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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. Conservative treatment of temporomandibular joint osteoarthrosis: intra-articular injection of sodium hyaluronate.

    PubMed

    Guarda-Nardini, L; Masiero, S; Marioni, G

    2005-10-01

    Promising short-term results in the treatment of temporomandibular joint osteoarthrosis with intra-articular injections of sodium hyaluronate (SH) have been reported in preliminary studies. The present prospective study compared long-term outcomes of temporomandibular joint SH injections with those of a conventional non-surgical treatment (bite-plane). Data from three groups of 20 patients with degenerative temporomandibular joint disease were considered. Group A underwent one cycle of five injections of 1 mL SH. Group B underwent a bite-plane treatment for at least 6 months. We considered a control group of 20 patients who refused any treatments. The description of the outcomes was based on objective and subjective parameters after a 6-month follow-up. Sodium hyaluronate and bite-plane treatments significantly improved patients conditions in all considered parameters. No significant differences in outcomes were confirmed by the statistical analysis. The tolerability of SH treatment resulted to be significantly higher. The analysis of results of serial controls in the SH treated group disclosed a significant worsening in pain at rest by comparing 1 and 6 months follow-up. Sodium hyaluronate infiltration resulted a valid non-surgical treatment for temporomandibular joint degenerative disease. Five well-tolerated intra-articular SH injections achieved equivalent results to those of a 6 months bite-plane treatment. We did not diagnose any complications of SH intra-articular injections. Longer time follow-up is necessary to determine the stability of SH properties.

  3. 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

  4. 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

  5. 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

  6. The articular disc surface in different functional conditions of the human temporo-mandibular joint.

    PubMed

    Marchetti, C; Bernasconi, G; Reguzzoni, M; Farina, A

    1997-07-01

    The peripheral discal tissue and the surface covering layer have been studied in normal and in variously damaged human temporo-mandibular joint discs. In the normal disc the tissue consisted of dense bundles of fibers and rare fibrocytes. The surface of the disc was covered by a regular basophilic and electron-dense layer. These morphological characteristics persisted also in some pathological discs in which fibrous derangements had already occurred in the deep parts. In very deformed and damaged discs associated with serious functional anomalies, the superficial discal tissue consisted of rare fibers dispersed in a loose ground substance and of an increased number of cells. The superficial coating was formed by an irregular dense lamina and aggregates of various materials containing cellular debris, vesicles, filaments and amorphous components. These deposits are probably due to degeneration processes of discal tissue. This investigation suggests that the superficial discal tissue and the covering layer are together involved in maintaining the functional properties of the articular surfaces. Their structural modification in severe functional anomalies leads to failure in the maintenance of nonadherence conditions and to deterioration of the functional defect.

  7. 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

  8. 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

  9. Finite element modelling of the articular disc behaviour of the temporo-mandibular joint under dynamic loads.

    PubMed

    Jaisson, Maxime; Lestriez, Philippe; Taiar, Redha; Debray, Karl

    2011-01-01

    The proposed biodynamic model of the articular disc joint has the ability to affect directly the complete chewing mechanism process and its related muscles defining its kinematics. When subjected to stresses from the mastication muscles, the disc absorbs one part and redistributes the other to become completely distorted. To develop a realistic model of this intricate joint a CT scan and MRI images from a patient were obtained to create sections (layers) and MRI images to create an anatomical joint CAD model, and its corresponding mesh element using a finite element method. The boundary conditions are described by the external forces applied to the joint model through a decomposition of the maximum muscular force developed by the same individual. In this study, the maximum force was operating at frequencies close to the actual chewing frequency measured through a cyclic loading condition. The reaction force at the glenoid fossa was found to be around 1035 N and is directly related to the frequency of indentation. It is also shown that over the years the areas of maximum stresses are located at the lateral portion of the disc and on its posterior rim. These forces can reach 13.2 MPa after a period of 32 seconds (s) at a frequency of 0.5 Hz. An important part of this study is to highlight resilience and the areas where stresses are at their maximum. This study provides a novel approach to improve the understanding of this complex joint, as well as to assess the different pathologies associated with the disc disease that would be difficult to study otherwise.

  10. 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 ...

  11. 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

  12. 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.

  13. 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

  14. [Temporo-mandibular joint. Morpho-functional considerations].

    PubMed

    Scutariu, M D; Indrei, Anca

    2004-01-01

    The temporo-mandibular joint is distinguished from most other synovial joints of the body by two features: 1. the two jointed components carry teeth whose position and occlusion introduce a very strong influence on the movements of the temporo-mandibular joint and 2. its articular surfaces are not covered by hyaline cartilage, but by a dense, fibrous tissue. This paper describes the parts of the temporo-mandibular joint: the articular surfaces (the condylar process of the mandible and the glenoid part of the temporal bone), the fibrocartilaginous disc which is interposed between the mandibular and the temporal surface, the fibrous capsule of the temporo-mandibular joint and the ligaments of this joint. All these parts present a very strong adaptation at the important functions of the temporo-mandibular joint.

  15. [Diagnostic temporo-mandibular arthroscopy. Principle lesions, apropos of 50 case reports].

    PubMed

    Chossegros, C; Cheynet, F; Blanc, J L; Gola, R; Lachard, J

    1991-01-01

    Diagnostic arthroscopy is reserved to patients who suffer from internal temporo-mandibular joint derangements resisting to conservative treatments. This technique allows an acute diagnostic approach to the intra-articular lesions of the superior compartment.

  16. Anatomical and physiological considerations regarding the temporomandibular joint.

    PubMed

    Boering, G

    1979-12-01

    The structure and function of the human temporomandibular joint has concerned several investigators but still fundamental questions exist and require further examination. A profound knowledge of the normal anatomy and histology of the temporomandibular joint is necessary to understand its function and functional disturbances. It is also necessary for a good understanding of clinical findings and the interpretation of radiographs. In this paper a clinically orientated description has been given of the anatomy and histology of the mandibular head, the articular fossa and eminence, the articular disc, the capsule and ligaments, the synovial membrane, the innervation of the joint and the normal relationship between the different components. About the physiology of the temporomandibular joint many controversial theories exist. A lot of research has still to be done, especially in the field of the co-ordination of the function of both joints, the muscles and the dentition.

  17. [Temporomandibular joint, occlusion and bruxism].

