperatively. In active and athletic patient populations, biological techniques that restore the articular surface may be options that provide symptom relief and return patients to their prior levels of function. PMID:24790697

  9. Editorial Commentary: Knee Lateral Extra-articular Tenodesis.

    PubMed

    Lubowitz, James H

    2015-10-01

    Knee lateral extra-articular tenodesis (LET) can be combined with anterior cruciate ligament (ACL) reconstruction with a goal of reducing anterolateral rotatory instability. Like double-bundle ACL reconstruction, LET combined with ACL reconstruction reduces pivot-shift, a subjective test, but results in no significant difference in clinical outcome. PMID:26433239

  10. Telomere erosion and senescence in human articular cartilage chondrocytes.

    PubMed

    Martin, J A; Buckwalter, J A

    2001-04-01

    Aging and the degeneration of articular cartilage in osteoarthritis are distinct processes, but a strong association exists between age and the incidence and prevalence of osteoarthritis. We hypothesized that this association is due to in vivo replicative senescence, which causes age-related declines in the ability of chondrocytes to maintain articular cartilage. For this hypothesis to be tested, senescence-associated markers were measured in human articular chondrocytes from donors ranging in age from 1 to 87 years. These measures included in situ staining for senescence-associated beta-galactosidase activity, (3)H-thymidine incorporation assays for mitotic activity, and Southern blots for telomere length determinations. We found that senescence-associated beta-galactosidase activity increased with age, whereas both mitotic activity and mean telomere length declined. These findings indicate that chondrocyte replicative senescence occurs in vivo and support the hypothesis that the association between osteoarthritis and aging is due in part to replicative senescence. The data also imply that transplantation procedures performed to restore damaged articular surfaces could be limited by the inability of older chondrocytes to form new cartilage after transplantation. PMID:11283188

  11. Corrective Osteotomy for Intra-Articular Distal Humerus Malunion

    PubMed Central

    Kinaci, Ahmet; Buijze, Geert A.; Leeuwen, Diederik H.van; Jupiter, Jesse B.; Marti, Rene K.; Kloen, Peter

    2016-01-01

    Background: An intra-articular distal humerus malunion can be disabling. To improve function, reduce pain and/or prevent further secondary osteoarthritis an intra-articular corrective osteotomy can be considered. Herein we present the indications, practical guidelines for pre- operative planning and surgical technique. Subsequently, we provide long-term results in a small series. Methods: We included six consecutive patients operated for intra-articular distal humerus malunion. Mean follow-up was 88 months. At lastest follow up elbow function was assessed according to standardized questionnaires and classification systems. Results: All six patients healed their osteotomies. Three patients had a postoperative complication which were treated succesfully. Range of motion improved significantly and all patients were satisfied with the outcome. The elbow performance scores were good to excellent in all. Correlation analyses showed that age and level of osteoarthritis are very strong predictors for the long-term elbow function and quality of life. Conclusion: An intra-articular corrective osteotomy for a malunited distal humerus fracture is a worthwhile procedure. Based on our results it should particularly be considered in young patients with minimal osteoarthritis and moderate to severe functional disability and/or pain. PMID:27200396

  12. Does temporomandibular disorder pain dysfunction syndrome affect dietary intake?

    PubMed

    Irving, J; Wood, G D; Hackett, A F

    1999-11-01

    Temporomandibular disorder pain dysfunction syndrome (TDPDS) is the most common cause of facial pain after toothache. The symptoms are varied but are likely to affect the choice, intake and enjoyment of food. This has not been previously investigated. In this paper a preliminary study of 35 patients attending a department of oral and maxillofacial surgery at a general hospital is presented. Thirty-one subjects reported that eating was a problem; 15 prepared food differently and 24 considered that their choice of food was limited. Four of the five foods most often reported to be difficult to eat are valuable in the diet: meat (22), apples (20), bread (13), toast (7) and toffees (6). Twenty-three subjects reported eating a softer diet. Most (25) reported pain when eating. Such circumstances make it harder for TDPDS sufferers to meet current nutritional guidelines, especially, perhaps, for some to achieve an adequate intake of iron. PMID:10765783

  13. Pigmented Villonodular Synovitis of the Temporomandibular Joint: A Unique Presentation.

    PubMed

    Pianosi, Kiersten; Rigby, Matthew; Hart, Robert; Trites, Jonathan; Taylor, S Mark

    2016-04-01

    Pigmented villonodular synovitis (PVNS) is a rare and benign proliferative disorder of synovium with potentially locally aggressive growth and invasion of the bone. Occurring within the joints, tendon sheaths, and bursae, it is most commonly a monoarticular disease affecting large joints. In particular, most cases of PVNS occur in the knee. PVNS of the temporomandibular joint (TMJ) is a highly rare disorder, with approximately 60 cases reported. Herein, we present a unique case of an elderly male presenting with ear pain and subsequently diagnosed with PVNS of the TMJ with a history of trauma to the area. Initial imaging of the TMJ and the surrounding region looked concerning for invasive and/or malignant disease, but an open biopsy confirmed PVNS. PMID:27200236

  14. Pigmented Villonodular Synovitis of the Temporomandibular Joint: A Unique Presentation

    PubMed Central

    Rigby, Matthew; Hart, Robert; Trites, Jonathan; Taylor, S. Mark

    2016-01-01

    Summary: Pigmented villonodular synovitis (PVNS) is a rare and benign proliferative disorder of synovium with potentially locally aggressive growth and invasion of the bone. Occurring within the joints, tendon sheaths, and bursae, it is most commonly a monoarticular disease affecting large joints. In particular, most cases of PVNS occur in the knee. PVNS of the temporomandibular joint (TMJ) is a highly rare disorder, with approximately 60 cases reported. Herein, we present a unique case of an elderly male presenting with ear pain and subsequently diagnosed with PVNS of the TMJ with a history of trauma to the area. Initial imaging of the TMJ and the surrounding region looked concerning for invasive and/or malignant disease, but an open biopsy confirmed PVNS. PMID:27200236

  15. Synovial Chondromatosis of the Temporomandibular Joint Successfully Treated by Surgery.

    PubMed

    Pinto, Aécio Abner Campos; Ferreira e Costa, Rafael; de Sousa, Sílvia Ferreira; Chagas, Marcelo Roncalli Pinheiro; do Carmo, Maria Auxiliadora Vieira; de Lacerda, Júlio César Tanos

    2015-12-01

    Synovial chondromatosis (SC) is a chronic process, defined as a reactive cartilaginous proliferation, characterized by formation of cartilaginous nodules, usually loose in the joint space of the synovial membrane. It mainly affects large joints such as knee, hip, shoulder, and elbow, commonly in male patients. However, its manifestation in the Temporomandibular joint (TMJ), is a rare finding, occurring predominantly in females. This paper reports a case of a woman who presented to the service of Stomatology complaining of mouth opening limitations and pain in her left pre-auricular region. After clinical and radiographic analyses, the condition was diagnosed as SC of the TMJ. The loose bodies within the TMJ were removed under general anesthesia. Histological and follow-up features of this lesion are also discussed. To our knowledge, this is the second report of SC of the TMJ in Brazil. PMID:25912648

  16. Osteochondroma with secondary synovial chondromatosis in the temporomandibular joint.

    PubMed

    Wang, Yiwen; Li, Lingzhi; Chen, Minjie; Yang, Chi

    2016-05-01

    Osteochondroma with secondary synovial chondromatosis is rare in the temporomandibular joint (TMJ), so we retrospectively reviewed 210 such patients who presented to our hospital from 2001-2013. The final sample included 3 patients with secondary synovial chondromatosis (mean (SD) age 40 (??) years), all of whom had symptoms of disorders of the TMJ. Condylar neoplasms and loose bodies were found during operation. Histopathological examination showed a bony growth capped with hyaline cartilage and clustering chondrocytes, with partial calcification and ossification of the loose bodies, and primary osteochondroma with secondary synovial chondromatosis was diagnosed. There were no recurrences during a follow-up that ranged from 3 months to 5 years. The presence of loose calcified bodies in osteochondroma is a possible sign of secondary synovial chondromatosis. PMID:26320566

  17. Multidetector computed tomography of temporomandibular joint: A road less travelled

    PubMed Central

    Pahwa, Shivani; Bhalla, Ashu Seith; Roychaudhary, Ajoy; Bhutia, Ongkila

    2015-01-01

    This article reviews the imaging anatomy of temporomandibular joint (TMJ), describes the technique of multi-detector computed tomography (MDCT) of the TMJ, and describes in detail various osseous pathologic afflictions affecting the joint. Traumatic injuries affecting the mandibular condyle are most common, followed by joint ankylosis as a sequel to arthritis. The congenital anomalies are less frequent, hemifacial microsomia being the most commonly encountered anomaly involving the TMJ. Neoplastic afflictions of TMJ are distinctly uncommon, osteochondroma being one of the most common lesions. MDCT enables comprehensive evaluation of osseous afflictions of TMJ, and is a valuable tool for surgical planning. Sagittal, coronal and 3D reformatted images well depict osseous TMJ lesions, and their relationship to adjacent structures. PMID:25984518

  18. Management of the temporomandibular joint in rheumatoid disorders.

    PubMed

    Sidebottom, A J; Salha, R

    2013-04-01

    This article summarises the rheumatoid diseases that particularly affect the temporomandibular joint (TMJ): psoriatic arthropathy, ankylosing spondylitis, and rheumatoid arthritis. Management is by a joint approach between rheumatologists and maxillofacial surgeons with a specific interest in diseases of the TMJ who give early surgical advice. Steroid injections, whilst useful in the short term, are not useful for long term or repeated treatment, and may lead to collapse of the joint and development of a deformed anterior open bite. These disorders should be managed primarily using standard conservative regimens, and failure to respond should lead to diagnostic or therapeutic arthroscopy and appropriate surgical treatment. When ankylosis develops or the joint collapses, a replacement joint should be considered and patients should be referred to an appropriately trained surgeon. PMID:22658606

  19. Probable Correlation between Temporomandibular Dysfunction and Vertigo in the Elderly

    PubMed Central

    Marchiori, Luciana Lozza de Moraes; Oltramari-Navarro, Paula Vanessa Pedron; Meneses-Barrivieira, Caroline Luiz; Melo, Juliana Jandre; Macedo, Julya; Bruniera, Juliana Ribeiro Zuculin; Gorres, Vanessa Cristina; Navarro, Ricardo de Lima

    2013-01-01

    Introduction Temporomandibular disorder (TMD) covers a variety of clinical problems, and some epidemiologic studies have tried to indicate mechanisms of interaction and association between vertigo and TMD, but this topic still is controversial. Objective To assess the presence of vertigo in elderly patients associated with TMD. Methods A cross-sectional study was conducted with the inclusion of elderly individuals who lived independently. TMD was assessed by dental evaluation and vertigo was verified by medical history. Statistical analysis was performed using the chi-square and relative risk. Results There was a significant association (p = 0.0256) between the TMD and vertigo (odds ratio = 2.3793). Conclusion These results highlighted the importance of identifying risk factors for vertigo that can be modified through specific interventions, which is essential to prevent future episodes, as well as managing the process of rehabilitation of elderly patients in general. PMID:25992063

  20. Early magnetic resonance imaging control after temporomandibular joint arthrocentesis

    PubMed Central

    Ângelo, David Faustino; Sousa, Rita; Pinto, Isabel; Sanz, David; Gil, F. Monje; Salvado, Francisco

    2015-01-01

    Temporomandibular joint (TMJ) lysis and lavage arthrocentesis with viscosupplementation are an effective treatment for acute disc displacement (DD) without reduction. Clinical success seems to be related to multiple factors despite the lack of understanding of its mechanisms. The authors present a case report of 17-year-old women with acute open mouth limitation (12 mm), right TMJ pain-8/10 visual analog scale, right deviation when opening her mouth. The clinical and magnetic resonance imaging (MRI) diagnosis was acute DD without reduction of right TMJ. Right TMJ arthrocentesis was purposed to the patient with lysis, lavage, and viscosupplementation of the upper joint space. After 5 days, a new MRI was performed to confirm upper joint space distension and disc position. Clinical improvement was obtained 5 days and 1 month after arthrocentesis. Upper joint space increased 6 mm and the disc remained displaced. We report the first early TMJ MRI image postoperative, with measurable upper joint space. PMID:26981483

  1. Temporomandibular Joint Ankylosis as a Complication of Neonatal Septic Arthritis

    PubMed Central

    Al-Saadi, Noor J.; Bakathir, Abdulaziz A.; Al-Hashmi, Ahmed K.; Al-Ismaili, Mohammad I.

    2015-01-01

    Temporomandibular joint (TMJ) ankylosis as a complication of neonatal septic arthritis is rarely reported in the literature. We report two clinical cases of unilateral TMJ ankylosis occurring in paediatric patients subsequent to neonatal septic arthritis. The first case was a 15-month-old male infant who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in May 2010. According to the published English scientific literature, he is the youngest person yet to be diagnosed with this condition. The second case was a five-year-old female who presented to the Al-Nahda Hospital, Muscat, Oman, in October 2011. Both cases presented with facial asymmetry and trismus. They subsequently underwent gap arthroplasty and interpositional temporalis muscle and fascia grafts which resulted in an immediate improvement in mouth opening. Postoperatively, the patients underwent active jaw physiotherapy which was initially successful. Both patients were followed up for a minimum of two years following their surgeries. PMID:26629387

  2. Early magnetic resonance imaging control after temporomandibular joint arthrocentesis.

    PubMed

    Ângelo, David Faustino; Sousa, Rita; Pinto, Isabel; Sanz, David; Gil, F Monje; Salvado, Francisco

    2015-01-01

    Temporomandibular joint (TMJ) lysis and lavage arthrocentesis with viscosupplementation are an effective treatment for acute disc displacement (DD) without reduction. Clinical success seems to be related to multiple factors despite the lack of understanding of its mechanisms. The authors present a case report of 17-year-old women with acute open mouth limitation (12 mm), right TMJ pain-8/10 visual analog scale, right deviation when opening her mouth. The clinical and magnetic resonance imaging (MRI) diagnosis was acute DD without reduction of right TMJ. Right TMJ arthrocentesis was purposed to the patient with lysis, lavage, and viscosupplementation of the upper joint space. After 5 days, a new MRI was performed to confirm upper joint space distension and disc position. Clinical improvement was obtained 5 days and 1 month after arthrocentesis. Upper joint space increased 6 mm and the disc remained displaced. We report the first early TMJ MRI image postoperative, with measurable upper joint space. PMID:26981483

  3. SAPHO syndrome of the temporomandibular joint associated with sudden deafness.

    PubMed

    Marsot-Dupuch, K; Doyen, J E; Grauer, W O; de Givry, S C

    1999-05-01

    We report a case of arthritis of the temporomandibular joint (TMJ) associated with sclerosing osteomyelitis of the mandible and temporal bone, causing deafness. The presence of a palmoplantar pustulosis established the diagnosis of SAPHO syndrome. SAPHO (an acronym referring to synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis) syndrome is defined by the association of characteristic osteoarticular and dermatologic manifestations, with diffuse sclerosing osteomyelitis of the mandible being a part of this entity. We review the literature of SAPHO syndrome with mandibular manifestations and discuss the mechanisms of inflammatory spread from the TMJ to the cochlea. To our knowledge, this is the first description of skull base involvement in a patient with SAPHO syndrome leading to sudden deafness. PMID:10369364

  4. Can orthodontic relapse be blamed on the temporomandibular joint?

    PubMed Central

    Wolford, Larry M

    2014-01-01

    There are many temporomandibular joint (TMJ) conditions that can cause orthodontic treatment instability and relapse. These conditions are often associated with dentofacial deformities, malocclusion, TMJ pain, headaches, myofascial pain, TMJ and jaw functional impairment, ear symptoms, etc., Many of these TMJ conditions can cause progressive and continuous changes in the occlusion and jaw relationships. Patients with these conditions may benefit from corrective orthodontic and surgical intervention. The difficulty for many clinicians may lie in identifying the presence of a TMJ condition, diagnosing the specific TMJ pathology, and selecting the proper treatment for that condition. This paper will discuss the most common TMJ pathologies that can adversely affect orthodontic stability and outcomes as well as present the treatment considerations to correct the specific TMJ conditions and associated jaw deformities to provide stable and predictable treatment results. PMID:25426452

  5. Association of temporomandibular disorder with occupational visual display terminal use

    PubMed Central

    SHIGEISHI, HIDEO

    2016-01-01

    Increased visual display terminal (VDT) use has raised the prevalence of VDT-related adverse conditions, such as dry eye disease, and musculoskeletal and psychopathological symptoms, in office workers, including temporomandibular disorder (TMD). Many factors contributing to TMD have been identified, such as parafunctional habit (bruxism and teeth clenching), trauma, mental disorders, lifestyle, poor health, and nutrition, as well as hormonal factors (i.e., estrogen). It is likely that various contributing factors overlap in TMD development in individuals who routinely use a VDT for work. However, the relationship between TMD and VDT use has not been fully elucidated. In this mini-review, findings of recent studies of TMD in relation to occupational VDT use in Japan are discussed, as well as characteristic features and prevention strategies. PMID:27330747

  6. Extra-articular ankle stabilization: a case series.

    PubMed

    Roukis, Thomas S

    2010-06-01

    Maintenance of the foot at 90 degrees to the lower leg following posterior calf lengthening or to prevent an equinus contracture in situations in which splint, cast, or external fixation is deemed inappropriate is a challenge. The author presents an observational case series involving 9 extra-articular ankle stabilizations performed in 9 consecutive patients. Each patient underwent his or her index surgery followed by percutaneous placement of 2 smooth 2.8-mm or larger diameter Steinmann pins extra-articular to the ankle joint. There were 6 men and 3 women with a mean age of 56.1 years (range, 31-73 years). Five patients had diabetes with peripheral neuropathy, 2 had critical limb ischemia, 1 had alcohol-induced neuropathy, 1 had lupus, and 1 was an active smoker. Eight patients had posterior calf lengthening, and 1 had open metatarsal fractures with severe soft-tissue disruption with an inability to use splint immobilization. Three patients had a transmetatarsal amputation, 2 patients had Chopart amputations, 2 patients had forefoot plastic surgery reconstructive procedures, 1 had a complex Charcot reconstruction, and 1 had a splittibialis anterior tendon transfer. Extra-articular ankle stabilization fixation was retained for a mean of 5.5 weeks (range, 2-10 weeks). Mean follow-up was 12 months (range, 1-17 months). All extra-articular stabilization procedures were deemed successful. When properly performed, extra-articular stabilization to maintain the foot at 90 degrees to the lower leg represents a safe, simple, reliable, and minimally invasive technique useful in situations in which traditional splint or cast immobilization is not possible and when external fixation is deemed inappropriate. PMID:20508012

  7. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†

    PubMed Central

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond; Look, John; Anderson, Gary; Goulet, Jean-Paul; List, Thomas; Svensson, Peter; Gonzalez, Yoly; Lobbezoo, Frank; Michelotti, Ambra; Brooks, Sharon L.; Ceusters, Werner; Drangsholt, Mark; Ettlin, Dominik; Gaul, Charly; Goldberg, Louis J.; Haythornthwaite, Jennifer A.; Hollender, Lars; Jensen, Rigmor; John, Mike T.; De Laat, Antoon; de Leeuw, Reny; Maixner, William; van der Meulen, Marylee; Murray, Greg M.; Nixdorf, Donald R.; Palla, Sandro; Petersson, Arne; Pionchon, Paul; Smith, Barry; Visscher, Corine M.; Zakrzewska, Joanna; Dworkin, Samuel F.

    2015-01-01

    Aims The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. Methods Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project—the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. Results The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0

  8. The Role of Tissue Engineering in Articular Cartilage Repair and Regeneration

    PubMed Central

    Zhang, Lijie; Hu, Jerry; Athanasiou, Kyriacos A.

    2011-01-01

    Articular cartilage repair and regeneration continue to be largely intractable due to the poor regenerative properties of this tissue. The field of articular cartilage tissue engineering, which aims to repair, regenerate, and/or improve injured or diseased articular cartilage functionality, has evoked intense interest and holds great potential for improving articular cartilage therapy. This review provides an overall description of the current state and progress in articular cartilage repair and regeneration. Traditional therapies and related problems are introduced. More importantly, a variety of promising cell sources, biocompatible tissue engineered scaffolds, scaffoldless techniques, growth factors, and mechanical stimuli used in current articular cartilage tissue engineering are reviewed. Finally, the technical and regulatory challenges of articular cartilage tissue engineering and possible future directions are discussed. PMID:20201770

  9. High-resolution arthrosonography of the temporomandibular joint with video and computer support

    NASA Astrophysics Data System (ADS)

    Sader, Robert; Zeilhofer, Hans-Florian U.; Deppe, Herbert; Horch, Hans-Henning; Kling, Bettina

    1995-05-01

    Ultrasound imaging of the temporomandibular joint has been problematic due to the lower frequency of the transducers used up to the present time. Imaging of temporomandibular joint structures being utilizable for diagnosis and therapy was only possible through time-consuming and expensive radiological image yielding procedures (computertomography, magnetic resonance imaging). 84 temporomandibular joints in 42 patients were examined clinically, radiologically, by axiographic tracing, magnetic resonance imaging and ultrasound imaging. An ultrasound unit was used with a high- frequency 13MHz transducer. The temporomandibular joint was examined preauricularily; by this the lateral section of the joint could be represented. The image sequences in functional condylus movements were taped via a video output into a film recorder. Selected ultrasound images from the beginning to the end of the movement could then be digitalized and read into a personal computer to be evaluated. The computer then calculated a line of movement and the angle of the joint's course. By ultrasound imaging the joint space could be represented and measured clearly. Compared with the space measured in the magnetic resonance image the value determined by ultrasonography was a tenth power more exact. The computer-supported image analysis of the condylus movements led to an exact presentation of the condylus course. The sonographically determined condylar guidance corresponded to the value traced by axiography with high significance within a range of 3 degrees. The temporomandibular joint's disc could be localized just as exactly as with the magnetic resonance imaging. The use of a 13MHz transducer offers a new low-cost method of noninvasive dynamic imaging of important temporomandibular joint structures. The possibility of video and computer support enables movement analysis and opens new possibilities in the morphological and functional evaluation of the temporomandibular joint.

  10. Contribution of synovial lining cells to synovial vascularization of the rat temporomandibular joint.

    PubMed

    Nozawa-Inoue, Kayoko; Harada, Fumiko; Magara, Jin; Ohazama, Atsushi; Maeda, Takeyasu

    2016-03-01

    The lining layer of the synovial membrane in the temporomandibular joint (TMJ) contains two types of lining cells: macrophage-like type A and fibroblast-like type B cells. The type B cells are particularly heterogeneous in their morphology and immunoreactivity, so that details of their functions remain unclear. Some of the type B cells exhibit certain resemblances in their ultrastructure to those of an activated capillary pericyte at the initial stage of the angiogenesis. The articular surface, composed of cartilage and the disc in the TMJ, has few vasculatures, whereas the synovial lining layer is richly equipped with blood capillaries to produce the constituent of synovial fluid. The present study investigated at both the light and electron microscopic levels the immunocytochemical characteristics of the synovial lining cells in the adult rat TMJ, focusing on their contribution to the synovial vascularization. It also employed an intravascular perfusion with Lycopersicon esculentum (tomato) lectin to identify functional vessels in vivo. Results showed that several type B cells expressed desmin, a muscle-specific intermediate filament which is known as the earliest protein to appear during myogenesis as well as being a marker for the immature capillary pericyte. These desmin-positive type B cells showed immunoreactions for vimentin and pericyte markers (neuron-glial 2; NG2 and PDGFRβ) but not for the other markers of myogenic cells (MyoD and myogenin) or a contractile apparatus (αSMA and caldesmon). Immunoreactivity for RECA-1, an endothelial marker, was observed in the macrophage-like type A cells. The arterioles and venules inside the synovial folds extended numerous capillaries with RECA-1-positive endothelial cells and desmin-positive pericytes to distribute densely in the lining layer. The distal portion of these capillaries showing RECA-1-immunoreactivity lacked lectin-staining, indicating a loss of blood-circulation due to sprouting or termination in the

  11. Fucose content of keratan sulphates from bovine articular cartilage.

    PubMed Central

    Tai, G H; Brown, G M; Morris, H G; Huckerby, T N; Nieduszynski, I A

    1991-01-01

    Alkaline-borohydride-reduced keratan sulphate chains were isolated from bovine articular cartilage (6-8-year-old animals). Nine keratan sulphate fractions of increasing molecular weight were prepared by gel-permeation chromatography on a calibrated column of TSK 30 XL. The samples were analysed for fucose and galactose contents (% by wt. of keratan sulphate) and fucose/galactose ratio. The fucose content increased with molecular size, but the galactose content remained constant. It was concluded that the alpha(1----3)-linked fucose [Thornton, Morris, Cockin, Huckerby, Nieduszynski, Carlstedt, Hardingham & Ratcliffe (1989) Biochem. J. 260, 277-282] was located within the poly-N-acetyl-lactosamine repeat sequence of articular-cartilage keratan sulphate. PMID:1991030

  12. Treatment of articular cartilage lesions of the knee

    PubMed Central

    Falah, Mazen; Nierenberg, Gabreil; Soudry, Michael; Hayden, Morris

    2010-01-01

    Treatment of articular cartilage lesions in the knee remains a challenge for the practising orthopaedic surgeon. A wide range of options are currently practised, ranging from conservative measures through various types of operations and, recently, use of growth factors and emerging gene therapy techniques. The end result of these methods is usually a fibrous repair tissue (fibrocartilage), which lacks the biomechanical characteristics of hyaline cartilage that are necessary to withstand the compressive forces distributed across the knee. The fibrocartilage generally deteriorates over time, resulting in a return of the original symptoms and occasionally reported progression to osteoarthritis. Our purpose in this study was to review the aetiology, pathogenesis and treatment options for articular cartilage lesions of the knee. At present, autologous cell therapies, growth factor techniques and biomaterials offer more promising avenues of research to find clinical answers. PMID:20162416

  13. 3D braid scaffolds for regeneration of articular cartilage.

    PubMed

    Ahn, Hyunchul; Kim, Kyoung Ju; Park, Sook Young; Huh, Jeong Eun; Kim, Hyun Jeong; Yu, Woong-Ryeol

    2014-06-01

    Regenerating articular cartilage in vivo from cultured chondrocytes requires that the cells be cultured and implanted within a biocompatible, biodegradable scaffold. Such scaffolds must be mechanically stable; otherwise chondrocytes would not be supported and patients would experience severe pain. Here we report a new 3D braid scaffold that matches the anisotropic (gradient) mechanical properties of natural articular cartilage and is permissive to cell cultivation. To design an optimal structure, the scaffold unit cell was mathematically modeled and imported into finite element analysis. Based on this analysis, a 3D braid structure with gradient axial yarn distribution was designed and manufactured using a custom-built braiding machine. The mechanical properties of the 3D braid scaffold were evaluated and compared with simulated results, demonstrating that a multi-scale approach consisting of unit cell modeling and continuum analysis facilitates design of scaffolds that meet the requirements for mechanical compatibility with tissues. PMID:24556323

  14. Structural and metabolic changes in articular cartilage induced by iodoacetate.

    PubMed Central

    Dunham, J.; Hoedt-Schmidt, S.; Kalbhen, D. A.

    1992-01-01

    The chemically induced injury to articular cartilage, caused by two successive intra-articular injections of sodium iodoacetate, has been used in studies on the effects of anti-inflammatory and of potentially chondroprotective agents. It has been assumed that the injurious effects are caused by inhibition of the glycolytic pathway. In the present study this inhibition has been shown to be greater than expected from in vitro studies, and to influence equally other oxidative pathways. However, the response is clearly not a simple one in that some of the surface chondrocytes, and synovial lining cells in close proximity to the cartilage, show virtually no inhibition. Images Fig. 2 Fig. 3 Fig. 4 PMID:1390193

  15. A Simulation Trainer for Complex Articular Fracture Surgery

    PubMed Central

    Yehyawi, Tameem M.; Thomas, Thaddeus P.; Ohrt, Gary T.; Marsh, J. Lawrence; Karam, Matthew D.; Brown, Thomas D.; Anderson, Donald D.

    2013-01-01

    Background: The purposes of this study were (1) to develop a physical model to improve articular fracture reduction skills, (2) to develop objective assessment methods to evaluate these skills, and (3) to assess the construct validity of the simulation. Methods: A surgical simulation was staged utilizing surrogate tibial plafond fractures. Multiple three-segment radio-opacified polyurethane foam fracture models were produced from the same mold, ensuring uniform surgical complexity between trials. Using fluoroscopic guidance, five senior and seven junior orthopaedic residents reduced the fracture through a limited anterior window. The residents were assessed on the basis of time to completion, hand movements (tracked with use of a motion capture system), and quality of the obtained reduction. Results: All but three of the residents successfully reduced and fixed the fracture fragments (one senior resident and two junior residents completed the reduction but were unsuccessful in fixating all fragments). Senior residents had an average time to completion of 13.43 minutes, an average gross articular step-off of 3.00 mm, discrete hand motions of 540 actions, and a cumulative hand motion distance of 79 m. Junior residents had an average time to completion of 14.75 minutes, an average gross articular step-off of 3.09 mm, discrete hand motions of 511 actions, and a cumulative hand motion distance of 390 m. Conclusions: The large difference in cumulative hand motion distance, despite comparable numbers of discrete hand motion events, indicates that senior residents were more precise in their hand motions. The present experiment establishes the basic construct validity of the simulation trainer. Further studies are required to demonstrate that this laboratory-based model for articular fracture reduction training, along with an objective assessment of performance, can be used to improve resident surgical skills. PMID:23824397

  16. Aural symptoms in patients referred for temporomandibular pain/dysfunction.

    PubMed

    Mejersjö, Christina; Näslund, Ingrid

    2016-01-01

    With the aim of studying frequency of aural symptoms and associations with symptoms of TMD new patients referred to the Orofacial Pain Clinic, Odontologen, Göteborg, were asked, at their first appointment and before meeting a specialist, to report any symptoms regarding pain or fullness/swelling of the ear, impaired hearing, sensitivity to sound, and irritation/itching of the ear. They also answered a standardized questionnaire regarding temporomandibular pain and/or dysfunction, and classified their degree of TMD symptoms on a five-point verbal scale and a visual analogue scale. 108 consecutive patients were included in the study, they completed the questionnaires and were examined and diagnosed by different specialists at the clinic. Any ear symptoms were reported by 68% of the patients, fullness of ear by 44% and impaired hearing by 37%. 38% of the patients had previously consulted a physician, and most of them had had pharmacological treatment due to their ear symptoms. Females reported more pain in the ear (P = 0.034) and more sensitivityto sound (P = 0.046) than men. No significant association was found between age and aural symptoms. The degree of TMD- symptoms, as reported by the five grade scale, showed significant association with aural symptoms (P < 0.001), as did the clinical dysfunction index of Helkimo (P = 0.005). The diagnoses of myalgia, arthralgia, arthritis and headache showed significant association with aural symptoms, while no association with crepitus (osteoartrosis) and disc displacement. Itching in the ear was frequently reported (24%) and was associated with myalgia (P = 0.003) and tension headache (P = 0.018). A medical examination by an ear-nose-throat specialist of 19 patients reporting a sensation of fullness of ear, did not reveal any objectifiable ear disease. To conclude, aural symptoms are common in patients with temporomandibular pain and/or dysfunction, are associated with TMD-symptoms and should be regarded as possible symptoms

  17. Oral squamous cell carcinoma: an atypical presentation mimicking temporomandibular joint disorder

    PubMed Central

    Jensen, Andrea; Nolet, Paul S; Diwan, Murtaza A

    2004-01-01

    A 50-year-old female presented to a chiropractic clinic with left jaw pain consistent with temporomandibular joint disorder. Examination revealed a large ulcerated mass on the posterolateral margin of the tongue which was later diagnosed as squamous cell carcinoma. Squamous cell carcinoma is the most common of the oral cancers. These cancers are often detected late making treatment more complicated and reducing the chance of survival. In the early stages squamous cell carcinoma can be asymptomatic. Symptoms can be similar to that of temporomandibular joint disorder making examination of the patient’s mouth important to rule out oral cancers. Oral cancers should be considered when patients present to a chiropractor with pain in the area of the temporomandibular joint. Risk factors such as chronic tobacco and alcohol use should raise concern in these patients. Suspicious lesions should be referred immediately for further investigation. PMID:17549104

  18. Repair and tissue engineering techniques for articular cartilage

    PubMed Central

    Makris, Eleftherios A.; Gomoll, Andreas H.; Malizos, Konstantinos N.; Hu, Jerry C.; Athanasiou, Kyriacos A.