    PubMed

    Orthlieb, J D; Ré, J P; Jeany, M; Giraudeau, A

    2016-09-01

    Temporomandibular joint and dental occlusion are joined for better and worse. TMJ has its own weaknesses, sometimes indicated by bad functional habits and occlusal disorders. Occlusal analysis needs to be addressed simply and clearly. The term "malocclusion" is not reliable to build epidemiological studies, etiologic mechanisms or therapeutic advice on this "diagnosis". Understanding the impact of pathogenic malocclusion is not just about occlusal relationships that are more or less defective, it requires to locate them within the skeletal framework, the articular and behavioural context of the patient, and above all to assess their impact on the functions of the masticatory system. The TMJ-occlusion couple is often symbiotic, developing together in relation to its environment, compensating for its own shortcomings. However, a third partner may alter this relationship, such as bruxism, or more generally oral parafunctions, trauma or an interventionist practitioner. PMID:27523443

  18. Temporomandibular joint arthrocentesis. Review of the literature

    PubMed Central

    Nitzan, Dorrit; González-Garcia, Raul

    2012-01-01

    The treatment of the temporomandibular joint (TMJ) is still controversial. TMJ arthrocentesis represents a form of minimally invasive surgical treatment in patients suffering from internal derangement of the TMJ, especially closed lock. It consists of washing the joint with the possibility of depositing a drug or other therapeutic substance. Resolution of symptoms is due to the removal of chemical inflammatory mediators and changes in intra-articular pressure. Numerous clinical studies regarding this technique have been published. The goal of this paper is to review all clinical articles that have been published with regard to the critique of this technique. 19 articles with different designs fulfilling selection guidelines were chosen. A series of clinical and procedure variables were analyzed. Although the mean of improvement was higher that 80%, further research is needed to determine more homogeneous indications for TMJ athrocentesis. Key words:Temporomandibular joint, arthrocentesis, minimally invasive surgery. PMID:22322493

  19. Temporomandibular Joint Disorders’ Impact on Pain, Function, and Disability

    PubMed Central

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

    2015-01-01

    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

  20. 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.

  1. 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 ...

  2. 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 ...

  3. Temporomandibular joint diagnostics using CBCT.

    PubMed

    Larheim, T A; 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.

  4. 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

  5. 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

  6. Temporomandibular joint arthrocentesis: long-term results.

    PubMed

    Spallaccia, F; Rivaroli, A; Cascone, P

    2000-01-01

    Arthrocentesis is a simple procedure, that may be performed under local anaesthesia and entails low risks of complications. It consists in the lavage of the upper joint compartment of the temporo-mandibular articulation through two transcutaneous needles of entrance and exit. The simplicity of execution, the low costs of the material employed and the excellent results published cause that this technique is beginning to be included in international protocols of treatment of temporomandibular dysfunctions. The clinical study involves 26 articulation in 25 patients. The age of the subjects at the time of the treatment ranged from 16 to 70 years. The follow-up of the patients treated ranges from a minimum of 12 to a maximum of 53 months. The most significant parameters to assess the effectiveness of the articular lavage, performed by the arthrocentesis technique, are the local pain intensity and the millimetre analytic comparison of the mouth opening and the mandibular movements in protrusion and laterality. A Student's "t" test was used to compare pre-treatment and post-treatment differences in level of TMJ pain and maximal mouth opening, in both cases section valve was less then 0.05 and so statistically significant.

  7. Three-dimensional temporomandibular joint modeling and animation.

    PubMed

    Cascone, Piero; Rinaldi, Fabrizio; Pagnoni, Mario; Marianetti, Tito Matteo; Tedaldi, Massimiliano

    2008-11-01

    The three-dimensional (3D) temporomandibular joint (TMJ) model derives from a study of the cranium by 3D virtual reality and mandibular function animation. The starting point of the project is high-fidelity digital acquisition of a human dry skull. The cooperation between the maxillofacial surgeon and the cartoonist enables the reconstruction of the fibroconnective components of the TMJ that are the keystone for comprehension of the anatomic and functional features of the mandible. The skeletal model is customized with the apposition of the temporomandibular ligament, the articular disk, the retrodiskal tissue, and the medial and the lateral ligament of the disk. The simulation of TMJ movement is the result of the integration of up-to-date data on the biomechanical restrictions. The 3D TMJ model is an easy-to-use application that may be run on a personal computer for the study of the TMJ and its biomechanics. PMID:19098544

  8. Regeneration ad integrum of the condyle head in a patient with temporomandibular disorders.

    PubMed

    Learreta, J A

    1999-07-01

    A 14-year-old who had suffered from a beta-hemolytic streptococcus infection presented with serious temporomandibular disorders, including a reabsorption of the condyle head on the right side, and reabsorption in the cavern of the left side. Her masticatory muscles were electronically deprogramed, achieving a mandibular position supported by a relaxed musculature. The patient's signs and symptoms subsequently disappeared. Study of the magnetic resonance image a year later clearly showed a regeneration ad integrum of the condyle head and a spontaneous reinsertion of the articular disk. The results suggest the need for use of electronic elements in order to treat patients with temporomandibular disorders effectively. PMID:10650410

  9. A study of the temporomandibular joint during bruxism.

    PubMed

    Commisso, María S; Martínez-Reina, Javier; Mayo, Juana

    2014-06-01

    A finite element model of the temporomandibular joint (TMJ) and the human mandible was fabricated to study the effect of abnormal loading, such as awake and asleep bruxism, on the articular disc. A quasilinear viscoelastic model was used to simulate the behaviour of the disc. The viscoelastic nature of this tissue is shown to be an important factor when sustained (awake bruxism) or cyclic loading (sleep bruxism) is simulated. From the comparison of the two types of bruxism, it was seen that sustained clenching is the most detrimental activity for the TMJ disc, producing an overload that could lead to severe damage of this tissue.

  10. 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.

  11. The temporalis muscle flap in temporo-mandibular joint surgery.

    PubMed

    Brusati, R; Raffaini, M; Sesenna, E; Bozzetti, A

    1990-11-01

    In the treatment of the severely damaged TMJ structural components (ankylosis, arthrosis, tumour, perforation or degeneration of the disc), it is advisable to insert a biological interposition between bony articular surfaces. The temporal muscle, due to its anatomical, topographical, and functional properties, can be successfully employed for this purpose. Based on the experience of Tessier, Delaire and Rowe, a temporalis muscle flap, inferiorly based, is rotated downwards and medially to the zygomatic arch, interposed and then fixed to condyle and capsule. Using this surgical technique, 12 patients and 13 temporo-mandibular joints were treated with good functional results and without any complication.

  12. 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

  13. 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

  14. 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.

  15. Loose bodies of the temporo-mandibular joint, synovial chondromatosis or osteoarthritis.

    PubMed

    Blenkinsopp, P T

    1978-07-01

    A patient is presented with multiple intra-articular loose bodies of the temporo-mandibular joint, the aetiology and management is discussed. In the absence of histological proof of metaplasia within the synovium the mechanism of cartilage production is open to question. Attention is drawn to the diagnostic problem in long-standing cases when osteo-arthritis supervenes. The clinical picture presented may represent the late stages of synovial chondromatosis or degenerative joint disease from another cause.

  16. Temporomandibular disorders: associated features.

    PubMed

    Auvenshine, Ronald C

    2007-01-01

    Temporomandibular disorder (TMD) encompasses a number of clinical problems involving the masticatory muscles or the temporomandibular joints. These disorders are a major cause of nondental pain in the orofacial region, and are considered to be a subclassification of musculoskeletal disorders. Orofacial pain and TMD can be associated with pathologic conditions or disorders related to somatic and neurologic structures. When patients present to the dental office with a chief complaint of pain or headaches, it is vital for the practitioner to understand the cause of the complaint and to perform a thorough examination that will lead to the correct diagnosis and appropriate treatment. A complete understanding of the associated medical conditions with symptomology common to TMD and orofacial pain is necessary for a proper diagnosis.

  17. [Total temporomandibular joint prostheses].

    PubMed

    Zwetyenga, N; Amroun, S; Wajszczak, B-L; Moris, V

    2016-09-01

    The temporomandibular joint (TMJ) is probably the most complex human joint. As in all joints, its prosthetic replacement may be indicated in selected cases. Significant advances have been made in the design of TMJ prostheses during the last three decades and the indications have been clarified. The aim of our work was to make an update on the current total TMJ total joint replacement. Indications, contraindications, prosthetic components, advantages, disadvantages, reasons for failure or reoperation, virtual planning and surgical protocol have been exposed.

  18. 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

  19. Articular cartilage biochemistry

    SciTech Connect

    Kuettner, K.E.; Schleyerbach, R.; Hascall, V.C.

    1986-01-01

    This book contains six parts, each consisting of several papers. The part titles are: Cartilage Matrix Components; Biosynthesis and Characterization of Cartilage--Specific Matrix Components and Events; Cartilage Metabolism; In Vitro Studies of Articular Cartilage Metabolism; Normal and Pathologic Metabolism of Cartilage; and Destruction of the Articular Cartilage in Rheumatoid Diseases. Some of the paper topics are: magnetic resonance imaging; joint destruction; age-related changes; proteoglycan structure; and biosynthesis of cartilage proteoglycan.

  20. Temporomandibular disorders in scuba divers-an increased risk during diving certification training.

    PubMed

    Oztürk, Ozmen; Tek, Mustafa; Seven, Hüseyin

    2012-11-01

    The design of a diving regulator's mouthpiece increases the risk of a temporomandibular disorder (TMD) in scuba divers. The total weight of a diving regulator is reflected directly on the temporomandibular joint, causing articular and periarticular disorders. In the current study, the prevalence of TMD in scuba divers triggered during diving certification training is investigated. We also aimed to determine the factors that lead to TMD during diving training and clarify the observation that there is an increased incidence of TMD in inexperienced divers. The study was held between 2006 and 2011. Ninety-seven divers were referred with the complaint of pain around temporomandibular area. The divers were classified according to their diving experience. Symptoms and signs of TMD were graded. Fourteen divers were diagnosed with TMD. Temporomandibular disorder was seen more frequently in inexperienced divers than in experienced divers (P = 0.0434). The most prevalent symptom was an increased effort for mouthpiece gripping. Temporomandibular joint tenderness and trigger point activation were the mostly seen physical signs. Thirteen divers had an improvement with therapy. The increased effort for stabilizing the mouthpiece is a recognized factor in TMD development. Attention must be paid to an association of scuba diving with TMDs, especially in inexperienced divers having a scuba certification training.

  1. Temporomandibular joint osteoarthrosis and temporomandibular joint hypermobility.

    PubMed

    Dijkstra, P U; de Bont, L G; de Leeuw, R; Stegenga, B; Boering, G

    1993-10-01

    For studying the relationship between condylar hypermobility of the temporomandibular joint (TMJ) and osteoarthrosis (OA), 13 patients with bilateral condylar hypermobility were evaluated clinically and radiographically, 30 years after non-surgical treatment. The evaluation included range of motion, joint and muscle tenderness to palpation, joint sounds and masticatory function. Radiographs of the TMJs were evaluated for the absence or presence of degenerative changes. The hypermobile group (HG) was compared with a control group (CG) (n = 13). The CG was evaluated in the same way as the HG. Statistics included t-tests (to compare ranges of motion in the HG over time and to compare ranges of motion in HG and CG), non-parametric tests (to compare tenderness of muscles and joints, joint sounds, masticatory function and radiographic changes over time in the HG). The tests were also used to compare the same variables between the HG and CG group. The groups' only difference was the presence of radiographic signs of OA. In the HG the number of joints with radiographic degenerative changes increased significantly over time and was significantly higher than the CG. Clinically and functionally, the HG and CG did not differ. Therefore, it is concluded that TMJ hypermobility is a subsidiary factor in the development of TMJ OA. PMID:8118897

  2. [An experimental study on change on the contralateral temporomandibular joint after unilateral condylectomy on one of the bilateral joints].

    PubMed

    Shimoda, T

    1989-01-01

    In this study I examined the macroscopic, radiological and histopathological changes on the contralateral temporomandibular joint following condylectomy on one of the bilateral temporomandibular joints on adult female Macaca fuscatas. I made a standardized radiographic apparatus for the temporomandibular joint and head for the Macaca fuscata on an experimental basis for radiological observation through the whole passage of time before making the experiment. The results were as follows: 1) In macroscopic observation, I noticed the entire mandible directed toward the operated side at opening the mandible and the anterior and molar (unoperated side) open bite after the operation. Besides the masticatory side altered and the degree of tooth attrition made progress with the passage of time. 2) According to radiographic investigation with an anteroposterior radiograph, complicated shift and rotation of the mandible were observed since the operation. According to the radiograph of condyle, distal displacement of the temporomandibular joint, widening of joint space and clockwise rotation of the mandible were confirmed. A shadow of bone was found in the articular surface of the mandibular head on the 123rd day. 3) The following findings were obtained in histopathology. (1) Heterotopic calcification appeared in an articular disk of one Macaca fuscata in control group and two in the 83rd-day-passaged Macaca fuscatas. (2) In the articular disk and the tissue around them, a tiny projection of connective tissue appeared in the posterior synovial portion of the superior articular cavity on the 10th day. And the intermediate zone of the articular disk showed itself to be fibrous small bundle daily as days passed on and cartilaginoid cells were found. (3) In the front edge of mandibular corpus and attachment region of the lateral pterygoid muscle, absorption of bone was observed by the 40th day from the operation, and additions of bone were observed during the period between the 40

  3. [Total temporomandibular joint prostheses].