    2015-01-01

    Chondral and osteochondral lesions due to injury or other pathology commonly result in the development of osteoarthritis, eventually leading to progressive total joint destruction. Although current progress suggests that biologic agents can delay the advancement of deterioration, such drugs are incapable of promoting tissue restoration. The limited ability of articular cartilage to regenerate renders joint arthroplasty an unavoidable surgical intervention. This Review describes current, widely used clinical repair techniques for resurfacing articular cartilage defects; short-term and long-term clinical outcomes of these techniques are discussed. Also reviewed is a developmental pipeline of regenerative biological products that over the next decade could revolutionize joint care by functionally healing articular cartilage. These products include cell-based and cell-free materials such as autologous and allogeneic cell-based approaches and multipotent and pluripotent stem-cell-based techniques. Central to these efforts is the prominent role that tissue engineering has in translating biological technology into clinical products; therefore, concomitant regulatory processes are also discussed. PMID:25247412

  19. The effects of exercise on human articular cartilage

    PubMed Central

    Eckstein, F; Hudelmaier, M; Putz, R

    2006-01-01

    The effects of exercise on articular hyaline articular cartilage have traditionally been examined in animal models, but until recently little information has been available on human cartilage. Magnetic resonance imaging now permits cartilage morphology and composition to be analysed quantitatively in vivo. This review briefly describes the methodological background of quantitative cartilage imaging and summarizes work on short-term (deformational behaviour) and long-term (functional adaptation) effects of exercise on human articular cartilage. Current findings suggest that human cartilage deforms very little in vivo during physiological activities and recovers from deformation within 90 min after loading. Whereas cartilage deformation appears to become less with increasing age, sex and physical training status do not seem to affect in vivo deformational behaviour. There is now good evidence that cartilage undergoes some type of atrophy (thinning) under reduced loading conditions, such as with postoperative immobilization and paraplegia. However, increased loading (as encountered by elite athletes) does not appear to be associated with increased average cartilage thickness. Findings in twins, however, suggest a strong genetic contribution to cartilage morphology. Potential reasons for the inability of cartilage to adapt to mechanical stimuli include a lack of evolutionary pressure and a decoupling of mechanical competence and tissue mass. PMID:16637874

  20. Finite element formulation of biphasic poroviscoelastic model for articular cartilage.

    PubMed

    Suh, J K; Bai, S

    1998-04-01

    The purpose of the present study was to develop a computationally efficient finite element model that could be useful for parametric analysis of the biphasic poroviscoelastic (BPVE) behavior of articular cartilage under various loading conditions. The articular cartilage was modeled as the BPVE mixture of a porous, linear viscoelastic, and incompressible solid and an inviscid and incompressible fluid. A finite element (FE) formulation of the BPVE model was developed using two different algorithms, the continuous and discrete spectrum relaxation functions for the viscoelasticity of the solid matrix. These algorithms were applied to the creep and stress relaxation responses to the confined compression of articular cartilage, and a comparison of their performances was made. It was found that the discrete spectrum algorithm significantly saved CPU time and memory, as compared to the continuous spectrum algorithm. The consistency analysis for the present FE formulation was performed in comparison with the IMSL, a commercially available numerical software package. It was found that the present FE formulation yielded consistent results in predicting model behavior, whereas the IMSL subroutine produced inconsistent results in the velocity field, and thereby in the strain calculation. PMID:10412380

  1. Colonies in engineered articular cartilage express superior differentiation.

    PubMed

    Selvaratnam, L; Abd Rahim, S; Kamarul, T; Chan, K Y; Sureshan, S; Penafort, R; Ng, C L L

    2005-07-01

    In view of poor regeneration potential of the articular cartilage, in-vitro engineering of cartilage tissue offers a promising option for progressive joint disease. This study aims to develop a biologically engineered articular cartilage for autologous transplantation. The initial work involved determination of chondrocyte yield and viability, and morphological analysis. Cartilage was harvested from the knee, hip and shoulder joints of adult New Zealand white rabbits and chondrocytes were isolated by enzymatic digestion of the extra-cellular matrix before serial cultivation in DMEM/Ham's F12 media as monolayer cultures. No differences were noted in cell yield. Although chondrocytes viability was optimal (>93%) following harvest from native cartilage, their viability tended to be lowered on passaging. Chondrocytes aggregated in isogenous colonies comprising ovoid cells with intimate intracellular contacts and readily exhibited Safranin-O positive matrix; features typically associated with articular cartilage in-vivo. However, chondrocytes also existed concurrently in scattered bipolar/multipolar forms lacking Safranin-O expression. Therefore, early data demonstrated successful serial culture of adult chondrocytes with differentiated morphology seen in established chondrocyte colonies synthesizing matrix proteoglycans. PMID:16381284

  2. Effects of vimentin disruption on the mechanoresponses of articular chondrocyte.

    PubMed

    Chen, Cheng; Yin, Li; Song, Xiongbo; Yang, Hao; Ren, Xiang; Gong, Xiaoyuan; Wang, Fuyou; Yang, Liu

    2016-01-01

    Human articular cartilage is subjected to repetitive mechanical loading during life time. As the only cellular component of articular cartilage, chondrocytes play a key role in the mechanotransduction within this tissue. The mechanoresponses of chondrocytes are largely determined by the cytoskeleton. Vimentin intermediate filaments, one of the major cytoskeletal components, have been shown to regulate chondrocyte phenotype. However, the contribution of vimentin in chondrocyte mechanoresponses remains less studied. In this study, we seeded goat articular chondrocytes on a soft polyacrylamide gel, and disrupted the vimentin cytoskeleton using acrylamide. Then we applied a transient stretch or compression to the cells, and measured the changes of cellular stiffness and traction forces using Optical Magnetic Twisting Cytometry and Traction Force Microscopy, respectively. In addition, to study the effects of vimentin disruption on the intracellular force generation, we treated the cells with a variety of reagents that are known to increase or decrease cytoskeletal tension. We found that, after a compression, the contractile moment and cellular stiffness were not affected in untreated chondrocytes, but were decreased in vimentin-disrupted chondrocytes; after a stretch, vimentin-disrupted chondrocytes showed a lower level of fluidization-resolidification response compared to untreated cells. Moreover, vimentin-disrupted chondrocytes didn't show much difference to control cells in responding to reagents that target actin and ROCK pathway, but showed a weaker response to histamine and isoproterenol. These findings confirmed chondrocyte vimentin as a major contributor in withstanding compressive loading, and its minor role in regulating cytoskeletal tension. PMID:26616052

  3. Multiscale Biofabrication of Articular Cartilage: Bioinspired and Biomimetic Approaches.

    PubMed

    Tatman, Philip David; Gerull, William; Sweeney-Easter, Sean; Davis, Jeffrey Isaac; Gee, Albert O; Kim, Deok-Ho

    2015-12-01

    Articular cartilage is the load-bearing tissue found inside all articulating joints of the body. It vastly reduces friction and allows for smooth gliding between contacting surfaces. The structure of articular cartilage matrix and cellular composition is zonal and is important for its mechanical properties. When cartilage becomes injured through trauma or disease, it has poor intrinsic healing capabilities. The spectrum of cartilage injury ranges from isolated areas of the joint to diffuse breakdown and the clinical appearance of osteoarthritis. Current clinical treatment options remain limited in their ability to restore cartilage to its normal functional state. This review focuses on the evolution of biomaterial scaffolds that have been used for functional cartilage tissue engineering. In particular, we highlight recent developments in multiscale biofabrication approaches attempting to recapitulate the complex 3D matrix of native articular cartilage tissue. Additionally, we focus on the application of these methods to engineering each zone of cartilage and engineering full-thickness osteochondral tissues for improved clinical implantation. These methods have shown the potential to control individual cell-to-scaffold interactions and drive progenitor cell differentiation into a chondrocyte lineage. The use of these bioinspired nanoengineered scaffolds hold promise for recreation of structure and function on the whole tissue level and may represent exciting new developments for future clinical applications for cartilage injury and restoration. PMID:26200439

  4. Use of indomethacin as an adjuvant to surgery for recurrent temporomandibular joint ankylosis in adults

    PubMed Central

    Bhatt, Krushna; Pandey, Sandeep; Bhutia, Ongkila; Roychoudhury, Ajoy

    2014-01-01

    Two cases with multiple recurrences of temporomandibular joint ankylosis and multiple failed interposition/gap arthroplasty procedures are presented here. Heterotopic bone formation was thought to be the reason. Indomethacin prophylaxis for prevention of heterotopic new bone formation at the osteoarthrectomy site was used as an adjuvant to surgery, in dosages of 75 mg/day for six weeks. Indomethacin is used frequently in hip and elbow arthroplasties to prevent heterotopic ossification, but its use in temporomandibular joint is not routine. The presented cases did not develop further recurrence and attained stable mouth opening over two-year follow-up after osteoarthrectomy and oral indomethacin. PMID:25937735

  5. Goldenhar Syndrome and Pain-Related Temporomandibular Disorders. A Case Report.

    PubMed

    Khawaja, Shehryar Nasir; Crow, Heidi; Gonzalez, Yoly

    2016-04-01

    Goldenhar syndrome (GS) is a development syndrome, characterized by incomplete development of the craniofacial region. The involvement is mainly unilateral; it varies from being mild to severe; and it can range from malocclusion and facial asymmetry to a more complex phenotype with complete absence of the mandibular ramus and temporomandibular joint. However, orthopedic symptoms of orofacial pain and dysfunction have not generally been considered as part of the symptom complex in GS cases. The case presented here is of a 15-year-old Caucasian patient, who was referred for evaluation because of bilateral pain in the masticatory muscles and temporomandibular joints. PMID:27348947

  6. Treatment of acute temporomandibular joint dislocation using manipulation technique for disk displacement.

    PubMed

    Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki; Kawai, Katsuya

    2014-03-01

    Temporomandibular joint dislocation is not frequently encountered, but it is often difficult to reduce the dislocation with conventional methods described in textbooks. The key points to success of reduction depend on the patient's position, route of approach, and timing of reducing each side. We apply a manipulation technique for disk displacement to the reduction that corresponds to these key points. Using our method, temporomandibular joint dislocation can be easily reduced, without using sedative or analgesics. This method is simple, convenient, and worth trying in place of the conventional method. PMID:24621705

  7. Grisel syndrome, acute otitis media, and temporo-mandibular reactive arthritis: A rare association.

    PubMed

    Martins, J; Almeida, S; Nunes, P; Prata, F; Lobo, M L; Marques, J G

    2015-08-01

    We present a case report of a four-year-old boy with torcicollis and trismus after acute otitis media. Grisel Syndrome diagnosis in association with temporo-mandibular reactive arthritis was admitted, leading to early conservative treatment. GS should be suspected in a child presenting with torticollis after an upper respiratory tract infection or an ENT surgical procedure. The association with temporo-mandibular reactive findings is somehow rarer but not impossible, due to the close vascular communication between retropharyngeal and pterigoid spaces. PMID:26060148

  8. Diagnostic accuracy of double-contrast arthrotomography of the temporomandibular joint: correlation with postmortem morphology

    SciTech Connect

    Westesson, P.L.; Rohlin, M.

    1984-09-01

    The diagnostic accuracy of double-contrast arthrotomography in the evaluation of internal derangement of the temporomandibular joint is unknown. Therefore, findings from double-contrast arthrotomograms of 48 temporomandibular joint autopsy specimens were correlated with postmortem morphology seen from dissections or cryosections. Arthrotomographic diagnosis was confirmed in 41 joints, signifying a diagnostic accuracy of 85%. Misinterpretations were made in seven joints. False-positive reports due to observation errors can be avoided with improved knowledge of the joint anatomy as well as with increased experience in the technique. False-negative examinations were due to limitation of the tomographic reproduction of the lateral part of the joint.

  9. Psychoeducation Program on Strategies for Coping with Stress in Patients with Temporomandibular Joint Dysfunction

    PubMed Central

    2014-01-01

    Lack of educational projects in the available literature was an inspiration to develop a psychoeducational program. The objective was to provide patients with basic information on the contribution of stressors in the occurrence of temporomandibular joint dysfunction and educate on methods for coping with stress most commonly used in psychology. In the course of three meetings, patients are familiarised with the issue of experienced stress as a potential source of psychosomatic illnesses (in particular, temporomandibular joint dysfunction). Preliminary patients' opinions, expressed through self-report methods, indicate significant usefulness of the developed psychoeducational program for the process of treatment and the quality of patients' lives. PMID:25610871

  10. Impact of temporomandibular joint pain in rheumatoid arthritis.

    PubMed

    Ahmed, Neveen; Mustafa, Hamid Masoud; Catrina, Anca Irinel; Alstergren, Per

    2013-01-01

    To investigate the impact of temporomandibular joint (TMJ) pain on daily activities and quality of life in relation to systemic inflammatory activity in patients with rheumatoid arthritis (RA), thirty-three consecutive outpatients with RA were included. TMJ pain intensity at rest, on maximum mouth opening, and on chewing was assessed on a 0-10 numerical rating scale. TMJ palpatory tenderness, degree of anterior open bite, the impact of TMJ pain on daily activities and quality of life were also assessed. The systemic inflammatory activity was estimated by the disease activity score 28 (DAS28), blood levels of inflammatory markers and number of painful musculoskeletal regions. TMJ pain at rest, on maximum mouth opening, and on chewing as well as DAS28 was correlated with the impact of the TMJ pain on daily activities and quality of life. Partial correlations showed a significant interaction between TMJ pain on movement and DAS28 that explained the TMJ pain impact on daily activities and quality of life to a significant degree. This study indicates that both current TMJ pain intensity and systemic inflammatory activity play roles in the impact of TMJ pain on daily living and quality of life in RA. PMID:24363501

  11. Effectiveness of two different splints to treat temporomandibular disorders.

    PubMed

    Aksakalli, Sertac; Temucin, Fatih; Pamukcu, Ayca; Ezirganlı, Seref; Kazancioglu, Hakki Oguz; Malkoc, Meral Arslan

    2015-07-01

    Nearly 5% of the the world's population has temporomandibular disorder (TMD) severe enough to make them seek treatment. A third of the total population has at least one TMD symptom. There are different types of splints to treat TMD. In our study, we compared the success of two different appliances [stabilization splint (ss), nociceptive trigeminal inhibition splint (NTI)] by using Fonseca's questionnaire, the OHQoL-UK and visual analog scale (VAS). A total of 40 patients suffering from TMD were included in this study and answered questionnaires twice, at the beginning of the treatment and 3 months later. Regarding TMD alone, 39 patients (97.5%) had some degree of the disorder, 7 of of these cases being mild (17.5%), 15 moderate (37.5%), and 17 severe (42.5%). We analyzed posttreatment changes compared to baseline. Pain complaints decreased in both groups, and the OHQoL-UK revealed better quality of life after treatment. Based on the posttreatment Fonseca's questionnaires, significant changes in the patients' complaints in the group SS (p < 0.01) were observed. The group NTI also displayed changes but these were not statistically significant after treatment (p > 0.05). Patients in both groups had fewer TMD complaints after TMJ treatment. According to the Fonseca's questionnaire, the patients' major TMD complaint was clenching-grinding, followed by pain in the craniomandibular joint, or earache. PMID:26149971

  12. Temporal Summation of Heat Pain in Temporomandibular Disorder Patients

    PubMed Central

    Raphael, Karen G.; Janal, Malvin N.; Ananthan, Sowmya; Cook, Dane B.; Staud, Roland

    2008-01-01

    Aims One possible mechanism underlying myofascial temporomandibular disorders (TMD) is altered central nervous system processing of painful stimuli. The current study aimed to compare TMD cases to controls on two measures of central processing, i.e., temporal summation of heat pain and decay of subsequent aftersensations, following thermal stimulation in both a trigeminal and extratrigeminal area. Methods Using a “wind-up” (WU) protocol, 19 female TMD patients and 17 controls were exposed to 15 heat stimuli at a rate of 0.3 Hz. Numeric pain ratings were elicited after the 1st, 5th, 10th and 15th stimulus presentation and every 15 seconds after final presentation (aftersensations), for up to 2 minutes. In separate trials, the thermode was placed on the thenar eminence of the hand and the skin overlying the masseter muscle. Results Groups did not differ with respect to the slope of WU when stimulated at either anatomic site, although asymptote occurred sooner for TMD patients than controls. In analysis of aftersensations, a significant group x site x time interaction was detected, in which TMD patients experienced more prolonged painful aftersensations than controls when stimulated on the skin overlying the masseter muscles. Conclusions These results are consistent with the presence of enhanced central sensitivity in TMD and suggest that this sensitivity may be largely confined to the region of clinical pain. This contrasts with conditions such as fibromyalgia, where central sensitivity appears to be widespread. PMID:19264036

  13. Temporomandibular disorder modifies cortical response to tactile stimulation

    PubMed Central

    Nebel, Mary Beth; Folger, Stephen; Tommerdahl, Mark; Hollins, Mark; McGlone, Francis; Essick, Gregory

    2010-01-01

    Individuals with temporomandibular disorder (TMD) suffer from persistent facial pain and exhibit abnormal sensitivity to tactile stimulation. To better understand the pathophysiological mechanisms underlying TMD, we investigated cortical correlates of this abnormal sensitivity to touch. Using functional magnetic resonance imaging (fMRI), we recorded cortical responses evoked by low frequency vibration of the index finger in subjects with TMD and in healthy controls (HC). Distinct subregions of contralateral SI, SII, and insular cortex responded maximally for each group. Although the stimulus was inaudible, primary auditory cortex was activated in TMDs. TMDs also showed greater activation bilaterally in anterior cingulate cortex and contralaterally in the amygdala. Differences between TMDs and HCs in responses evoked by innocuous vibrotactile stimulation within SI, SII, and the insula paralleled previously reported differences in responses evoked by noxious and innocuous stimulation, respectively, in healthy individuals. This unexpected result may reflect a disruption of the normal balance between central resources dedicated to processing innocuous and noxious input, manifesting itself as increased readiness of the pain matrix for activation by even innocuous input. Activation of the amygdala in our TMD group could reflect the establishment of aversive associations with tactile stimulation due to the persistence of pain. Perspective This article presents evidence that central processing of innocuous tactile stimulation is abnormal in TMD. Understanding the complexity of sensory disruption in chronic pain could lead to improved methods for assessing cerebral cortical function in these patients. PMID:20462805

  14. Could Acupuncture Be Useful in the Treatment of Temporomandibular Dysfunction?

    PubMed

    Grillo, Cássia Maria; Canales, Giancarlo De la Torre; Wada, Ronaldo Seichi; Alves, Marcelo Corrêa; Barbosa, Célia Marisa Rizzatti; Berzin, Fausto; de Sousa, Maria da Luz Rosário

    2015-08-01

    In this study, the effects of acupuncture in comparison with flat occlusal plane appliance were evaluated in patient with myogenic temporomandibular dysfunction (TMD). The sample consisted of 40 women with TMD and unbalanced energy predominance of Yang Liver Ascension, selected using the Renying and Cunkou pulses, randomly divided into two groups: acupuncture and splint. The effect of treatments on the masseter and anterior temporal muscles was evaluated after 4 weeks of treatment, by means of electromyographic activity (root mean square) and pain pressure threshold. Pain intensity was measured using the visual analog scale, and range of mouth opening was evaluated using a millimeter ruler. All evaluations were performed at the beginning and end of the treatment. Visual analog scale score was reduced equally in the two groups (p < 0001), and the increase in range of mouth opening was significant in both groups. A significant difference was detected only in pain pressure threshold of the left masseter in the acupuncture group (p < 0.05). Only root mean square in the at rest position of the right temporal muscle diminished in the final stage of the splint group (p < 0.05). Both treatments reduced the pain intensity of myogenic TMD in the short term and may be considered strategies for control of chronic pain related to TMD. PMID:26276455

  15. Predictors for the development of temporomandibular disorders in scuba divers.

    PubMed

    Lobbezoo, F; van Wijk, A J; Klingler, M C; Ruiz Vicente, E; van Dijk, C J; Eijkman, M A J

    2014-08-01

    The aim was to determine predictors for the development of complaints of temporomandibular disorders (TMD) in a large sample of Dutch scuba divers who were free of any TMD complaints before they started diving actively. Five-hundred and thirty-six scuba divers (mean ± SD age = 40.4 ± 11.9 years; 34.1% women) completed a specifically developed questionnaire, either online or on paper. Stepwise forward logistic regression analysis was performed to predict the presence of TMD pain, with several potential risk factors as predictors. Four hundred and eighty-five of the 536 respondents were free of any TMD pain before they started diving actively. In this sample, TMD pain was present in 214 persons (44.1%). Four predictors contributed significantly to the presence of TMD pain, viz., clenching (OR = 2.466), warm water (OR = 1.685), biting on the mouthpiece (OR = 1.598), and the quality rating of the mouthpiece (OR = 0.887, that is, a higher rating means a smaller odds of having TMD pain). TMD pain is a common complaint among scuba divers who were free of such complaints before they started diving actively. Clenching, biting on the mouthpiece, and a low rating of the mouthpiece are predictors for the presence of TMD pain in scuba divers, while diving in cold water serves as a protective factor for TMD pain. PMID:24766672

  16. Pseudodynamic imaging of the temporomandibular joint: SE versus GE sequences

    SciTech Connect

    Masui, Takayuki; Isoda, Haruo; Mochizuki, Takao

    1996-05-01

    Pseudodynamic MR imaging of the temporomandibular joints (TMJs) has been used for the evaluation of the functional aspects of the TMJs. To evaluate the value of T1-weighted spin-echo (SE) and gradient-echo (GE) techniques, both techniques were performed in 9 asymptomatic (mean 25.7 years, 22-32 years), and 25 symptomatic (mean 44.9 years, 20-71 years) subjects with signs and symptoms of internal derangement or osteoarthrosis of the TMJs. The imaging time for the SE (180 ms / 15 ms / 110{degrees} repetition time / echo time /flip angle) and GE (fast low angle shot; FLASH, 90 ms / 12 ms / 40{degrees}) sequences was 27 and 28 s, respectively. In asymptomatic and symptomatic subjects, the confidence of the identification of the meniscal position was better on SE than GE images (3.6 {+-} 0.6 vs. 2.9 {+-} 0.9, p < 0.01, 3.2 {+-} 0.8 vs. 2.8 {+-} 0.8, p < 0.05), respectively and the sizes of the menisci were bigger on SE than GE images. The delineation of the condylar cortex was better on GE than SE images. For pseudodynamic imaging display of the TMJs, the SE images might be better than GE images to provide the stable recognition of the menisci. 17 refs., 7 figs., 5 tabs.

  17. Ear pruritus: a new otologic finding related to temporomandibular disorder.

    PubMed

    Vasconcelos, Belmiro Cavalcanti do Egito; Barbosa, Lívia Mirelle; Barbalho, Jimmy Charles Melo; Araújo, Gabriela Madeira; Melo, Auremir Rocha; Santos, Lucas Alexandre de Morais

    2016-01-01

    This prospective clinical study evaluated the correlation among temporomandibular disorder (TMD), otologic manifestations, and parafunctional habits in a sample of 100 patients with TMD. The subjects were evaluated by clinical examination, use of a simplified anamnestic questionnaire for TMD diagnosis, and the investigation of otologic manifestations and parafunctional habits of the stomatognathic system. The prevalence of TMD and correlations with otologic manifestations and parafunctional habits were calculated. Patients ranged in age from 13 to 70 years, and 79.0% of the patients were between the ages of 30 and 59 years. Women represented 88.0% of the sample. Otologic manifestations were found in 92.0% of patients with TMD. Sex showed a significant correlation with severity of TMD (P = 0.024). A significant correlation was observed between female patients and both otalgia (P = 0.036) and ear pruritus (P < 0.001). Otalgia showed a significant association with the symptoms of TMD (P = 0.003). Significant correlations between severe TMD and otalgia (P < 0.001), tinnitus (P = 0.010), ear pruritus (P < 0.001), and aural fullness (P = 0.014) were also observed. Ear pruritus, otalgia, and aural fullness are the most common otologic manifestations in patients with TMD, showing a significant correlation with the female sex, severity of TMD, and frequency of TMD symptoms. PMID:27599280

  18. Headaches and myofascial temporomandibular disorders: overlapping entities, separate managements?

    PubMed

    Conti, P C R; Costa, Y M; Gonçalves, D A; Svensson, P

    2016-09-01

    There are relevant clinical overlaps between some of the painful temporomandibular disorders (TMD) and headache conditions that may hamper the diagnostic process and treatment. A non-systematic search for studies on the relationship between TMD and headaches was carried out in the following databases: PubMed, Cochrane Library and Embase. Important pain mechanisms contributing to the close association and complex relationship between TMD and headache disorders are as follows: processes of peripheral and central sensitisation which take place in similar anatomical areas, the possible impairment of the descending modulatory pain pathways and the processes of referred pain. In addition, the clinical examination does not always provide distinguishing information to differentiate between headaches and TMD. So, considering the pathophysiology and the clinical presentation of some types of headache and myofascial TMD, such overlap can be considered not only a matter of comorbid relationship, but rather a question of disorders where the distinction lines are sometimes hard to identify. These concerns are certainly reflected in the current classification systems of both TMD and headache where the clinical consequences of diagnosis such as headache attributed to or associated with TMD are uncertain. There are several similarities in terms of therapeutic strategies used to manage myofascial TMD and headaches. Considering all these possible levels of interaction, we reinforce the recommendation for multidisciplinary approaches, by a team of oro-facial pain specialists and a neurologist (headache specialist), to attain the most precise differential diagnosis and initiate the best and most efficient treatment. PMID:27191928

  19. Circulating Omentin-1 and Chronic Painful Temporomandibular Disorder

    PubMed Central

    Harmon, Jennifer B.; Sanders, Anne E.; Wilder, Rebecca S.; Essick, Greg K.; Slade, Gary D.; Hartung, Jane E.; Nackley, Andrea G.

    2016-01-01

    AIMS The biological basis for painful temporomandibular disorder (TMD) remains unclear. An emerging literature implicates circulating inflammatory cytokines in the development of pain sensitivity and painful TMD. One newly discovered anti-inflammatory adipokine, omentin-1, has decreased expression in several inflammatory conditions including osteoarthritis. The aim of this study was to investigate the relationship between omentin-1 levels and painful TMD. METHODS Using a case-control design, chronic painful TMD cases (n=90) and TMD-free controls (n=54) were selected participants in the multisite OPPERA study (Orofacial Pain: Prospective Evaluation and Risk Assessment). Painful TMD case status was determined by examiner using established Research Diagnostic Criteria for TMD. Levels of omentin-1 were measured in stored blood plasma samples using an enzyme-linked immunosorbent assay. Binary logistic regression calculated the odds ratios (ORs) and 95% confidence limits (CLs) for the association between omentin-1 and painful TMD. Models adjusted for study site, age, sex, and body mass index (BMI). RESULTS The unadjusted association between omentin-1 and chronic painful TMD was statistically non-significant (P=.072) Following adjustment of the negative confounding bias of covariates, odds of painful decreased 36% per standard deviation increase in circulating omentin-1 (adjusted OR=0.64, 95% CL: 0.43, 0.96. P=.031). CONCLUSION Circulating levels of omentin-1 were significantly lower in painful TMD cases than controls, suggesting that painful TMD pain is mediated by inflammatory pathways. PMID:27472522

  20. Methadone treatment, bruxism, and temporomandibular disorders among male prisoners.

    PubMed

    Enguelberg-Gabbay, Judith V; Schapir, Lior; Israeli, Yair; Hermesh, Haggai; Weizman, Abraham; Winocur, Ephraim

    2016-06-01

    There is little information on bruxism related to illicit drug use. Prolonged drug use may damage the stomatognathic system via oral motor overactivity. The aim of the present study was to compare the rates of bruxism and temporomandibular disorders (TMDs) between prisoners with and without drug-use disorders, to evaluate the association between methadone treatment and bruxism and to assess the possible relationship between bruxism and pain. The sample included 152 male prisoners, 69 of whom were drug users maintained on methadone. All prisoners were examined by an experienced dentist and completed a questionnaire on their oral habits, with the aim of detecting signs or symptoms of TMD and/or bruxism. Additional data were collected from medical files. The prevalence of sleep bruxism and awake bruxism, but not of TMDs, was significantly higher among drug-user than non-drug user prisoners (52.2% vs. 34.9% for sleep bruxism, 59.7% vs. 30.1% for awake bruxism, and 46.3% vs. 25.6% for TMDs, respectively). Participants with awake bruxism were statistically more sensitive to muscle palpation compared with participants with sleep bruxism [rating scores (mean ± SD): 0.32 ± 0.21 vs. 0.19 ± 0.28, respectively]. An association was found between sleep bruxism and awake bruxism. It seems that there is a direct or an indirect association between methadone maintenance treatment and sleep bruxism or awake bruxism in male prisoners. PMID:27041534

  1. Differences in skeletal components of temporomandibular joint of an early medieval and contemporary Croatian population obtained by different methods.

    PubMed

    Kranjcic, Josip; Slaus, Mario; Persic, Sanja; Vodanovic, Marin; Vojvodic, Denis

    2016-01-01

    The temporomandibular joint (TMJ) is one of the most complex joints in the human body. The anatomical configuration of the TMJ allows for a large range of mandibular movements as well as transmission of masticatory forces and loads to the skull base. The measurements of the TMJ's anatomical structures and their interpretations contribute to the understanding of how pathological changes, tooth loss, and the type of diet (changing throughout human history) can affect biomechanical conditions of the masticatory system and the TMJ. The human TMJ and its constituent parts are still the subject of extensive investigation and comparisons of measurement methods are being made in order to determine the most precise and suitable measurement methods. The aim of this study has been to examine the morphology of skeletal components of TMJ of an early medieval population (EMP) in Croatia and to compare measured values with TMJ values of the contemporary Croatian population (CP) using various methods of measurement. The study was performed on 30 EMP specimens - human dry skulls, aged from 18 to 55 years, and 30 CP human dry skulls, aged from 18 to 65 years. Only fully preserved specimens (in measured areas) were included. The articular eminence (AE) inclination was measured in relation to the Frankfurt horizontal using two methods. Also, the AE height (glenoid fossa depth) and the length of the curved line - highest to the lowest point of the AE were measured. Measurements were performed on lateral skull photographs, panoramic radiographs and lateral cephalograms using VistaMetrix software on skull images. The results were statistically analyzed using SPSS statistical software. No statistically significant differences were obtained for AE parameters between the EMP and CP populations independent of age and gender. However, statistically significant (p<0.05) differences were revealed when comparing results of three different measuring methods. It could not be determined which of

  2. Application of the rapid prototyping technique to design a customized temporomandibular joint used to treat temporomandibular ankylosis

    PubMed Central

    Chaware, Suresh M.; Bagaria, Vaibhav; Kuthe, Abhay

    2009-01-01

    Anthropometric variations in humans make it difficult to replace a temporomandibular joint (TMJ), successfully using a standard “one-size-fits-all” prosthesis. The case report presents a unique concept of total TMJ replacement with customized and modified TMJ prosthesis, which is cost-effective and provides the best fit for the patient. The process involved in designing and modifications over the existing prosthesis are also described. A 12-year- old female who presented for treatment of left unilateral TMJ ankylosis underwent the surgery for total TMJ replacement. A three-dimensional computed tomography (CT) scan suggested features of bony ankylosis of left TMJ. CT images were converted to a sterolithographic model using CAD software and a rapid prototyping machine. A process of rapid manufacturing was then used to manufacture the customized prosthesis. Postoperative recovery was uneventful, with an improvement in mouth opening of 3.5 cm and painless jaw movements. Three years postsurgery, the patient is pain-free, has a mouth opening of about 4.0 cm and enjoys a normal diet. The postoperative radiographs concur with the excellent clinical results. The use of CAD/CAM technique to design the custom-made prosthesis, using orthopaedically proven structural materials, significantly improves the predictability and success rates of TMJ replacement surgery. PMID:19881026

  3. Intra-Articular Injections of Polyphenols Protect Articular Cartilage from Inflammation-Induced Degradation: Suggesting a Potential Role in Cartilage Therapeutics.

    PubMed

    Natarajan, Venkatachalam; Madhan, Balaraman; Tiku, Moti L

    2015-01-01

    Arthritic diseases, such as osteoarthritis and rheumatoid arthritis, inflict an enormous health care burden on society. Osteoarthritis, a degenerative joint disease with high prevalence among older people, and rheumatoid arthritis, an autoimmune inflammatory disease, both lead to irreversible structural and functional damage to articular cartilage. The aim of this study was to investigate the effect of polyphenols such as catechin, quercetin, epigallocatechin gallate, and tannic acid, on crosslinking type II collagen and the roles of these agents in managing in vivo articular cartilage degradation. The thermal, enzymatic, and physical stability of bovine articular cartilage explants following polyphenolic treatment were assessed for efficiency. Epigallocatechin gallate and tannic acid-treated explants showed >12 °C increase over native cartilage in thermal stability, thereby confirming cartilage crosslinking. Polyphenol-treated cartilage also showed a significant reduction in the percentage of collagen degradation and the release of glycosaminoglycans against collagenase digestion, indicating the increase physical integrity and resistance of polyphenol crosslinked cartilage to enzymatic digestion. To examine the in vivo cartilage protective effects, polyphenols were injected intra-articularly before (prophylactic) and after (therapeutic) the induction of collagen-induced arthritis in rats. The hind paw volume and histomorphological scoring was done for cartilage damage. The intra-articular injection of epigallocatechin gallate and tannic acid did not significantly influence the time of onset or the intensity of joint inflammation. However, histomorphological scoring of the articular cartilage showed a significant reduction in cartilage degradation in prophylactic- and therapeutic-groups, indicating that intra-articular injections of polyphenols bind to articular cartilage and making it resistant to degradation despite ongoing inflammation. These studies establish

  4. Intra-Articular Injections of Polyphenols Protect Articular Cartilage from Inflammation-Induced Degradation: Suggesting a Potential Role in Cartilage Therapeutics

    PubMed Central

    Natarajan, Venkatachalam; Madhan, Balaraman; Tiku, Moti L.

    2015-01-01

    Arthritic diseases, such as osteoarthritis and rheumatoid arthritis, inflict an enormous health care burden on society. Osteoarthritis, a degenerative joint disease with high prevalence among older people, and rheumatoid arthritis, an autoimmune inflammatory disease, both lead to irreversible structural and functional damage to articular cartilage. The aim of this study was to investigate the effect of polyphenols such as catechin, quercetin, epigallocatechin gallate, and tannic acid, on crosslinking type II collagen and the roles of these agents in managing in vivo articular cartilage degradation. The thermal, enzymatic, and physical stability of bovine articular cartilage explants following polyphenolic treatment were assessed for efficiency. Epigallocatechin gallate and tannic acid-treated explants showed >12 °C increase over native cartilage in thermal stability, thereby confirming cartilage crosslinking. Polyphenol-treated cartilage also showed a significant reduction in the percentage of collagen degradation and the release of glycosaminoglycans against collagenase digestion, indicating the increase physical integrity and resistance of polyphenol crosslinked cartilage to enzymatic digestion. To examine the in vivo cartilage protective effects, polyphenols were injected intra-articularly before (prophylactic) and after (therapeutic) the induction of collagen-induced arthritis in rats. The hind paw volume and histomorphological scoring was done for cartilage damage. The intra-articular injection of epigallocatechin gallate and tannic acid did not significantly influence the time of onset or the intensity of joint inflammation. However, histomorphological scoring of the articular cartilage showed a significant reduction in cartilage degradation in prophylactic- and therapeutic-groups, indicating that intra-articular injections of polyphenols bind to articular cartilage and making it resistant to degradation despite ongoing inflammation. These studies establish

  5. Signs and symptoms of temporomandibular disorders and radiologically observed abnormalities in the condyles of the temporomandibular joints of professional violin and viola players.

    PubMed

    Kovero, O; Könönen, M

    1995-04-01

    The frequency of temporomandibular disorders (TMDs) and radiologically observed abnormalities in the condyles of the temporomandibular joints (TMJs) of professional violin and viola players was investigated in 26 orchestra violinists/violists (VP group) and in their sex-, age-, and dentition-matched controls (C group). A routine clinical stomatognathic examination, a standardized interview, and radiography of the condyles were carried out for all subjects. The VP group showed a higher frequency of subjective symptoms and clinical signs of TMD, such as palpatory tenderness of masticatory muscles, TMJ clicking, painful mandibular movements, and deviation on opening or closing. There was no difference between the groups in terms of radiologic findings in the condyles. Weekly playing hours correlated positively with some signs of TMD. It is concluded that professional violin or viola playing might be a predisposing factor for TMD. PMID:7610780

  6. Regeneration of Articular Cartilage Surface: Morphogens, Cells, and Extracellular Matrix Scaffolds.

    PubMed

    Sakata, Ryosuke; Iwakura, Takashi; Reddi, A Hari

    2015-10-01

    The articular cartilage is a well-organized tissue for smooth and friction-free joint movement for locomotion in animals and humans. Adult articular cartilage has a very low self-regeneration capacity due to its avascular nature. The regeneration of articular cartilage surface is critical to prevent the progression to osteoarthritis (OA). Although various joint resurfacing procedures in experimental articular cartilage defects have been developed, no standardized clinical protocol has yet been established. The three critical ingredients for tissue regeneration are morphogens and growth factors, cells, and scaffolds. The concepts based on the regeneration triad have been extensively investigated in animal models. However, these studies in animal models have demonstrated variable results and outcomes. An optimal animal model must precisely mimic and model the sequence of events in articular cartilage regeneration in human. In this article, the progress and remaining challenges in articular cartilage regeneration in animal models are reviewed. The role of individual morphogens and growth factors in cartilage regeneration has been investigated. In normal articular cartilage homeostasis, morphogens and growth factors function sequentially in tissue regeneration. Mesenchymal stem cell-based repair of articular cartilage defects, performed with or without various growth factors and scaffolds, has been widely attempted in animal models. Stem cells, including embryonic and adult stem cells and induced pluripotent stem cells, have also been reported as attractive cell sources for articular cartilage surface regeneration. Several studies with regard to scaffolds have been advanced, including recent investigations based on nanomaterials, functional mechanocompatible scaffolds, multilayered scaffolds, and extracellular matrix scaffolds for articular cartilage surface regeneration. Continuous refinement of animal models in chondral and osteochondral defects provide opportunities

  7. Groningen temporomandibular total joint prosthesis: an 8-year longitudinal follow-up on function and pain.

    PubMed

    Schuurhuis, Jennifer M; Dijkstra, Pieter U; Stegenga, Boudewijn; de Bont, Lambert G M; Spijkervet, Fred K L

    2012-12-01

    Total temporomandibular joint replacement is a surgical procedure for patients with severe temporomandibular joint afflictions affecting quality of life, which have not responded beneficially to previous conventional surgery. The aim of this study was to assess the long-term outcome of the Groningen temporomandibular joint (TMJ) prosthesis in patients with chronic pain and mutilated temporomandibular joints following multiple surgical procedures, with respect to prosthesis failure, the patient's postoperative level of satisfaction and longitudinal changes in maximum mouth opening, functional mandibular impairment and pain. Eight female patients were studied in whom Groningen TMJ prostheses were inserted, two unilaterally and six bilaterally. The Groningen TMJ prosthesis was mechanically successful during 8 years of follow-up in seven out of eight patients with a disc dislocation being seen in one patient (7%). Patients were satisfied, despite the limited improvement of the maximum mouth opening, and pain scores. Although the decline of MFIQ scores during 8 years of follow-up was significant compared to baseline (p=0.027), the effects of the prosthesis on maximum mouth opening, function and pain were limited. This may be due to persistent chronic pain and the adverse effects of multiple previous surgical procedures. PMID:22484125

  8. [Synovial chondromatosis of the right temporomandibular joint: report of one case].

    PubMed

    Fan, Rui-xian; Zhang, Kui-hong; Ding, Wei; Wang, Yan-ling

    2016-04-01

    Synovial chondromatosis of the temporomandibular joint(TMJ) is an extremely rare condition. A case of synovial chondromatosis with postoperative recurrence and involvement of base of skull was reported. The clinic pathological features, diagnosis and treatment were discussed with literature review. PMID:27329898

  9. Biofeedback and Relaxation Therapy for Chronic Temporomandibular Joint Pain: Predicting Successful Outcomes.

    ERIC Educational Resources Information Center

    Funch, Donna P.; Gale, Elliot N.

    1984-01-01

    Randomly assigned 57 patients with chronic temporomandibular joint (TMJ) pain to receive either relaxation or biofeedback therapy. Successful patients in the relaxation condition tended to be younger and had experienced TMJ pain for a shorter period of time than the successful biofeedback patients. (BH)

  10. Psoriatic arthritis of the temporomandibular joints with ankylosis. Literature review and case reports.

    PubMed

    Koorbusch, G F; Zeitler, D L; Fotos, P G; Doss, J B

    1991-03-01

    Psoriatic arthritis is currently defined as psoriasis associated with chronic, erosive inflammatory arthritis, which is seronegative for rheumatoid factor. A review of the etiology, pathogenesis, diagnosis, and treatment is accompanied by two unusual case reports of psoriatic arthritis affecting the temporomandibular joints with ankylosis. PMID:2011347

  11. Temporomandibular joint ankylosis caused by chondroid hyperplasia from the callus of condylar neck fracture.

    PubMed

    Kim, Soung Min; Park, Jung Min; Kim, Ji Hyuck; Kwon, Kwang Jun; Park, Young Wook; Lee, Jong Ho; Lee, Sang Shin; Lee, Suk Keun

    2009-01-01

    A patient who complained of difficulty in opening his mouth after condylar neck fracture 1 year ago presented typical features of temporomandibular joint ankylosis in clinical and radiologic examinations. To demonstrate a possible pathogenesis of temporomandibular joint ankylosis after condylar neck fracture, the fractured condylar portion removed was examined by histologic and immunohistochemical stainings. Interpositional gap arthroplasty was performed by removing the inferomesially displaced fractured condyle, and reconstruction with subcutaneous dermis to the previous vertical height was performed immediately. The fractured condylar portion was almost intact with slight erosion of the condylar cartilage. In the hematoxylin and eosin and Masson trichrome stainings, an extensive chondroid hyperplasia with abundant hyaline cartilage was shown in the removed condylar portion. There were also hyperplastic features of the synovial membrane, which were abnormally distributed throughout the chondroid tissues. In the immunohistochemical stainings of proliferating cell nuclear antigen (PCNA) and bone morphogenetic protein (BMP)-2 and BMP-4, the chondroid tissues were conspicuously hyperplastic and strongly positive for BMP-4 but sparse for BMP-2. From these results, we think that the hyperplastic chondroid tissue was derived from the callus of the primary fractured site of the condylar neck and propose that the chondroid tissue could proliferate continuously because of synovial tissue support from around the temporomandibular joint, resulting in temporomandibular joint ankylosis. This pathogenesis is quite different from those of other diaphyseal fracture of long bones. PMID:19165036

  12. Importance of reference gene selection for articular cartilage mechanobiology studies

    PubMed Central

    Al-Sabah, A.; Stadnik, P.; Gilbert, S.J.; Duance, V.C.; Blain, E.J.