    PubMed

    Zwetyenga, N; Amroun, S; Wajszczak, B-L; Moris, V

    2016-09-01

    The temporomandibular joint (TMJ) is probably the most complex human joint. As in all joints, its prosthetic replacement may be indicated in selected cases. Significant advances have been made in the design of TMJ prostheses during the last three decades and the indications have been clarified. The aim of our work was to make an update on the current total TMJ total joint replacement. Indications, contraindications, prosthetic components, advantages, disadvantages, reasons for failure or reoperation, virtual planning and surgical protocol have been exposed. PMID:27554487

  4. 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

  5. [Aseptic necrosis of the temporomandibular joint in systemic lupus erythematosus].

    PubMed

    Grinin, V M; Maksimovskiĭ, Iu M; Nasonova, V A

    1999-01-01

    A total of 285 patients with verified systemic lupus erythematosus (SLE) were examined. They complained of painful temporo-mandibular joint (TMJ) and/or limited mobility of the mandible. Eight patients with chronic arthritis of the TMJ and a shortened (by 3-4 mm) mandibular branch were detected. In 4 female patients aged 25-38 with SLE lasting for about 5.5 years, unilateral signs of myoarticular dysfunction of the TMJ, flattening and decrease of the articular head without erosion and destruction, subcortical round foci with uneven internal contours were found in the central or median part of the head, with the compact bone above the foci thinned and the articular surface flattened; this prompted us to regard these changes as avascular necrosis (AN) of the joint. Shortening of the mandibular branch was caused by deformation of the neck of the articular process and its declination backwards. The detected changes in the TMJ were not accompanied by involvement of other joints. All these 4 patients with SLE and TMJ AN suffered from cerebropathy with epileptic attacks (frequent in 2 patients), Raynaud's syndrome, and bright capillaries of the palms and soles; 2 patients developed clinical picture of the antiphospholipid syndrome. Computer tomography and magnetic resonance findings validating the development of TMJ AN in?

  6. Synovial chondromatosis of the temporomandibular joint.

    PubMed

    Reyes Macías, Juan Francisco; Sánchez Prieto, Martín

    2007-01-01

    Synovial Chondromatosis (SC) is a disease whose etiology is unknown, can be defined as a benign synovial process characterized by the formation of metaplastic cartilaginous nodes inside connective tissue of articular surfaces, is considered an active metaplastic phenomenon better than a neoplastic process; it presents a greater preference to affect women who constitute almost 70% of reported cases, the age range is wide and oscillates between 18-75 years (average 44.6 years). Between the main clinical findings are: pain, crackle, volume augmentation and a limited buccal opening. SC is an unusual state and the reports in the English literature are no more than 75 cases, only 66 of those where histologically verified, most of those were affecting great joints like hip, knee and shoulder, but if SC is not frequent in this sites, is even more infrequent on temporomandibular joint. The aim of this paper is to report a clinical case and at the same time to realize a brief review of the literature.

  7. On the development, morphology and function of the temporomandibular joint in the light of the orofacial system.

    PubMed

    Fanghänel, Jochen; Gedrange, Tomasz

    2007-01-01

    The temporomandibular joint has a key role in the biocybernetic functional cycle of the orofacial system. It has developed as a "secondary joint" and displays a number of features relating to the articular tubercle, the mandibular condyle, the articular disc, the joint cartilage and the retroarticular pad. The joint cartilage of the mandibular condyle is a primary compensatory growth centre also comprising distant effects. The coordinate course of the mandibular movements is controlled by a complex reflex mechanism and neuronal controller cycles. Morphology, function and clinical aspects are of equal interest to both physicians and dentists.

  8. Myofascial Temporomandibular Disorder.

    PubMed

    Fernández-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

  9. [Intra-articular injections].

    PubMed

    Chapelle, Ch

    2015-09-01

    It is not unusual for a specialist or general practitioner to be presented with a pathology which necessitates the use of an intra-articular injection of corticosteroids, hyaluronic acid or a local anaesthetic. It would seem to be interesting to update and to precise the techniques and methods of intraarticular injections which have appeared in recent international publications, when we know that 30 % of the injections given into the knee and so called "dry" are incorrect and, therefore, inefficient. The indication of an articular injection depends, firstly, on the diagnosis which should be done with great care; after which should be an objective analysis complete with secondary effects linked to both the injection and the product used. The conditions of asepsis, the choice of needles and quantities of the injection and even the ways of the injections should be reviewed in detail. The last studies clearly question the secondary effects of the cartilage degradations of the cortisone given as an intra-articular injection and shows its efficiency on the pain and inflammatory phenomonen in osteoarthritis. Studies on hyaluronic acid are often contradictory going from a modest result to an important pain relief but it is necessary to be aware that the objective criteria are difficult to interpret. The use of local anaesthetics in intra-articular is limited by the few indications in view of the major risk of aggravating the pre-existing lesions by the disappearing signs of pain.

  10. 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

  11. Jacob's disease associated with temporomandibular joint dysfunction: a case report.

    PubMed

    Capote, Ana; Rodríguez, Francisco J; Blasco, Ana; Muñoz, Mario F

    2005-01-01

    Jacob's disease is regarded a rare condition in which a joint formation is established between an enlarged mandibular coronoid process and the inner aspect of the zygomatic body. Chronic temporomandibular joint (TMJ) disk displacement has been proposed as etiological factor of coronoid process enlargement. We present a 23-year-old woman with long-standing TMJ dysfunction and restricted interincisal opening, who developed a progressive zygomatic asymmetry. The patient underwent treatment by intraoral coronoidectomy and homolateral TMJ arthroscopy in the same surgery. The histopathological diagnosis of the coronoid sample was cartilage-capped exostoses with presence of articular fibrous cartilage. Although the low prevalence of this entity, it should be considered as a possible diagnosis in patients with progressive limitation of mouth opening, although a TMJ syndrome may be present as a cause of this entity.

  12. 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

  13. Internal derangements of the temporomandibular joint: A review of the anatomy, diagnosis, and management

    PubMed Central

    Young, Andrew L.

    2015-01-01

    Internal derangements of the temporomandibular joint are conditions in which the articular disc has become displaced from its original position the condylar head. Relevant anatomic structures and their functional relationships are briefly discussed. The displacement of the disc can result in numerous presentations, with the most common being disc displacement with reduction (with or without intermittent locking), and disc displacement without reduction (with or without limited opening). These are described in this article according to the standardized Diagnostic Criteria for Temporomandibular Disorders, as well as the less common posterior disc displacement. Appropriate management usually ranges from patient education and monitoring to splints, physical therapy, and medications. In rare and select cases, surgery may be necessary. However, in for the majority of internal derangements, the prognosis is good, particularly with conservative care. PMID:26929478

  14. 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

  15. [Temporo-mandibular ankylosis].