    2016-01-01

    Summary Objective Identification of genes differentially expressed in mechano-biological pathways in articular cartilage provides insight into the molecular mechanisms behind initiation and/or progression of osteoarthritis (OA). Quantitative PCR (qPCR) is commonly used to measure gene expression, and is reliant on the use of reference genes for normalisation. Appropriate validation of reference gene stability is imperative for accurate data analysis and interpretation. This study determined in vitro reference gene stability in articular cartilage explants and primary chondrocytes subjected to different compressive loads and tensile strain, respectively. Design The expression of eight commonly used reference genes (18s, ACTB, GAPDH, HPRT1, PPIA, RPL4, SDHA and YWHAZ) was determined by qPCR and data compared using four software packages (comparative delta-Ct method, geNorm, NormFinder and BestKeeper). Calculation of geometric means of the ranked weightings was carried out using RefFinder. Results Appropriate reference gene(s) for normalisation of mechanically-regulated transcript levels in articular cartilage tissue or isolated chondrocytes were dependent on experimental set-up. SDHA, YWHAZ and RPL4 were the most stable genes whilst glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and to a lesser extent Hypoxanthine-guanine phosphoribosyltransferase (HPRT), showed variable expression in response to load, demonstrating their unsuitability in such in vitro studies. The effect of using unstable reference genes to normalise the expression of aggrecan (ACAN) and matrix metalloproteinase 3 (MMP3) resulted in inaccurate quantification of these mechano-sensitive genes and erroneous interpretation/conclusions. Conclusion This study demonstrates that commonly used ‘reference genes’ may be unsuitable for in vitro cartilage chondrocyte mechanobiology studies, reinforcing the principle that careful validation of reference genes is essential prior to each experiment to

  13. Biochemical analysis of normal articular cartilage in horses.

    PubMed

    Vachon, A M; Keeley, F W; McIlwraith, C W; Chapman, P

    1990-12-01

    Articular cartilage specimens from the distal articular surface of 32 radiocarpal bones from 24 2- to 5-year-old horses were analyzed. The total collagen content was determined on the basis of the 4-hydroxyproline content, using a colorimetric method. A method for estimating the proportions of types-I and -II collagen by measuring spectrophotometric densities of specific cyanogen bromide peptide bands from mixtures of types-I and -II collagen on sodium dodecyl sulfate-polyacrylamide gels was used. The cyanogen bromide peptides representative of each collagen types-I and -II were identified. The peptide ratios were then computed for each of several standards of type-I and -II mixtures. A standard curve was derived from the correlation between these ratios and the corresponding proportions of type-II collagen in standard mixtures. Galactosamine and glucosamine content (hexosamines) were measured by ion chromatography. The galactosamine-to-glucosamine ratio, chondroitin sulfate and keratan sulfate values, and total glycosaminoglycan content were derived from the measured hexosamine content. The total collagen content averaged 556 mg/g (55.6 mg/100 mg) of tissue (dry weight, [dw]). Type-II collagen was the major collagen type in normal articular cartilage specimens. The ratio of the area under the alpha 1 (II)CB10 peak to the area under the alpha 1 (I)CB 7,8 + alpha 1 (II)CB11 peak was a second-order polynomial function of the proportion of type-II collagen in the specimens. The mean galactosamine and glucosamine content were 20.6 mg/g and 7.9 mg/g (dw), respectively. The mean galactosamine-to-glucosamine ratio was 3.74 +/- 0.62.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2085215

  14. Mechanical properties of normal and osteoarthritic human articular cartilage.

    PubMed

    Robinson, Dale L; Kersh, Mariana E; Walsh, Nicole C; Ackland, David C; de Steiger, Richard N; Pandy, Marcus G

    2016-08-01

    Isotropic hyperelastic models have been used to determine the material properties of normal human cartilage, but there remains an incomplete understanding of how these properties may be altered by osteoarthritis. The aims of this study were to (1) measure the material constants of normal and osteoarthritic human knee cartilage using isotropic hyperelastic models; (2) determine whether the material constants correlate with histological measures of structure and/or cartilage tissue damage; and (3) quantify the abilities of two common isotropic hyperelastic material models, the neo-Hookean and Yeoh models, to describe articular cartilage contact force, area, and pressure. Small osteochondral specimens of normal and osteoarthritic condition were retrieved from human cadaveric knees and from the knees of patients undergoing total knee arthroplasty and tested in unconfined compression at loading rates and large strains representative of weight-bearing activity. Articular surface contact area and lateral deformation were measured concurrently and specimen-specific finite element models then were used to determine the hyperelastic material constants. Structural parameters were measured using histological techniques while the severity of cartilage damage was quantified using the OARSI grading scale. The hyperelastic material constants correlated significantly with OARSI grade, indicating that the mechanical properties of cartilage for large strains change with tissue damage. The measurements of contact area described anisotropy of the tissue constituting the superficial zone. The Yeoh model described contact force and pressure more accurately than the neo-Hookean model, whereas both models under-predicted contact area and poorly described the anisotropy of cartilage within the superficial zone. These results identify the limits by which isotropic hyperelastic material models may be used to describe cartilage contact variables. This study provides novel data for the

  15. Patterns of radiocarpal joint articular cartilage wear in cadavers.

    PubMed

    Gorniak, Gerard C; Conrad, Will; Conrad, Erin; Decker, Bonnie

    2012-05-01

    The radiocarpal joint transmits about 80% of the compression forces crossing the wrist. However, primary osteoarthritis of this joint is surprisingly uncommon, suggesting that articular cartilage wear is not sufficient to produce arthritic symptoms. By examining the distal radius, scaphoid, and lunate in aged cadavers, wear patterns were charted and measured, allowing assessment of radiocarpal joint wear and mechanics. Bilateral radiocarpal joints of 16 females and 14 males (age 77.7 ± 14.4, N = 30) were exposed and measurements of the wear recorded microscopically. Wear locations were mapped, and X-Y loci and wear areas calculated. Gender right and sides compared. Over 95% of distal radius wear showed distinct radial-scaphoid and radial-lunate wear areas. These bilateral areas were in the palmar half of the distal radius. One main central wear area was seen in 95% of the scaphoid, and 97% of the lunate articular surfaces that were examined. Articular wear showed a circular pattern and was minimal in 95.7% of the surfaces, and the lunate showed the largest wear area. Wear patterns in males and females support the literature that for most ADLs the wrist is in slight extension and ulnar deviation. There are gender differences, but wear areas between sides were similar. Female wear indicates their wrist is positioned more often in a more extended and ulnarly deviated position than males. The wear patterns suggest rotational movements of the scaphoid and lunate during wrist motion and that the wrist is most often used in neutral flexion/extension to slight extension. PMID:22095798

  16. Membrane channel gene expression in human costal and articular chondrocytes

    PubMed Central

    Asmar, A.; Barrett-Jolley, R.; Werner, A.; Kelly, R.; Stacey, M.

    2016-01-01

    ABSTRACT Chondrocytes are the uniquely resident cells found in all types of cartilage and key to their function is the ability to respond to mechanical loads with changes of metabolic activity. This mechanotransduction property is, in part, mediated through the activity of a range of expressed transmembrane channels; ion channels, gap junction proteins, and porins. Appropriate expression of ion channels has been shown essential for production of extracellular matrix and differential expression of transmembrane channels is correlated to musculoskeletal diseases such as osteoarthritis and Albers-Schönberg. In this study we analyzed the consistency of gene expression between channelomes of chondrocytes from human articular and costal (teenage and fetal origin) cartilages. Notably, we found 14 ion channel genes commonly expressed between articular and both types of costal cartilage chondrocytes. There were several other ion channel genes expressed only in articular (6 genes) or costal chondrocytes (5 genes). Significant differences in expression of BEST1 and KCNJ2 (Kir2.1) were observed between fetal and teenage costal cartilage. Interestingly, the large Ca2+ activated potassium channel (BKα, or KCNMA1) was very highly expressed in all chondrocytes examined. Expression of the gap junction genes for Panx1, GJA1 (Cx43) and GJC1 (Cx45) was also observed in chondrocytes from all cartilage samples. Together, this data highlights similarities between chondrocyte membrane channel gene expressions in cells derived from different anatomical sites, and may imply that common electrophysiological signaling pathways underlie cellular control. The high expression of a range of mechanically and metabolically sensitive membrane channels suggest that chondrocyte mechanotransduction may be more complex than previously thought. PMID:27116676

  17. ROCK inhibitor prevents the dedifferentiation of human articular chondrocytes

    SciTech Connect

    Matsumoto, Emi; Furumatsu, Takayuki; Kanazawa, Tomoko; Tamura, Masanori; Ozaki, Toshifumi

    2012-03-30

    Highlights: Black-Right-Pointing-Pointer ROCK inhibitor stimulates chondrogenic gene expression of articular chondrocytes. Black-Right-Pointing-Pointer ROCK inhibitor prevents the dedifferentiation of monolayer-cultured chondrocytes. Black-Right-Pointing-Pointer ROCK inhibitor enhances the redifferentiation of cultured chondrocytes. Black-Right-Pointing-Pointer ROCK inhibitor is useful for preparation of un-dedifferentiated chondrocytes. Black-Right-Pointing-Pointer ROCK inhibitor may be a useful reagent for chondrocyte-based regeneration therapy. -- Abstract: Chondrocytes lose their chondrocytic phenotypes in vitro. The Rho family GTPase ROCK, involved in organizing the actin cytoskeleton, modulates the differentiation status of chondrocytic cells. However, the optimum method to prepare a large number of un-dedifferentiated chondrocytes is still unclear. In this study, we investigated the effect of ROCK inhibitor (ROCKi) on the chondrogenic property of monolayer-cultured articular chondrocytes. Human articular chondrocytes were subcultured in the presence or absence of ROCKi (Y-27632). The expression of chondrocytic marker genes such as SOX9 and COL2A1 was assessed by quantitative real-time PCR analysis. Cellular morphology and viability were evaluated. Chondrogenic redifferentiation potential was examined by a pellet culture procedure. The expression level of SOX9 and COL2A1 was higher in ROCKi-treated chondrocytes than in untreated cells. Chondrocyte morphology varied from a spreading form to a round shape in a ROCKi-dependent manner. In addition, ROCKi treatment stimulated the proliferation of chondrocytes. The deposition of safranin O-stained proteoglycans and type II collagen was highly detected in chondrogenic pellets derived from ROCKi-pretreated chondrocytes. Our results suggest that ROCKi prevents the dedifferentiation of monolayer-cultured chondrocytes, and may be a useful reagent to maintain chondrocytic phenotypes in vitro for chondrocyte

  18. Optical clearing of articular cartilage: a comparison of clearing agents

    NASA Astrophysics Data System (ADS)

    Bykov, Alexander; Hautala, Tapio; Kinnunen, Matti; Popov, Alexey; Karhula, Sakari; Saarakkala, Simo; Nieminen, Miika T.; Tuchin, Valery

    2015-07-01

    Optical clearing technique was applied to the problem of OCT imaging of articular cartilage and subchondral bone. We show that optical clearing significantly enhances visualization of articular cartilage and cartilage-bone interface. The effect of different clearing agents was analyzed. For the clearing, iohexol solution and propylene glycol (PG) were used. Clearing was performed in vitro at room temperature by immersion method. Cylindrical osteochondral samples (d=4.8mm) were drilled from bovine lateral femur and stored in phosphate-buffered saline at -20°C until clearing. Monitoring of clearing process was performed using high-speed spectral-domain OCT system providing axial resolution of 5.8μm at 930nm. Total duration of experiment was 90-100min to ensure saturation of clearing. We have shown that iohexol solution and PG are capable to optically clear articular cartilage enabling reliable characterization of cartilagebone interface with OCT. Being a low osmolarity agent, iohexol provides minimal changes to the thickness of cartilage sample. Clearing saturation time for the cartilage sample with the thickness of 0.9 mm measured with OCT is of 50 min. However, less than 15 min is enough to reliably detect the rear cartilage boundary. Alternatively, PG significantly (60%) reduces the cartilage thickness enabling better visualization of subchondral bone. It was observed that PG has higher clearing rate. The clearing saturation time is of 30 min, however less than 5 min is enough to detect cartilage-bone interface. We conclude that iohexol solution is superior for OCT imaging of cartilage and cartilage-bone interface, while PG suits better for subhondral bone visualization.

  19. The collagen fibril organization in human articular cartilage.

    PubMed Central

    Minns, R J; Steven, F S

    1977-01-01

    In this scanning electron microscopic study blocks of collagen fibrils were prepared from human articular cartilage, using two techinques which selectively removed either the proteoglycans alone, or both the proteoglycans and the collagen fibrils, of the non-calcified cartilage layer. Amino acid analysis of the fibrils confirmed the purity of the collagen after proteoglycan extraction. The cartilage was scanned in four different ways: (1) normal to the articular surface, (2) in superficial sections, (3) on surfaces of blocks which had been broken in planes parallel to artificial splits make by the insertion of a pin, and (4) on fracture surfaces which traversed the calcified cartilage and the subchondral bone. Five features of the organization of the collagen fibrils were specially noted: (1) Individual fibrils within the trabeculae joined to form small fibre bundles which became grouped into larger bundles at the calcified/uncalcified interface. (2) Fibrils in the deep and middle zones which, exhibiting the characteristic surface periodicity of collagen, were generally oriented towars the articular surface in large bundles approximately 55 micronm across. (3) In the superficial zone, fibrils ran parallel to the surface. (4) The surface fibrils had random orientation, even at the bases of empty lacunae vacated by chondrocytes during specimen preparation. (5) The collagen fibrils of the lacunar walls appeared to be thinner and more closely packed than thos between the lacunae. The fine collagen fibrils associated with the lacunar walls were frequently observed to pass through a large lacunar space, resulting in the formation of two or more compartments, each of which was presumably filled with a chondrocyte in the living cartilage. Images Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 PMID:870478

  20. Differences Regarding Branded HA in Italy, Part 2: Data from Clinical Studies on Knee, Hip, Shoulder, Ankle, Temporomandibular Joint, Vertebral Facets, and Carpometacarpal Joint

    PubMed Central

    Migliore, A.; Bizzi, E.; De Lucia, O.; Delle Sedie, A.; Tropea, S.; Bentivegna, M.; Mahmoud, A.; Foti, C.

    2016-01-01

    OBJECTIVES The aim of the current study is to collect scientific data on all branded hyaluronic acid (HA) products in Italy that are in use for intra-articular (IA) injection in osteoarthritis (OA) compared with that reported in the leaflet. METHODS An extensive literature research was performed for all articles reporting data on the IA use of HA in OA. Selected studies were taken into consideration only if they are related to products based on HAs that are currently marketed in Italy with the specific joint indication for IA use in patients affected by OA. RESULTS Sixty-two HA products are marketed in Italy: 30 products are indicated for the knee but only 8 were proved with some efficacy; 9 products were effective for the hip but only 6 had hip indication; 7 products proved to be effective for the shoulder but only 3 had the indication; 5 products proved effective for the ankle but only one had the indication; 6 products were effective for the temporomandibular joint but only 2 had the indication; only 2 proved effective for vertebral facet joints but only 1 had the indication; and 5 products proved effective for the carpometacarpal joint but only 2 had the indication. CONCLUSIONS There are only a few products with some evidences, while the majority of products remain without proof. Clinicians and regulators should request postmarketing studies from pharmaceuticals to corroborate with that reported in the leaflet and to gather more data, allowing the clinicians to choose the adequate product for the patient. PMID:27279754

  1. Self-regulatory deficits in fibromyalgia and temporomandibular disorders.

    PubMed

    Solberg Nes, Lise; Carlson, Charles R; Crofford, Leslie J; de Leeuw, Reny; Segerstrom, Suzanne C

    2010-10-01

    Chronic pain conditions such as fibromyalgia (FM) and temporomandibular disorders (TMDs) are accompanied by complex interactions of cognitive, emotional, and physiological disturbances. Such conditions are complicated and draining to live with, and successful adaptation may depend on ability to self-regulate. Self-regulation involves capacity to exercise control and guide or alter reactions and behavior, abilities essential for human adjustment. Research indicates that self-regulatory strength is a limited source that can be depleted or fatigued, however, and the current study aimed to show that patients with FM and TMD are vulnerable to self-regulatory fatigue as a consequence of their condition. Patients (N=50) and pain-free matched controls (N=50) were exposed to an experimental self-regulation task followed by a persistence task. Patients displayed significantly less capacity to persist on the subsequent task compared with controls. In fact, patients exposed to low self-regulatory effort displayed similar low persistence to patients and controls exposed to high self-regulatory effort, indicating that patients with chronic pain conditions may be suffering from chronic self-regulatory fatigue. Baseline heart rate variability, blood glucose, and cortisol predicted persistence, more so for controls than for patients, and more so in the low vs. high self-regulation condition. Impact of chronic pain conditions on self-regulatory effort was mediated by pain, but not by any other factors. The current study suggests that patients with chronic pain conditions likely suffer from chronic self-regulatory fatigue, and underlines the importance of taking self-regulatory capacity into account when aiming to understand and treat these complex conditions. PMID:20561749

  2. Angioarchitecture and morphology of temporomandibular joint of Monodelphis domestica.

    PubMed

    Minucci, Matheus Silvestre; Issa, João Paulo Mardegan; Yokoyama, Fernando Yukio; Dias, Fernando José; Iyomasa, Daniela Mizusaki; Guimarães, Elaine Aparecida Del-Bel Belluz; Watanabe, Ii-Sei; Iyomasa, Mamie Mizusaki

    2016-09-01

    The opossum Monodelphis domestica presents movement of the temporomandibular joint (TMJ) reflecting adaptation to eating habits similar to movement in humans, but the structure of the TMJ is not yet known. Thus, nine young M. domestica, of both sexes were weighed, anesthetized with xylazine (10 mg kg(-1) ), and ketamine (70 mg kg(-1) ) and processed for: 1. The analyses of the macroscopic angioarchitecture after latex injection, as well as the topography of the TMJ; 2. The analysis of microvascularization after injection of Mercox resin and corrosion of soft tissue with NaOH using scanning electron microscopy and; 3. The histological evaluation of the TMJ with an optical microscope. Macroscopic analysis of the latex injected vessels revealed the distribution of the arteries from the common carotid artery, receiving branches of the superficial temporal and maxillary arteries. The mandibular condyle has the long axis in the lateral-lateral direction, and is convex in the anterior-posterior direction. Its topography was determined in relation to the eye and external acoustic meatus. With scanning electron microscopy, microvascularization consists of arterioles of varying diameter (85-15 µm) of the meandering capillary network in the retrodiscal region, and a network of straight capillaries in the TMJ anterior region. Via light microscopy the TMJ has similar histological features to those of humans. These macroscopic, microscopic and ultrastructural data from TMJ of the M. domestica could be a suitable model for TMJ physiology and pathophysiology studies for then speculate on possible human studies. Microsc. Res. Tech. 79:806-813, 2016. © 2016 Wiley Periodicals, Inc. PMID:27324400

  3. Chronic HPA Axis Response to Stress in Temporomandibular Disorder

    PubMed Central

    Lambert, Cynthia A.; Sanders, Anne; Wilder, Rebecca S.; Slade, Gary D.; Van Uum, Stan; Russell, Evan; Koren, Gideon; Maixner, William

    2016-01-01

    Purpose Perceived stress is associated with temporomandibular disorder (TMD), but whether cortisol levels are elevated in individuals with TMD is unknown. We hypothesized that cortisol concentration, a biomarker of hypothalamic-pituitary-adrenal (HPA) axis function, was elevated in TMD cases relative to controls, and that perceived stress was positively correlated with cortisol concentration. Methods In this case control study, TMD case status was determined by examiners using TMD Research Diagnostic Criteria. Participants (n=116) aged 18 to 59 years were recruited from within a 50 mile radius of the University of North Carolina at Chapel Hill. Following examination, cases (n=45) and controls (n=71) completed the 14-item Perceived Stress Scale using a reference interval of the past 3 months. Approximately 100 strands of hair were cut from the posterior vertex segment of their scalp. The 3 centimeters of hair most proximal to the scalp was analyzed with a commercially available salivary cortisol enzyme immunoassay adapted for hair cortisol. This length corresponds to the last 3 months of systemic HPA axis activity. Results TMD cases perceived higher stress than controls (p=0.001). However, hair cortisol concentration was lower in TMD cases than controls (p<0.001). The correlation coefficient revealed a weak negative relationship (r=−0.188) between perceived stress and hair cortisol concentration (p=0.044). In analysis stratified by case status, the relationship of perceived stress and hair cortisol concentration was non-significant for cases (p=0.169) and controls (p=0.498). Conclusion Despite greater perceived stress, TMD cases had lower hair cortisol concentrations than controls and the 2 measures of stress were weakly and negatively correlated. PMID:25071145

  4. Association between temporomandibular disorders and abnormal head postures.

    PubMed

    Faulin, Evandro Francisco; Guedes, Carlos Gramani; Feltrin, Pedro Paulo; Joffiley, Cláudia Maria Mithie Suda Costa

    2015-01-01

    This study examines the possible correlation between the prevalence of temporomandibular disorders (TMD) and different head postures in the frontal and sagittal planes using photographs of undergraduate students in the School of Dentistry at the Universidade de Brasília - UnB, Brazil. In this nonrandomized, cross-sectional study, the diagnoses of TMD were made with the Research Diagnostic Criteria (RDC)/TMD axis I. The craniovertebral angle was used to evaluate forward head posture in the sagittal plane, and the interpupillary line was used to measure head tilt in the frontal plane. The measurements to evaluate head posture were made using the Software for the Assessment of Posture (SAPO). Students were divided into two study groups, based on the presence or absence of TMD. The study group comprised 46 students and the control group comprised 80 students. Data about head posture and TMD were analyzed with the Statistical Package for the Social Sciences, version 13. Most cases of TMD were classified as degenerative processes (group III), followed by disk displacement (group II) and muscle disorders (group I). There was no sex predominance for the type of disorder. No association was found between prevalence rates for head postures in the frontal plane and the occurrence of TMD. The same result was found for the association of TMD diagnosis with craniovertebral angle among men and women, and the group that contained both men and women. Abnormal head postures were common among individuals both with and without TMD. No association was found between head posture evaluated in the frontal and sagittal planes and TMD diagnosis with the use of RDC/TMD. PMID:26017489

  5. Effects of growth factors on temporomandibular joint disc cells.

    PubMed

    Detamore, Michael S; Athanasiou, Kyriacos A

    2004-07-01

    The effects of growth factors on cartilaginous tissues are well documented. An exception is the temporomandibular joint (TMJ) disc, where data for growth factor effects on proliferation and biosynthesis are very limited. The purpose of this study was to quantify proliferation of and synthesis by TMJ disc cells cultured in monolayer with either platelet derived growth factor-AB (PDGF), basic fibroblast growth factor (bFGF) or insulin-like growth factor-I (IGF), at either a low (10 ng/ml) or high (100 ng/ml) concentration. Proliferation was assessed with a DNA quantitation technique, collagen synthesis was measured via a hydroxyproline assay, and GAG synthesis was determined with a dimethylmethylene blue dye binding assay at 14 days. Overall, the most beneficial growth factor was bFGF, which was most potent in increasing proliferation and GAG synthesis, and also effective in promoting collagen synthesis. At the high concentration, bFGF resulted in 96% more cells than the control and 30 to 45% more cells than PDGF and IGF. PDGF and bFGF were the most potent upregulators of GAG synthesis, producing 2-3 times more GAG than the control. IGF had no significant effect on GAG production, although at its higher concentration it increased collagen production by 4.5 times over the control. Collagen synthesis was promoted by bFGF at its lower concentration, with levels 4.2 times higher than the control, whereas PDGF had no significant effect on collagen production. In general, higher concentrations increased proliferation, whereas lower concentrations favoured biosynthesis. PMID:15126139

  6. Effects of Enzymatic Degradation after Loading in Temporomandibular Joint

    PubMed Central

    Asakawa-Tanne, Y.; Su, S.; Kunimatsu, R.; Hirose, N.; Mitsuyoshi, T.; Okamoto, Y.; Tanaka, E.; Tanne, K.

    2015-01-01

    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. PMID:25503611

  7. Pain Mechanisms and Centralized Pain in Temporomandibular Disorders.

    PubMed

    Harper, D E; Schrepf, A; Clauw, D J

    2016-09-01

    Until recently, most clinicians and scientists believed that the experience of pain is perceptually proportional to the amount of incoming peripheral nociceptive drive due to injury or inflammation in the area perceived to be painful. However, many cases of chronic pain have defied this logic, leaving clinicians perplexed as to how patients are experiencing pain with no obvious signs of injury in the periphery. Conversely, there are patients who have a peripheral injury and/or inflammation but little or no pain. What makes some individuals experience intense pain with minimal peripheral nociceptive stimulation and others experience minimal pain with serious injury? It is increasingly well accepted in the scientific community that pain can be generated and maintained or, through other mechanisms, suppressed by changes in the central nervous system, creating a complete mismatch between peripheral nociceptive drive and perceived pain. In fact, there is no known chronic pain condition where the observed extent of peripheral damage reproducibly engenders the same level of pain across individuals. Temporomandibular disorders (TMDs) are no exception. This review focuses on the idea that TMD patients range on a continuum-from those whose pain is generated peripherally to those whose pain is centralized (i.e., generated, exacerbated, and/or maintained by central nervous system mechanisms). This article uses other centralized chronic pain conditions as a guide, and it suggests that the mechanistic variability in TMD pain etiology has prevented us from adequately treating many individuals who are diagnosed with the condition. As the field moves forward, it will be imperative to understand each person's pain from its own mechanistic standpoint, which will enable clinicians to deliver personalized medicine to TMD patients and eventually provide relief in even the most recalcitrant cases. PMID:27422858

  8. Painful Temporomandibular Disorder: Decade of Discovery from OPPERA Studies.

    PubMed

    Slade, G D; Ohrbach, R; Greenspan, J D; Fillingim, R B; Bair, E; Sanders, A E; Dubner, R; Diatchenko, L; Meloto, C B; Smith, S; Maixner, W

    2016-09-01

    In 2006, the OPPERA project (Orofacial Pain: Prospective Evaluation and Risk Assessment) set out to identify risk factors for development of painful temporomandibular disorder (TMD). A decade later, this review summarizes its key findings. At 4 US study sites, OPPERA recruited and examined 3,258 community-based TMD-free adults assessing genetic and phenotypic measures of biological, psychosocial, clinical, and health status characteristics. During follow-up, 4% of participants per annum developed clinically verified TMD, although that was a "symptom iceberg" when compared with the 19% annual rate of facial pain symptoms. The most influential predictors of clinical TMD were simple checklists of comorbid health conditions and nonpainful orofacial symptoms. Self-reports of jaw parafunction were markedly stronger predictors than corresponding examiner assessments. The strongest psychosocial predictor was frequency of somatic symptoms, although not somatic reactivity. Pressure pain thresholds measured at cranial sites only weakly predicted incident TMD yet were strongly associated with chronic TMD, cross-sectionally, in OPPERA's separate case-control study. The puzzle was resolved in OPPERA's nested case-control study where repeated measures of pressure pain thresholds revealed fluctuation that coincided with TMD's onset, persistence, and recovery but did not predict its incidence. The nested case-control study likewise furnished novel evidence that deteriorating sleep quality predicted TMD incidence. Three hundred genes were investigated, implicating 6 single-nucleotide polymorphisms (SNPs) as risk factors for chronic TMD, while another 6 SNPs were associated with intermediate phenotypes for TMD. One study identified a serotonergic pathway in which multiple SNPs influenced risk of chronic TMD. Two other studies investigating gene-environment interactions found that effects of stress on pain were modified by variation in the gene encoding catechol O

  9. [Brucine chitosan thermosensitive hydrogel for intra-articular injection].

    PubMed

    Chen, Zhi-Peng; Liu, Wen; Chen, Hong-Xuan; Cai, Bao-Chang

    2012-05-01

    The aim of this study was to develop a sustained release converse thermosensitive hydrogel for intra-articular injection using chitosan-glycerol-borax as matrix, its physical properties and biocompatibility were investigated. Taking gelation time and gelation condition as index, the influence of concentration of chitosan, ratio of chitosan to glycerol, pH on physical properties of hydrogel were investigated. And then the in vitro drug release, rheological properties and biocompatibility were studied. The thermosensitive hydrogel flows easily at room temperature and turns to gelation at body temperature, which can certainly prolong the release of drug and has good biocompatibility. PMID:22812012

  10. Microscale surface friction of articular cartilage in early osteoarthritis.

    PubMed

    Desrochers, Jane; Amrein, Matthias W; Matyas, John R

    2013-09-01

    Articular cartilage forms the articulating surface of long bones and facilitates energy dissipation upon loading as well as joint lubrication and wear resistance. In normal cartilage, boundary lubrication between thin films at the cartilage surface reduces friction in the absence of interstitial fluid pressurization and fluid film lubrication by synovial fluid. Inadequate boundary lubrication is associated with degenerative joint conditions such as osteoarthritis (OA), but relations between OA and surface friction, lubrication and wear in boundary lubrication are not well defined. The purpose of the present study was to measure microscale boundary mode friction of the articular cartilage surface in an in vivo experimental model to better understand changes in cartilage surface friction in early OA. Cartilage friction was measured on the articular surface by atomic force microscopy (AFM) under applied loads ranging from 0.5 to 5 μN. Microscale AFM friction analyses revealed depth dependent changes within the top-most few microns of the cartilage surface in this model of early OA. A significant increase of nearly 50% was observed in the mean engineering friction coefficient for OA cartilage at the 0.5 μN load level; no significant differences in friction coefficients were found under higher applied loads. Changes in cartilage surface morphology observed by scanning electron microscopy included cracking and roughening of the surface indicative of disruption and wear accompanied by an apparent disintegration of the thin surface lamina from the underlying matrix. Immunohistochemical staining of lubricin - an important cartilage surface boundary lubricant - did not reveal differences in spatial distribution near the cartilage surface in OA compared to controls. The increase in friction at the 0.5 μN force level is interpreted to reflect changes in the interfacial mechanics of the thin surface lamina of articular cartilage: increased friction implies reduced

  11. [Joint morphogenesis and development of permanent articular cartilage].

    PubMed

    Ohta, Yoichi; Iwamoto, Masahiro

    2011-06-01

    During limb skeletogenesis progenitor mesenchymal cells aggregate at specific times and sites to form continuous precartilaginous condensations. With time the condensations undergo chondrogenesis and give rise to cartilaginous anlagen that exhibit incipient synovial joints at each end. A multitude of factors regulates subdivision into discrete skeletal elements and the formation, organization, morphogenesis and structure of the joints. This review summarizes recent advance of joint morphogenesis and actions of key players of joint and articular cartilage formation. In addition, we would like to discuss possible direction to translate basic research findings towards treatment of joint diseases. PMID:21628794

  12. Extra-articular Synovial Chondromatosis Eroding and Penetrating the Acromion

    PubMed Central

    El Rassi, George; Matta, Jihad; Hijjawi, Ayman; Khair, Ousama Abou; Fahs, Sara

    2015-01-01

    Synovial chondromatosis of the shoulder is an uncommon disorder. It usually affects the glenohumeral joint and is characterized by metaplasia of the synovium leading to the formation of osteochondral loose bodies. Few cases of extra-articular subacromial synovial chondromatosis involving the rotator cuff tendon have been reported in the literature. The treatment of previously reported cases consisted of open bursectomy and removal of loose bodies. We report a case of subacromial synovial chondromatosis without rotator cuff involvement but with severe erosion and fracture of the acromion. Treatment consisted of shoulder arthroscopy to remove all loose bodies, total bursectomy, and debridement of the acromion. Potential benefits of arthroscopy were also evaluated. PMID:26697302

  13. Extra-articular Synovial Chondromatosis Eroding and Penetrating the Acromion.

    PubMed

    El Rassi, George; Matta, Jihad; Hijjawi, Ayman; Khair, Ousama Abou; Fahs, Sara

    2015-10-01

    Synovial chondromatosis of the shoulder is an uncommon disorder. It usually affects the glenohumeral joint and is characterized by metaplasia of the synovium leading to the formation of osteochondral loose bodies. Few cases of extra-articular subacromial synovial chondromatosis involving the rotator cuff tendon have been reported in the literature. The treatment of previously reported cases consisted of open bursectomy and removal of loose bodies. We report a case of subacromial synovial chondromatosis without rotator cuff involvement but with severe erosion and fracture of the acromion. Treatment consisted of shoulder arthroscopy to remove all loose bodies, total bursectomy, and debridement of the acromion. Potential benefits of arthroscopy were also evaluated. PMID:26697302

  14. Effect of passive motion on articular cartilage in rat osteoarthritis.

    PubMed

    Qian, Jie; Liang, Jun; Wang, Yubin; Wang, Huifang

    2014-08-01

    The aim of the present study was to investigate the effect of moderate passive motion on articular cartilage in osteoarthritis (OA) caused by knee fracture. Sprague-Dawley rats (age, 8 weeks) with knee fractures were used to construct rat knee early- and middle-stage OA models. The stages were fixed for three and six weeks, with 20 rats analyzed at each stage. The experimental groups were exercised daily for 15 m/min with a specified duration. Following the completion of exercise, the effects of proper passive motion on cartilage thickness, the Mankin rating, cartilage collagen matrix, proteoglycan content and the morphological structure of the cartilage in the rat OA models were measured at the various degenerative stages caused by knee fracture. The proteoglycan content of the cartilage matrix, type II collagen fibers and the number of cartilage cells undergoing apoptosis were semiquantified. For early- and middle-stage OA, the cartilage layers in the three- or six-week experimental groups were significantly thicker and the levels of proteoglycans and type II collagen fibers in the weight-bearing area of the cartilage were significantly higher when compared with the control groups (P<0.05). In addition, the Mankin ratings were lower and ligament tension was increased when compared with the control group (P<0.05). In the early-stage OA group, significantly decreased apoptotic rates (P<0.05) were observed in the three- and six-week experimental groups, however, no significant decrease was observed in the middle-stage OA group. In the early-stage OA rats, the thickness of the cartilage layer, as well as the levels of proteoglycans and type II collagen fibers, in the six-week experimental group, were significantly higher compared with the control and three-week subgroups, and a decreased apoptotic rate was observed (P<0.05). In the six-week experimental middle-stage OA group, significant differences were observed in the content of proteoglycans and type II collagen

  15. Effect of passive motion on articular cartilage in rat osteoarthritis

    PubMed Central

    QIAN, JIE; LIANG, JUN; WANG, YUBIN; WANG, HUIFANG

    2014-01-01

    The aim of the present study was to investigate the effect of moderate passive motion on articular cartilage in osteoarthritis (OA) caused by knee fracture. Sprague-Dawley rats (age, 8 weeks) with knee fractures were used to construct rat knee early- and middle-stage OA models. The stages were fixed for three and six weeks, with 20 rats analyzed at each stage. The experimental groups were exercised daily for 15 m/min with a specified duration. Following the completion of exercise, the effects of proper passive motion on cartilage thickness, the Mankin rating, cartilage collagen matrix, proteoglycan content and the morphological structure of the cartilage in the rat OA models were measured at the various degenerative stages caused by knee fracture. The proteoglycan content of the cartilage matrix, type II collagen fibers and the number of cartilage cells undergoing apoptosis were semiquantified. For early- and middle-stage OA, the cartilage layers in the three- or six-week experimental groups were significantly thicker and the levels of proteoglycans and type II collagen fibers in the weight-bearing area of the cartilage were significantly higher when compared with the control groups (P<0.05). In addition, the Mankin ratings were lower and ligament tension was increased when compared with the control group (P<0.05). In the early-stage OA group, significantly decreased apoptotic rates (P<0.05) were observed in the three- and six-week experimental groups, however, no significant decrease was observed in the middle-stage OA group. In the early-stage OA rats, the thickness of the cartilage layer, as well as the levels of proteoglycans and type II collagen fibers, in the six-week experimental group, were significantly higher compared with the control and three-week subgroups, and a decreased apoptotic rate was observed (P<0.05). In the six-week experimental middle-stage OA group, significant differences were observed in the content of proteoglycans and type II collagen

  16. Intra-articular and Peri-articular Tumours and Tumour Mimics- What a Clinician and Onco-imaging Radiologist Should Know

    PubMed Central

    DHANDA, Sunita; QUEK, Swee Tian; BATHLA, Girish; JAGMOHAN, Pooja

    2014-01-01

    Definitive determination of the cause of articular swelling may be difficult based on just the clinical symptoms, physical examinations and laboratory tests. Joint disorders fall under the realms of rheumatology and general orthopaedics; however, patients with joint conditions manifesting primarily as intra-articular and peri-articular soft tissue swelling may at times be referred to an orthopaedic oncology department with suspicion of a tumour. In such a situation, an onco-radiologist needs to think beyond the usual neoplastic lesions and consider the diagnoses of various non-neoplastic arthritic conditions that may be clinically masquerading as masses. Differential diagnoses of articular lesions include infectious and non-infectious synovial proliferative processes, degenerative lesions, deposition diseases, vascular malformations, benign and malignant neoplasms and additional miscellaneous conditions. Many of these diseases have specific imaging findings. Knowledge of these radiological characteristics in an appropriate clinical context will allow for a more confident diagnosis. PMID:24876802

  17. Prevalence of articular chondrocalcinosis in elderly subjects in a rural area of Catalonia.

    PubMed Central

    Sanmartí, R; Pañella, D; Brancós, M A; Canela, J; Collado, A; Brugués, J

    1993-01-01

    OBJECTIVES--To undertake an epidemiological survey of the prevalence of radiological chondrocalcinosis in the elderly population of Osona, a rural area of Catalonia, north east Spain. METHODS--Knee and wrist radiographs were performed on 261 subjects (141 women, 120 men) aged at least 60 years, who attended a series of 35 general practitioners for various medical problems. RESULTS--Twenty seven subjects had articular chondrocalcinosis, which represents a crude prevalence of 10%. Articular chondrocalcinosis was more often observed in women than in men (14 v 6%). Articular chondrocalcinosis increases in occurrence with age, rising from 7% in subjects aged 60-69 years to 43% in subjects older than 80 years. A similar occurrence of articular chondrocalcinosis was noted in the indigenous population, in which several cases of familial chondrocalcinosis have previously been reported, and in subjects born in other areas of Spain. All but one subject with articular chondrocalcinosis had chondrocalcinosis of the knee. The occurrence of rheumatic disorders did not differ significantly between subjects with articular chondrocalcinosis and those without. CONCLUSIONS--Articular chondrocalcinosis is an age related disorder, which could partly explain the discrepancies in its prevalence reported in previous studies. In most subjects with articular chondrocalcinosis recruited from an unselected population the clinical manifestations are probably mild or even absent. PMID:8323393

  18. [The temporomandibular joint in juvenile idiopathic arthritis: what radiologists need to look for on magnetic resonance imaging].

    PubMed

    De La Hoz Polo, M; Navallas, M

    2014-01-01

    The term "juvenile idiopathic arthritis" (JIA) encompasses a group of arthritis of unknown cause with onset before the age of 16 years that last for at least 6 weeks. The prevalence of temporomandibular joint involvement in published series ranges from 17% to 87%. Temporomandibular joint involvement is difficult to detect clinically, so imaging plays a key role in diagnosis and monitoring treatment. MRI is the technique of choice for the study of arthritis of the temporomandibular joint because it is the most sensitive technique for detecting acute synovitis and bone edema. Power Doppler ultrasonography can also detect active synovitis by showing the hypervascularization of the inflamed synovial membrane, but it cannot identify bone edema. This article describes the MRI technique for evaluating the temporomandibular joint in patients with juvenile idiopathic arthritis, defines the parameters to look for, and illustrates the main findings. PMID:24792314

  19. In vivo bone tunnel remodeling in symptomatic patients after ACL reconstruction: a retrospective comparison of articular and extra-articular fixation

    PubMed Central

    Mathis, Dominic T.; Rasch, Helmut; Hirschmann, Michael T.

    2015-01-01

    Summary Background there is only a paucity of studies dealing with bone remodeling within the tunnels after anterior cruciate ligament (ACL) reconstruction. The objective of this study was to evaluate the influence of tendon graft type and surgical fixation technique on bone tunnel remodeling in patients with symptomatic knees after ACL reconstruction. Methods in a retrospective study 99mTc-HDP bone tracer uptake (BTU) in SPECT/CT of 57 knees with symptoms of pain and/or instability after ACL reconstruction was investigated. All 57 knees were subdivided according their anatomy (femur and tibia), fixation (articular versus extra-articular fixation) and graft types into eight groups: femoral-articular versus extra-articular fixation using bone-patellar tendon-bone (BPTB) and hamstring autografts; tibial-articular versus extra-articular fixation using patellar tendon and hamstring autografts; BTU grading for each area of the localisation scheme were recorded. Tunnel diameter and length was measured in the CT scans. Results BTU was higher for the articular fixation in the femur and for the extra-articular fixation in the tibial tunnel. Patellar tendon graft fixation showed a significantly higher BTU in the superior-lateral and posterior-central area of the tibia, meaning the areas of the tibial tunnel near the entrance into the joint. Tunnel enlargement correlated significantly with increased BTU (p<0.05). Conclusion assessment of in vivo bone tunnel remodelling in symptomatic patients after ACL reconstruction revealed different patterns of BTU with regards to graft and fixation method. PMID:26958543

  20. Extra-articular hip impingement: a narrative review of the literature

    PubMed Central

    Cheatham, Scott W.

    2016-01-01

    There is growing subgroup of patients with poor outcomes after hip arthroscopy for intra-articular pathology suggesting unrecognized cause(s) of impingement may exist. Extra-articular hip impingement (EHI) is an emerging group of conditions that have been associated with intra-articular causes of impingement and may be an unrecognized source of pain. EHI is caused by abnormal contact between the extra-articular regions of the proximal femur and pelvis. This review discusses the most common forms for EHI including: central iliopsoas impingement, subspine impingement, ischiofemoral impingement, and greater trochanteric-pelvic impingement. The clinical presentation of each pathology will be discussed since EHI conditions share similar clinical features as the intra-articular pathology but also contain some unique characteristics. PMID:27069266

  1. Hydrogels for the Repair of Articular Cartilage Defects

    PubMed Central

    Maher, Suzanne A.; Lowman, Anthony M.

    2011-01-01

    The repair of articular cartilage defects remains a significant challenge in orthopedic medicine. Hydrogels, three-dimensional polymer networks swollen in water, offer a unique opportunity to generate a functional cartilage substitute. Hydrogels can exhibit similar mechanical, swelling, and lubricating behavior to articular cartilage, and promote the chondrogenic phenotype by encapsulated cells. Hydrogels have been prepared from naturally derived and synthetic polymers, as cell-free implants and as tissue engineering scaffolds, and with controlled degradation profiles and release of stimulatory growth factors. Using hydrogels, cartilage tissue has been engineered in vitro that has similar mechanical properties to native cartilage. This review summarizes the advancements that have been made in determining the potential of hydrogels to replace damaged cartilage or support new tissue formation as a function of specific design parameters, such as the type of polymer, degradation profile, mechanical properties and loading regimen, source of cells, cell-seeding density, controlled release of growth factors, and strategies to cause integration with surrounding tissue. Some key challenges for clinical translation remain, including limited information on the mechanical properties of hydrogel implants or engineered tissue that are necessary to restore joint function, and the lack of emphasis on the ability of an implant to integrate in a stable way with the surrounding tissue. Future studies should address the factors that affect these issues, while using clinically relevant cell sources and rigorous models of repair. PMID:21510824

  2. Human Articular Chondrocytes Express Multiple Gap Junction Proteins

    PubMed Central

    Mayan, Maria D.; Carpintero-Fernandez, Paula; Gago-Fuentes, Raquel; Martinez-de-Ilarduya, Oskar; Wang, Hong-Zhang; Valiunas, Virginijus; Brink, Peter; Blanco, Francisco J.

    2014-01-01

    Osteoarthritis (OA) is the most common joint disease and involves progressive degeneration of articular cartilage. The aim of this study was to investigate if chondrocytes from human articular cartilage express gap junction proteins called connexins (Cxs). We show that human chondrocytes in tissue express Cx43, Cx45, Cx32, and Cx46. We also find that primary chondrocytes from adults retain the capacity to form functional voltage-dependent gap junctions. Immunohistochemistry experiments in cartilage from OA patients revealed significantly elevated levels of Cx43 and Cx45 in the superficial zone and down through the next approximately 1000 μm of tissue. These zones corresponded with regions damaged in OA that also had high levels of proliferative cell nuclear antigen. An increased number of Cxs may help explain the increased proliferation of cells in clusters that finally lead to tissue homeostasis loss. Conversely, high levels of Cxs in OA cartilage reflect the increased number of adjacent cells in clusters that are able to interact directly by gap junctions as compared with hemichannels on single cells in normal cartilage. Our data provide strong evidence that OA patients have a loss of the usual ordered distribution of Cxs in the damaged zones and that the reductions in Cx43 levels are accompanied by the loss of correct Cx localization in the nondamaged areas. PMID:23416160

  3. Delivering Agents Locally into Articular Cartilage by Intense MHz Ultrasound

    PubMed Central

    Nieminen, Heikki J.; Ylitalo, Tuomo; Suuronen, Jussi-Petteri; Rahunen, Krista; Salmi, Ari; Saarakkala, Simo; Serimaa, Ritva; Hæggström, Edward

    2015-01-01

    There is no cure for osteoarthritis. Current drug delivery relies on systemic delivery or injections into the joint. Because articular cartilage (AC) degeneration can be local and drug exposure outside the lesion can cause adverse effects, localized drug delivery could permit new drug treatment strategies. We investigated whether intense megahertz ultrasound (frequency: 1.138 MHz, peak positive pressure: 2.7 MPa, Ispta: 5 W/cm2, beam width: 5.7 mm at −6 dB, duty cycle: 5%, pulse repetition frequency: 285 Hz, mechanical index: 1.1) can deliver agents into AC without damaging it. Using ultrasound, we delivered a drug surrogate down to a depth corresponding to 53% depth of the AC thickness without causing histologically detectable damage to the AC. This may be important because early osteoarthritis typically exhibits histopathologic changes in the superficial AC. In conclusion, we identify intense megahertz ultrasound as a technique that potentially enables localized non-destructive delivery of osteoarthritis drugs or drug carriers into articular cartilage. PMID:25922135

  4. Quantitative proteomic profiling of human articular cartilage degradation in osteoarthritis.

    PubMed

    Lourido, Lucía; Calamia, Valentina; Mateos, Jesús; Fernández-Puente, Patricia; Fernández-Tajes, Juan; Blanco, Francisco J; Ruiz-Romero, Cristina

    2014-12-01

    Osteoarthritis (OA) is the most common rheumatic pathology and is characterized primarily by articular cartilage degradation. Despite its high prevalence, there is no effective therapy to slow disease progression or regenerate the damaged tissue. Therefore, new diagnostic and monitoring tests for OA are urgently needed, which would also promote the development of alternative therapeutic strategies. In the present study, we have performed an iTRAQ-based quantitative proteomic analysis of secretomes from healthy human articular cartilage explants, comparing their protein profile to those from unwounded (early disease) and wounded (advanced disease) zones of osteoarthritic tissue. This strategy allowed us to identify a panel of 76 proteins that are distinctively released by the diseased tissue. Clustering analysis allowed the classification of proteins according to their different profile of release from cartilage. Among these proteins, the altered release of osteoprotegerin (decreased in OA) and periostin (increased in OA), both involved in bone remodelling processes, was verified in further analyses. Moreover, periostin was also increased in the synovial fluid of OA patients. Altogether, the present work provides a novel insight into the mechanisms of human cartilage degradation and a number of new cartilage-characteristic proteins with possible biomarker value for early diagnosis and prognosis of OA. PMID:25383958

  5. A nonlinear biphasic viscohyperelastic model for articular cartilage.

    PubMed

    García, José Jaime; Cortés, Daniel Humberto

    2006-01-01

    Experiments on articular cartilage have shown nonlinear stress-strain curves under finite deformations as well as intrinsic viscous effects of the solid phase. The aim of this study was to propose a nonlinear biphasic viscohyperelastic model that combines the intrinsic viscous effects of the proteoglycan matrix with a nonlinear hyperelastic constitutive equation. The proposed equation satisfies objectivity and reduces for uniaxial loading to a solid type viscous model in which the actions of the springs are represented by the hyperelastic function proposed by Holmes and Mow [1990. J. Biomechanics 23, 1145-1156.]. Results of the model, that were efficiently implemented in an updated Lagrangian algorithm, were compared with experimental infinitesimal data reported by DiSilverstro and Suh [2001. J. Biomechanics 34, 519-525.] and showed acceptable fitting for the axial force (R(2)=0.991) and lateral displacement (R(2)=0.914) curves in unconfined compression as well as a good fitting of the axial indentation force curve (R(2)=0.982). In addition, the model showed an excellent fitting of finite-deformation confined compression stress relaxation data reported by Ateshian et al. [1997. J. Biomechanics 30, 1157-1164.] and Huang et al. [2005. J. Biomechanics 38, 799-809.] (R(2)=0.993 and R(2)=0.995, respectively). The constitutive equation may be used to represent the mechanical behavior of the proteoglycan matrix in a fiber reinforced model of articular cartilage. PMID:16316659

  6. Subtalar versus triple arthrodesis after intra-articular calcaneal fractures

    PubMed Central

    Kieboom, Brenda C. T.; Bessems, Gert H. J. M.; Vogels, Lucas M. M.; van Lieshout, Esther M. M.; Patka, Peter

    2010-01-01

    Depending upon initial treatment, between 2 and 30% of patients with a displaced intra-articular calcaneal fracture require a secondary arthrodesis. The aim of this study was to investigate the effect of subtalar versus triple arthrodesis on functional outcome. A total of 33 patients with 37 secondary arthrodeses (17 subtalar and 20 triple) with a median follow-up of 116 months were asked to complete questionnaires regarding disease-specific functional outcome (Maryland Foot Score, MFS), quality of life (SF-36) and overall satisfaction with the treatment (Visual Analogue Scale, VAS). Patient groups were comparable considering median age at fracture, initial treatment (conservative or operative), time to arthrodesis, median follow-up, and post-arthrodesis radiographic angles. The MFS score was similar after subtalar versus triple arthrodesis (59 vs. 56 points; P = 0.79). No statistically significant difference was found for the SF-36 (84 vs. 83 points; P = 0.67) and the VAS (5 vs. 6; P = 0.21). Smoking was statistically significantly associated with a non-union (χ2 = 6.60, P = 0.017). The current study suggests that there is no significant difference in functional outcome between an in situ subtalar or triple arthrodesis as a salvage technique for symptomatic arthrosis after an intra-articular calcaneal fracture. Smoking is a risk factor for non-union. PMID:21811905

  7. Radiation synovectomy stimulates glycosaminoglycan synthesis by normal articular cartilage

    SciTech Connect

    Myers, S.L.; Slowman, S.D.; Brandt, K.D.

    1989-07-01

    Radiation synovectomy has been considered a therapeutic alternative to surgical synovectomy. Whether intraarticular irradiation affects the composition or biochemistry, and therefore the biomechanical properties, of normal articular cartilage has not been established. In the present study, yttrium 90 silicate was injected into one knee of nine normal adult dogs, and three other dogs received nonradioactive yttrium silicate. When the animals were killed 4 to 13 weeks after the injection, synovium from the irradiated knees showed areas of necrosis and fibrosis. Up to 29% less hyaluronate was synthesized in vitro by the synovial intima from irradiated knees than by the intima from the contralateral knees (mean difference 18%). Morphologic abnormalities were not observed in articular cartilage from either the irradiated or control knees, nor did the water content or concentrations of uronic acid or DNA in cartilage from the irradiated knees differ from that in cartilage from the contralateral knees. However, net /sup 35/SO/sub 4/-labeled glycosaminoglycan synthesis in organ cultures of cartilage from irradiated knees was increased (mean difference 21%, p = 0.03) in comparison with that in cultures of contralateral knee cartilage.

  8. Resurfacing Damaged Articular Cartilage to Restore Compressive Properties

    PubMed Central

    Grenier, Stephanie; Donnelly, Patrick E.; Gittens, Jamila; Torzilli, Peter A.

    2014-01-01

    Surface damage to articular cartilage is recognized as the initial underlying process causing the loss of mechanical function in early-stage osteoarthritis. In this study, we developed structure-modifying treatments to potentially prevent, stabilize or reverse the loss in mechanical function. Various polymers (chondroitin sulfate, carboxymethylcellulose, sodium hyaluronate) and photoinitiators (riboflavin, irgacure 2959) were applied to the surface of collagenase-degraded cartilage and crosslinked in situ using UV light irradiation. While matrix permeability and deformation significantly increased following collagenase-induced degradation of the superficial zone, resurfacing using tyramine-substituted sodium hyaluronate and riboflavin decreased both values to a level comparable to that of intact cartilage. Repetitive loading of resurfaced cartilage showed minimal variation in the mechanical response over a 7 day period. Cartilage resurfaced using a low concentration of riboflavin had viable cells in all zones while a higher concentration resulted in a thin layer of cell death in the uppermost superficial zone. Our approach to repair surface damage initiates a new therapeutic advance in the treatment of injured articular cartilage with potential benefits that include enhanced mechanical properties, reduced susceptibility to enzymatic degradation and reduced adhesion of macrophages. PMID:25468298

  9. A reappraisal of the structure of normal canine articular cartilage.

    PubMed Central

    Dunham, J; Shackleton, D R; Billingham, M E; Bitensky, L; Chayen, J; Muir, I H

    1988-01-01

    It has been shown that some of the controversy over the structure of articular cartilage may be due to slight differences in the orientation of the sample that has been studied. As our decisive criterion we have used the simple physical fact that elongate proteins, such as collagen micelles, that can exhibit form-birefringence, had to show virtually straight extinction when viewed under crossed polars. The use of a variably adjustable microtome chuck facilitated small adjustments in the orientation of the cartilage to meet this criterion. Under these conditions, the collagen of the matrix has been shown to be aligned mainly perpendicularly to the surface which was bounded by a thin lamina in which the collagen showed birefringence at 90 degrees to that of the matrix. The conventionally described zonation of articular cartilage has been shown to be inadequate for that of the dog tibial plateau. The conventional Zone 2 has been shown to consist of two zones, Zones 2a and 2b, with different cell sizes, cell concentrations, and concentration of matrix components. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:3198487

  10. Combinatorial scaffold morphologies for zonal articular cartilage engineering.

    PubMed

    Steele, J A M; McCullen, S D; Callanan, A; Autefage, H; Accardi, M A; Dini, D; Stevens, M M

    2014-05-01

    Articular cartilage lesions are a particular challenge for regenerative medicine strategies as cartilage function stems from a complex depth-dependent organization. Tissue engineering scaffolds that vary in morphology and function offer a template for zone-specific cartilage extracellular matrix (ECM) production and mechanical properties. We fabricated multi-zone cartilage scaffolds by the electrostatic deposition of polymer microfibres onto particulate-templated scaffolds produced with 0.03 or 1.0mm(3) porogens. The scaffolds allowed ample space for chondrocyte ECM production within the bulk while also mimicking the structural organization and functional interface of cartilage's superficial zone. Addition of aligned fibre membranes enhanced the mechanical and surface properties of particulate-templated scaffolds. Zonal analysis of scaffolds demonstrated region-specific variations in chondrocyte number, sulfated GAG-rich ECM, and chondrocytic gene expression. Specifically, smaller porogens (0.03mm(3)) yielded significantly higher sGAG accumulation and aggrecan gene expression. Our results demonstrate that bilayered scaffolds mimic some key structural characteristics of native cartilage, support in vitro cartilage formation, and have superior features to homogeneous particulate-templated scaffolds. We propose that these scaffolds offer promise for regenerative medicine strategies to repair articular cartilage lesions. PMID:24370641

  11. Expression of Angiotensin II Receptor-1 in Human Articular Chondrocytes

    PubMed Central

    Kawakami, Yuki; Matsuo, Kosuke; Murata, Minako; Yudoh, Kazuo; Nakamura, Hiroshi; Shimizu, Hiroyuki; Beppu, Moroe; Inaba, Yutaka; Saito, Tomoyuki; Kato, Tomohiro; Masuko, Kayo

    2012-01-01

    Background. Besides its involvement in the cardiovascular system, the renin-angiotensin-aldosterone (RAS) system has also been suggested to play an important role in inflammation. To explore the role of this system in cartilage damage in arthritis, we investigated the expression of angiotensin II receptors in chondrocytes. Methods. Articular cartilage was obtained from patients with osteoarthritis, rheumatoid arthritis, and traumatic fractures who were undergoing arthroplasty. Chondrocytes were isolated and cultured in vitro with or without interleukin (IL-1). The expression of angiotensin II receptor types 1 (AT1R) and 2 (AT2R) mRNA by the chondrocytes was analyzed using reverse transcription-polymerase chain reaction (RT-PCR). AT1R expression in cartilage tissue was analyzed using immunohistochemistry. The effect of IL-1 on AT1R/AT2R expression in the chondrocytes was analyzed by quantitative PCR and flow cytometry. Results. Chondrocytes from all patient types expressed AT1R/AT2R mRNA, though considerable variation was found between samples. Immunohistochemical analysis confirmed AT1R expression at the protein level. Stimulation with IL-1 enhanced the expression of AT1R/AT2R mRNA in OA and RA chondrocytes. Conclusions. Human articular chondrocytes, at least partially, express angiotensin II receptors, and IL-1 stimulation induced AT1R/AT2R mRNA expression significantly. PMID:23346400

  12. Septic Arthritis of the Temporomandibular Joint--Unusual Presentations.

    PubMed

    Lohiya, Sapna; Dillon, Jasjit

    2016-01-01

    This report describes 2 patients whose septic arthritis of the temporomandibular joint (SATMJ) presented atypically, resulting in treatment delay and complications. A 49-year-old man developed left-side facial allodynia, which was first treated unsuccessfully as trigeminal neuralgia. On day 21, the patient sustained facial trauma from a fall and presented to the emergency department (ED). Maxillofacial contrast-enhanced computed tomographic (CT) scan was suggestive of parotiditis, SATMJ, or hemarthrosis. His condition did not improve with empiric antibiotic treatment. On day 30, contrast-enhanced magnetic resonance imaging (MRI) confirmed SATMJ. Incision and drainage yielded 6 mL of pus and produced clinical improvement. Cultures grew methicillin-resistant Staphylococcus aureus, which was treated with amoxicillin plus clavulanate and sulfamethoxazole plus trimethoprim for 30 days. On day 59, the patient still had slight preauricular pain and CT-proved TMJ osteoarthritic changes. A 56-year-old woman developed right-side facial pain after a crown procedure on her right mandibular second molar. Oral prednisone (and clindamycin) produced partial relief. Her primary physician suspected temporal arteritis, but its biopsy result on day 11 was normal. Gradually, the patient developed trismus and malocclusion refractory to various medicines. On day 49, she presented to the ED. A contrast-enhanced maxillofacial CT scan suggested SATMJ. Incision and drainage yielded 30 mL of pus and produced clinical improvement. During days 50 to 57, the patient received intravenous ampicillin plus sulbactam and metronidazole. However, preauricular tenderness and drainage from the surgical incision persisted. On day 55, CT scan showed a residual abscess. Secondary debridement yielded 5 mL of pus. Culture grew coagulase-negative S aureus. On day 141, the patient still had slight preauricular pain and TMJ osteoarthritic changes on MRI. In these cases, the SATMJ diagnosis was delayed owing

  13. Ultrasound evaluation of site-specific effect of simulated microgravity on articular cartilage.

    PubMed

    Wang, Qing; Zheng, Yong-Ping; Wang, Xiao-Yun; Huang, Yan-Ping; Liu, Mu-Qing; Wang, Shu-Zhe; Zhang, Zong-Kang; Guo, Xia

    2010-07-01

    Space flight induces acute changes in normal physiology in response to the microgravity environment. Articular cartilage is subjected to high loads under a ground reaction force on Earth. The objectives of this study were to investigate the site dependence of morphological and ultrasonic parameters of articular cartilage and to examine the site-specific responses of articular cartilage to simulated microgravity using ultrasound biomicroscopy (UBM). Six rats underwent tail suspension (simulated microgravity) for four weeks and six other rats were kept under normal Earth gravity as controls. Cartilage thickness, ultrasound roughness index (URI), integrated reflection coefficient (IRC) and integrated backscatter coefficient (IBC) of cartilage tissues, as well as histological degeneration were measured at the femoral head (FH), medial femoral condyle (MFC), lateral femoral condyle (LFC), patello-femoral groove (PFG) and patella (PAT). The results showed site dependence not significant in all UBM parameters except cartilage thickness (p < 0.01) in the control specimens. Only minor changes in articular cartilage were induced by 4-week tail suspension, although there were significant decreases in cartilage thickness at the MFC and PAT (p < 0.05) and a significant increase in URI at the PAT (p < 0.01). This study suggested that the 4-week simulated microgravity had only mild effects on femoral articular cartilage in the rat model. This information is useful for human spaceflight and clinical medicine in improving understanding of the effect of microgravity on articular cartilage. However, the effects of longer duration microgravity experience on articular cartilage need further investigation. PMID:20620696

  14. MRI features of cervical articular process degenerative joint disease in Great Dane dogs with cervical spondylomyelopathy.

    PubMed

    Gutierrez-Quintana, Rodrigo; Penderis, Jacques

    2012-01-01

    Cervical spondylomyelopathy or Wobbler syndrome commonly affects the cervical vertebral column of Great Dane dogs. Degenerative changes affecting the articular process joints are a frequent finding in these patients; however, the correlation between these changes and other features of cervical spondylomyelopathy are uncertain. We described and graded the degenerative changes evident in the cervical articular process joints from 13 Great Danes dogs with cervical spondylomyelopathy using MR imaging, and evaluated the relationship between individual features of cervical articular process joint degeneration and the presence of spinal cord compression, vertebral foraminal stenosis, intramedullary spinal cord changes, and intervertebral disc degenerative changes. Degenerative changes affecting the articular process joints were common, with only 13 of 94 (14%) having no degenerative changes. The most severe changes were evident between C4-C5 and C7-T1 intervertebral spaces. Reduction or loss of the hyperintense synovial fluid signal on T2-weighted MR images was the most frequent feature associated with articular process joint degenerative changes. Degenerative changes of the articular process joints affecting the synovial fluid or articular surface, or causing lateral hypertrophic tissue, were positively correlated with lateral spinal cord compression and vertebral foraminal stenosis. Dorsal hypertrophic tissue was positively correlated with dorsal spinal cord compression. Disc-associated spinal cord compression was recognized less frequently. PMID:22236021

  15. Inter- and intra-specific scaling of articular surface areas in the hominoid talus

    PubMed Central

    Parr, William C H; Chatterjee, Helen J; Soligo, Christophe

    2011-01-01

    The morphology of postcranial articular surfaces is expected to reflect their weight-bearing properties, as well as the stability and mobility of the articulations to which they contribute. Previous studies have mainly confirmed earlier predictions of isometric scaling between articular surface areas and body mass; the exception to this is ‘male-type’, convex articular surface areas, which may scale allometrically due to differences in locomotor strategies within the analysed samples. In the present study, we used new surface scanning technology to quantify more accurately articular surface areas and to test those predictions within the talus of hominoid primates, including modern humans. Our results, contrary to predictions, suggest that there are no generalised rules of articular scaling within the talus of hominoids. Instead, we suggest that articular scaling patterns are highly context-specific, depending on the role of each articulation during locomotion, as well as taxon- and sex-specific differences in locomotion and ontogenetic growth trajectories within any given sample. While this may prove problematic for inferring body mass based on articular surface area, it also offers new opportunities of gaining substantial insights into the locomotor patterns of extinct species. PMID:21323919

  16. Advances in Surgical Management of Intra-articular Calcaneus Fractures.

    PubMed

    Hsu, Andrew R; Anderson, Robert B; Cohen, Bruce E

    2015-07-01

    Intra-articular calcaneus fractures are commonly sustained after high-energy trauma, and a variety of techniques exists for anatomic reduction and surgical fixation. Traditional approaches using an extended L-shaped lateral incision with lateral plating for open reduction and internal fixation have relatively high complication rates. Common complications include hematoma formation, skin edge necrosis, wound breakdown, and superficial or deep infection. As a result, less invasive techniques have been developed in recent years, including limited-incision sinus tarsi open reduction and internal fixation, percutaneous fixation, and arthroscopic-assisted fixation. These techniques are associated with lower complication rates and equivalent clinical and radiographic outcomes in certain fracture patterns and patient populations. PMID:26111874

  17. Studies on cathepsin B in human articular cartilage.

    PubMed Central

    Bayliss, M T; Ali, S Y

    1978-01-01

    The thiol proteinase cathepsin B (EC 3.4.22.1), previously called cathepsin B1, was assayed in human articular cartilage by its hydrolysis of the synthetic substrate alpha-N-benzoyl-DL-arginine 2-naphthylamide. The enzyme was activated by cysteine and EDTA and completely inhibited by iodoacetamide and HgCl2. It was also partially inhibited by whole human serum. Human osteoarthrotic cartilage had increased activity when compared with normal cartilage. Cathepsin B activity of normal cartilage was age-related, being high in juveniles and declining to low values in adult and elderly individuals. Cathepsin D and cathepsin B both exhibited a zonal variation through the cartilage depth; the surface cells appeared to contain more activity than those close to the subchondral bone. PMID:417724

  18. Radiofrequency (electrosurgical) ablation of articular cartilage: a study in sheep.

    PubMed

    Turner, A S; Tippett, J W; Powers, B E; Dewell, R D; Mallinckrodt, C H

    1998-09-01

    The objective of this study was to examine the effect of a bipolar ablation probe on experimentally roughened articular cartilage and compare it with the traditional mechanical shaving technique using the knee joint of sheep. Twenty-eight skeletally mature ewes were divided randomly into two groups: one group was treated with a rotating shaving device and another group was treated using the bipolar ablation probe (Bipolar Arthroscopic Probe; Electroscope, Inc, Boulder, CO). Animals were killed at 0, 6, 12, and 24 weeks, and histological sections of the experimental limbs were compared with sections of the opposite limb using a modified Mankin scale. The following variables were used to determine scores: surface (0-6), cells (0-4), hypocellularity (0-3), matrix staining (transitional zone [0-4], radiate zone [0-4], and focal empty lacunae or hypereosinophilic cells (0-3). Differences in scores for all response variables were calculated as treated limb minus sham limb. Response variables were formed: score >0 recoded as 1 (favorable response treated better than sham), score of 0 recoded as 2 (neutral response no differences), and score <0 recoded as 3 (unfavorable response treated worse than sham). Bipolar ablative probe-treated limbs had 14.29% favorable responses and 35.71% favorable or neutral responses, whereas shave-treated limbs had 0% favorable and only 7.14% favorable or neutral responses. For all variables, bipolar ablative probe-treated limbs had more favorable responses. The less severe histological change in the bipolar ablative probe-treated joints compared with the shave-treated joints suggests that bipolar ablation of articular cartilage may be a better treatment for chondromalacia than the usual shaving methods of debridement. Further, there were no pathological changes in the subchondral bone. PMID:9754476

  19. MRI rotating frame relaxation measurements for articular cartilage assessment

    PubMed Central

    Ellermann, Jutta; Ling, Wen; Nissi, Mikko J.; Arendt, Elizabeth; Carlson, Cathy S.; Garwood, Michael; Michaeli, Shalom; Mangia, Silvia

    2015-01-01

    In the present work we introduced two MRI rotating frame relaxation methods, namely adiabatic T1ρ and Relaxation Along a Fictitious Field (RAFF), along with an inversion-prepared Magnetization Transfer (MT) protocol for assessment of articular cartilage. Given the inherent sensitivity of rotating frame relaxation methods to slow molecular motions that are relevant in cartilage, we hypothesized that adiabatic T1ρ and RAFF would have higher sensitivity to articular cartilage degradation as compared to laboratory frame T2 and MT. To test this hypothesis, a proteoglycan depletion model was used. Relaxation time measurements were performed at 0 and 48 hours in ten bovine patellar specimens, 5 of which were treated with trypsin and 5 untreated controls were stored under identical conditions in isotonic saline for 48 hours. Relaxation times measured at 48 hours were longer than those measured at 0 hours in both groups. The changes in T2 and MT relaxation times after 48 hours were approximately 3 times larger in the trypsin treated specimens as compared to the untreated group, whereas increases of adiabatic T1ρ and RAFF were 4 to 5 fold larger. Overall, these findings demonstrate a higher sensitivity of adiabatic T1ρ and RAFF to the trypsin-induced changes in bovine patellar cartilage as compared to the commonly used T2 and MT. Since adiabatic T1ρ and RAFF are advantageous for human applications as compared to standard continuous-wave T1ρ methods, adiabatic T1ρ and RAFF are promising tools for assessing cartilage degradation in clinical settings. PMID:23993794

  20. Black Colouration of the Knee Articular Cartilage after Spontaneously Recurrent Haemarthrosis

    PubMed Central

    Ishimaru, Daichi; Ogawa, Hiroyasu; Akiyama, Haruhiko

    2016-01-01

    Mild discolouration of the articular cartilage is known to gradually occur during aging. However, pathological tissue pigmentation is occasionally induced under several specific conditions. In the present case, we performed total knee replacement in a patient with recurrent haemarthrosis. However, during the operation, we observed severe black colouration of the knee articular cartilage, due to the deposition of hemosiderin and lipofuscin. To our knowledge, this is the first report of severe cartilage pigmentation, due to hemosiderin and lipofuscin deposition in articular cartilage. PMID:27293933

  1. Derangement of the temporomandibular joint; a case study using Mechanical Diagnosis and Therapy.

    PubMed

    Krog, C; May, S

    2012-10-01

    Mechanical Diagnosis and Therapy (MDT) is widely used for spinal problems, and more recently the principles and mechanical syndromes have been applied to extremity musculoskeletal problems. One of the most common classifications is derangement syndrome, which describes a presentation in which repeated movements causes a decrease in symptoms and a restoration of restricted range of movement. The case study describes the application of repeated movements to a patient with a 7-year history of non-specific temporomandibular pain and reduced function, who had had lots of previous failed treatment. Examination using repeated movements resulted in a classification of derangement, and the patient rapidly responded in 4 treatment sessions, with an abolition of pain and full restoration of function, and remained improved after many years. The case study demonstrates the application of Mechanical Diagnosis and Therapy principles to a patient with a temporomandibular problem. PMID:22177711

  2. Application of Infrared Thermal Imaging in a Violinist with Temporomandibular Disorder.

    PubMed

    Clemente, M; Coimbra, D; Silva, A; Aguiar Branco, C; Pinho, J C

    2015-12-01

    Temporomandibular disorders (TMD) consist of a group of pathologies that affect the masticatory muscles, temporomandibular joints (TMJ), and/or related structures. String instrumentalists, like many orchestra musicians, can spend hours with head postures that may influence the biomechanical behavior of the TMJ and the muscles of the craniocervicomandibular complex (CCMC). The adoption of abnormal postures acquired during performance by musicians can lead to muscular hyperactivity of the head and cervical muscles, with the possible appearance of TMD. Medical infrared thermography is a non-invasive procedure that can monitor the changes in the superficial tissue related to blood circulation and may serve as a complement to the clinical examination. The objective of this study was to use infrared thermography to evaluate, in one subject, the cutaneous thermal changes adjacent to the CCMC that occur before, during, and after playing a string instrument. PMID:26614980

  3. Evaluation of body posture in individuals with internal temporomandibular joint derangement.

    PubMed

    Munhoz, Wagner Cesar; Marques, Amélia Pasqual; de Siqueira, José Tadeu Tesseroli

    2005-10-01

    Temporomandibular dysfunctions (TMD) comprise a great number of disruptions that may affect the temporomandibular joint (TMJ), the masticatory muscles, or both. TMJ internal derangement is a specific type of TMD, of which the etiology and physiopathology are broadly unknown, but have been suggested to be linked to head, neck, and body posture factors. This study aimed at verifying possible relationships between body posture and TMJ internal derangements (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Subjects' clinical evaluations included anamnesis, stomatognatic system evaluation, and plotting analysis on body posture photographs. No statistically significant differences were found between the groups. Results do not support the assertion that body posture plays a role in causing or enhancing TMD; however, these results should be cautiously considered because of the small number of subjects evaluated and the many posture variables submitted to statistical procedures that lead to high standard deviations. PMID:16353467

  4. Interference of Different Types of Mastication on Static Balance in Individuals without Temporomandibular Disorder

    PubMed Central

    Politti, Fabiano; El Hage, Yasmin; de Sousa, Dowglas Fernando Magalhães; Amorin, Cesar Ferreira; Gonzalez, Tabajara de Oliveira; Biasotto-Gonzalez, Daniela Aparecida

    2014-01-01

    Purpose: This study was to determine whether non-habitual (isotonic) bilateral and unilateral mastication with eyes open and eyes closed exerts an influence on static balance in individuals without temporomandibular disorder (TMD). Method: An observational, cross-sectional study was conducted involving 20 volunteers aged 20 to 40 years without temporomandibular disorder. Static balance was assessed with the individuals in a quiet standing position on a force plate performing different types of mastication under six separate conditions. Results: Significant differences (p < .05) were found in the area of oscillation during bilateral mastication (eyes open) and the right unilateral mastication, significant differences were only found for oscillation area with eyes open and mediolateral center of pressure with eyes closed (p < .05). Conclusions: The findings of the present study reveal that the stomatognathic system (bilateral and unilateral mastication) promote changes in some variables of static balance. PMID:25792903

  5. MRI Slice Segmentation and 3D Modelling of Temporomandibular Joint Measured by Microscopic Coil

    NASA Astrophysics Data System (ADS)

    Smirg, O.; Liberda, O.; Smekal, Z.; Sprlakova-Pukova, A.