    PubMed

    Bénateau, H; Chatellier, A; Caillot, A; Diep, D; Kün-Darbois, J-D; Veyssière, A

    2016-09-01

    Ankylosis of the temporomandibular joint is defined as a permanent constriction of the jaws with less than 30mm mouth opening measured between the incisors, occurring because of bony, fibrous or fibro-osseous fusion. Resulting complications such as speech, chewing, swallowing impediment and deficient oral hygiene may occur. The overall incidence is decreasing but remains significant in some developing countries. The most frequent etiology in developed countries is the post-traumatic ankylosis occurring after condylar fracture. Other causes may be found: infection (decreasing since the advent of antibiotics), inflammation (rheumatoid arthritis and ankylosing spondylitis mainly) and congenital diseases (very rare). Management relies on surgery: resection of the ankylosis block in combination with bilateral coronoidectomy… The block resection may be offset by the interposition temporal fascia flap, a costochondral graft or a TMJ prosthesis according to the loss of height and to the impact on dental occlusion. Postoperative rehabilitation is essential and has to be started early, to be intense and prolonged. Poor rehabilitation is the main cause of ankylosis recurrence.

  16. 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

  17. [Temporo-mandibular ankylosis].

    PubMed

    Bénateau, H; Chatellier, A; Caillot, A; Diep, D; Kün-Darbois, J-D; Veyssière, A

    2016-09-01

    Ankylosis of the temporomandibular joint is defined as a permanent constriction of the jaws with less than 30mm mouth opening measured between the incisors, occurring because of bony, fibrous or fibro-osseous fusion. Resulting complications such as speech, chewing, swallowing impediment and deficient oral hygiene may occur. The overall incidence is decreasing but remains significant in some developing countries. The most frequent etiology in developed countries is the post-traumatic ankylosis occurring after condylar fracture. Other causes may be found: infection (decreasing since the advent of antibiotics), inflammation (rheumatoid arthritis and ankylosing spondylitis mainly) and congenital diseases (very rare). Management relies on surgery: resection of the ankylosis block in combination with bilateral coronoidectomy… The block resection may be offset by the interposition temporal fascia flap, a costochondral graft or a TMJ prosthesis according to the loss of height and to the impact on dental occlusion. Postoperative rehabilitation is essential and has to be started early, to be intense and prolonged. Poor rehabilitation is the main cause of ankylosis recurrence. PMID:27481673

  18. Topical versus systemic diclofenac in the treatment of temporo-mandibular joint dysfunction symptoms.

    PubMed

    Di Rienzo Businco, L; Di Rienzo Businco, A; D'Emilia, M; Lauriello, M; Coen Tirelli, G

    2004-10-01

    The most frequent symptom of craniomandibular dysfunction is pain in the preauricular area or in the temporo-mandibular joint, usually localized at the level of the masticatory musculature. Patients sometimes also complain of reflect otalgia, headaches and facial pain. Osteoarthrosis is a frequent degenerative debilitating chronic disorder that can affect the temporomandibular joint. It causes pain and articular rigidity, a reduction in mobility, and radiological alterations are visible in stratigraphy. The aim of this study was to compare the efficacy of a topically applied non-steroid anti-inflammatory drug that has recently become commercially available (diclofenac sodium in a patented carrier containing dimethyl sulfoxide, that favours transcutaneous absorption) which is commonly used to alleviate pain in knee or elbow joints, versus oral diclofenac, in the treatment of symptoms of temporomandibular joint dysfunction. Dysfunction of the temporomandibular joint was diagnosed in 36 adult patients. The patients were randomized in two age- and gender -matched groups. Group A (18 patients) received oral diclofenac sodium administered after a meal in 50-mg tablets twice a day for 14 days. Group B (18 patients) received 16 mg/ml topical diclofenac (diclofenac topical solution, 10 drops 4 times a day for 14 days). All patients completed a questionnaire at the start and end of therapy. Patients were asked to quantify on a graded visual analogue scale and to reply to questions about the pain and tenderness of the temporomandibular joint and the functional limitation of mouth opening. Patients were also requested to report side-effects of the treatment. All patients showed relief from pain after treatment: the difference between the two groups was not significant (p > 0.05). Post-treatment, 16 patients of group A had epigastralgic symptoms. Three patients treated with topical diclofenac showed a modest irritation of the temporomandibular joint region, and disappeared

  19. Dynamic stereometry of the temporomandibular joint.

    PubMed

    Palla, S; Gallo, L M; Gössi, D

    2003-01-01

    Studies on jaw kinematics have provided a good understanding of the motion of the mandible in space, but are of little biomechanical relevance because they could not relate the movements to anatomic structures. This is possible by the combination of three-dimensional reconstructions of the temporomandibular joint (TMJ) anatomy with jaw motion recordings. This technique allows us to analyze the variation of the relationship between the articular surfaces, providing indirect insight into disk deformation during function and parafunction as well as TMJ loading. As far as the variation of the condyle-fossa distance is concerned, data indicated that during chewing the distance was smaller 1) on closing than on opening; 2) on the balancing than on the working side; and 3) during chewing of hard than soft food. Moreover, during a forceful static biting, the condyle-fossa distance decreased more on the contralateral, i.e. on the balancing side than on the working side. The decrease was related to the degree of clenching force. These results support the content that both condyles are loaded during chewing and the balancing side joint more than the working one. Biomechanically, the development of osteoarthrosis is more likely related to the magnitude and frequency of stresses applied on the cartilage. Joint movements produce tractional forces that may cause shear stresses contributing to cartilage wear and fatigue. Tractional forces are the result of frictional forces caused by the cartilage surface rubbing and of plowing forces caused by the translation of a stress-field through the cartilage matrix, as the intra-articular space changes during motion. Translation of the stress-field in mediolateral direction seems to be particularly important for the integrity of the TMJ disk because of its anisotropic properties. Dynamic stereometry showed that stress-fields translate in mediolateral direction during opening/closing, protrusion and laterotrusion, and that their translatory

  20. 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.

  1. 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

  2. The human temporo-mandibular joint: current anatomic and physiologic status.

    PubMed

    Le Toux, G; Duval, J M; Darnault, P

    1989-01-01

    The aim of this study was to take stock of current anatomic and physiologic knowledge of the human temporo-mandibular joint. Though the lateral pterygoid m. plays an essential role in joint movements, we believe that the small deep portion of the masseter and temporalis have a supplementary action in guiding the articular disc forward. The embryologists have demonstrated joint movements in the two-month embryo and at this stage there already exists a triple attachment of the temporalis, pterygoid and masseter to the disc.