    2012-01-01

    The paper focuses on the segmentation of magnetic resonance imaging (MRI) slices and 3D modelling of the temporomandibular joint disc in order to help physicians diagnose patients with dysfunction of the temporomandibular joint (TMJ). The TMJ is one of the most complex joints in the human body. The most common joint dysfunction is due to the disc. The disc is a soft tissue, which in principle cannot be diagnosed by the CT method. Therefore, a 3D model is made from the MRI slices, which can image soft tissues. For the segmentation of the disc in individual slices a new method is developed based on spatial distribution and anatomical TMJ structure with automatic thresholding. The thresholding is controlled by a genetic algorithm. The 3D model is realized using the marching cube method.

  6. Juvenile idiopathic arthritis and the temporomandibular joint: A comprehensive review.

    PubMed

    El Assar de la Fuente, S; Angenete, O; Jellestad, S; Tzaribachev, N; Koos, B; Rosendahl, K

    2016-05-01

    Juvenile idiopathic arthritis is the most common inflammatory rheumatic disease of childhood and represents a series of chronic inflammatory arthritides of unknown cause. Involvement of the temporomandibular joint has been reported in up to 87% of children with juvenile idiopathic arthritis when based on magnetic tomography imaging; it can be asymptomatic and may lead to severe long term complications. In this review a summary of the contemporary literature of imaging of the temporomandibular joint in children with juvenile idiopathic arthritis will be provided, including ultrasound which is a valuable method for guided joint injections, but does not necessarily allow detection of acute inflammation, cone beam computed tomography, which has emerged as a feasible and accurate low-dose alternative as compared to conventional computed tomography to detect destructive change, and magnetic resonance imaging which is considered the method of choice for assessing acute, inflammatory change, although the lack of normative standards remains a challenge in children. PMID:26924432

  7. In vitro application of optical transmission systems in erbium:YAG laser temporomandibular joint surgery

    NASA Astrophysics Data System (ADS)

    Nuebler-Moritz, Michael; Hering, Peter; Niederdellmann, Herbert; Deuerling, Christian; Dammer, Ralf

    1995-05-01

    The experimental setup of this study is focused on the changes in temporomandibular joint tissue after irradiation with an Erbium:YAG laser. Initially, the free-running beam from the laser was focused onto freshly excised porcine tissue samples, indicating an optimum average energy density and pulse duration for the purpose of temporomandibular joint surgery of about 15 - 60 J/cm2 and 120 microsecond(s) - 240 microsecond(s) , respectively. Consecutively, an attempt was made to couple the Erbium:YAG laser beam on the one hand to optical fibers made of infrared-transmitting glasses (fluoride- and chalcogenide-based), on the other hand to a recently developed sapphire and liquid core fiber, respectively. From the preliminary observations of this investigation it appears that both the liquid core and the sapphire fiber are the most promising candidates for delivery of Erbium-YAG laser radiation in arthroscopic surgery of the craniomandibular articulation.

  8. Giant cell tumor of bone involving the temporomandibular joint and temporal bone.

    PubMed

    Akyigit, Abdulvahap; Karlidag, Turgut; Sakallioglu, Öner; Polat, Cahit; Keles, Erol

    2014-07-01

    Giant cell tumor is a primary bone tumor that usually originates from the epiphysis of the long bones and is rarely seen in the cranial region. Most frequently, the tumor develops in the sphenoid and temporal bones in the middle cranial fossa. Giant cell tumor generally shows diversity with respect to benignity, local invasiveness, and histology. Although surgical excision with negative surgical margin may lead to cure, adjuvant radiotherapy is still debated. The patient was admitted with a humming in the left ear and hearing loss. After radiologic examination, a mass with temporomandibular joint involvement as well as temporal and sphenoid bone localization was detected. The patient was diagnosed with giant cell tumor after a biopsy specimen was taken from the mass extending to the middle ear and destroying the temporomandibular joint. The current study reviewed the patient's clinical features, diagnosis, and treatment in light of the literature. PMID:25006918

  9. Hypohidrotic ectodermal dysplasia with ankylosis of temporomandibular joint and cleft palate: A rare presentation

    PubMed Central

    Goyal, Manisha; Pradhan, Gaurav; Gupta, Sunita; Kapoor, Seema

    2015-01-01

    The ectodermal dysplasias are a heterogenous group of diseases, which have one or more anomalies of the hair, teeth, nails, and sweat glands. Hypohidrotic ectodermal dysplasia (HED) is the most common type and is usually transmitted as an X-linked recessive trait. It is characterized by classical triad of hypotrichosis, anhidrosis/hypohidrosis, and hypodontia/anodontia. Here, we describe an Indian boy affected with HED and rare features including ankylosis of temporomandibular joint and cleft palate. PMID:25684924

  10. Reconstruction of Temporomandibular Joint With a Fibula Free Flap: A Case Report With a Histological Study.

    PubMed

    Fariña, Rodrigo; Campos, Pía; Beytía, Javiera; Martínez, Benjamín

    2015-12-01

    Reconstruction of the temporomandibular joint (TMJ) for congenital or acquired deformities is a major challenge for maxillofacial surgeons. The alternatives for reconstructing the TMJ include free grafts (costochondral, iliac crest, clavicle, or metatarsus), free flaps (fibula), osteogenic distraction, and alloplastic grafts. The lack of biological knowledge of cartilaginous grafts and their reaction to the environment of the TMJ is largely responsible for the inability to predict growth. This report describes the use of a free flap for TMJ reconstruction. PMID:26342950

  11. Physiologic neuromuscular dental paradigm for the diagnosis and treatment of temporomandibular disorders.

    PubMed

    Raman, Prabu

    2014-08-01

    Shifting from traditional anatomical/mechanistic models, the physiologic neuromuscular dentistry (PNMD) paradigm acknowledges the primacy of physiology in shaping and controlling anatomy in a functioning human body. Occlusal disharmony from mandibular discrepancy to cranium leads to temporomandibular disorders (TMD), which is a disease of musculoskeletal imbalance in the postural chain exceeding the individual's physiologic adaptive capacity. To diagnose optimal craniomandibular alignment, PNMD is guided by real-time objective physiologic data such as electromyography (EMG). PMID:25174214

  12. Condylar resorption following temporomandibular joint arthroscopy in a patient with essential thrombocythemia.

    PubMed

    Balasubramaniam, Ramesh; Van Sickels, Joseph; Falace, Donald

    2006-05-01

    Condylar resorption of the temporomandibular joint (TMJ) is a poorly understood phenomenon that is the subject of much controversy. The following case report depicts a unique case of condylar resorption (CR) in a 49-year-old female patient with essential thrombocythemia who underwent arthrocentesis of the TMJ. The exact cause of the CR is unclear but it is speculated that it was likely due to hemorrhagic and thrombotic complications during surgery secondary to an elevated platelet count. PMID:16632268

  13. Surgical treatment of temporomandibular disorder in a 24-year-old male patient with ganglion cyst.

    PubMed

    Zheng, Zhi Wei; Shao, Xia; Yang, Chi; Fang, Yi Ming

    2015-03-01

    Ganglion cysts are common pseudocystic masses, whereas those arising from the temporomandibular joint (TMJ) are rare entities. We report a case of ganglion cyst of the right TMJ with symptomatic bilateral TMJ internal derangement in a 24-year-old man. Disk repositioning using bone anchors and excision of the ganglion cyst were performed. A unique characteristic of inflammatory infiltrates was revealed in the specimen, and the relationship between these 2 distinct entities and probable pathogenesis of infectious involvement are discussed. PMID:25643336

  14. Modified T-Plate Interpositional Arthroplasty for Temporomandibular Joint Ankylosis: A New and Versatile Option

    PubMed Central

    Ahmad, Imran; Bariar, Lalit Mohan

    2015-01-01

    Background This study has been conducted with the aim of evaluating modified T-plate interpositional arthroplasty. Methods A prospective comparative study in patients admitted with temporomandibular joint ankylosis. Ankylotic temporomandibular joint arthroplasty included condylectomy gap arthroplasty in 7, temporalis muscle flap interpositional arthroplasty in 8, and modified T-plate interpositional arthroplasty in 13 cases. The patients were followed for three years. Collected data were tabulated and subjected to Fisher's exact test, chi-square test and probability estimation. Results A significant increase in interincisal distance of 32 mm was seen in 12 (92.31%) patients in the T-plate interposition group, in 2 (25%) cases of the temporalis muscle flap interposition group, and in 1 case (14.28%) of the condylectomy group at 12, 24, and 36 months. Re-ankylosis was observed in 1 case (9.69%) of the T-plate interposition group, while as it was observed in 4 (50%) cases in the temporalis muscle flap interposition group and 4 (57.14%) cases in the condylectomy group, and these differences were statistically significant. Conclusions Our clinical experience with the use of the T-plate over the past 5 years has been encouraging, and our physiotherapy technique is quite simple. Even illiterate parents can assess it easily. Hence, we recommend this easy technique that does not damage the temporalis muscle for the management of temporomandibular joint ankylosis. PMID:26618118

  15. Association between estrogen levels and temporomandibular disorders: a systematic literature review

    PubMed Central

    Berger, Marcin; Szalewski, Leszek; Bakalczuk, Magdalena; Bakalczuk, Szymon; Szkutnik, Jacek

    2015-01-01

    Introduction To evaluate whether the hypothesis that estrogen levels are associated with temporomandibular disorders (TMD) in humans can be confirmed or contradicted by available literature. Material and methods A systematic review based on the content of PubMed, Scopus, and Cochrane Library databases was performed. Studies were identified using a combination of key words ‘temporomandibular disorder’ and ‘estrogen’. Nine studies were included into our review. Results The relationship between estrogen levels and TMD was found in seven out of nine reviewed papers. Results from two papers suggest that a high estrogen level is associated with an increased prevalence of TMD. Five additional papers found a relationship between a low estrogen level and an increase in TMD pain. In considering the value of evidence and inconsistencies of results in the reviewed publications, we state that there is weak evidence to support the hypothesis that estrogen levels are associated with TMD. Conclusions Results of reviewed studies were divergent and sometimes contradictory. One possible explanation is that estrogen influences TMD pain processing differently than temporomandibular joints (TMJ) structures, as shown in many animal studies. Estrogen may influence TMD pain processing differently than TMJ structures. We suggest consideration of the dual action of estrogen when planning future studies on its association with TMD. PMID:26848299

  16. Parasympathetic Reactivity in Fibromyalgia and Temporomandibular Disorder: Associations with Sleep Problems, Symptom Severity, and Functional Impairment

    PubMed Central

    Eisenlohr-Moul, Tory A.; Crofford, Leslie J.; Howard, Thomas; Yepes, Juan F.; Carlson, Charles R.; de Leeuw, Reny

    2015-01-01

    Despite evidence of autonomic disturbances in chronic multi-symptom illnesses such as temporomandibular joint disorder (TMD) and fibromyalgia (FM), additional work is needed to characterize the role of parasympathetic reactivity in these disorders. Given the high levels of comorbidity with psychiatric disorders characterized by stronger parasympathetic reductions than controls in safe contexts (leading to higher arousal), it was hypothesized that individuals with TMD and FM would respond similarly. In this preliminary investigation, 43 women with TMD (n = 17), TMD + FM (n = 11), or neither (controls; n = 15) completed a baseline assessment of respiratory sinus arrhythmia (RSA; a measure of parasympathetic activity) followed by ongoing parasympathetic assessment during a questionnaire period. As predicted, patients showed greater parasympathetic decline in response to the questionnaire period, suggesting an autonomic stance that supports defensive rather than engagement behaviors. Individual differences in parasympathetic reduction during the questionnaire period were related to a variety of physical and psychosocial variables. Although this study has a number of key limitations, including a convenience sampling approach and the small group sizes, if replicated in larger samples, the findings would have important implications for the treatment of patients with these disorders. Perspective Compared to controls, individuals with temporomandibular disorders or temporomandibular disorder and fibromyalgia demonstrated greater parasympathetic reduction during psychosocial assessment, and individual differences in parasympathetic reduction predicted negative patient outcomes. Such parasympathetic reductions may betray a tendency to readily perceive danger in safe environments. PMID:25542636

  17. The Role of Transcutaneous Electrical Nerve Stimulation in the Management of Temporomandibular Joint Disorder.

    PubMed

    Awan, Kamran Habib; Patil, Shankargouda

    2015-12-01

    Temporomandibular joint disorders (TMD) constitutes of a group of diseases that functionally affect the masticatory system, including the muscles of mastication and temporomandibular joint (TMJ). A number of etiologies with specific treatment have been identified, including the transcutaneous electrical nerve stimulation (TENS). The current paper presents a literature review on the use of TENS in the management of TMD patients. Temporomandibular joint disorder is very common disorder with approximately 75% of people showing some signs, while more than quarter (33%) having at least one symptom. An attempt to treat the pain should be made whenever possible. However, in cases with no defined etiology, starting with less intrusive and reversible techniques is prescribed. Transcutaneous electrical nerve stimulation is one such treatment modality, i.e. useful in the management of TMD. It comprises of controlled exposure of electrical current to the surface of skin, causing hyperactive muscles relaxation and decrease pain. Although the value of TENS to manage chronic pain in TMD patients is still controversial, its role in utilization for masticatory muscle pain is significant. However, an accurate diagnosis is essential to minimize its insufficient use. Well-controlled randomized trials are needed to determine the utilization of TENS in the management of TMD patients. PMID:27018034

  18. The presence of altered craniocervical posture and mobility in smartphone-addicted teenagers with temporomandibular disorders.

    PubMed

    Kee, In-Kyung; Byun, Jin-Seok; Jung, Jae-Kwang; Choi, Jae-Kap

    2016-01-01

    [Purpose] Smartphones are widely used by teenagers and adults for various purposes. As teenagers use smartphones more actively than adults, they are more prone to be addicted to smartphones. Furthermore, excessive usage of smartphones can lead to various psychosocial and physical symptoms. [Subjects and Methods] One hundred teenage subjects were recruited and divided into normal and addiction groups, based on the criteria of the smartphone addiction scale-short version questionnaire. Craniocervical posture and mobility were examined by lateral cephalometric analysis and a cervical range of motion instrument. [Results] Cephalometric analysis showed no significant difference in the craniocervical angles of the resting positions of the two groups. However, measurement using an inclinometer revealed a significantly flexed cervical posture while using smartphones and decreased cervical range of motion in the smartphone-addicted teenagers. The clinical profile of temporomandibular disorders revealed that muscular problems were more frequently presented in the smartphone-addicted teenagers. [Conclusion] These findings suggest that smartphone addiction has a negative influence on craniocervical posture and mobility. Further, it can be postulated that smartphone addiction among teenagers may have contributed to the occurrence of myogenous temporomandibular disorders. In conclusion, smartphone-addicted teenagers may be more frequently subjected to muscular disturbance in the craniocervical area, which probably affects the pathologic process of temporomandibular disorders in teenagers. PMID:27065516

  19. The presence of altered craniocervical posture and mobility in smartphone-addicted teenagers with temporomandibular disorders

    PubMed Central

    Kee, In-Kyung; Byun, Jin-Seok; Jung, Jae-Kwang; Choi, Jae-Kap

    2016-01-01

    [Purpose] Smartphones are widely used by teenagers and adults for various purposes. As teenagers use smartphones more actively than adults, they are more prone to be addicted to smartphones. Furthermore, excessive usage of smartphones can lead to various psychosocial and physical symptoms. [Subjects and Methods] One hundred teenage subjects were recruited and divided into normal and addiction groups, based on the criteria of the smartphone addiction scale-short version questionnaire. Craniocervical posture and mobility were examined by lateral cephalometric analysis and a cervical range of motion instrument. [Results] Cephalometric analysis showed no significant difference in the craniocervical angles of the resting positions of the two groups. However, measurement using an inclinometer revealed a significantly flexed cervical posture while using smartphones and decreased cervical range of motion in the smartphone-addicted teenagers. The clinical profile of temporomandibular disorders revealed that muscular problems were more frequently presented in the smartphone-addicted teenagers. [Conclusion] These findings suggest that smartphone addiction has a negative influence on craniocervical posture and mobility. Further, it can be postulated that smartphone addiction among teenagers may have contributed to the occurrence of myogenous temporomandibular disorders. In conclusion, smartphone-addicted teenagers may be more frequently subjected to muscular disturbance in the craniocervical area, which probably affects the pathologic process of temporomandibular disorders in teenagers. PMID:27065516

  20. Physical therapy and anesthetic blockage for treating temporomandibular disorders: A clinical trial

    PubMed Central

    Nascimento, Mirella M.; Porto, Gabriela G.; Ferdinanda, Greiciane; Nogueira, Cyntia M.; Raimundo, Ronaldo C.

    2013-01-01

    Purpose: the aim of this study was to evaluate the use of physical therapy and anesthetic blockage of the auriculotemporal nerve as a treatment for temporomandibular joint disorders. Methods: the sample comprised of twenty patients with a diagnosis of disc displacement with/ without reduction and arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD Axis I Group IIa, IIb and IIIa). Ten patients (group 1) underwent a cycle of eight anesthetic blockages of the auriculotemporal nerve with injections (1 per week) of 1 ml of bupivacaine 0.5% without vasoconstrictor for 8 weeks. The other 10 patients (group 2) received anesthetic blockage and physical therapy (massage and muscular stretching exercises). After the end of treatment all patients were evaluated at baseline, 1st week, 4th week and 2 months. The t-Student and F (ANOVA) tests were used for statistical analysis, with a significance rate of 5%. Results: there was a significant difference when both groups were compared according to VAS score (p=0.027). There was no significant difference for the other variables: MMO and jaw protrusion. Conclusion: the anesthetic blockage and physical therapy, when used together, are effective in the reduction of pain in patients with TMD. Key words:Temporomandibular joint disorders, physical therapy, physiotherapy and nerve block, local anesthetic, bupivacaine. PMID:23229236

  1. Pathogenesis and Prevention of Posttraumatic Osteoarthritis After Intra-articular Fracture

    PubMed Central

    Schenker, Mara L.; Mauck, Robert L.; Ahn, Jaimo; Mehta, Samir

    2015-01-01

    Posttraumatic osteoarthritis (PTOA) occurs after traumatic injury to the joint. It is most common following injuries that disrupt the articular surface or lead to joint instability. The reported risk of PTOA following significant joint trauma is as high as 75%; articular fractures can increase the risk more than 20-fold. Despite recent advances in surgical management, the incidence of PTOA following intra-articular fractures has remained relatively unchanged over the last few decades. Pathogenesis of PTOA after intra-articular fracture is likely multifactorial and may be associated with acute cartilage injury as well as chronic joint overload secondary to instability, incongruity, and malalignment. Additional studies are needed to better elucidate how these factors contribute to the development of PTOA and to develop advanced treatment algorithms that consist of both acute biologic interventions targeted to decrease inflammation and cellular death in response to injury and improved surgical methods to restore stability, congruity, and alignment. PMID:24382876

  2. [Intra-articular fracture of the distal radius: results following osteosynthesis with a support plate].

    PubMed

    Ferguson, G A; Leutenegger, A; Mark, G; Breiter, H; Rüedi, T

    1989-01-01

    The treatment of comminuted intra-articular fractures of the distal radius often requires an operative fixation. Beside the recently recommended external fixator, the support plate fixation offers a helpful alternative to treatment. Between 1980 and 1986, 30 wrists in 29 patients with intra-articular fractures of the distal radius were stabilized with a buttress plate an the Kantonsspital Chur, Switzerland. The mean follow-up-time was 15 months. These follow-ups showed that the buttress plate in treatment of complicated intra-articular fractures allows a satisfactory reduction and stabilization with restoration of the articular congruity and the possibility for early active assisted motion. Buttress plate fixation still remains a demanding technique, which in complicated cases, should be reserved for the experienced surgeon. PMID:2500786

  3. Exercise increases osteophyte formation and diminishes fibrillation following chemically induced articular cartilage injury.

    PubMed Central

    Williams, J M; Brandt, K D

    1984-01-01

    The present study shows that a treadmill exercise regimen imposed on guinea-pigs whose articular cartilage has been damaged by intra-articular injection of IA reduces chondrocyte depletion, results in an increase in pericellular Safranin-O staining around surviving chondrocytes, and prevents fibrillation of the articular surface. The data suggest that exercise protected, or facilitated recovery of, chondrocytes subjected to chemical injury, and that the surviving cells then synthesised a matrix which was sufficiently normal to withstand impulsive joint loading. On the other hand, the exercise regimen accelerated osteophyte formation, and led to formation of osteophytes in sites at which they did not develop in animals which received intra-articular IA but which were not exercised. Images Fig. 1 (cont.) Fig. 1 Fig. 2 Fig. 3 PMID:6526713

  4. 'Costen's syndrome'--correlation or coincidence: a review of 45 patients with temporomandibular joint dysfunction, otalgia and other aural symptoms.

    PubMed

    Brookes, G B; Maw, A R; Coleman, M J

    1980-02-01

    Forty-five patients with temporomandibular joint dysfunction, and otalgia together with other aural symptoms (deafness, tinnitus, pressure/blockage and vertigo) were evaluated clinically and audiometrically. The theoretical mechanisms by which aural symptoms may be produced as a result of temporomandibular joint dysfunction are outlined and discussed in the light of the patients under review. The wide diversity in the incidence of additional aural symptoms apart from otalgia reported in the literature is noted, together with the general lack of full objective audiometric assessment. In 37 patients the aural symptoms were directly attributable to other coincidental otolaryngological pathology. Details of the remaining 8 cases are presented. The other aural symptoms of 4 of these patients were also probably accounted for by other coincidental otalaryngological pathology. It may be significant that 2 of the other patients were suffering from concurrent psychiatric disorders. Thus in this series at least 9% of the patients were considered to have other aural symptoms coincidental to temporomandibular joint dysfunction. This is compatible with the relatively common occurrence of both temporomandibular joint dysfunction and aural symptoms in the general population. This study leads us to believe that there is no direct aetiological basis to link temporomandibular joint dysfunction and other aural symptoms apart from otalgia. PMID:7363490

  5. Effects of immobilization on articular cartilage: Autohistoradiographic findings with S35

    NASA Technical Reports Server (NTRS)

    Digiovanni, C.; Desantis, E.

    1980-01-01

    The effect of immobilization on the articular cartilage of rabbits was studied by light microscope. The knee joint of each rabbit was immobilized in a plaster in a position midway between flexion and extension for a 10 to 120 days period. Degenerative changes in the articular cartilage of increasing severity were observed. The fixation of the labeled SO4 by cartilage cells was decreased in advanced immobilization.

  6. Patellar Articular Overlap on MRI Is a Simple Alternative to Conventional Measurements of Patellar Height

    PubMed Central

    Munch, Jacqueline L.; Sullivan, Jaron P.; Nguyen, Joseph T.; Mintz, Douglas; Green, Daniel W.; Shubin Stein, Beth E.; Strickland, Sabrina

    2016-01-01

    Background: Patella alta describes an abnormally high-riding patella in relationship to the femur and has been shown to correlate with patellofemoral pain, instability, chondromalacia, and arthrosis. Conventional measurements of patella alta involve multiple measurements and are often not defined on cross-sectional imaging as related to radiographs. Hypothesis: Patellar articular overlap on sagittal magnetic resonance imaging (MRI) will correlate well with conventional measurements of patella alta as measured by a standardized technique defined by our group. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: MRIs of 239 knees were reviewed by 3 attending surgeons with practices focusing on patellofemoral disease, as well as 2 sports medicine fellows and 1 musculoskeletal radiologist. Measurements included articular overlap, percentage of articular coverage, Caton-Deschamps index, Blackburne-Peel index, and modified Insall-Salvati index. Results: Interrater reliability was high for Caton-Deschamps, Blackburne-Peel, and modified Insall-Salvati indices (intraclass correlation coefficient [ICC], 0.877, 0.828, and 0.787, respectively). Articular overlap and percentage articular coverage correlated well with each other (ICC, 0.961; P < .001) and with the Caton-Deschamps (overlap r = –0.271, P < .001; coverage r = –0.131, P = .037) and Blackburne-Peel (overlap r = 0.343, P < .001; coverage r = –0.238, P < .001) indices. Articular overlap and percentage coverage failed to correlate with the modified Insall-Salvati index (overlap r = –0.117, P = .091; coverage r = 0.007, P = .918). Conclusion: Patellar articular overlap and percentage of patellar articular coverage show promise as a simpler alternative to conventional, ratio-based measurements of patellar height. Future studies are needed to evaluate the range of normal and the relationship to our traditionally used measurements. PMID:27482530

  7. Diagnosis and management of an intra-articular foreign body in the foot.

    PubMed

    Mulhall, K J; Sheehan, E; Kearns, S; O'Connor, P; Stephens, M M

    2002-10-01

    We describe a case of a small intra-articular foreign body in the foot presenting 48 hours following injury, which at operation showed early evidence of septic arthritis. It is essential to accurately localise periarticular foreign bodies in the foot and proceed to arthrotomy and debridement in all cases where there is radiological or clinical evidence to suggest intra-articular retention of a foreign body. PMID:12470001

  8. Condylar Osteochondroma Treated with Total Condylectomy and Preservation of the Articular Disc: A Case Report

    PubMed Central

    Dominguez, Manuel Fernandez; Castillo, Jose Luis Del; Guerra, Mario Muñoz; Sanchez, Ruth Sanchez; La Plata, Maria Mancha De

    2014-01-01

    Osteochondroma is frequently found in the general skeleton but is rare in the condylar region of the mandible. We report a case of an osteochondroma of large size and rapid growth in the mandibular condyle, which was treated with total condylectomy and condylar replacement with a costochondral graft and preservation of the articular disc. In cases with a healthy and well-positioned articular disc, it may be preserved with no need of disc repositioning. PMID:26000086

  9. The classic: Chapter XVIII. Operative treatment in chronic articular ostitis. 1884.

    PubMed

    Gibney, Virgil P

    2010-02-01

    This Classic article is a reprint of the original work by Virgil P. Gibney, Chapter XVIII. Operative Treatment in Chronic Articular Ostitis. An accompanying biographical sketch of Virgil P. Gibney, MD, is available at DOI 10.1007/s11999-009-1166-2 . The Classic Article is (c)1884 and is abridged from Gibney VP. Operative treatment in chronic articular ostitis. In: The Hip and Its Diseases. New York, NY, London, UK: Bermingham & Co; 1884:388-402. PMID:19936860

  10. The effect of ice on intra-articular temperature in the knee of the dog.

    PubMed

    Bocobo, C; Fast, A; Kingery, W; Kaplan, M

    1991-08-01

    The effect of surface cooling on intra-articular temperature was examined in dogs' knees. Four treatment protocols were examined: local ice compress application for 5, 15 and 30 min and local ice bath immersion for 15 min. Intra-articular temperatures were recorded using a needle microprobe inserted into the knee and continuous temperature recordings were made before, during and after the treatment. Rectal temperatures were also simultaneously recorded. Intra-articular temperatures rapidly dropped during icing. Five minutes of ice compress application resulted in a 2.2 +/- 1.2 degrees C intra-articular temperature drop with no change in rectal temperature. After 15 min of ice compress application, the joint temperature fell 4.1 +/- 1.3 degrees C with no change in rectal temperature. Thirty minutes of local ice compress application dropped the knee temperature 6.5 +/- 4.0 degrees C with a slight 0.5 +/- 0.3 degrees C drop in rectal temperature. Fifteen minutes of ice water immersion caused a much greater drop in intra-articular temperatures (20.2 +/- 8.4 degrees C) than could be achieved with ice compress. Rectal temperatures fell slightly during immersion (1.6 +/- 0.3 degrees C). After the removal of any type of cryotherapy, intra-articular temperatures continued to drop for several minutes and then a prolonged rewarming period commenced. The mean time required to return to baseline intra-articular temperature varied from 22-60 min, depending on the type and duration of cryotherapy. We conclude that brief periods of topical cold application to a dog's knee can induce significant and long lasting depression of intra-articular temperatures and that this is a local effect not dependent on core temperature cooling. PMID:1878175

  11. Nanoengineered particles for enhanced intra-articular retention and delivery of proteins.

    PubMed

    Singh, Ankur; Agarwal, Rachit; Diaz-Ruiz, Carlos A; Willett, Nick J; Wang, Peiyi; Lee, L Andrew; Wang, Qian; Guldberg, Robert E; García, Andrés J

    2014-10-01

    Localized intra-articular delivery of anti-inflammatory proteins can reduce inflammation in osteoarthritis but poses a challenge because of raid clearance within few hours of injection. A new class of polymer is developed that forms self-assembled nanoparticles ranging from 300 to 900 nm and demonstrates particle size dependent prolonged retention in intra-articular joint spaces compared to bolus protein over a period of 14 d. PMID:24687997

  12. Human Adipose-Derived Mesenchymal Progenitor Cells Engraft into Rabbit Articular Cartilage

    PubMed Central

    Wang, Wen; He, Na; Feng, Chenchen; Liu, Victor; Zhang, Luyi; Wang, Fei; He, Jiaping; Zhu, Tengfang; Wang, Shuyang; Qiao, Weiwei; Li, Suke; Zhou, Guangdong; Zhang, Li; Dai, Chengxiang; Cao, Wei

    2015-01-01

    Mesenchymal stem cells (MSCs) are known to have the potential for articular cartilage regeneration, and are suggested for the treatment of osteoarthritis (OA). Here, we investigated whether intra-articular injection of xenogeneic human adipose-derived mesenchymal progenitor cells (haMPCs) promoted articular cartilage repair in rabbit OA model and engrafted into rabbit articular cartilage. The haMPCs were cultured in vitro, and phenotypes and differentiation characteristics of cells were evaluated. OA was induced surgically by anterior cruciate ligament transection (ACLT) and medical meniscectomy of knee joints. At six weeks following surgery, hyaluronic acid (HA) or haMPCs was injected into the knee joints, the contralateral knee served as normal control. All animals were sacrificed at the 16th week post-surgery. Assessments were carried out by macroscopic examination, hematoxylin/eosin (HE) and Safranin-O/Fast green stainings and immunohistochemistry. The data showed that haMPC treatment promoted cartilage repair. Signals of human mitochondrial can be directly detected in haMPC treated cartilage. The haMPCs expressed human leukocyte antigen I (HLA-I) but not HLA-II-DR in vivo. These results suggest that intra-articular injection of haMPCs promotes regeneration of articular cartilage in rabbit OA model, and support the notion that MPCs are transplantable between HLA-incompatible individuals. PMID:26023716

  13. Characterization of Chondrocyte Scaffold Carriers for Cell-based Gene Therapy in Articular Cartilage Repair

    PubMed Central

    Shui, Wei; Yin, Liangjun; Luo, Jeffrey; Li, Ruidong; Zhang, Wenwen; Zhang, Jiye; Huang, Wei; Hu, Ning; Liang, Xi; Deng, Zhong-Liang; Hu, Zhenming; Shi, Lewis; Luu, Hue H.; Haydon, Rex C.; He, Tong-Chuan; Ho, Sherwin

    2014-01-01

    Articular cartilage lesions in the knee are common injuries. Chondrocyte transplant represents a promising therapeutic modality for articular cartilage injuries. Here, we characterize the viability and transgene expression of articular chondrocytes cultured in 3-D scaffolds provided by four types of carriers. Articular chondrocytes are isolated from rabbit knees and cultured in four types of scaffolds: type I collagen sponge, fibrin glue, hyaluronan, and Open-cell PolyLactic Acid (OPLA). The cultured cells are transduced with adenovirus expressing green fluorescence protein (AdGFP) and luciferase (AdGL3-Luc). The viability and gene expression in the chondrocytes are determined with fluorescence microscopy and luciferase assay. Cartilage matrix production is assessed by Alcian blue staining. Rabbit articular chondrocytes are effectively infected by AdGFP and exhibited sustained GFP expression. All tested scaffolds support the survival and gene expression of the infected chondrocytes. However, the highest transgene expression is observed in the OPLA carrier. At four weeks, Alcian blue-positive matrix materials are readily detected in OPLA cultures. Thus, our results indicate that, while all tested carriers can support the survival of chondrocytes, OPLA supports the highest transgene expression and is the most conductive scaffold for matrix production, suggesting that OPLA may be a suitable scaffold for cell-based gene therapy of articular cartilage repairs. PMID:23629940

  14. Mesenchymal stem cells can survive on the extracellular matrix-derived decellularized bovine articular cartilage scaffold

    PubMed Central

    Tavassoli, Amin; Matin, Maryam Moghaddam; Niaki, Malihe Akbarzade; Mahdavi-Shahri, Nasser; Shahabipour, Fahimeh

    2015-01-01

    Objective (s): The scarcity of articular cartilage defect to repair due to absence of blood vessels and tissue engineering is one of the promising approaches for cartilage regeneration. The objective of this study was to prepare an extracellular matrix derived decellularized bovine articular cartilage scaffold and investigate its interactions with seeded rat bone marrow mesenchymal stem cells (BM-MSCs). Materials and Methods: Bovine articular cartilage that was cut into pieces with 2 mm thickness, were decellularized by combination of physical and chemical methods including snap freeze-thaw and treatment with sodium dodecyl sulfate (SDS). The scaffolds were then seeded with 1, 1’-dioctadecyl-3, 3, 3’, 3’-tetramethylindocarbocyanine perchlorate (DiI) labeled BM-MSCs and cultured for up to two weeks. Results: Histological studies of decellularized bovine articular cartilage showed that using 5 cycles of snap freeze-thaw in liquid nitrogen and treatment with 2.5% SDS for 4 hr led to the best decellularization, while preserving the articular cartilage structure. Adherence and penetration of seeded BM-MSCs on to the scaffold were displayed by histological and florescence examinations and also confirmed by electron microscopy. Conclusion: ECM-derived decellularized articular cartilage scaffold provides a suitable environment to support adhesion and maintenance of cultured BM-MSCs and could be applied to investigate cellular behaviors in this system and may also be useful for studies of cartilage tissue engineering. PMID:26877852

  15. Techniques and Applications of in vivo Diffusion Imaging of Articular Cartilage

    PubMed Central

    Raya, José G.

    2014-01-01

    Early in the process of osteoarthritis (OA) the composition (water, proteoglycan [PG], and collagen) and structure of articular cartilage is altered leading to changes in its mechanical properties. A technique that can assess the composition and structure of the cartilage in vivo can provide insight in the mechanical integrity of articular cartilage and become a powerful tool for the early diagnosis of OA. Diffusion tensor imaging (DTI) has been proposed as a biomarker for cartilage composition and structure. DTI is sensitive to the PG content through the mean diffusivity (MD) and to the collagen architecture through the fractional anisotropy (FA). However, the acquisition of DTI of articular cartilage in vivo is challenging due to the short T2 of articular cartilage (~40 ms at 3 T) and the high resolution needed (0.5–0.7 mm in plane) to depict the cartilage anatomy. We describe the pulse sequences used for in vivo DTI of articular cartilage and discus general strategies for protocol optimization. We provide a comprehensive review of measurements of DTI of articular cartilage from ex vivo validation experiments to its recent clinical applications. PMID:25865215

  16. Comparison of friction and wear of articular cartilage on different length scales.

    PubMed

    Kienle, Sandra; Boettcher, Kathrin; Wiegleb, Lorenz; Urban, Joanna; Burgkart, Rainer; Lieleg, Oliver; Hugel, Thorsten

    2015-09-18

    The exceptional tribological properties of articular cartilage are still far from being fully understood. Articular cartilage is able to withstand high loads and provide exceptionally low friction. Although the regeneration abilities of the tissue are very limited, it can last for many decades. These biomechanical properties are realized by an interplay of different lubrication and wear protection mechanisms. The deterioration of cartilage due to aging or injury leads to the development of osteoarthritis. A current treatment strategy focuses on supplementing the intra-articular fluid with a saline solution containing hyaluronic acid. In the work presented here, we investigated how changing the lubricating fluid affects friction and wear of articular cartilage, focusing on the boundary and mixed lubrication as well as interstitial fluid pressurization mechanisms. Different length and time scales were probed by atomic force microscopy, tribology and profilometry. We compared aqueous solutions with different NaCl concentrations to a viscosupplement containing hyaluronic acid (HA). In particular, we found that the presence of ions changes the frictional behavior and the wear resistance. In contrast, hyaluronic acid showed no significant impact on the friction coefficient, but considerably reduced wear. This study confirms the previous notion that friction and wear are not necessarily correlated in articular cartilage tribology and that the main role of HA might be to provide wear protection for the articular surface. PMID:26294356

  17. Elastin fibers display a versatile microfibril network in articular cartilage depending on the mechanical microenvironments.

    PubMed

    He, Bo; Wu, Jian Ping; Chen, Hong Hui; Kirk, Thomas Brett; Xu, Jiake

    2013-09-01

    Elastin fibers are major extracellular matrix macromolecules that are critical in maintaining the elasticity and resilience of tissues such as blood vessels, lungs and skins. However, the role of elastin in articular cartilage is poorly defined. The present study investigated the organization of elastin fiber in articular cartilage, its relationship to collagen fibers and the architecture of elastin fibers from different mechanical environments by using a kangaroo model. Five morphologies of elastin fibers were identified: Straight fiber, straight fiber with branches, branching fibers directly associated with chondrocyte, wave fiber and fine elastin. The architecture of the elastin network varied significantly with cartilage depth. In the most superficial layer of tibial plateau articular cartilage, dense elastin fibers formed a distinctive cobweb-like meshwork which was parallel to the cartilage surface. In the superficial zone, elastin fibers were well organized in a preferred orientation which was parallel to collagen fibers. In the deep zone, no detectable elastin fiber was found. Moreover, differences in the organization of elastin fibers were also observed between articular cartilage from the tibial plateau, femoral condyle, and distal humerus. This study unravels the detailed microarchitecture of elastin fibers which display a well-organized three-dimensional versatile network in articular cartilage. Our findings imply that elastin fibers may play a crucial role in maintaining the integrity, elasticity, and the mechanical properties of articular cartilage, and that the local mechanical environment affects the architectural development of elastin fibers. PMID:23649803

  18. Role of uppermost superficial surface layer of articular cartilage in the lubrication mechanism of joints

    PubMed Central

    KUMAR, P.; OKA, M.; TOGUCHIDA, J.; KOBAYASHI, M.; UCHIDA, E.; NAKAMURA, T.; TANAKA, K.

    2001-01-01

    The uppermost superficial surface layer of articular cartilage, the ‘lamina splendens’ which provides a very low friction lubrication surface in articular joints, was investigated using atomic force microscopy (AFM). Complementary specimens were also observed under SEM at −10 °C without dehydration or sputter ion coating. Fresh adult pig osteochondral specimens were prepared from the patellas of pig knee joints and digested with the enzymes, hyaluronidase, chondroitinase ABC and alkaline protease. Friction coefficients between a pyrex glass plate and the osteochondral specimens digested by enzymes as well as natural (undigested) specimens were measured, using a thrust collar apparatus. Normal saline, hyaluronic acid (HA) and a mixture of albumin, globulin, HA (AGH) were used as lubrication media. The surface irregularities usually observed in SEM studies were not apparent under AFM. The articular cartilage surface was resistant to hyaluronidase and also to chondroitinase ABC, but a fibrous structure was exhibited in alkaline protease enzymes-digested specimens. AFM analysis revealed that the thickness of the uppermost superficial surface layer of articular cartilage was between 800 nm and 2 μm in adult pig articular cartilage. The coefficient of friction (c.f.) was significantly higher in chondroitinase ABC and alkaline protease enzymes digested specimens. Generally, in normal saline lubrication medium, c.f. was higher in comparison to HA and AGH lubrication media. The role of the uppermost, superficial surface layer of articular cartilage in the lubrication mechanism of joints is discussed. PMID:11554503

  19. Role of uppermost superficial surface layer of articular cartilage in the lubrication mechanism of joints.

    PubMed

    Kumar, P; Oka, M; Toguchida, J; Kobayashi, M; Uchida, E; Nakamura, T; Tanaka, K

    2001-09-01

    The uppermost superficial surface layer of articular cartilage, the 'lamina splendens' which provides a very low friction lubrication surface in articular joints, was investigated using atomic force microscopy (AFM). Complementary specimens were also observed under SEM at -10 degrees C without dehydration or sputter ion coating. Fresh adult pig osteochondral specimens were prepared from the patellas of pig knee joints and digested with the enzymes, hyaluronidase, chondroitinase ABC and alkaline protease. Friction coefficients between a pyrex glass plate and the osteochondral specimens digested by enzymes as well as natural (undigested) specimens were measured, using a thrust collar apparatus. Normal saline, hyaluronic acid (HA) and a mixture of albumin, globulin, HA (AGH) were used as lubrication media. The surface irregularities usually observed in SEM studies were not apparent under AFM. The articular cartilage surface was resistant to hyaluronidase and also to chondroitinase ABC, but a fibrous structure was exhibited in alkaline protease enzymes-digested specimens. AFM analysis revealed that the thickness of the uppermost superficial surface layer of articular cartilage was between 800 nm and 2 microm in adult pig articular cartilage. The coefficient of friction (c.f.) was significantly higher in chondroitinase ABC and alkaline protease enzymes digested specimens. Generally, in normal saline lubrication medium, c.f. was higher in comparison to HA and AGH lubrication media. The role of the uppermost, superficial surface layer of articular cartilage in the lubrication mechanism of joints is discussed. PMID:11554503

  20. Techniques and applications of in vivo diffusion imaging of articular cartilage.

    PubMed

    Raya, José G

    2015-06-01

    Early in the process of osteoarthritis (OA) the composition (water, proteoglycan [PG], and collagen) and structure of articular cartilage is altered leading to changes in its mechanical properties. A technique that can assess the composition and structure of the cartilage in vivo can provide insight in the mechanical integrity of articular cartilage and become a powerful tool for the early diagnosis of OA. Diffusion tensor imaging (DTI) has been proposed as a biomarker for cartilage composition and structure. DTI is sensitive to the PG content through the mean diffusivity and to the collagen architecture through the fractional anisotropy. However, the acquisition of DTI of articular cartilage in vivo is challenging due to the short T2 of articular cartilage (∼40 ms at 3 Tesla) and the high resolution needed (0.5-0.7 mm in plane) to depict the cartilage anatomy. We describe the pulse sequences used for in vivo DTI of articular cartilage and discus general strategies for protocol optimization. We provide a comprehensive review of measurements of DTI of articular cartilage from ex vivo validation experiments to its recent clinical applications. PMID:25865215

  1. Intercellular Ca2+ waves in mechanically stimulated articular chondrocytes.

    PubMed

    D'Andrea, P; Calabrese, A; Capozzi, I; Grandolfo, M; Tonon, R; Vittur, F

    2000-01-01

    Articular cartilage is a tissue designed to withstand compression during joint movement and, in vivo, is subjected to a wide range of mechanical loading forces. Mechanosensitivity has been demonstrated to influence chondrocyte metabolism and cartilage homeostasis, but the mechanisms underlying mechanotransduction in these cells are poorly understood. In many cell types mechanical stimulation induces increases of the cytosolic Ca2+ concentration that propagates from cell to cell as an intercellular Ca2+ wave. Cell-to-cell communication through gap junctions underlies tissue co-ordination of metabolism and sensitivity to extracellular stimuli: gap junctional permeability to intracellular second messengers allows signal transduction pathways to be shared among several cells, ultimately resulting in co-ordinated tissue responses. Mechanically-induced Ca2+ signalling was investigated with digital fluorescence video imaging in primary cultures of rabbit articular chondrocytes. Mechanical stimulation of a single cell, obtained by briefly distorting the plasmamembrane with a micropipette, induced a wave of increased Ca2+ that was communicated to surrounding cells. Intercellular Ca2+ spreading was inhibited by 18 alpha-glycyrrhetinic acid, suggesting the involvement of gap junctions in signal propagation. The functional expression of gap junctions was assessed, in confluent chondrocyte cultures, by the intercellular transfer of Lucifer yellow dye in microinjection experiments while the expression of connexin 43 could be detected in Western blots. A series of pharmacological tools known to interfere with the cell calcium handling capacity were employed to investigate the mechanism of mechanically-induced Ca2+ signalling. In the absence of extracellular Ca2+ mechanical stimulation induced communicated Ca2+ waves similar to controls. Mechanical stress induced Ca2+ influx both in the stimulated chondrocyte but not in the adjacent cells, as assessed by the Mn2+ quenching

  2. An examination of the psychometric structure of the Multidimensional Pain Inventory in temporomandibular disorder patients: a confirmatory factor analysis

    PubMed Central

    Andreu, Yolanda; Galdon, Maria J; Durá, Estrella; Ferrando, Maite; Pascual, Juan; Turk, Dennis C; Jiménez, Yolanda; Poveda, Rafael

    2006-01-01

    Background This paper seeks to analyse the psychometric and structural properties of the Multidimensional Pain Inventory (MPI) in a sample of temporomandibular disorder patients. Methods The internal consistency of the scales was obtained. Confirmatory Factor Analysis was carried out to test the MPI structure section by section in a sample of 114 temporomandibular disorder patients. Results Nearly all scales obtained good reliability indexes. The original structure could not be totally confirmed. However, with a few adjustments we obtained a satisfactory structural model of the MPI which was slightly different from the original: certain items and the Self control scale were eliminated; in two cases, two original scales were grouped in one factor, Solicitous and Distracting responses on the one hand, and Social activities and Away from home activities, on the other. Conclusion The MPI has been demonstrated to be a reliable tool for the assessment of pain in temporomandibular disorder patients. Some divergences to be taken into account have been clarified. PMID:17169143

  3. Rice Body Formation Within a Peri-Articular Shoulder Mass

    PubMed Central

    Caram, Anthony; Flores, Miguel; Scherer, Kurt

    2016-01-01

    Most commonly associated with chronic inflammatory conditions, rice bodies represent an uncommon, nonspecific, often intra-articular inflammatory process. Presumably, rice bodies represent the sequelae of microvascular infarcts of the joint synovium. However, rice bodies have been seen in pleural fluid, in the setting of bursitis, and within the tendon sheath. The etiology and prognostic significance of rice bodies are not clear. MRI is the diagnostic imaging modality of choice for the evaluation of rice body formation. Here we present a case of a 28-year-old female with a history of rheumatoid arthritis (RA) who presented to her primary care physician with a palpable mass around her right shoulder which was presumed to be a lipoma. An initial ultrasound showed a fluid filled structure with internal debris. Subsequent MRI evaluation was confirmatory for subacromial-subdeltoid bursitis with rice body formation. The salient point of this report is to highlight the importance of patient-specific differential diagnosis. While lipomas are a very common benign soft tissue tumor, patients with RA often have disease-specific sequelae that should be included in the diagnostic deliberation. Thus, when ordering diagnostic testing for patients with a palpable mass and rheumatoid arthritis, MRI--possibly preceded by conventional radiography--is the most appropriate diagnostic algorithm.

  4. Regeneration of articular cartilage using adipose stem cells.

    PubMed

    Im, Gun-Il

    2016-07-01

    Articular cartilage (AC) has limited potential for self-regeneration and damage to AC eventually leads to the development and progression of osteoarthritis (OA). Cell implantation strategies have emerged as a new treatment modality to regenerate AC. Adipose stem cells/adipose-derived stromal cells (ASCs) have gained attention due to their abundance, excellent proliferative potential, and minimal morbidity during harvest. These advantages lower the cost of cell therapy by circumventing time-consuming procedure of culture expansion. ASCs have drawn attention as a potential source for cartilage regeneration since the feasibility of chondrogenesis from ASCs was first reported. After several groups reported inferior chondrogenesis from ASCs, numerous methods were devised to overcome the intrinsic properties. Most in vivo animal studies have reported good results using predifferentiated or undifferentiated, autologous or allogeneic ASCs to regenerate cartilage in osteochondral defects or surgically-induced OA. In this review, we summarize literature on the isolation and in vitro differentiation processes of ASCs, in vivo studies to regenerate AC in osteochondral defects and OA using ASCs, and clinical applications of ASCs. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 104A: 1830-1844, 2016. PMID:26990234

  5. Adaptive cellular response to osmotic stress in pig articular chondrocytes.

    PubMed

    Borghetti, P; Della Salda, L; De Angelis, E; Maltarello, M C; Petronini, P G; Cabassi, E; Marcato, P S; Maraldi, N M; Borghetti, A F

    1995-04-01

    The authors studied the effects of a wide range of medium osmolarities (from 0.28 osM (physiological osmolarity of plasma and synovial fluid) to 0.58 osM) by altering Na+ concentration in high density cultures of pig articular chondrocytes in order to analyze the behaviour of some functional and structural parameters during cell adaptation to these imposed changes in the ionic environment. Biochemical and morphological results indicated that, even if isolated from the tissue matrix and cultured in vitro, chondrocytes maintained active osmoregulation systems which are present in living conditions. They showed a similar biochemical and morphological behavior when cultured at 0.28 osM and 0.38 osM but they were able, with regard to protein synthesis, aminoacid transport and proliferation rates, to respond quickly and to adapt to 0.48 osM medium as well. On the contrary, the treatment at the highest osmolarity (0.58 osM) early altered these biochemical parameters and was detrimental or even gave rise to lethal damage during long-term treatment. Furthermore, while chondrocytes cultured in 0.28-0.38 osM medium maintained phenotypic characteristics in culture, the higher osmolarities (0.48-0.58 osM) caused morphological changes in cell populations resulting in loss of phenotypic cell stability as demonstrated by their taking on a fibroblast-like shape as well as a lack of ability to assembly matrix proteoglycans. PMID:7778094

  6. Tribology approach to the engineering and study of articular cartilage.

    PubMed

    Wimmer, Markus A; Grad, Sibylle; Kaup, Thomas; Hänni, Markus; Schneider, Erich; Gogolewski, Sylwester; Alini, Mauro

    2004-01-01

    This study has been based on the assumption that articular motion is an important aspect of mechanotransduction in synovial joints. For this reason a new bioreactor concept, able to reproduce joint kinematics more closely, has been designed. The prototype consists of a rotating scaffold and/or cartilage pin, which is pressed onto an orthogonally rotating ball. By oscillating pin and ball in phase difference, elliptical displacement trajectories are generated that are similar to the motion paths occurring in vivo. Simultaneously, dynamic compression may be applied with a linear actuator, while two-step-motors generate the rotation of pin and ball. The whole apparatus is placed in an incubator. The control station is located outside. Preliminary investigations at the gene expression level demonstrated promising results. Compared with free-swelling control and/or simply compression-loaded samples, chondrocyte-seeded scaffolds as well as nasal cartilage explants exposed to interface motion both showed elevated levels of cartilage oligomeric matrix protein mRNA. The final design of the bioreactor will include four individual stations in line, which will facilitate the investigation of motion-initiated effects at the contacting surfaces in more detail. PMID:15588403

  7. Physiotherapy for the prevention of articular contraction in haemophilia.

    PubMed

    Buzzard, B M

    1999-03-01

    The idea of prevention and preventative care is not new. History and culture have given us many examples of the importance of physical well-being and the prvention of illness and disease. The ancient societies of China focused on the balance of Yin and Yang in promoting health; Greece and Rome valued the importance of health and physical culture; the earliest Hebrew societies documented the importance of diet and dietary restrictions as a means towards good health. Through this century health professionals have advocated the importance of preventive care as an integral element of the quality of health. Haemophilia is a life-long condition with a high potential towards disability, handicap and impairment if not adequately treated. It is therefore essential that those with haemophilia are taught the importance of physical fitness at an early age as a means of preventing articular contractures. Physiotherapy is of great importance in this field, especially in third-world countries where the supply of replacement products are scarce or non-existent. PMID:10365294

  8. Rice Body Formation Within a Peri-Articular Shoulder Mass.

    PubMed

    Edison, Michele N; Caram, Anthony; Flores, Miguel; Scherer, Kurt

    2016-01-01

    Most commonly associated with chronic inflammatory conditions, rice bodies represent an uncommon, nonspecific, often intra-articular inflammatory process. Presumably, rice bodies represent the sequelae of microvascular infarcts of the joint synovium. However, rice bodies have been seen in pleural fluid, in the setting of bursitis, and within the tendon sheath. The etiology and prognostic significance of rice bodies are not clear. MRI is the diagnostic imaging modality of choice for the evaluation of rice body formation. Here we present a case of a 28-year-old female with a history of rheumatoid arthritis (RA) who presented to her primary care physician with a palpable mass around her right shoulder which was presumed to be a lipoma. An initial ultrasound showed a fluid filled structure with internal debris. Subsequent MRI evaluation was confirmatory for subacromial-subdeltoid bursitis with rice body formation. The salient point of this report is to highlight the importance of patient-specific differential diagnosis. While lipomas are a very common benign soft tissue tumor, patients with RA often have disease-specific sequelae that should be included in the diagnostic deliberation. Thus, when ordering diagnostic testing for patients with a palpable mass and rheumatoid arthritis, MRI--possibly preceded by conventional radiography--is the most appropriate diagnostic algorithm. PMID:27625904

  9. Treatment of Focal Articular Cartilage Defects in the Knee

    PubMed Central

    Magnussen, Robert A.; Dunn, Warren R.; Carey, James L.

    2008-01-01

    We asked whether autologous chondrocyte implantation or osteochondral autograft transfer yields better clinical outcomes compared with one another or with traditional abrasive techniques for treatment of isolated articular cartilage defects and whether lesion size influences this clinical outcome. We performed a literature search and identified five randomized, controlled trials and one prospective comparative trial evaluating these treatment techniques in 421 patients. The operative procedures included autologous chondrocyte implantation, osteochondral autograft transfer, matrix-induced autologous chondrocyte implantation, and microfracture. Minimum followup was 1 year (mean, 1.7 years; range, 1–3 years). All studies documented greater than 95% followup for clinical outcome measures. No technique consistently had superior results compared with the others. Outcomes for microfracture tended to be worse in larger lesions. All studies reported improvement in clinical outcome measures in all treatment groups when compared with preoperative assessment; however, no control (nonoperative) groups were used in any of the studies. A large prospective trial investigating these techniques with the addition of a control group would be the best way to definitively address the clinical questions. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18196358

  10. Imaging articular cartilage using second harmonic generation microscopy

    NASA Astrophysics Data System (ADS)

    Mansfield, Jessica C.; Winlove, C. Peter; Knapp, Karen; Matcher, Stephen J.

    2006-02-01

    Sub cellular resolution images of equine articular cartilage have been obtained using both second harmonic generation microscopy (SHGM) and two-photon fluorescence microscopy (TPFM). The SHGM images clearly map the distribution of the collagen II fibers within the extracellular matrix while the TPFM images show the distribution of endogenous two-photon fluorophores in both the cells and the extracellular matrix, highlighting especially the pericellular matrix and bright 2-3μm diameter features within the cells. To investigate the source of TPF in the extracellular matrix experiments have been carried out to see if it may originate from the proteoglycans. Pure solutions of the following proteoglycans hyaluronan, chondroitin sulfate and aggrecan have been imaged, only the aggrecan produced any TPF and here the intensity was not great enough to account for the TPF in the extracellular matrix. Also cartilage samples were subjected to a process to remove proteoglycans and cellular components. After this process the TPF from the samples had decreased by a factor of two, with respect to the SHG intensity.

  11. Thermal energy effects on articular cartilage: a multidisciplinary evaluation

    NASA Astrophysics Data System (ADS)

    Kaplan, Lee D.; Ernsthausen, John; Ionescu, Dan S.; Studer, Rebecca K.; Bradley, James P.; Chu, Constance R.; Fu, Freddie H.; Farkas, Daniel L.

    2002-05-01

    Partial thickness articular cartilage lesions are commonly encountered in orthopedic surgery. These lesions do not have the ability to heal by themselves, due to lack of vascular supply. Several types of treatment have addressed this problem, including mechanical debridement and thermal chondroplasty. The goal of these treatments is to provide a smooth cartilage surface and prevent propagation of the lesions. Early thermal chondroplasty was performed using lasers, and yielded very mixed results, including severe damage to the cartilage, due to poor control of the induced thermal effects. This led to the development (including commercial) of probes using radiofrequency to generate the thermal effects desired for chondroplasty. Similar concerns over the quantitative aspects and control ability of the induced thermal effects in these treatments led us to test the whole range of complex issues and parameters involved. Our investigations are designed to simultaneously evaluate clinical conditions, instrument variables for existing radiofrequency probes (pressure, speed, distance, dose) as well as the associated basic science issues such as damage temperature and controllability (down to the subcellular level), damage geometry, and effects of surrounding conditions (medium, temperature, flow, pressure). The overall goals of this work are (1) to establish whether thermal chondroplasty can be used in a safe and efficacious manner, and (2) provide a prescription for multi-variable optimization of the way treatments are delivered, based on quantitative analysis. The methods used form an interdisciplinary set, to include precise mechanical actuation, high accuracy temperature and temperature gradient control and measurement, advanced imaging approaches and mathematical modeling.

  12. Localization of hyaluronic acid in human articular cartilage.

    PubMed

    Asari, A; Miyauchi, S; Kuriyama, S; Machida, A; Kohno, K; Uchiyama, Y

    1994-04-01

    To demonstrate localization of hyaluronic acid (HA) in articular cartilage of the human femur, biotinylated HA-binding region, which specifically binds HA molecules, was applied to the tissue. In sections fixed by 2% paraformaldehyde-2% glutaraldehyde, HA staining was detected in lamina splendens and chondrocytes in the middle zone. By pretreatment with trypsin, intense HA staining appeared in the extracellular matrix of the deep zone and weak staining in the superficial and middle zones. Moreover, pre-treatment with chondroitinase ABC (CHase ABC) intensely enhanced the stainability for HA in the superficial and middle zones and weakly in the deeper zone. Combined pre-treatment of trypsin with CHase ABC abolished intra- and extracellular staining for HA in all zones. By microbiochemical study, the concentrations of HA and dermatan sulfate were high in the middle zone, whereas those of chondroitin sulfate and keratan sulfate were high in the deep zone. These results suggest that HA is abundantly synthesized in and secreted from the chondrocytes, particularly in the middle zone, whereas it is largely masked by proteoglycan constituents in the extracellular matrix. PMID:8126377

  13. Stem cells for tissue engineering of articular cartilage.

    PubMed

    Gao, J; Yao, J Q; Caplan, A I

    2007-07-01

    Articular cartilage injuries are one of the most common disorders in the musculo-skeletal system. Injured cartilage tissue cannot spontaneously heal and, if not treated, can lead to osteoarthritis of the affected joints. Although a variety of procedures are being employed to repair cartilage damage, methods that result in consistent durable repair tissue are not yet available. Tissue engineering is a recently developed science that merges the fields of cell biology, engineering, material science, and surgery to regenerate new functional tissue. Three critical components in tissue engineering of cartilage are as follows: first, sufficient cell numbers within the defect, such as chondrocytes or multipotent stem cells capable of differentiating into chondrocytes; second, access to growth and differentiation factors that modulate these cells to differentiate through the chondrogenic lineage; third, a cell carrier or matrix that fills the defect, delivers the appropriate cells, and supports cell proliferation and differentiation. Stem cells that exist in the embyro or in adult somatic tissues are able to renew themselves through cell division without changing their phenotype and are able to differentiate into multiple lineages including the chondrogenic lineage under certain physiological or experimental conditions. Here the application of stem cells as a cell source for cartilage tissue engineering is reviewed. PMID:17822146

  14. Differences in Tendon Graft Healing Between the Intra-articular and Extra-articular Ends of a Bone Tunnel

    PubMed Central

    Bedi, Asheesh; Kawamura, Sumito; Ying, Liang

    2008-01-01

    The basic biology of healing between a tendon graft and bone tunnel remains incompletely understood. Distinct variability in the morphological characteristics of the healing tendon–bone attachment site has been reported. We hypothesized that spatial and temporal differences in tendon-to-bone healing exist at different regions of a surgically created bone tunnel. Twenty-four male, Sprague–Dawley rats underwent anterior cruciate ligament (ACL) reconstruction in the left knee using a flexor digitorum longus tendon graft secured using suspensory periosteal fixation. Animals were sacrificed at 4, 7, 11, 14, 21, and 28 days after surgery and prepared for routine histology and immunohistochemical analysis of the healing enthesis at the intra-articular aperture (IAA), mid-tunnel, and extra-articular aperture (EAA). Six animals were used to measure mineral apposition rate (MAR) along the healing bone tunnel by double fluorochrome labeling at 14 and 28 days after surgery. The total area of calcified bone matrix was assessed with von Kossa staining and Goldner-Masson trichrome staining, respectively. The healing tendon–bone interface tissue exhibited a wide chondroid matrix at the IAA, in contrast to a narrow, fibrous matrix at the EAA. There were significantly more osteoclasts at the IAA compared to EAA throughout the study period, except 4 days after surgery (p < 0.05). Collagen continuity between the tendon graft and bone tunnel increased over time, with a more parallel orientation and increased collagen fiber continuity between tendon and bone at the EAA compared to the IAA. MAR was also significantly greater at the EAA at 4 weeks (p < 0.001). Significant differences in healing between the tendon graft and bone exist along the length of bone tunnel secured with suspensory fixation. The etiology of these differences is likely multifactorial in nature, including variable biological and biomechanical environments at different ends of the tunnel

  15. Effect of low-level laser therapy on pain levels in patients with temporomandibular disorders: a systematic review

    PubMed Central

    MAIA, Mila Leite de Moraes; BONJARDIM, Leonardo Rigoldi; QUINTANS, Jullyana de Souza Siqueira; RIBEIRO, Maria Amália Gonzaga; MAIA, Luiz Guilherme Martins; CONTI, Paulo César Rodrigues

    2012-01-01

    Temporomandibular disorders (TMD) are characterized by the presence of temporomandibular joint (TMJ) and/or masticatory muscle pain and dysfunction. Low-level laser is presented as an adjuvant therapeutic modality for the treatment of TMD, especially when the presence of inflammatory pain is suspected. Objective To systematically review studies that investigated the effect of low level laser therapy (LLLT) on the pain levels in individuals with TMD. Material and Methods The databases Scopus, embase, ebsco and PubMed were reviewed from January/2003 to October/2010 with the following keywords: laser therapy, low-level laser therapy, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, temporomandibular joint, temporomandibular, facial pain and arthralgia, with the inclusion criteria for intervention studies in humans. exclusion criteria adopted were intervention studies in animals, studies that were not written in english, Spanish or Portuguese, theses, monographs, and abstracts presented in scientific events. Results After a careful review, 14 studies fit the criteria for inclusion, of which, 12 used a placebo group. As for the protocol for laser application, the energy density used ranged from 0.9 to 105 J/cm2, while the power density ranged from 9.8 to 500 mW. The number of sessions varied from 1 to 20 and the frequency of applications ranged from daily for 10 days to 1 time per week for 4 weeks. A reduction in pain levels was reported in 13 studies, with 9 of these occurring only in the experimental group, and 4 studies reporting pain relief for both the experimental group and for the placebo. Conclusion Most papers showed that LLLT seemed to be effective in reducing pain from TMD. However, the heterogeneity of the standardization regarding the parameters of laser calls for caution in interpretation of these results. Thus, it is necessary to conduct further research in order to obtain a consensus regarding the best application protocol

  16. Combined Intra- and Extra-articular Reconstruction of the Anterior Cruciate Ligament: The Reconstruction of the Knee Anterolateral Ligament

    PubMed Central

    Helito, Camilo Partezani; Bonadio, Marcelo Batista; Gobbi, Riccardo Gomes; da Mota e Albuquerque, Roberto Freire; Pécora, José Ricardo; Camanho, Gilberto Luis; Demange, Marco Kawamura

    2015-01-01

    We present a new technique for the combined intra- and extra-articular reconstruction of the anterior cruciate ligament. Intra-articular reconstruction is performed in an outside-in manner according to the precepts of the anatomic femoral tunnel technique. Extra-articular reconstruction is performed with the gracilis tendon while respecting the anatomic parameters of the origin and insertion points and the path described for the knee anterolateral ligament. PMID:26258037

  17. Amino acid racemization reveals differential protein turnover in osteoarthritic articular and meniscal cartilages

    PubMed Central

    Stabler, Thomas V; Byers, Samuel S; Zura, Robert D; Kraus, Virginia Byers

    2009-01-01

    Introduction Certain amino acids within proteins have been reported to change from the L form to the D form over time. This process is known as racemization and is most likely to occur in long-lived low-turnover tissues such as normal cartilage. We hypothesized that diseased tissue, as found in an osteoarthritic (OA) joint, would have increased turnover reflected by a decrease in the racemized amino acid content. Methods Using high-performance liquid chromatography methods, we quantified the L and D forms of amino acids reported to racemize in vivo on a biological timescale: alanine, aspartate (Asp), asparagine (Asn), glutamate, glutamine, isoleucine, leucine (Leu), and serine (Ser). Furthermore, using a metabolically inactive control material (tooth dentin) and a control material with normal metabolism (normal articular cartilage), we developed an age adjustment in order to make inferences about the state of protein turnover in cartilage and meniscus. Results In the metabolically inactive control material (n = 25, ages 13 to 80 years) and the normal metabolizing control material (n = 19, ages 17 to 83 years), only Asp + Asn (Asx), Ser, and Leu showed a significant change (increase) in racemization with age (P < 0.01). The age-adjusted proportions of racemized to total amino acid (D/D+L expressed as a percentage of the control material) for Asx, Ser, and Leu when compared with the normal articular cartilage control were 97%, 74%, and 73% in OA meniscal cartilage and 97%, 70%, and 78% in OA articular cartilage. We also observed lower amino acid content in OA articular and meniscal cartilages compared with normal articular cartilage as well as a loss of total amino acids with age in the OA meniscal but not the OA articular cartilage. Conclusions These data demonstrate comparable anabolic responses for non-lesioned OA articular cartilage and OA meniscal cartilage but an excess of catabolism over anabolism for the meniscal cartilage. PMID:19267899

  18. Gene Expression Profiling Reveals Similarities between the Spatial Architectures of Postnatal Articular and Growth Plate Cartilage

    PubMed Central

    Chau, Michael; Lui, Julian C.; Landman, Ellie B. M.; Späth, Stephan-Stanislaw; Vortkamp, Andrea; Baron, Jeffrey; Nilsson, Ola

    2014-01-01

    Articular and growth plate cartilage are discrete tissues but arise from a common cartilaginous condensation and have comparable spatial architectures consisting of distinct layers of chondrocytes. To investigate similarities and differences between articular and growth plate cartilage and to explore transcriptional changes that occur during the onset of their divergence, we performed manual microdissection of 10-day-old rat proximal tibias, microarray analysis, bioinformatics, and real-time PCR to compare gene expression profiles in individual cartilage layers. We found that many genes that were spatially upregulated in the intermediate/deep zone of articular cartilage were also spatially upregulated in the resting zone of growth plate cartilage (overlap greater than expected by chance, P<0.001). Interestingly, the superficial zone of articular cartilage showed an expression profile with similarities to both the proliferative and hypertrophic zones of growth plate cartilage (P<0.001 each). Additionally, significant numbers of known proliferative zone markers (3 out of 6) and hypertrophic zone markers (27 out of 126) were spatially upregulated in the superficial zone (more than expected by chance, P<0.001 each). In conclusion, we provide evidence that the intermediate/deep zone of articular cartilage has a gene expression profile more similar to that of the resting zone of growth plate cartilage, whereas the superficial zone has a gene expression profile more similar to those of the proliferative and hypertrophic zones. These findings suggest that the superficial zone chondrocytes of articular cartilage differentiate according to a program that is not completely different from but instead has distinct similarities to the hypertrophic differentiation program of growth plate chondrocytes. We also present functional signaling pathways implicated by differential gene expression between articular and growth plate cartilage during their initial separation by the

  19. Coronal joint spaces of the Temporomandibular joint: Systematic review and meta-analysis

    PubMed Central

    Silva, Joana-Cristina; Pires, Carlos A.; Ponces-Ramalhão, Maria-João-Feio; Lopes, Jorge-Dias

    2015-01-01

    Introduction The joint space measurements of the temporomandibular joint have been used to determine the condyle position variation. Therefore, the aim of this study is to perform a systematic review and meta-analysis on the coronal joint spaces measurements of the temporomandibular joint. Material and Methods An electronic database search was performed with the terms “condylar position”; “joint space”AND”TMJ”. Inclusionary criteria included: tomographic 3D imaging of the TMJ, presentation of at least two joint space measurements on the coronal plane. Exclusionary criteria were: mandibular fractures, animal studies, surgery, presence of genetic or chronic diseases, case reports, opinion or debate articles or unpublished material. The risk of bias of each study was judged as high, moderate or low according to the “Cochrane risk of bias tool”. The values used in the meta-analysis were the medial, superior and lateral joint space measurements and their differences between the right and left joint. Results From the initial search 2706 articles were retrieved. After excluding the duplicates and all the studies that did not match the eligibility criteria 4 articles classified for final review. All the retrieved articles were judged as low level of evidence. All of the reviewed studies were included in the meta-analysis concluding that the mean coronal joint space values were: medial joint space 2.94 mm, superior 2.55 mm and lateral 2.16 mm. Conclusions the analysis also showed high levels of heterogeneity. Right and left comparison did not show statistically significant differences. Key words:Temporomandibular joint, systematic review, meta-analysis. PMID:26330944

  20. Effect of Facial Massage on Static Balance in Individuals with Temporomandibular Disorder – a Pilot Study

    PubMed Central

    El Hage, Yasmin; Politti, Fabiano; Herpich, Carolina Marciela; de Souza, Dowglas Fernando Magalhães; de Paula Gomes, Cid André Fidelis; Amorim, Cesar Ferreira; de Oliveira Gonzalez, Tabajara; Biasotto-Gonzalez, Daniela Aparecida

    2013-01-01

    Introduction The influence of the neuromuscular system on the cervical region and mastication is directly associated with mandibular movements and neck posture. Normal occlusal homeostasis depends on complex sensory feedback mechanisms of the periodontal ligament, temporomandibular joint and other structures of the stomatognathic system. This feedback serves as a regulatory mechanism that helps determine the force and nature of muscle contractions. Alterations in the muscles of mastication, neck muscles, and occlusal characteristics constitute causal factors of imbalances in the postural muscle chains, leading to alterations in the center of pressure (CoP) of the feet. Thus, therapies that seek occlusal reestablishment, such as muscle relaxation techniques, may lead to a restructuring of the global equilibrium of the neuromuscular system and an improvement in body posture. Purpose The aim of the present pilot study was to investigate the immediate effect of facial massage on the CoP in the anteroposterior (CoPAP) and mediolateral (CoPML) directions in individuals with temporomandibular disorder (TMD). Methods Twenty individuals with a diagnosis of TMD based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were submitted to a facial massage technique. CoPAP and CoPML were evaluated using a force plate. Evaluations were performed under two visual conditions (eyes open and eyes closed) prior to resting in dorsal decubitus (baseline), after 10 minutes of rest (premassage) and after the administration of the massage technique (postmassage). Results No significant differences were found regarding CoPAP velocity with eyes open or the following aspects under either visual condition (eyes open or closed): CoPML velocity, RMS of CoPAP, RMS of CoPML, and sway area. The only significant difference was found for mean CoPAP velocity with eyes closed. Conclusions While the results of the present study demonstrate the reliability of the reproduction of

  1. A Collaborative Approach Between Chiropractic and Dentistry to Address Temporomandibular Dysfunction: A Case Report

    PubMed Central

    Rubis, Lisa M.; Rubis, David; Winchester, Brett

    2014-01-01

    Objective The purpose of this case report is to describe the chiropractic and dental comanagement of a patient with temporomandibular dysfunction, headaches, and myalgia. Clinical features A 38-year-old black female patient presented for chiropractic care with a chief concern of jaw pain, tinnitus, headaches, and neck and shoulder soreness of 8 months’ duration. The patient rated the pain a 6/10. The patient had a maximum mouth opening of 42 mm, graphed evidence of disk displacement, loss of translation on opening of the right temporomandibular joint viewed on the lateral radiograph, and numerous areas of point tenderness on the Kinnie-Funt Chief Complaint Visual Index. She had decreased lateral cervical flexion. Intervention and outcome Dental treatment consisted of an anterior repositioning splint. Chiropractic care consisted of Activator treatment to the pelvis and the thoracic and cervical spine. Manual manipulation of the temporomandibular joint was performed along with a soft tissue technique intraorally on the lateral pterygoid. Postisometric relaxation in the head and neck region was also done. The patient was treated 6 times over 3 weeks. At the end of treatment, the patient had a pain rating of 0/10, maximum mouth opening of 49 mm, no tender points on the follow-up Kinnie-Funt, and increased cervical range of motion. Conclusion The patient demonstrated increased mouth opening, decreased pain rating, improved Kinnie-Funt visual index, and an increased cervical lateral flexion range of motion after 3 weeks of a combination of chiropractic and dental care. PMID:24711786

  2. Interspecific scaling patterns of talar articular surfaces within primates and their closest living relatives

    PubMed Central

    Yapuncich, Gabriel S; Boyer, Doug M

    2014-01-01

    The articular facets of interosseous joints must transmit forces while maintaining relatively low stresses. To prevent overloading, joints that transmit higher forces should therefore have larger facet areas. The relative contributions of body mass and muscle-induced forces to joint stress are unclear, but generate opposing hypotheses. If mass-induced forces dominate, facet area should scale with positive allometry to body mass. Alternatively, muscle-induced forces should cause facets to scale isometrically with body mass. Within primates, both scaling patterns have been reported for articular surfaces of the femoral and humeral heads, but more distal elements are less well studied. Additionally, examination of complex articular surfaces has largely been limited to linear measurements, so that ‘true area' remains poorly assessed. To re-assess these scaling relationships, we examine the relationship between body size and articular surface areas of the talus. Area measurements were taken from microCT scan-generated surfaces of all talar facets from a comprehensive sample of extant euarchontan taxa (primates, treeshrews, and colugos). Log-transformed data were regressed on literature-derived log-body mass using reduced major axis and phylogenetic least squares regressions. We examine the scaling patterns of muscle mass and physiological cross-sectional area (PCSA) to body mass, as these relationships may complicate each model. Finally, we examine the scaling pattern of hindlimb muscle PCSA to talar articular surface area, a direct test of the effect of mass-induced forces on joint surfaces. Among most groups, there is an overall trend toward positive allometry for articular surfaces. The ectal (= posterior calcaneal) facet scales with positive allometry among all groups except ‘sundatherians', strepsirrhines, galagids, and lorisids. The medial tibial facet scales isometrically among all groups except lemuroids. Scaling coefficients are not correlated with sample

  3. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation

    PubMed Central

    2011-01-01

    Background Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. Method and materials A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. Result A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. Conclusion The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques. PMID:21676208

  4. RAPID COMMUNICATION: Nanostructured diamond film deposition on curved surfaces of metallic temporomandibular joint implant

    NASA Astrophysics Data System (ADS)

    Fries, Marc D.; Vohra, Yogesh K.