  3. 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

  4. Manual reduction of articular disc after traumatic extraction of mandibular third molar: a case report

    PubMed Central

    Camino, Rubens; Manzi, Marcello Roberto; de Carvalho, Matheus Furtado; Luz, João Gualberto de Cerqueira; Pimentel, Angélica Castro; Deboni, Maria Cristina Zindel

    2015-01-01

    Introduction: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex. With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening. This disorder is associated with persistent limited mandibular opening. Case report: The patient presented severe limitation to fully open the mouth, interfering in her ability to eat. Clinical examination also revealed maximum assisted jaw opening (passive stretch) with less than 40 mm of maximum interincisal opening. Magnetic resonance imaging was the method of choice to identify the temporomandibular disorders. Conclusion: By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements. PMID:26560828

  5. Collagen fiber arrangement in temporo-mandibular joint (TMJ) disks from human subjects with functional diseases. Scanning electron microscopy investigations.

    PubMed

    Piacentini, C; Marchetti, C; Bernasconi, G; Menghini, P; Baciliero, U; Brusotti, C

    1994-01-01

    Twelve articular disks from patients with temporo-mandibular joint (TMJ) arthropathy were studied and compared with two normal disks. Scanning electron microscopy (SEM) examination of the surfaces and of longitudinal and cross-sections of the disks allowed the observation of the arrangement of the collagen fiber component in different parts of the disk. The superficial part of the articular disks appears to be formed by rather compact fibers. The internal portion is usually formed by bundles of collagen fibers in sheets, alternating with isolated fibers arranged in a parallel or irregular way. In some samples, blood vessels were observed. Our investigations suggested that the appearance of vascularization is the first remarkable histological change that can be observed in functionally abnormal articular disks.

  6. 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

  7. 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.

  8. Lubricin Protects the Temporomandibular Joint Surfaces from Degeneration

    PubMed Central

    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

  9. 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.

  10. 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

  11. [The oto-meniscal relationship of temporo-mandibular joint in the new-born man (author's transl)].

    PubMed

    Couly, G; Hureau, J

    1976-01-01

    Although they are anatomically immature at the time of birth, the temporo-mandibular joints are able to ensure efficient suction due to the branchial blastema interposed between the two articular nuclei. This conjunctive formation is the principal factor in the constitution of the meniscus and its frena, the articular surfaces, the capsule and the ligaments. This constitutes not only an embryological but also a functional entity. The joint runs the risk of paying heavily for this functionnal availability, by its relationship with the ear-drum which is a potentially infectious cavity. In fact, at birth there is still evidence of the original branchial continuum between the unknit tympanal and squamosal in the shape of the posterior meniscal frenum, the conjunctivo-vascular isthmus which puts the vascularization of the mucosa of the ear-drum in communication with the very rich vascularization of the neonatal temporo-mandibular joint. Therefore, 1/3 of the so-called congenital temporo-mandibular ankyloses, apparently without cause, could probably be explained by the otomeniscal relationship existing in the new-born baby and continuing during the first few months of life in the form of a conjunctivo-vascular link.

  12. 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

  13. [Do temporomandibular disorders really exist?].

    PubMed

    Winocur, E; Emodi-Perlman, A; Finkelstein, T; Sharabi-Ventura, Y; Gavish, A

    2003-01-01

    Temporomandibular Disorders (TMD) is a collective term embracing a number of clinical problems that involve the muscles of mastication, the temporomandibular joint (TMJ) and associated structures or both. This group of disorders has been identified as the chief cause of pain, which is not of dental origin, in the orofacial area, and is defined as a subgroup in the category of musculoskeletal disorders. These disorders impair the quality of life of those suffering from them due to the extent of the pain and the chronic nature of its symptoms. It is known that chronic pain causes the development of psychological disturbances (anxiety, depression, etc.). The most common symptoms of TMD are the pain that usually appears as the result of mandibular activity (speaking or chewing), and is usually located in the masticulatory muscles, in the preauricular area and the temporomandibular joint (TMJ). Additional common symptoms are: a. restriction in jaw movement; b. asymmetry in jaw movement; c. noises from the joint. Patients suffering from TMD are likely to exhibit additional symptoms: hypertrophy of the muscles of mastication (an adaptive and asymptomatic phenomenon), abnormal occlusar erosion due to nighttime or daytime bruxism, or teeth grinding. Most functional temporomandibular disorders have similar signs and symptoms. As a result, diagnosis of the various disorders presents a serious problem. Functional temporomandibular disorders are often accompanied by mental symptoms such as depression, anxiety and/or somatization on various levels. One of today's accepted methods of classification also refers to the mental aspect and thus enables, for the first time, a suitable scientific comparison of the epidemiological, diagnostic and treatment data in the various studies. This method, initiated by Dworkin and LeResche (1992) is known as Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The purpose of this method is to classify every subgroup of TMD

  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 vibration in bruxers.

    PubMed

    Li, Xueling; Lin, Xuefeng; Wang, Yan

    2009-07-01

    Temporomandibular joint vibration is considered an important physical sign of joint dysfunction and/or joint pathology. The aim of this study was to compare the difference of joint vibration between bruxers and asymptomatic individuals, evaluate the effect of bruxism on the temporomandibular joint (TMJ) and the association between bruxism and temporomandibular disorders. Twenty-four (24) bruxers and 16 asymptomatic subjects were included in the study. Bilateral joint vibrations with jaw tracking were recorded using a TMJ detecting instrument during rhythmic jaw opening and closing movement. The results showed that the vibratory energy and amplitude of the moderate to severe bruxers were significantly higher than that of the mild bruxers and asymptomatic subjects. The percentage of joint vibration occurrence in asymptomatic subjects, mild bruxers, and moderate to severe bruxers was 75.0%, 77.8%, and 100%, respectively. It was concluded that bruxism might induce abnormal joint vibrations, and that the energy of abnormal vibrations might increase with the degree of bruxism.

  16. Etiological factors of temporomandibular joint disorders

    PubMed Central

    Sharma, Shalender; Gupta, D. S.; Pal, U. S.; Jurel, Sunit Kumar

    2011-01-01

    The temporomandibular joint receives its name from the two bones that enter into its formation, namely the temporal bone and the mandible. This complex synovial system is composed of two temporomandibular joints together with their articulating ligaments and masticatory muscles. This articulation affects other synovial joints that relate specifically to masticatory function. The causes of temporomandibular disorders are complex and multifactorial. There are numerous factors that can contribute to temporomandibular disorders. In some instances a single factor may serve one or all of these roles. Iatrogenic injuries can act as both initiating as well as predisposing factors. The term craniomandibular disorder is used synonymously with the term temporomandibular disorders and is considered a major cause of nondental pain in the orofacial pain region. The successful management of temporomandibular disorders is dependent on identifying and controlling the contributing factors. The temporomandibular disorders are more common in females, the reason is not clearly known. The following article provides detailed information regarding temporomandibular joint disorders. PMID:22639496

  17. Evaluation of Sports-Related Temporomandibular Dysfunctions

    PubMed Central

    Sailors, Matthew E.

    1996-01-01

    Objective: To analyze the steps used in evaluation of sports- related temporomandibular dysfunctions and make recommendation for treatment and referral based upon the evaluation findings. Data Sources: This review searched Cinahl (1982 to 1995) and Medline (1986 to 1995). Key words searched included “sports related temporomandibular dysfunction,” “temporomandibular dysfunction,” and “temporomandibular joint.” Data Synthesis: This paper provides an introduction to the anatomy and biomechanics of the temporomandibular joint (TMJ) as well as causes of temporomandibular disorders in athletes. An analysis of the evaluative steps used for the temporomandibular joint is also given. Findings that suggest specific temporomandibular dysfunctions are discussed. Conclusions/Recommendations: Recommendations about when dental consultation is most appropriate or if conservative treatment is indicated are included. Hopefully, this will provide the sports medicine practitioner with a better understanding of the joint and its dysfunctions, as well as eliminate some unnecessary and costly dental referrals for our athletes. ImagesFig 2.Fig 3.Fig 4. PMID:16558422

  18. 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

  19. Biglycan and Fibromodulin Have Essential Roles in Regulating Chondrogenesis and Extracellular Matrix Turnover in Temporomandibular Joint Osteoarthritis

    PubMed Central

    Embree, Mildred C.; Kilts, Tina M.; Ono, Mitsuaki; Inkson, Colette A.; Syed-Picard, Fatima; Karsdal, Morten A.; Oldberg, Åke; Bi, Yanming; Young, Marian F.

    2010-01-01

    The temporomandibular joint is critical for jaw movements and allows for mastication, digestion of food, and speech. Temporomandibular joint osteoarthritis is a degenerative disease that is marked by permanent cartilage destruction and loss of extracellular matrix (ECM). To understand how the ECM regulates mandibular condylar chondrocyte (MCC) differentiation and function, we used a genetic mouse model of temporomandibular joint osteoarthritis that is deficient in two ECM proteins, biglycan and fibromodulin (Bgn−/0Fmod−/−). Given the unavailability of cell lines, we first isolated primary MCCs and found that they were phenotypically unique from hyaline articular chondrocytes isolated from the knee joint. Using Bgn−/0 Fmod−/− MCCs, we discovered the early basis for temporomandibular joint osteoarthritis arises from abnormal and accelerated chondrogenesis. Transforming growth factor (TGF)-β1 is a growth factor that is critical for chondrogenesis and binds to both biglycan and fibromodulin. Our studies revealed the sequestration of TGF-β1 was decreased within the ECM of Bgn−/0 Fmod−/− MCCs, leading to overactive TGF-β1 signal transduction. Using an explant culture system, we found that overactive TGF-β1 signals induced chondrogenesis and ECM turnover in this model. We demonstrated for the first time a comprehensive study revealing the importance of the ECM in maintaining the mandibular condylar cartilage integrity and identified biglycan and fibromodulin as novel key players in regulating chondrogenesis and ECM turnover during temoporomandibular joint osteoarthritis pathology. PMID:20035055

  20. Extra-articular Snapping Hip

    PubMed Central

    2010-01-01

    Context: Snapping hip, or coxa saltans, is a vague term used to describe palpable or auditory snapping with hip movements. As increasing attention is paid to intra-articular hip pathologies such as acetabular labral tears, it is important to be able to identify and understand the extra-articular causes of snapping hip. Evidence Acquisition: The search terms snapping hip and coxa sultans were used in PubMed to locate suitable studies of any publication date (ending date, November 2008). Results: Extra-articular snapping may be caused laterally by the iliotibial band or anteriorly by the iliopsoas tendon. Snapping of the iliopsoas tendon usually requires contraction of the hip flexors and may be difficult to differentiate from intra-articular causes of snapping. Dynamic ultrasound can help detect abrupt tendon translation during movement, noninvasively supporting the diagnosis of extra-articular snapping hip. The majority of cases of snapping hip resolve with conservative treatment, which includes avoidance of aggravating activities, stretching, and anti-inflammatory medication. In recalcitrant cases, surgery to lengthen the iliotibial band or the iliopsoas tendon has produced symptom relief but may result in prolonged weakness. Conclusions: In treating active patients with snapping soft tissues around the hip, clinicians should recognize that the majority of cases resolve without surgical intervention, while being mindful of the potential for concomitant intra-articular and internal snapping hips. PMID:23015936

  1. 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

  2. Resident mesenchymal progenitors of articular cartilage

    PubMed Central

    Candela, Maria Elena; Yasuhara, Rika; Iwamoto, Masahiro; Enomoto-Iwamoto, Motomi

    2015-01-01

    Articular cartilage has poor capacity of self-renewal and repair. Insufficient number and activity of resident mesenchymal (connective tissue) progenitors is likely one of the underlying reasons. Chondroprogenitors reside not only in the superficial zone of articular cartilage but also in other zones of articular cartilage and in the neighboring tissues, including perichondrium (groove of Ranvier), synovium and fat pad. These cells may respond to injury and contribute to articular cartilage healing. In addition, marrow stromal cells can migrate through subchondral bone when articular cartilage is damaged. We should develop drugs and methods that correctly stimulate resident progenitors for improvement of repair and inhibition of degenerative changes in articular cartilage. PMID:25179676

  3. Resident mesenchymal progenitors of articular cartilage.

    PubMed

    Candela, Maria Elena; Yasuhara, Rika; Iwamoto, Masahiro; Enomoto-Iwamoto, Motomi

    2014-10-01

    Articular cartilage has poor capacity of self-renewal and repair. Insufficient number and activity of resident mesenchymal (connective tissue) progenitors is likely one of the underlying reasons. Chondroprogenitors reside not only in the superficial zone of articular cartilage but also in other zones of articular cartilage and in the neighboring tissues, including perichondrium (groove of Ranvier), synovium and fat pad. These cells may respond to injury and contribute to articular cartilage healing. In addition, marrow stromal cells can migrate through subchondral bone when articular cartilage is damaged. We should develop drugs and methods that correctly stimulate resident progenitors for improvement of repair and inhibition of degenerative changes in articular cartilage. PMID:25179676

  4. 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

  5. Temporomandibular Joint Dysfunction: A Dental Overview

    PubMed Central

    Hillier, Clyde D.