    2002-10-01

    Microwave plasma chemical vapour deposition of nanostructured diamond films was carried out on curved surfaces of Ti-6Al-4V alloy machined to simulate the shape of a temporomandibular joint (TMJ) dental implant. Raman spectroscopy shows that the deposited films are uniform in chemical composition along the radius of curvature of the TMJ condyle. Thin film x-ray diffraction reveals an interfacial carbide layer and nanocrystalline diamond grains in this coating. Nanoindentation hardness measurements show an ultra-hard coating with a hardness value of 60+/-5 GPa averaged over three samples.

  5. Synovial chondromatosis in the temporomandibular joint: case report with review of the literature.

    PubMed

    Ivask, Oksana; Leibur, Edvitar; Voog-Oras, Ülle

    2015-01-01

    Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign condition characterized by the formation of metaplastic cartilage in the synovium resulting in numerous attached and unattached osteocartilagenous (calcified) loose bodies within the joint. The purpose of this article is to present a case of SC of the TMJ and to discuss current diagnostic approaches, treatment options and relevant follow-up data. We present a case of SC in the TMJ that was confirmed by histopathological analysis and treated via arthrotomy, and present the typical imaging findings, including Computed Tomography (CT) and orthopantomography (OPTG) findings. PMID:26879402

  6. Computed tomography of the meniscus of the temporomandibular joint: preliminary observations

    SciTech Connect

    Helms, C.A.; Morrish, R.B. Jr.; Kircos, L.T.; Dolwick, M.F.

    1982-12-01

    Anterior displacement of the meniscus of the temporomandibular joint (TMJ) was diagnosed in nine patients who had undergone arthrography, and they were later examined with computed tomography (CT) to see if this modality could supplant arthrography in some patients with TMJ dysfunction. The anteriorly displaced menisci were visualizsed in all nine patients by using sagittal reformations and blink mode. Four of the nine patients had the diagnosis confirmed at surgery. The precise protocol for the CT examination and how to interpret it are discussed. We are optimistic that CT may replace TMJ arthrography in selected patients.

  7. Giant Solitary Synovial Chondromatosis of the Temporomandibular Joint with Intracranial Extension

    PubMed Central

    Gil-Salú, José L.; Lázaro, Rafael; Aldasoro, José; Gonzalez-Darder, José M.

    1998-01-01

    Synovial chondromatosis are rare entities but are well-described lesions in the literature that can affect many joint areas of the body. A case of tumoral synovial chondromatosis involving the temporomandibular joint with intracranial extension through mandibular fossa is reported. As long as there was significant infratemporal and extradural invasion of the middle and posterior fossa, a transtemporal and infratemporal approach was performed and total removal of the lesions was achieved. A brief review of skull base synovial chondromatosis is presented. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11 PMID:17171059

  8. Internal derangements of the temporomandibular joint: diagnosis by direct sagittal computed tomography

    SciTech Connect

    Manzione, J.V.; Katzberg, R.W.; Brodsky, G.L.; Seltzer, S.E.; Mellins, H.Z.

    1984-01-01

    The authors performed direct sagittal computed tomography (CT) on 4 cadaver temporomandibular joints (TMJ) and examined 51 TMJs in 47 patients clinically. The results were correlated with cadaver anatomical sections and clinical arthrographic findings. A fat plane between the bellies of the lateral pterygoid muscles, termed the ''lateral pterygoid fat pad,'' served as the anatomical basis for detection of internal derangements by CT. CT was 94% accurate in detecting meniscal derangements and 96% accurate in detecting degenerative arthritis. The authors suggest that CT rather than arthrography be employed as the primary TMJ imaging modality when internal derangement or arthritis is suspected.

  9. Emergency route diagnosis of mucoepidermoid carcinoma initially diagnosed as a temporomandibular disorder.

    PubMed

    Chmieliauskaite, Milda; Sollecito, Thomas P; Stoopler, Eric T

    2016-01-01

    Salivary gland malignancy (SGM) can affect both major and minor glands and manifests clinically with various presentations. The most common type of SGM is mucoepidermoid carcinoma (MEC), which has been previously reported to be associated with symptomatology associated with temporomandibular disorders (TMD). This case report describes a patient with an aggressive form of MEC of the parotid gland that was initially diagnosed as TMD. In addition, the patient's MEC was diagnosed emergently based on development of acute clinical symptomatology. To the best of our knowledge, emergency route diagnosis of MEC affecting the parotid gland has not been previously reported in the literature. PMID:26782364

  10. Adaptive mechanically controlled lubrication mechanism found in articular joints

    PubMed Central

    Greene, George W.; Banquy, Xavier; Lee, Dong Woog; Lowrey, Daniel D.; Yu, Jing; Israelachvili, Jacob N.

    2011-01-01

    Articular cartilage is a highly efficacious water-based tribological system that is optimized to provide low friction and wear protection at both low and high loads (pressures) and sliding velocities that must last over a lifetime. Although many different lubrication mechanisms have been proposed, it is becoming increasingly apparent that the tribological performance of cartilage cannot be attributed to a single mechanism acting alone but on the synergistic action of multiple “modes” of lubrication that are adapted to provide optimum lubrication as the normal loads, shear stresses, and rates change. Hyaluronic acid (HA) is abundant in cartilage and synovial fluid and widely thought to play a principal role in joint lubrication although this role remains unclear. HA is also known to complex readily with the glycoprotein lubricin (LUB) to form a cross-linked network that has also been shown to be critical to the wear prevention mechanism of joints. Friction experiments on porcine cartilage using the surface forces apparatus, and enzymatic digestion, reveal an “adaptive” role for an HA-LUB complex whereby, under compression, nominally free HA diffusing out of the cartilage becomes mechanically, i.e., physically, trapped at the interface by the increasingly constricted collagen pore network. The mechanically trapped HA-LUB complex now acts as an effective (chemically bound) “boundary lubricant”—reducing the friction force slightly but, more importantly, eliminating wear damage to the rubbing/shearing surfaces. This paper focuses on the contribution of HA in cartilage lubrication; however, the system as a whole requires both HA and LUB to function optimally under all conditions. PMID:21383143

  11. Adaptive mechanically controlled lubrication mechanism found in articular joints.

    PubMed

    Greene, George W; Banquy, Xavier; Lee, Dong Woog; Lowrey, Daniel D; Yu, Jing; Israelachvili, Jacob N

    2011-03-29

    Articular cartilage is a highly efficacious water-based tribological system that is optimized to provide low friction and wear protection at both low and high loads (pressures) and sliding velocities that must last over a lifetime. Although many different lubrication mechanisms have been proposed, it is becoming increasingly apparent that the tribological performance of cartilage cannot be attributed to a single mechanism acting alone but on the synergistic action of multiple "modes" of lubrication that are adapted to provide optimum lubrication as the normal loads, shear stresses, and rates change. Hyaluronic acid (HA) is abundant in cartilage and synovial fluid and widely thought to play a principal role in joint lubrication although this role remains unclear. HA is also known to complex readily with the glycoprotein lubricin (LUB) to form a cross-linked network that has also been shown to be critical to the wear prevention mechanism of joints. Friction experiments on porcine cartilage using the surface forces apparatus, and enzymatic digestion, reveal an "adaptive" role for an HA-LUB complex whereby, under compression, nominally free HA diffusing out of the cartilage becomes mechanically, i.e., physically, trapped at the interface by the increasingly constricted collagen pore network. The mechanically trapped HA-LUB complex now acts as an effective (chemically bound) "boundary lubricant"--reducing the friction force slightly but, more importantly, eliminating wear damage to the rubbing/shearing surfaces. This paper focuses on the contribution of HA in cartilage lubrication; however, the system as a whole requires both HA and LUB to function optimally under all conditions. PMID:21383143

  12. Articular cartilage of the knee 3 years after ACL reconstruction

    PubMed Central

    Bae, Ji-Hoon; Hosseini, Ali; Wang, Yang; Torriani, Martin; Gill, Thomas J; Grodzinsky, Alan J

    2015-01-01

    Background and purpose T1ρ or T2 relaxation imaging has been increasingly used to evaluate the cartilage of the knee. We investigated the cartilage of ACL-reconstructed knees 3 years after surgery using T2 relaxation times. Patients and methods 10 patients with a clinically successful unilateral ACL reconstruction were examined 3 years after surgery. Multiple-TE fast-spin echo sagittal images of both knees were acquired using a 3T MRI scanner for T2 mapping of the tibiofemoral cartilage. T2 values of the superficial and deep zones of the tibiofemoral cartilage were analyzed in sub-compartmental areas and compared between the ACL-reconstructed and uninjured contralateral knees. Results Higher T2 values were observed in 1 or more sub-compartmental areas of each ACL-reconstructed knee compared to the uninjured contralateral side. Most of the T2 increases were observed at the superficial zones of the cartilage, especially at the medial compartment. At the medial compartment of the ACL-reconstructed knee, the T2 values of the femoral and tibial cartilage were increased by 3–81% compared to the uninjured contralateral side, at the superficial zones of the weight-bearing areas. T2 values in the superficial zone of the central medial femoral condyle differed between the 2 groups (p = 0.002). Interpretation The articular cartilage of ACL-reconstructed knees, although clinically satisfactory, had higher T2 values in the superficial zone of the central medial femoral condyle than in the uninjured contralateral side 3 years after surgery. Further studies are warranted to determine whether these patients would undergo cartilage degeneration over time. PMID:25854533

  13. Arthroscopic laser in intra-articular knee cartilage disorders

    NASA Astrophysics Data System (ADS)

    Nosir, Hany R.; Siebert, Werner E.

    1996-12-01

    Different assemblies have endeavored to develop arthroscopic laser surgery. Various lasers have been tried in the treatment of orthopaedic problems, and the most useful has turned out to be the Hol-YAG laser 2.1 nm which is a near- contact laser. By using the laser as a powerful tool, and cutting back on the power level, one is able to better achieve the desired treatment effect. Clinical studies to evaluating the role of the laser in different arthroscopic knee procedures, comparing to conventional techniques, showed that the overall outcome attains a momentous confidence level which is shifted to the side of the laser versus the conventional for all maneuvers, barring meniscectomy where there is not perceiving disparity between laser versus the conventional. Meniscectomy continues to be one of the most commonly performed orthopaedic procedures. Laser provides a single tool which can ablate and debride meniscal rims with efficiency and safety. Chondroplasty can also be accomplished with ease using defocused laser energy. Both lateral release and soft tissue cermilization benefit from the cutting effect of laser along with its hemostatic effect. Synovial reduction with a defocused laser is also easily accomplished. By one gadget, one can cut, ablate, smooth, coagulate, congeal and with authentic tissue depth control The future of laser arthroscopic surgery lies in its ability to weld or repair tissues. Our research study has shown that laser activated photoactive dyes can produce a molecular bonding of collagen fibers, and therefore a repair 'weld' can be achieved with both meniscal tissues and with articular cartilage lesions.

  14. Subtalar arthrodesis for complications of intra-articular calcaneal fractures.

    PubMed

    Flemister, A S; Infante, A F; Sanders, R W; Walling, A K

    2000-05-01

    Eighty six subtalar arthrodeses performed between 1985 and 1996 for complications associated with intra-articular calcaneal fractures were retrospectively evaluated. Patients were divided into three Groups: (I) 59 patients with calcaneal malunions (II) 13 patients with failed open reduction and internal fixation, and (III) eight patients undergoing open reductions and primary fusion for highly comminuted fractures. In each scenario, internal fixation was achieved with cancellous lag screws. Bone graft material consisted of either autogenous iliac crest graft, local graft obtained from the lateral wall exostectomy of the malunion, or freeze-dried cancellous allograft. Fusions in Groups II and III were performed in situ. Fusions in Group I were performed either in situ or utilizing a variety of reconstructive procedures depending upon the type of malunion encountered. Eighty three of the 86 fusion attempts were successful following the initial operations for a union rate of 96%. Fusion rates were similar regardless of the graft material used. Complications included four varus malunions, four cases of osteomyelitis, and two cases of reflex sympathetic dystrophy. A statistically significant shorter hospital stay was found for patients not undergoing iliac crest bone graft procedures. Eighty patients with at least two year follow up achieved a mean American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score of 75.0. Scores were similar for all three groups and for the various types of reconstructive procedures used. No correlation was found between postoperative talar declination angle and the AOFAS ankle-hindfoot score. Worker's compensation patients tended to have a poorer clinical outcome. PMID:10830657

  15. Stick-slip friction and wear of articular joints

    PubMed Central

    Lee, Dong Woog; Banquy, Xavier; Israelachvili, Jacob N.

    2013-01-01

    Stick-slip friction was observed in articular cartilage under certain loading and sliding conditions and systematically studied. Using the Surface Forces Apparatus, we show that stick-slip friction can induce permanent morphological changes (a change in the roughness indicative of wear/damage) in cartilage surfaces, even under mild loading and sliding conditions. The different load and speed regimes can be represented by friction maps—separating regimes of smooth and stick-slip sliding; damage generally occurs within the stick-slip regimes. Prolonged exposure of cartilage surfaces to stick-slip sliding resulted in a significant increase of surface roughness, indicative of severe morphological changes of the cartilage superficial zone. To further investigate the factors that are conducive to stick-slip and wear, we selectively digested essential components of cartilage: type II collagen, hyaluronic acid (HA), and glycosaminoglycans (GAGs). Compared with the normal cartilage, HA and GAG digestions modified the stick-slip behavior and increased surface roughness (wear) during sliding, whereas collagen digestion decreased the surface roughness. Importantly, friction forces increased up to 2, 10, and 5 times after HA, GAGs, and collagen digestion, respectively. Also, each digestion altered the friction map in different ways. Our results show that (i) wear is not directly related to the friction coefficient but (ii) more directly related to stick-slip sliding, even when present at small amplitudes, and that (iii) the different molecular components of joints work synergistically to prevent wear. Our results also suggest potential noninvasive diagnostic tools for sensing stick-slip in joints. PMID:23359687

  16. Permeation of dimethyl sulfoxide into articular cartilage at subzero temperatures.

    PubMed

    Zhang, Shao-Zhi; Yu, Xiao-Yi; Chen, Guang-Ming

    2012-03-01

    Osteochondral allografting has been proved to be a useful method to treat diseased or damaged areas of joint surfaces. Operational long-term stocks of grafts which supply a buffer between procurement and utilization would contribute to the commercialization or industrialization of this technology. Vitrification has been thought to be a promising method for successful preservation of articular cartilage (AC), but high concentration cryoprotectants (CPAs) are used which may cause high cellular toxicity. An effective way to reduce CPA toxicity is to increase CPA concentration gradually while the temperature is lowered. Understanding the mechanism of CPA permeation at subzero temperatures is important for designing the cryopreservation protocol. In this research, the permeation of dimethyl sulfoxide (Me(2)SO) in ovine AC at subzero temperatures was studied experimentally. Pretreated AC discs were exposed in Me(2)SO solutions for different time (0, 5, 15, 30, 50, 80, and 120 min) at three temperature levels (-10, -20, and -30 °C). The Me(2)SO concentration within the tissue was determined by ultraviolet (UV) spectrophotometry. The diffusion coefficients were estimated to be 0.85×10(-6), 0.48×10(-6), and 0.27×10(-6) cm(2)/s at -10, -20, and -30 °C, respectively, and the corresponding activation energy was 29.23 kJ/mol. Numerical simulation was performed to compare two Me(2)SO addition protocols, and the results demonstrated that the total loading duration could be effectively reduced with the knowledge of permeation kinetics. PMID:22374614

  17. Multi-parametric MRI characterization of enzymatically degraded articular cartilage.

    PubMed

    Nissi, Mikko J; Salo, Elli-Noora; Tiitu, Virpi; Liimatainen, Timo; Michaeli, Shalom; Mangia, Silvia; Ellermann, Jutta; Nieminen, Miika T

    2016-07-01

    Several laboratory and rotating frame quantitative MRI parameters were evaluated and compared for detection of changes in articular cartilage following selective enzymatic digestion. Bovine osteochondral specimens were subjected to 44 h incubation in control medium or in collagenase or chondroitinase ABC to induce superficial collagen or proteoglycan (glycosaminoglycan) alterations. The samples were scanned at 9.4 T for T1 , T1 Gd (dGEMRIC), T2 , adiabatic T1 ρ , adiabatic T2 ρ , continuous-wave T1 ρ , TRAFF2 , and T1 sat relaxation times and for magnetization transfer ratio (MTR). For reference, glycosaminoglycan content, collagen fibril orientation and biomechanical properties were determined. Changes primarily in the superficial cartilage were noted after enzymatic degradation. Most of the studied parameters were sensitive to the destruction of collagen network, whereas glycosaminoglycan depletion was detected only by native T1 and T1 Gd relaxation time constants throughout the tissue and by MTR superficially. T1 , adiabatic T1 ρ , adiabatic T2 ρ , continuous-wave T1 ρ , and T1 sat correlated significantly with the biomechanical properties while T1 Gd correlated with glycosaminoglycan staining. The findings indicated that most of the studied MRI parameters were sensitive to both glycosaminoglycan content and collagen network integrity, with changes due to enzymatic treatment detected primarily in the superficial tissue. Strong correlation of T1 , adiabatic T1ρ , adiabatic T2 ρ , continuous-wave T1 ρ , and T1 sat with the altered biomechanical properties, reflects that these parameters were sensitive to critical functional properties of cartilage. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1111-1120, 2016. PMID:26662555

  18. Modeling IL-1 induced degradation of articular cartilage.

    PubMed

    Kar, Saptarshi; Smith, David W; Gardiner, Bruce S; Li, Yang; Wang, Yang; Grodzinsky, Alan J

    2016-03-15

    In this study, we develop a computational model to simulate the in vitro biochemical degradation of articular cartilage explants sourced from the femoropatellar grooves of bovine calves. Cartilage explants were incubated in culture medium with and without the inflammatory cytokine IL-1α. The spatio-temporal evolution of the cartilage explant's extracellular matrix components is modelled. Key variables in the model include chondrocytes, aggrecan, collagen, aggrecanase, collagenase and IL-1α. The model is first calibrated for aggrecan homeostasis of cartilage in vivo, then for data on (explant) controls, and finally for data on the IL-1α driven proteolysis of aggrecan and collagen over a 4-week period. The model was found to fit the experimental data best when: (i) chondrocytes continue to synthesize aggrecan during the cytokine challenge, (ii) a one to two day delay is introduced between the addition of IL-1α to the culture medium and subsequent aggrecanolysis, (iii) collagen degradation does not commence until the total concentration of aggrecan (i.e. both intact and degraded aggrecan) at any specific location within the explant becomes ≤ 1.5 mg/ml and (iv) degraded aggrecan formed due to the IL-1α induced proteolysis of intact aggrecan protects the collagen network while collagen degrades in a two-step process which, together, significantly modulate the collagen network degradation. Under simulated in vivo conditions, the model predicts increased aggrecan turnover rates in the presence of synovial IL-1α, consistent with experimental observations. Such models may help to infer the course of events in vivo following traumatic joint injury, and may also prove useful in quantitatively evaluating the efficiency of various therapeutic molecules that could be employed to avoid or modify the course of cartilage disease states. PMID:26874194

  19. [Basophilic line of the articular cartilage in normal and various pathological states].

    PubMed

    Gongadze, L R

    1987-04-01

    Epiphyses of long tubular bones in the man and animals of various age, as well as experimental material of the adjuvant arthritis, with special reference to the basal part of the articular cartilage have been studied by means of histological, histochemical and histometrical methods. The structural-chemical organization of the basophilic line (tidemark) of the articular cartilage ensures its barrier role and participation in regulating selective permeability. Reconstruction of the tidemark in the process of physiological ageing and in cases of the articular pathology is aimed to preserve its integrity and in this way a complete differentiation of the noncalcified and calcified structures is secured. Disturbance of the basophilic line results in changes of the articular selective permeability, in invasion of vessels and structural elements of the bone marrow, and in development of profound distrophic and destructive changes of the cartilage--in deforming artrosis. Deflations in the structural-chemical organization of the tidemark indicate certain disturbances in the state of the system articular cartilage--subchondral bone. These data can be of prognostic importance. PMID:3606408

  20. Role of computer aided detection (CAD) integration: case study with meniscal and articular cartilage CAD applications

    NASA Astrophysics Data System (ADS)

    Safdar, Nabile; Ramakrishna, Bharath; Saiprasad, Ganesh; Siddiqui, Khan; Siegel, Eliot

    2008-03-01

    Knee-related injuries involving the meniscal or articular cartilage are common and require accurate diagnosis and surgical intervention when appropriate. With proper techniques and experience, confidence in detection of meniscal tears and articular cartilage abnormalities can be quite high. However, for radiologists without musculoskeletal training, diagnosis of such abnormalities can be challenging. In this paper, the potential of improving diagnosis through integration of computer-aided detection (CAD) algorithms for automatic detection of meniscal tears and articular cartilage injuries of the knees is studied. An integrated approach in which the results of algorithms evaluating either meniscal tears or articular cartilage injuries provide feedback to each other is believed to improve the diagnostic accuracy of the individual CAD algorithms due to the known association between abnormalities in these distinct anatomic structures. The correlation between meniscal tears and articular cartilage injuries is exploited to improve the final diagnostic results of the individual algorithms. Preliminary results from the integrated application are encouraging and more comprehensive tests are being planned.

  1. Intra-articular injection of tranexamic acid reduce blood loss in cemented total knee arthroplasty.

    PubMed

    Digas, G; Koutsogiannis, I; Meletiadis, G; Antonopoulou, E; Karamoulas, V; Bikos, Ch

    2015-10-01

    The purpose of this study was to compare the efficacy of intravenous and topical tranexamic acid (TXA) versus control group for reduction in blood loss following primary total knee arthroplasty (TKA). A total of 90 patients were prospectively allocated to each of three groups (control, intravenous IV and intra-articular) and underwent unilateral total knee arthroplasty. In the IV group, patients received one dose of TXA of 15 mg/kg before deflation of the tourniquet, while in the intra-articular group patients received 2 g TXA via the drain retrogradely after closure of the wound. The mean drained blood loss in control, IV and intra-articular groups was 415 ± 24, 192 ± 21 and 121 ± 17 ml, respectively. About 43 % (control), 23 % (IV) and 17 % (intra-articular) of each group required transfusion, and the mean transfusion was 338, 168 and 79 ml, respectively. Preoperative hemoglobin values decreased at 24 h by 2.80 ± 0.14, 2.24 ± 0.17 and 2.26 ± 0.18 mg/dl, respectively. TXA reduced blood loss and transfusion requirement. Compared with one-dose intravenous administration, intra-articular administration of TXA seems to be more effective in terms of reducing drained blood loss and transfusion frequency. We recommend administration of topical TXA in primary TKA in healthy patients to decrease perioperative blood loss. PMID:26169991

  2. Intra-Articular Synovial Sarcomas: Incidence and Differentiating Features from Localized Pigmented Villonodular Synovitis

    PubMed Central

    Nordemar, D.; Öberg, J.; Brosjö, O.; Skorpil, M.

    2015-01-01

    Purpose. To determine the incidence of intra-articular synovial sarcomas and investigate if any radiological variables can differentiate them from localized (unifocal) pigmented villonodular synovitis (PVNS) and if multivariate data analysis could be used as a complementary clinical tool. Methods. Magnetic resonance images and radiographs of 7 cases of intra-articular synovial sarcomas and 14 cases of localized PVNS were blindedly reviewed. Variables analyzed were size, extra-articular growth, tumor border, blooming, calcification, contrast media enhancement, effusion, bowl of grapes sign, triple signal intensity sign, synovial low signal intensity, synovitis, age, and gender. Univariate and multivariate data analysis, the method of partial least squares-discriminant analysis (PLS-DA), were used. Register data on all synovial sarcomas were extracted for comparison. Results. The incidence of intra-articular synovial sarcomas was 3%. PLS-DA showed that age, effusion, size, and gender were the most important factors for discrimination between sarcomas and localized PVNS. No sarcomas were misclassified as PVNS with PLS-DA, while some PVNS were misclassified as sarcomas. Conclusions. The most important variables in differentiating intra-articular sarcomas from localized PVNS were age, effusion, size, and gender. Multivariate data analysis can be helpful as additive information to avoid a biopsy, if the tumor is classified as most likely being PVNS. PMID:26819567

  3. Winner of the 1996 Cabaud Award. The effect of lifelong exercise on canine articular cartilage.

    PubMed

    Newton, P M; Mow, V C; Gardner, T R; Buckwalter, J A; Albright, J P

    1997-01-01

    The effect of long-term exercise on canine knees was studied to determine whether an increased level of lifelong weightbearing exercise causes degeneration, or changes that may lead to degeneration, of articular cartilage. Eleven dogs were exercised on a treadmill at 3 km/hr for 75 minutes 5 days a week for 527 weeks while carrying jackets weighing 130% of their body weight. Ten control dogs were allowed unrestricted activity in cages for the 550 weeks. At the completion of the study all knee joints were inspected for evidence of joint injury and degeneration. Articular cartilage surfaces from the medial tibial plateau were examined by light microscopy, the cartilage thickness was measured, and the intrinsic material properties were determined by mechanical testing. No joints had ligament or meniscal injuries, cartilage erosions, or osteophytes. Light microscopy did not demonstrate cartilage fibrillation or differences in safranin O staining of the tibial articular cartilages between the two groups. Furthermore, the tibial articular cartilage thickness and mechanical properties did not differ between the two groups. These results show that a lifetime of regular weightbearing exercise in dogs with normal joints did not cause alterations in the structure and mechanical properties of articular cartilage that might lead to joint degeneration. PMID:9167804

  4. Lipoma arborescens arising in the extra-articular bursa of the knee joint

    PubMed Central

    Minami, Shinji; Miyake, Yusuke; Kinoshita, Hirofumi

    2016-01-01

    Lipoma arborescens arising in the extra-articular bursa of the knee joint is extremely rare. We describe an 11-year-old boy who complained of a gradual swelling mass of the lateral knee joint. Magnetic resonance imaging (MRI) showed a high signal intensity tumor on T1- and T2-weighted images with a thickened septa and nodular lesion that showed low signal intensity. The radiologist suggested the possible differential diagnosis of well-differentiated liposarcoma. At operation, the tumor was found under the iliotibial tract and was not in contact with the knee joint. Histopathologically, this lesion was diagnosed as lipoma arborescens arising in the extra-articular bursa of the knee joint. On MRI, the appearance of lipoma arborescens arising in the extra-articular bursa of the knee joint differed from that of conventional intra-articular lipoma arborescens. In this report, we describe a case of extra-articular lipoma arborescens of the knee joint bursa and discuss the diagnosis and etiology. PMID:27382924

  5. Chondrocyte survival in articular cartilage: the influence of subchondral bone in a bovine model.

    PubMed

    Amin, A K; Huntley, J S; Simpson, A H R W; Hall, A C

    2009-05-01

    The aim of this study was to determine whether subchondral bone influences in situ chondrocyte survival. Bovine explants were cultured in serum-free media over seven days with subchondral bone excised from articular cartilage (group A), subchondral bone left attached to articular cartilage (group B), and subchondral bone excised but co-cultured with articular cartilage (group C). Using confocal laser scanning microscopy, fluorescent probes and biochemical assays, in situ chondrocyte viability and relevant biophysical parameters (cartilage thickness, cell density, culture medium composition) were quantified over time (2.5 hours vs seven days). There was a significant increase in chondrocyte death over seven days, primarily within the superficial zone, for group A, but not for groups B or C (p < 0.05). There was no significant difference in cartilage thickness or cell density between groups A, B and C (p > 0.05). Increases in the protein content of the culture media for groups B and C, but not for group A, suggested that the release of soluble factors from subchondral bone may have influenced chondrocyte survival. In conclusion, subchondral bone significantly influenced chondrocyte survival in articular cartilage during explant culture. The extrapolation of bone-cartilage interactions in vitro to the clinical situation must be made with caution, but the findings from these experiments suggest that future investigation into in vivo mechanisms of articular cartilage survival and degradation must consider the interactions of cartilage with subchondral bone. PMID:19407309

  6. Polyethylene-Glycol-Modified Single-Walled Carbon Nanotubes for Intra-Articular Delivery to Chondrocytes

    PubMed Central

    Sacchetti, Cristiano; Liu-Bryan, Ru; Magrini, Andrea; Rosato, Nicola; Bottini, Nunzio; Bottini, Massimo

    2015-01-01

    Osteoarthritis (OA) is a common and debilitating degenerative disease of articular joints for which no disease-modifying medical therapy is currently available. Inefficient delivery of pharmacologic agents into cartilage-resident chondrocytes after systemic administration has been a limitation to the development of anti-OA medications. Direct intra-articular injection enables delivery of high concentrations of agents in close proximity to chondrocytes; however, the efficacy of this approach is limited by the fast clearance of small molecules and biomacromolecules after injection into the synovial cavity. Coupling of pharmacologic agents with drug delivery systems able to enhance their residence time and cartilage penetration can enhance the effectiveness of intra-articularly injected anti-OA medications. Herein we describe an efficient intra-articular delivery nanosystem based on single-walled carbon nanotubes (SWCNTs) modified with polyethylene glycol (PEG) chains (PEG-SWCNTs). We show that PEG-SWCNTs are capable to persist in the joint cavity for a prolonged time, enter the cartilage matrix, and deliver gene inhibitors into chondrocytes of both healthy and OA mice. PEG-SWCNT nanoparticles did not elicit systemic or local side effects. Our data suggest that PEG-SWCNTs represent a biocompatible and effective nanocarrier for intra-articular delivery of agents to chondrocytes. PMID:25415768

  7. A simple technique for the distraction and mobilization of the temporomandibular joint condyle in nonreducing disk derangements.

    PubMed

    Harkins, S J; Marteney, J L; Cueva, L

    1987-11-01

    The clothespin traction technique described in this article is simple, inexpensive, and offers high patient compliance when used by the patient outside the clinic. This procedure may be effective in recapturing nonreducible disks and regaining range of motion in hypomobile temporomandibular joints. PMID:3479559

  8. Directed differentiation of induced pluripotent stem cells into chondrogenic lineages for articular cartilage treatment

    PubMed Central

    Lach, Michał; Richter, Magdalena; Pawlicz, Jarosław; Suchorska, Wiktoria M

    2014-01-01

    In recent years, increases in the number of articular cartilage injuries caused by environmental factors or pathological conditions have led to a notable rise in the incidence of premature osteoarthritis. Osteoarthritis, considered a disease of civilization, is the leading cause of disability. At present, standard methods for treating damaged articular cartilage, including autologous chondrocyte implantation or microfracture, are short-term solutions with important side effects. Emerging treatments include the use of induced pluripotent stem cells, a technique that could provide a new tool for treatment of joint damage. However, research in this area is still early, and no optimal protocol for transforming induced pluripotent stem cells into chondrocytes has yet been established. Developments in our understanding of cartilage developmental biology, together with the use of modern technologies in the field of tissue engineering, provide an opportunity to create a complete functional model of articular cartilage. PMID:25383175

  9. What can biophotonics tell us about the 3D microstructure of articular cartilage?

    PubMed

    Matcher, Stephen J

    2015-02-01

    Connective tissues such as articular cartilage have been the subject of study using novel optical techniques almost since the invention of polarized light microscopy (PLM). Early studies of polarized light micrographs were the main evidential basis for the establishment of quantitative models of articular cartilage collagen structure by Benninghoff and others. Even now, state of the art optical techniques including quantitative polarized light microscopy (qPLM), optical coherence tomography (OCT), polarization-sensitive optical coherence tomography (PS-OCT), second harmonic generation (SHG) microscopy, Fourier-transform infrared (FTIR) microscopy, Raman and optical hyperspectral reflectance and fluorescence imaging are providing new insights into articular cartilage structure from the nanoscale through to the mesoscale. New insights are promised by emerging modalities such as optical elastography. This short review highlights some key recent results from modern optical techniques. PMID:25694964

  10. Giant extra-articular synovial osteochondromatosis of the left proximal thigh: A case report

    PubMed Central

    YU, XIAOLONG; LI, WEI; DAI, MIN; ZHANG, BIN; ZOU, FAN; LIU, HUCHENG

    2015-01-01

    Extra-articular synovial osteochondromatosis is a rare disease. The present study describes the case of a 46-year-old female who suffered from extra-articular synovial osteochondromatosis of the left proximal thigh with limited hip movement. The patient underwent a total tumor resection and recovered well. The tumor was 15×14×5 cm3 in size and located in the muscle gap. After a 3-month follow-up, the patient's left hip motion was improved and a computed tomography scan demonstrated no evidence of recurrence. However, the long-term efficacy of this procedure requires continuous observation of the patient. To the best of our knowledge, this is the first case of a giant extra-articular synovial osteochondromatosis of the proximal thigh muscle gap. PMID:26788172

  11. What can biophotonics tell us about the 3D microstructure of articular cartilage?

    PubMed Central

    2015-01-01

    Connective tissues such as articular cartilage have been the subject of study using novel optical techniques almost since the invention of polarized light microscopy (PLM). Early studies of polarized light micrographs were the main evidential basis for the establishment of quantitative models of articular cartilage collagen structure by Benninghoff and others. Even now, state of the art optical techniques including quantitative polarized light microscopy (qPLM), optical coherence tomography (OCT), polarization-sensitive optical coherence tomography (PS-OCT), second harmonic generation (SHG) microscopy, Fourier-transform infrared (FTIR) microscopy, Raman and optical hyperspectral reflectance and fluorescence imaging are providing new insights into articular cartilage structure from the nanoscale through to the mesoscale. New insights are promised by emerging modalities such as optical elastography. This short review highlights some key recent results from modern optical techniques. PMID:25694964

  12. Quantitative characterization of articular cartilage using Mueller matrix imaging and multiphoton microscopy

    NASA Astrophysics Data System (ADS)

    Ellingsen, Pa˚L. Gunnar; Lilledahl, Magnus Borstad; Aas, Lars Martin Sandvik; Davies, Catharina De Lange; Kildemo, Morten

    2011-11-01

    The collagen meshwork in articular cartilage of chicken knee is characterized using Mueller matrix imaging and multiphoton microscopy. Direction and degree of dispersion of the collagen fibers in the superficial layer are found using a Fourier transform image-analysis technique of the second-harmonic generated image. Mueller matrix images are used to acquire structural data from the intermediate layer of articular cartilage where the collagen fibers are too small to be resolved by optical microscopy, providing a powerful multimodal measurement technique. Furthermore, we show that Mueller matrix imaging provides more information about the tissue compared to standard polarization microscopy. The combination of these techniques can find use in improved diagnosis of diseases in articular cartilage, improved histopathology, and additional information for accurate biomechanical modeling of cartilage.

  13. Irrigating solutions used in arthroscopy and their effect on articular cartilage. An in vivo study

    SciTech Connect

    Arciero, R.A.; Little, J.S.; Liebenberg, S.P.; Parr, T.J.

    1986-11-01

    The effect of arthroscopic irrigating solutions on articular cartilage was determined by the use of an animal model. Rabbit knee joints were irrigated continuously for two hours with either normal saline, Ringer's lactate, or sterile water. Subsequently, the rate of incorporation of /sup 35/SO/sub 4/ by articular cartilage was used to measure the effect of the irrigants on chondrocyte metabolism. In addition, the irrigated groups were compared to an unirrigated control group. There was no significant difference in /sup 35/SO/sub 4/ incorporation between the groups. This suggested that none of the irrigating solutions used in this study adversely affected articular cartilage function. On the basis of these findings, it appears that normal saline, Ringer's lactate, and sterile water can be safely used as irrigating solutions during most arthroscopic procedures.

  14. Intra-Articular Giant Heterotopic Ossification following Total Knee Arthroplasty for Charcot Arthropathy

    PubMed Central

    Tsuge, Shintaro; Aoki, Yasuchika; Sonobe, Masato; Shibata, Yoshifumi; Sasaki, Yu; Nakagawa, Koichi

    2013-01-01

    Although the Charcot arthropathy may be associated with serious complications, total knee arthroplasty (TKA) is the preferred choice of treatment by patients. This case report presents an 80-year-old man with intra-articular giant heterotopic ossification following loosening of femoral and tibial implants and femoral condylar fracture. He had undergone TKA because of Charcot neuropathy seven years ago and had been doing well since. Immediately after a left knee sprain, he became unable to walk. Because he had developed a skin ulcer on his left calf where methicillin-resistant Staphylococcus aureus was detected, we postponed revision surgery until the ulcer was completely healed. While waiting, intra-articular bony fragments grew larger and formed giant heterotopic ossified masses. Eventually, the patient underwent revision surgery, and two major ossified masses were carefully and successfully extirpated. It should be noted that intra-articular heterotopic giant ossification is a significant complication after TKA for neuropathic arthropathy. PMID:24151574

  15. Large bone distractor for open reconstruction of articular fractures of the calcaneus

    PubMed Central

    Twardosz, Wojciech; Tondel, Wieslaw; Olewicz-Gawlik, Anna; Hrycaj, Pawel

    2009-01-01

    The results of operative treatment of two groups of patients with articular fractures of the calcaneus were evaluated. Twenty-three cases were treated surgically using a standard reconstruction procedure. In the second group of 19 patients a large bone distractor was used; it held the soft tissue flap retracted, while aiding in articular and tuberosity fragment reduction and increasing visualisation by distraction of the posterior talocalcaneal joint. After a year, the anatomical and functional results, together with the operative time, were evaluated. All fractures healed with good or very good anatomical results. All cases, except those with complications (n = 3), achieved good (n = 28) or very good (n = 11) functional scoring. The distractor group had significantly shorter operative times, and less manpower was needed during surgery. We conclude that the large bone distractor is a useful tool in open reconstruction of articular calcaneal fractures. PMID:19404639

  16. Mapping the Articular Contact Area of the Long Head of the Biceps Tendon on the Humeral Head

    PubMed Central

    Morris, Brent J.; Byram, Ian R.; Lathrop, Ray A.; Dunn, Warren R.; Kuhn, John E.

    2014-01-01

    The purpose of this investigation was to calculate the contact surface area of the long head of the biceps (LHB) in neutral position and abduction. We sought to determine whether the LHB articulates with the humeral head in a consistent pattern comparing articular contact area in neutral position and abduction. Eleven fresh frozen matched cadaveric shoulders were analyzed. The path of the biceps tendon on the articular surface of the humeral head and the total articular surface were digitized using a MicronTracker 2 H3-60 three-dimensional optical tracker. Contact surface area was significantly less in abduction than in neutral position (P = 0.002) with a median ratio of 41% (36%, 47.5%). Ratios of contact area in neutral position to full articular surface area were consistent between left and right shoulders (rho = 1, P = 0.017) as were ratios of abduction area to full articular surface area (rho = 0.97, P = 0.005). The articular contact surface area is significantly greater in neutral position than abduction. The ratios of articular contact surface areas to total humeral articular surface areas have a narrow range and are consistent between left and right shoulders of the same cadaver. PMID:25210631

  17. Intra-articular hyaluronate, tenoxicam and vitamin E in a rat model of osteoarthritis: evaluation and comparison of chondroprotective efficacy

    PubMed Central

    Ozkan, Feyza Unlu; Uzer, Gokcer; Türkmen, Ismail; Yildiz, Yavuz; Senol, Serkan; Ozkan, Korhan; Turkmensoy, Fatih; Ramadan, Saime; Aktas, Ilknur

    2015-01-01

    Objective: The aim of this experimental study was to evaluate and compare the chondroprotective efficacy of intra-articular hyaluronic acid, tenoxicam and vitamin E in osteoarthritis. Methods: An osteoarthritis model was created by anterior cruciate ligament transection and medial menisectomy in knees of 28 rats. The rats were randomized into four groups; first group served as a control group and received intra-articular injections of saline solution, intra-articular HA, intra-articular tenoxicam and intra-articular Vit E were applied to the treatment groups. First intra-articular injections were applied at second week postoperatively and repeated once a week for 5 weeks. At 8th week after the operation groups were compared based on the histologic scores of cartilage degeneration by Mankin Histological Grading Scale. Results: Total cartilage degeneration score was significantly increased in the control group (P=0.004). Total Mankin scores of HA, tenoxicam and Vit E groups were significantly lower than the control group (P=0.004, P=0.016, P=0.012 respectively). There was no statistically siginificant difference between the treatment groups in terms of total Mankin scores (P>0.05). Conclusion: Intra-articular application of HA, tenoxicam and Vit E are chondroprotective in early osteoarthritis model in rats. Chondroprotective activity of tenoxicam and Vit E are comparable with the beneficial effects of HA on articular cartilage. PMID:25785088

  18. Morphological, genetic and phenotypic comparison between human articular chondrocytes and cultured chondrocytes.

    PubMed

    Mata-Miranda, Mónica Maribel; Martinez-Martinez, Claudia María; Noriega-Gonzalez, Jesús Emmanuel; Paredes-Gonzalez, Luis Enrique; Vázquez-Zapién, Gustavo Jesús

    2016-08-01

    Articular cartilage is an avascular and aneural tissue with limited capacity for regeneration. On large articular lesions, it is recommended to use regenerative medicine strategies, like autologous chondrocyte implantation. There is a concern about morphological changes that chondrocytes suffer once they have been isolated and cultured. Due to the fact that there is little evidence that compares articular cartilage chondrocytes with cultured chondrocytes, in this research we proposed to obtain chondrocytes from human articular cartilage, compare them with themselves once they have been cultured and characterize them through genetic, phenotypic and morphological analysis. Knee articular cartilage samples of 10 mm were obtained, and each sample was divided into two fragments; a portion was used to determine gene expression, and from the other portion, chondrocytes were obtained by enzymatic disaggregation, in order to be cultured and expanded in vitro. Subsequently, morphological, genetic and phenotypic characteristics were compared between in situ (articular cartilage) and cultured chondrocytes. Obtained cultured chondrocytes were rounded in shape, possessing a large nucleus with condensed chromatin and a clear cytoplasm; histological appearance was quite similar to typical chondrocyte. The expression levels of COL2A1 and COL10A1 genes were higher in cultured chondrocytes than in situ chondrocytes; moreover, the expression of COL1A1 was almost undetectable on cultured chondrocytes; likewise, COL2 and SOX9 proteins were detected by immunofluorescence. We concluded that chondrocytes derived from adult human cartilage cultured for 21 days do not tend to dedifferentiate, maintaining their capacity to produce matrix and also retaining their synthesis capacity and morphology. PMID:27094849

  19. BMP Receptor Signaling Is Required for Postnatal Maintenance of Articular Cartilage

    PubMed Central

    2004-01-01

    Articular cartilage plays an essential role in health and mobility, but is frequently damaged or lost in millions of people that develop arthritis. The molecular mechanisms that create and maintain this thin layer of cartilage that covers the surface of bones in joint regions are poorly understood, in part because tools to manipulate gene expression specifically in this tissue have not been available. Here we use regulatory information from the mouse Gdf5 gene (a bone morphogenetic protein [BMP] family member) to develop new mouse lines that can be used to either activate or inactivate genes specifically in developing joints. Expression of Cre recombinase from Gdf5 bacterial artificial chromosome clones leads to specific activation or inactivation of floxed target genes in developing joints, including early joint interzones, adult articular cartilage, and the joint capsule. We have used this system to test the role of BMP receptor signaling in joint development. Mice with null mutations in Bmpr1a are known to die early in embryogenesis with multiple defects. However, combining a floxed Bmpr1a allele with the Gdf5-Cre driver bypasses this embryonic lethality, and leads to birth and postnatal development of mice missing the Bmpr1a gene in articular regions. Most joints in the body form normally in the absence of Bmpr1a receptor function. However, articular cartilage within the joints gradually wears away in receptor-deficient mice after birth in a process resembling human osteoarthritis. Gdf5-Cre mice provide a general system that can be used to test the role of genes in articular regions. BMP receptor signaling is required not only for early development and creation of multiple tissues, but also for ongoing maintenance of articular cartilage after birth. Genetic variation in the strength of BMP receptor signaling may be an important risk factor in human osteoarthritis, and treatments that mimic or augment BMP receptor signaling should be investigated as a possible

  20. The protective effect of meniscus allograft transplantation on articular cartilage: a systematic review of animal studies.

    PubMed

    Rongen, J J; Hannink, G; van Tienen, T G; van Luijk, J; Hooijmans, C R

    2015-08-01

    Despite widespread reporting on clinical results, the effect of meniscus allograft transplantation on the development of osteoarthritis is still unclear. The aim of this study was to systematically review all studies on the effect of meniscus allograft transplantation on articular cartilage in animals. Pubmed and Embase were searched for original articles concerning the effect of meniscus allograft transplantation on articular cartilage compared with both its positive (meniscectomy) and negative (either sham or non-operated) control in healthy animals. Outcome measures related to assessment of damage to articular cartilage were divided in five principal outcome categories. Standardized mean differences (SMD) were calculated and pooled to obtain an overall SMD and 95% confidence interval. 17 articles were identified, representing 14 original animal cohorts with an average timing of data collection of 24 weeks [range 4 weeks; 30 months]. Compared to a negative control, meniscus allograft transplantation caused gross macroscopic (1.45 [0.95; 1.95]), histological (3.43 [2.25; 4.61]) damage to articular cartilage, and osteoarthritic changes on radiographs (3.12 [1.42; 4.82]). Moreover, results on histomorphometrics and cartilage biomechanics are supportive of this detrimental effect on cartilage. On the other hand, meniscus allograft transplantation caused significantly less gross macroscopic (-1.19 [-1.84; -0.54]) and histological (-1.70 [-2.67; -0.74]) damage to articular cartilage when compared to meniscectomy. However, there was no difference in osteoarthritic changes on plain radiographs (0.04 [-0.48; 0.57]), and results on histomorphometrics and biomechanics did neither show a difference in effect between meniscus allograft transplantation and meniscectomy. In conclusion, although meniscus allograft transplantation does not protect articular cartilage from damage, it reduces the extent of it when compared with meniscectomy. PMID:25960117

  1. Comparison of nonlinear mechanical properties of bovine articular cartilage and meniscus.

    PubMed

    Danso, E K; Honkanen, J T J; Saarakkala, S; Korhonen, R K

    2014-01-01

    Nonlinear, linear and failure properties of articular cartilage and meniscus in opposing contact surfaces are poorly known in tension. Relationships between the tensile properties of articular cartilage and meniscus in contact with each other within knee joints are also not known. In the present study, rectangular samples were prepared from the superficial lateral femoral condyle cartilage and lateral meniscus of bovine knee joints. Tensile tests were carried out with a loading rate of 5mm/min until the tissue rupture. Nonlinear properties of the toe region, linear properties in larger strains, and failure properties of both tissues were analysed. The strain-dependent tensile modulus of the toe region, Young's modulus of the linear region, ultimate tensile stress and toughness were on average 98.2, 8.3, 4.0 and 1.9 times greater (p<0.05) for meniscus than for articular cartilage. In contrast, the toe region strain, yield strain and failure strain were on average 9.4, 3.1 and 2.3 times greater (p<0.05) for cartilage than for meniscus. There was a significant negative correlation between the strain-dependent tensile moduli of meniscus and articular cartilage samples within the same joints (r=-0.690, p=0.014). In conclusion, the meniscus possesses higher nonlinear and linear elastic stiffness and energy absorption capability before rupture than contacting articular cartilage, while cartilage has longer nonlinear region and can withstand greater strains before failure. These findings point out different load carrying demands that both articular cartilage and meniscus have to fulfil during normal physiological loading activities of knee joints. PMID:24182695

  2. Extraction of mechanical properties of articular cartilage from osmotic swelling behavior monitored using high frequency ultrasound.

    PubMed

    Wang, Q; Zheng, Y P; Niu, H J; Mak, A F T

    2007-06-01

    Articular cartilage is a biological weight-bearing tissue covering the bony ends of articulating joints. Negatively charged proteoglycan (PG) in articular cartilage is one of the main factors that govern its compressive mechanical behavior and swelling phenomenon. PG is nonuniformly distributed throughout the depth direction, and its amount or distribution may change in the degenerated articular cartilage such as osteoarthritis. In this paper, we used a 50 MHz ultrasound system to study the depth-dependent strain of articular cartilage under the osmotic loading induced by the decrease of the bathing saline concentration. The swelling-induced strains under the osmotic loading were used to determine the layered material properties of articular cartilage based on a triphasic model of the free-swelling. Fourteen cylindrical cartilage-bone samples prepared from fresh normal bovine patellae were tested in situ in this study. A layered triphasic model was proposed to describe the depth distribution of the swelling strain for the cartilage and to determine its aggregate modulus H(a) at two different layers, within which H(a) was assumed to be linearly dependent on the depth. The results showed that H(a) was 3.0+/-3.2, 7.0+/-7.4, 24.5+/-11.1 MPa at the cartilage surface, layer interface, and deep region, respectively. They are significantly different (p<0.01). The layer interface located at 70%+/-20% of the overall thickness from the uncalcified-calcified cartilage interface. Parametric analysis demonstrated that the depth-dependent distribution of the water fraction had a significant effect on the modeling results but not the fixed charge density. This study showed that high-frequency ultrasound measurement together with triphasic modeling is practical for quantifying the layered mechanical properties of articular cartilage nondestructively and has the potential for providing useful information for the detection of the early signs of osteoarthritis. PMID:17536909

  3. Alterations in periarticular bone and cross talk between subchondral bone and articular cartilage in osteoarthritis.

    PubMed

    Goldring, Steven R

    2012-08-01

    The articular cartilage and the subchondral bone form a biocomposite that is uniquely adapted to the transfer of loads across the diarthrodial joint. During the evolution of the osteoarthritic process biomechanical and biological processes result in alterations in the composition, structure and functional properties of these tissues. Given the intimate contact between the cartilage and bone, alterations of either tissue will modulate the properties and function of the other joint component. The changes in periarticular bone tend to occur very early in the development of OA. Although chondrocytes also have the capacity to modulate their functional state in response to loading, the capacity of these cells to repair and modify their surrounding extracellular matrix is relatively limited in comparison to the adjacent subchondral bone. This differential adaptive capacity likely underlies the more rapid appearance of detectable skeletal changes in OA in comparison to the articular cartilage. The OA changes in periarticular bone include increases in subchondral cortical bone thickness, gradual decreases in subchondral trabeular bone mass, formation of marginal joint osteophytes, development of bone cysts and advancement of the zone of calcified cartilage between the articular cartilage and subchondral bone. The expansion of the zone of calcified cartilage contributes to overall thinning of the articular cartilage. The mechanisms involved in this process include the release of soluble mediators from chondrocytes in the deep zones of the articular cartilage and/or the influences of microcracks that have initiated focal remodeling in the calcified cartilage and subchondral bone in an attempt to repair the microdamage. There is the need for further studies to define the pathophysiological mechanisms involved in the interaction between subchondral bone and articular cartilage and for applying this information to the development of therapeutic interventions to improve the

  4. Single cell sorting identifies progenitor cell population from full thickness bovine articular cartilage

    PubMed Central

    Yu, Yin; Zheng, Hongjun; Buckwalter, Joseph A.; Martin, James A.

    2014-01-01

    Objective To date, no approved clinical intervention successfully prevents the progressive degradation of injured articular cartilage that leads to osteoarthritis (OA). Stem/progenitor cell populations within tissues of diarthrodial joint have shown their therapeutic potential in treating OA. However, this potential has not been fully realized due in part to the heterogeneity of these subpopulations. Characterization of clonal populations derived from a single cell may help identify more homogenous stem/progenitor populations within articular cartilage. Moreover, chondrogenic potential of clonal populations from different zones could be further examined to elucidate their differential roles in maintaining articular cartilage homeostasis. Method We combined FACS (Fluorescence-activated cell sorting) and clonogenicity screening to identify stem/progenitor cells cloned from single cells. High-efficiency colony-forming cells (HCCs) were isolated, and evaluated for stem/progenitor cell characteristics. HCCs were also isolated from different zones of articular cartilage. Their function was compared by lineage-specific gene expression, and differentiation potential. Results A difference in colony-forming efficiency was observed in terms of colony sizes. HCCs were highly clonogenic and multipotent, and overexpressed stem/progenitor cell markers. Also, proliferation and migration associated genes were over-expressed in HCCs. HCCs showed zonal differences with deep HCCs more chondrogenic and osteogenic than superficial HCCs. Conclusion Our approach is a simple yet practical way to identify homogeneous stem/progenitor cell populations with clonal origin. The discovery of progenitor cells demonstrates the intrinsic self-repairing potential of articular cartilage. Differences in differentiation potential may represent the distinct roles of superficial and deep zone stem/progenitor cells in the maintenance of articular cartilage homeostasis. PMID:25038490

  5. Biological Effects of the Plant-derived Polyphenol Resveratrol in Human Articular Cartilage and Chondrosarcoma Cells

    PubMed Central

    Im, Hee-Jeong; Li, Xin; Chen, Di; Yan, Dongyao; Kim, Jaesung; Ellman, Michael B; Stein, Gary S.; Cole, Brian; Ranjan, KC; Cs-Szabo, Gabriella; van Wijnen, Andre J

    2012-01-01

    The natural phytoestrogen resveratrol (RSV) may have therapeutic potential for arthritic conditions. RSV is chondroprotective for articular cartilage in rabbit models for arthritis, but its biological effects on human articular cartilage and chondrosarcoma cells are unknown. Effects of RSV on human articular cartilage homeostasis were studied by assessing production of matrix-degrading enzymes (MMP-13, ADAMTS-4, and ADAMTS-5), as well as proteoglycan production and synthesis. The counteractions of RSV against catabolic factors (e.g., FGF-2 or IL-1β) were examined by in vitro and ex vivo using monolayer, three-dimensional alginate beads and cartilage explants cultures, respectively. RSV improves cell viability of articular chondrocytes and effectively antagonizes cartilage-degrading protease production that was initiated by catabolic and/or anti-anabolic cytokines in human articular chondrocytes. RSV significantly also enhances BMP7-promoted proteoglycan synthesis as assessed by 35S-sulfate incorporation. Protein-DNA interaction arrays suggest that RSV inhibits the activation of transcription factors involved in inflammation and cartilage catabolic signaling pathways, including direct downstream regulators of MAPK (e.g., AP-1, PEA3) and NFκB. RSV selectively compromises survival of human chondrosarcoma cells, but not primary articular chondrocytes, revealing cell-specific activity of RSV on non-tumorigenic versus tumor-derived cells. We propose that RSV exerts its chondroprotective functions, in part, by deactivating p53-induced apoptosis in human primary chondrocytes, but not human chondrosarcoma. Our findings suggest that RSV has potential as a unique biologic treatment for both prevention and treatment of cartilage degenerative diseases. PMID:22252971

  6. Clinical and MRI investigation of temporomandibular joint in major depressed patients

    PubMed Central

    Lopes, SLPC; Costa, ALF; Cruz, AD; Li, LM; de Almeida, SM

    2012-01-01

    Objective The aim of the present study was to describe the clinical and MRI findings of the temporomandibular joint (TMJ) in patients with major depressive disorders (MDDs) of the non-psychotic type. Methods 40 patients (80 TMJs) who were diagnosed as having MDDs were selected for this study. The clinical examination of the TMJs was conducted according to the research diagnostic criteria and temporomandibular disorders (TMDs). The MRIs were obtained bilaterally in each patient with axial, parasagittal and paracoronal sections within a real-time dynamic sequence. Two trained oral radiologists assessed all images. For statistical analyses, Fisher's exact test and χ2 test were applied (α = 0.05). Results Migraine was reported in 52.5% of subjects. Considering disc position, statistically significant differences between opening patterns with and without alteration (p = 0.00) and between present and absent joint noises (p = 0.00) were found. Regarding muscular pain, patients with and without abnormalities in disc function and patients with and without abnormalities in disc position were not statistically significant (p = 0.42 and p = 0.40, respectively). Significant differences between mandibular pathway with and without abnormalities (p = 0.00) and between present and absent joint noises (p = 0.00) were observed. Conclusion Based on the preliminary results observed by clinical and MRI examination of the TMJ, no direct relationship could be determined between MDDs and TMDs. PMID:22517997

  7. Effectiveness of a Home Exercise Program in Combination with Ultrasound Therapy for Temporomandibular Joint Disorders

    PubMed Central

    Ucar, Mehmet; Sarp, Ümit; Koca, İrfan; Eroğlu, Selma; Yetisgin, Alparslan; Tutoglu, Ahmet; Boyacı, Ahmet

    2014-01-01

    [Purpose] This study compared the effectiveness of home exercise alone versus home exercise combined with ultrasound for patients with temporomandibular joint disorders. [Subjects and Methods] This study enrolled 23 female and 15 male patients who were divided randomly into two groups. The home exercise group performed a home exercise program consisting of an exercise program and patient education, and the home exercise combined with ultrasound group received ultrasound therapy in addition to the home exercise program. Pain intensity was evaluated using a visual analogue scale. Pain free maximum mouth opening was evaluated at baseline and 2 weeks after the treatment. [Results] There was no difference between the two groups in baseline values. After the treatment, the visual analogue scale decreased and pain free maximum mouth opening scores improved significantly in each group. Additionally, both values were higher in the home exercise combined with ultrasound group than in the home exercise group. [Conclusion] The combination of home exercise combined with ultrasound appears to be more effective at providing pain relief and increasing mouth opening than does home exercise alone for patients with temporomandibular joint disorders. PMID:25540479

  8. Use of Theraflex-TMJ topical cream for the treatment of temporomandibular joint and muscle pain.

    PubMed

    Lobo, Silvia Lobo; Mehta, Noshir; Forgione, Albert G; Melis, Marcello; Al-Badawi, Emad; Ceneviz, Caroline; Zawawi, Khalid H

    2004-04-01

    This randomized, double-blind study was designed to evaluate the effectiveness of the topical cream Theraflex-TMJ (NaBob/Rx, San Mateo, CA) in patients with masseter muscle pain and temporomandibular joint (TMJ) pain. Fifty-two subjects (5 males and 47 females) were instructed to apply a cream over the afflicted masseter muscle(s) or over the jaw joint(s) twice daily for two weeks. Theraflex-TMJ cream was used by the experimental group, while a placebo cream was used by the control group. The means of pain ratings were calculated prior to the application of the cream (baseline), after ten days of tx (period 1), and 15 days of tx (period 2) days of treatment and five days after stopping the treatment (follow-up). There was a significant decrease in reported pain levels from baseline in the experimental group for period 1 (p < 0.01), period 2 (p < 0.001), and follow-up (p < 0.01). For the control group, no significant differences were found between the different time periods (p > 0.05). There was evidence of minor side effects such as skin irritation and/or burning on the site of the application in two subjects in the experimental as well as two subjects in the control groups. The data strongly suggest that Theraflex-TMJ topical cream is safe and effective for reducing pain in the masseter muscle and the temporomandibular joint. PMID:15134414

  9. The relationship between unilateral mandibular angle fracture and temporomandibular joint function.

    PubMed

    Baltrusaityte, Ausra; Surna, Algimantas; Pileicikiene, Gaivile; Kubilius, Ricardas; Gleiznys, Alvydas; Zilinskas, Juozas

    2014-01-01

    PURPOSE. Aim of this study was to analyze relation of occlusal correction and alterations of temporomandibular joint function during treatment of unilateral mandibular fractures. MATERIALS AND METHODS. We compared 49 patients treated for unilateral mandibular fracture without occlusal correction with 21 patient treated for unilateral mandibular fracture along with early and consequent occlusal analysis and correction and with 49 control subjects. Patients' complaints, mandibular movements and occlusal parameters were evaluated during the period of healing. ZEBRIS ultrasound system (Jaw Motion Analyzer, Zebris Medical GmbH, Isny, Germany) was used for analysis of mandibular movements and T-Scan analyzer (Tekscan, Inc., Boston, MA, USA) was used for occlusal analysis. RESULTS. Findings of our study showed statistically significant (p<0.05) diminution of patients complaints, mandibular movement alterations and occlusal disturbances in patients who received occlusal correction during MF treatment if compared to patients treated without occlusal correction, except noises from the joint in the injured side and mandibular lateral track to the injured side in the final stage of investigation. Despite applied treatment recovery of the TMJ function was not complete and the investigated parameters remained worse if compared to the control group. CONCLUSIONS. Results of this study confirmed positive influence of early and subsequent occlusal analysis and correction during stages of MF treatment on diminution of functional alterations of the temporomandibular joint function. Timely occlusal correction improves and hastens process of rehabilitation therefore it is indispensable part of MF treatment. PMID:25471992

  10. Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students.

    PubMed

    Iunes, Denise Hollanda; Chaves, Érika de Cássia Lopes; Moura, Caroline de Castro; Côrrea, Bruna; Carvalho, Leonardo César; Silva, Andreia Maria; de Carvalho, Emília Campos

    2015-01-01

    Introduction. The aim of this study was to evaluate the role of auriculotherapy with mustard seeds in the treatment of temporomandibular disorders (TMDs), anxiety, and electromyographic (EMG) activity in university students. Methodology. The State Trait Anxiety Inventory (STAI), Research Diagnostic Criteria (RDC) for TMDs (RDC/TMDs), and electromyography were used in this study of 44 college students with high levels of anxiety and TMDs. The subjects were divided into two groups: an auriculotherapy (AA) group (n = 31) and an AA sham group (n = 13). The mustard seeds were applied to the shenmen, rim, sympathetic, brain stem, and temporomandibular joint (TMJ) points in the AA group and to sham points in the external ear and wrist in the AA sham group. The treatment protocol was 10 sessions (two treatments per week). Results. Anxiety (p < 0.01) was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region (p = 0.04) and in the right side of the submandibular region (p = 0.02). Complaints of bilateral pain were reduced in the temporal tendon (p ≤ 0.01) and in the left side of the ATM (p < 0.01). In addition, electromyographic (EMG) activity was reduced during temporal muscle contraction (p = 0.03).  Conclusion. Auriculotherapy was effective in the treatment of students with anxiety and TMDs. PMID:26495012

  11. Is There a Relation between Tension-Type Headache, Temporomandibular Disorders and Sleep?

    PubMed

    Caspersen, N; Hirsvang, J R; Kroell, L; Jadidi, F; Baad-Hansen, L; Svensson, P; Jensen, R

    2013-01-01

    Introduction. Tension-Type Headache (TTH) is the most prevalent headache often associated with impaired function and quality of life. Temporomandibular Disorders (TMD) and TTH frequently coexist; characterized by pericranial tenderness and impact on daily life. We aim to apply a standardized questionnaire for TMD to characterize and analyse an eventual relation between sleep and oral health in TTH in a controlled design. Material and Methods. 58 consecutive TTH patients and 58 healthy controls were included. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire, Oral Health Impact profile (OHIP) and questionnaires for sleep were applied. Results. TTH-patients had significantly higher pain scores (P < 0.001), decreased quality of life (P < 0.001), and higher total sleep scores (P < 0.001) compared to controls. Conclusion. For the first time we have identified a clear relation between TTH and TMD symptoms, depression, anxiety, poor sleep, and impairments of oral function in carefully classified patients. These findings indicate a close, but incomplete, overlap between TTH and TMD. Their underlying pathophysiological mechanisms need further research. PMID:24349777

  12. Quality of life and general health in patients with temporomandibular disorders.

    PubMed

    Resende, Camila Maria Bastos Machado de; Alves, Arthur César de Medeiros; Coelho, Lidiane Thomaz; Alchieri, Joõo Carlos; Roncalli, Angelo Giuseppe; Barbosa, Gustavo Augusto Seabra

    2013-01-01

    The aim of this study was to associate minor psychiatric disorders (general health) and quality of life with temporomandibular disorders (TMD) in patients diagnosed with different TMD classifications and subclassifications with varying levels of severity. Among 150 patients reporting TMD symptoms, 43 were included in the present study. Fonseca's anamnestic index was used for initial screening while axis I of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD) was used for TMD diagnosis (muscle-related, joint-related or muscle and joint-related). Minor psychiatric disorders were evaluated through the General Health Questionnaire (GHQ) and quality of life was assessed using the World Health Organization Quality Of Life-Brief Version (WHOQOL-BREF). An association was found between minor psychiatric disorders and TMD severity, except for stress. A stronger association was found with mild TMD. Considering TMD classifications and severity together, only the item "death wish" from the GHQ was related to severe muscle-related TMD (p = 0.049). For quality of life, an association was found between disc displacement with reduction and social domain (p = 0.01). Physical domains were associated with TMD classifications and severity and the association was stronger for muscle and joint-related TMD (p = 0.37) and mild TMD (p = 0.042). It was concluded that patients with TMD require multiple focuses of attention since psychological indicators of general health and quality of life are likely associated with dysfunction. PMID:23459771

  13. Differential Diagnostics of Pain in the Course of Trigeminal Neuralgia and Temporomandibular Joint Dysfunction

    PubMed Central

    Pihut, M.; Szuta, M.; Ferendiuk, E.; Zeńczak-Więckiewicz, D.

    2014-01-01

    Chronic oral and facial pain syndromes are an indication for intervention of physicians of numerous medical specialties, while the complex nature of these complaints warrants interdisciplinary diagnostic and therapeutic approach. Oftentimes, lack of proper differentiation of pain associated with pathological changes of the surrounding tissues, neurogenic pain, vascular pain, or radiating pain from idiopathic facial pain leads to improper treatment. The objective of the paper is to provide detailed characterization of pain developing in the natural history of trigeminal neuralgia and temporomandibular joint dysfunction, with particular focus on similarities accounting for the difficulties in diagnosis and treatment as well as on differences between both types of pain. It might seem that trigeminal neuralgia can be easily differentiated from temporomandibular joint dysfunction due to the acute, piercing, and stabbing nature of neuralgic pain occurring at a single facial location to spread along the course of the nerve on one side, sometimes a dozen or so times a day, without forewarning periods. Both forms differ significantly in the character and intensity of pain. The exact analysis of the nature, intensity, and duration of pain may be crucial for the differential diagnostics of the disorders of our interest. PMID:24995309

  14. A radiographic evaluation of temporomandibular and hand (Metacarpophalangeal) / wrist joints of patients with adult rheumatoid arthritis

    PubMed Central

    Kurup, Seema; Gharote, Harshkant; Jose, Renju

    2012-01-01

    Background: A review of literature revealed that, although the involvement of temporomandibular joint (TMJ) in rheumatoid arthritis (RA) patients is not uncommon, variation in presentation persist. Comparative studies of bony changes in the right and left TMJ with the right and left peripheral hand (Metacarpophalangeal-MCP)/wrist joints have not been done, to the best of our knowledge. Materials and Methods: In this cross-sectional study, the temporomandibular and hand (MCP) and wrist joints of fifteen rheumatoid arthritis patients were evaluated with questionnaires, clinical and lab assessment and radiographically using conventional radiographs and computed tomography. Students t-test was applied for the statistical analysis of the data obtained and a P value of 0.05 was considered as statistically significant. Results: Comparisons between the right TMJ with right MCP/wrist joint and left TMJ with left MCP/wrist joint did not reveal statistically significant results. Radiographically, flattening and erosions were the common manifestations. MCP joints were more affected than the wrist, but whenever the wrist was involved, it was more likely to be bilaterally affected. Conclusions: Although the TMJ showed osseous changes of a higher grade than the hand (MCP) and wrist joints radiographically, it was observed that patients were more aware of the peripheral joint discomfort. There were no significant differences between TMJ and peripheral joints on both right and left sides. PMID:23814559

  15. Is there a niche for arthroscopic laser surgery of the temporomandibular joint?

    NASA Astrophysics Data System (ADS)

    Nuebler-Moritz, Michael; Hering, Peter; Bachmaier, Uli; Schiessl, Robert; Rueschoff, Josef; Meister, Joerg

    1996-04-01

    The purpose of this in vitro study was to investigate and compare effects of currently available laser systems at different wavelengths (XeCl excimer laser, Holmium:YAG laser, Erbium:YAG laser) on porcine articulating facets, capsule and meniscus of the temporomandibular joint via photomacroscopy, light and scanning electron microscopy. From a critical review of the relevant literature and the preliminary observations of this investigation, it appears that the Neodymium:YAG laser is inappropriate for TMJ arthroscopic surgery with regard to the huge thermal injury caused to the remaining tissue. The Holmium:YAG laser suffers from remarkable photomechanical and photothermal side effects, whereas the Erbium:YAG laser ablates temporomandibular joint tissue efficiently with minimal adjacent damage--similar to the XeCl excimer laser, without entailing the risk of potential mutagenity. To sum up, it can be concluded that there is a clinical need for laser- assisted arthroscopic surgery of the craniomandibular articulation. Nevertheless, at present none of the available laser systems meet the medical demands completely. Currently, the Erbium:YAG laser seems to be the most suitable for TMJ arthroscopic surgery.

  16. Differential diagnostics of pain in the course of trigeminal neuralgia and temporomandibular joint dysfunction.

    PubMed

    Pihut, M; Szuta, M; Ferendiuk, E; Zeńczak-Więckiewicz, D

    2014-01-01

    Chronic oral and facial pain syndromes are an indication for intervention of physicians of numerous medical specialties, while the complex nature of these complaints warrants interdisciplinary diagnostic and therapeutic approach. Oftentimes, lack of proper differentiation of pain associated with pathological changes of the surrounding tissues, neurogenic pain, vascular pain, or radiating pain from idiopathic facial pain leads to improper treatment. The objective of the paper is to provide detailed characterization of pain developing in the natural history of trigeminal neuralgia and temporomandibular joint dysfunction, with particular focus on similarities accounting for the difficulties in diagnosis and treatment as well as on differences between both types of pain. It might seem that trigeminal neuralgia can be easily differentiated from temporomandibular joint dysfunction due to the acute, piercing, and stabbing nature of neuralgic pain occurring at a single facial location to spread along the course of the nerve on one side, sometimes a dozen or so times a day, without forewarning periods. Both forms differ significantly in the character and intensity of pain. The exact analysis of the nature, intensity, and duration of pain may be crucial for the differential diagnostics of the disorders of our interest. PMID:24995309

  17. Dexmedetomidine premedication for fiberoptic intubation in patients of temporomandibular joint ankylosis: A randomized clinical trial

    PubMed Central

    Gupta, Kumkum; Jain, Manish; Gupta, Prashant K.; Rastogi, Bhawna; Saxena, Sanjeev K.; Manngo, Aman

    2012-01-01

    Background: Fiberoptic intubation is the gold standard technique for difficult airway management in patients of temporomandibular joint. This study was aimed to evaluate the clinical efficacy and safety of dexmedetomidine as premedication with propofol infusion for fiberoptic intubation. Methods: Consent was obtained from 46 adult patients of temporomandibular joint ankylosis, scheduled for gap arthroplasty. They were enrolled for thisdouble-blind, randomized, prospective clinical trial with two treatment groups – Group D and Group P, of 23 patients each. Group D patients had received premedication of dexmedetomidine 1 μg/kg infused over 10 min followed by sedative propofol infusion and the control Group P patients were given only propofol infusion to achieve sedation. Condition achieved at endoscopy, intubating conditions, hemodynamic changes and postoperative events were evaluated as primary outcome. Results: The fiberoptic intubation was successful with satisfactory endoscopic and intubating condition in all patients. Dexmedetomidine premedication has provided satisfactory conditions for fiberoptic intubation and attenuated the hemodynamic response of fiberoptic intubation than the propofol group. Conclusion: Fiberoptic intubation was found to be easier with dexmedetomidine premedication along with sedative infusion of propofol with complete amnesia of the procedure, hemodynamic stability and preservation of patent airway. PMID:23162393

  18. Gene Expression Profiling of IL-17A-Treated Synovial Fibroblasts from the Human Temporomandibular Joint

    PubMed Central

    Hattori, Toshio; Ogura, Naomi; Akutsu, Miwa; Kawashima, Mutsumi; Watanabe, Suguru; Ito, Ko; Kondoh, Toshirou

    2015-01-01

    Synovial fibroblasts contribute to the inflammatory temporomandibular joint under pathogenic stimuli. Synovial fibroblasts and T cells participate in the perpetuation of joint inflammation in a mutual activation feedback, via secretion of cytokines and chemokines that stimulate each other. IL-17 is an inflammatory cytokine produced primarily by Th17 cells which plays critical role in the pathogenesis of numerous autoimmune and inflammatory diseases. Here, we investigated the roles of IL-17A in temporomandibular joint disorders (TMD) using genome-wide analysis of synovial fibroblasts isolated from patients with TMD. IL-17 receptors were expressed in synovial fibroblasts as assessed using real-time PCR. Microarray analysis indicated that IL-17A treatment of synovial fibroblasts upregulated the expression of IL-6 and chemokines. Real-time PCR analysis showed that the gene expression of IL-6, CXCL1, IL-8, and CCL20 was significantly higher in IL-17A-treated synovial fibroblasts compared to nontreated controls. IL-6 protein production was increased by IL-17A in a time- and a dose-dependent manner. Additionally, IL-17A simulated IL-6 protein production in synovial fibroblasts samples isolated from three patients. Furthermore, signal inhibitor experiments indicated that IL-17-mediated induction of IL-6 was transduced via activation of NFκB and phosphatidylinositol 3-kinase/Akt. These results suggest that IL-17A is associated with the inflammatory progression of TMD. PMID:26839464

  19. Long-term stability of conservative orthodontic treatment in a patient with temporomandibular joint disorder

    PubMed Central

    Mitsui, Silvia Naomi; Yasue, Akihiro; Kuroda, Shingo; Tanaka, Eiji

    2016-01-01

    This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function. PMID:27556023

  20. Innovative Surgical Management of the Synovial Chondromatosis of Temporo-Mandibular Joints: Highly Conservative Surgical Technique.

    PubMed

    Ionna, Franco; Amantea, Massimiliano; Mastrangelo, Filiberto; Ballini, Andrea; Maglione, Maria Grazia; Aversa, Corrado; De Cecio, Rossella; Russo, Daniela; Marrelli, Massimo; Tatullo, Marco

    2016-07-01

    Synovial chondromatosis (SC) is an uncommon disease characterized by a benign nodular cartilaginous proliferation arising from the joint synovium, bursae, or tendon sheaths. Although the temporomandibular joint is rarely affected by neoplastic lesions, SC is the most common neoplastic lesion of this joint. The treatment of this disease consists in the extraoral surgery with a wide removal of the lesion; in this study, the authors described a more conservative intraoral surgical approach. Patient with SC of temporomandibular joint typically refer a limitation in the mouth opening, together with a persistent not physiological mandibular protrusion and an appearance of a neoformation located at the right preauricular region: the authors reported 1 scholar patient. After biopsy of the neoformation, confirming the synovial chondromatosis, the patient underwent thus to the surgical excision of the tumor, via authors' conservative transoral approach, to facilitate the enucleation of the neoformation. The mass fully involved the pterygo-maxillary fossa with involvement of the parotid lodge and of the right TMJ: this multifocal extension suggested for a trans-oral surgical procedure, in the light of the suspicion of a possible malignant nature of the neoplasm. Our intraoral conservative approach to surgery is aimed to reduce the presence of unaesthetic scars in preauricular and facial regions, with surgical results undoubtedly comparable to the traditional surgical techniques much more aggressive. Our technique could be a valid, alternative, and safe approach to treat this rare and complex kind of oncological disease. PMID:27300457