    1985-01-01

    Temporomandibular joint dysfunction is common and often acutely painful. Because of the large and diverse symptom complex created by this disorder, patients frequently first seek relief from their physician rather than their dentist. In this article temporomandibular joint (TMJ) dysfunction is defined and the presenting signs and symptoms are discussed. Their etiology is described in relation to the anatomy of the temporomandibular joint. Examination techniques can help in the differential diagnosis. Current treatment ranges from heat, local anesthesia and ultrasound to anxiolytics, transcutaneous nerve stimulation and nutritional supplementation. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8 PMID:21274225

  6. 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

  7. Articular Cartilage Injury in Athletes

    PubMed Central

    McAdams, Timothy R.; Mithoefer, Kai; Scopp, Jason M.; Mandelbaum, Bert R.

    2010-01-01

    Articular cartilage lesions in the athletic population are observed with increasing frequency and, due to limited intrinsic healing capacity, can lead to progressive pain and functional limitation over time. If left untreated, isolated cartilage lesions can lead to progressive chondropenia or global cartilage loss over time. A chondropenia curve is described to help predict the outcome of cartilage injury based on different lesion and patient characteristics. Nutriceuticals and chondroprotective agents are being investigated as tools to slow the development of chondropenia. Several operative techniques have been described for articular cartilage repair or replacement and, more recently, cartilage regeneration. Rehabilitation guidelines are being developed to meet the needs of these new techniques. Next-generation techniques are currently evaluated to optimize articular cartilage repair biology and to provide a repair cartilage tissue that can withstand the high mechanical loads experienced by the athlete with consistent long-term durability. PMID:26069548

  8. 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.

  9. [The temporo-mandibular articulation].

    PubMed

    Dargaud, J; Vinkka-Puhakka, H

    2004-04-01

    The standing posture of humans has created both morphological and functional adaptations in the temporo-mandibular joint and the masticatory function. This biped state is the one of the most important characteristic of human evolution. It is furthermore the agent determining most of the functional changes in the whole body. This survey will be carried out in several levels including, a descriptive anatomy, biomechanics, radiological imaging, functioning in the articulation of TMJ. The descriptive anatomic picture will be obtained by the traditional dissection techniques. 20 TMJ joints are dissected from 10 cadavers: 7 cadavers, 65-75 year old, 3 cadavers, 60-65 year old. The x-rays are lateral view and the subjects of the radiological imaging are young's, adults and olds: 1, 3 y-old Male; 1, 7 y-old Female; 1, 14 y-old Female; 10, 19-23 y-old Male; 1, 26 y-old Female; 1, 34 y-old Male; 1, 75 y-old Female. The anatomic elements in the TMJ well resembled the ones described in the literature of the capsule, the ligament, the masticator muscles (masseter, temporal, medial and lateral pterygoids). The temporo-mandibular ligament proved to be difficult to separate from the capsule in some of the specimens. Sometimes it was not always found after a dissection.

  10. Cyclophosphamide-induced temporomandibular synostosis.

    PubMed

    Bacon, W

    1983-06-01

    The study of malformations helps toward a better understanding of normal development, which is of significance to the orthodontist. Experiments in teratology have induced an extensive variety of facial abnormalities, but temporomandibular joint (TMJ) synostosis has never been previously reported. Ten pregnant female rabbits were treated with a daily injection of 50 mg. cyclophosphamide (DNA synthesis inhibitor), from day 11 to day 14, which is the period that precedes formation of the face. The control sample comprised five female rabbits. The fetuses were obtained by cesarean section on day 28 and stained with alizarin. Six of the ten treated female animals produced offspring that had TMJ synostosis. The skull with TMJ synostosis showed a retrognathic mandibular pattern in relation to the maxilla, and the bony trabeculae in the mandibular angle showed a downward orientation instead of the horizontal orientation seen in animals without synostosis. The length of the heads was significantly smaller in the treatment group than in the control group; within the treatment group, the heads with synostosis were significantly smaller than those without synostosis. It could be hypothesized that the cyclophosphamide might have affected intrinsic factors in the temporomandibular mesenchyma; an impairment in the development and function of the mandibular musculature, which is a vital factor in joint development and maintenance, might also have contributed to the genesis of the malformation. The association of immobilization and mandibular hypodevelopment seems to be in agreement with today's theories on maxillofacial growth.

  11. 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

  12. Osteoma of temporomandibular joint: a rarity.

    PubMed

    Misra, Neeta; Srivastava, Saurabh; Bodade, Pankaj R; Rastogi, Vikalp

    2013-09-06

    Osteoma is a benign tumour consisting of mature bone tissue. It is an uncommon lesion that occurs in the bones of the craniofacial complex. Only a few cases involving the temporomandibular joint have been reported. An osteoma of the left temporomandibular joint causing limited mouth opening in a 22-year-old man with CT findings revealing the unusual possibility in differential diagnosis of trismus.

  13. Osteoma of temporomandibular joint: a rarity

    PubMed Central

    Misra, Neeta; Srivastava, Saurabh; Bodade, Pankaj R; Rastogi, Vikalp

    2013-01-01

    Osteoma is a benign tumour consisting of mature bone tissue. It is an uncommon lesion that occurs in the bones of the craniofacial complex. Only a few cases involving the temporomandibular joint have been reported. An osteoma of the left temporomandibular joint causing limited mouth opening in a 22-year-old man with CT findings revealing the unusual possibility in differential diagnosis of trismus. PMID:24014334

  14. Prediction of volumetric strain in the human temporomandibular joint cartilage during jaw movement

    PubMed Central

    Koolstra, J H; van Eijden, T M G J

    2006-01-01

    Human temporomandibular joint loading causes pressurization and flow of interstitial fluid in its cartilaginous structures. This largely determines its load-bearing and maintenance capacity. It was hypothesized that during cyclical jaw movements normal pressure distribution dynamics would enable fluid to reach all necessary cartilage regions. This was tested qualitatively by analysis of local volumetric strain dynamics during jaw open–close movements predicted by a dynamic model of the human masticatory system. Finite-element analysis was performed in separate regions of the articular cartilage layers and articular disc. Heterogeneous patterns of dilatation and compression were predicted. Compression was found to be more dominant during jaw closing than opening. The pressure gradient in the superior layer of the articular disc was more mediolaterally orientated than in its inferior layer. The findings suggest that, where necessary, regionally the cartilage can imbibe fluid to protect the subchondral bone from impact loads effectively. In the disc itself presumably all areas receive regular refreshment of interstitial fluid. PMID:16928205

  15. Presence of neuroreceptors in normal and diseased temporo-mandibular joints.

    PubMed

    Favia, G; Maiorano, E

    1995-01-01

    An immunohistochemical study was performed on the articular disk and periarticular tissues of the temporo-mandibular joint (TMJ) in order to ascertain the presence of neuroreceptors (NRec) in these sites. The study was carried out with the APAAP technique on tissue samples obtained from 10 subjects without known TMJ disease and from 5 patients with severe TMJ arthritis or arthrosis. The antibodies used were directed against the following antigens: Gliofibrillary Acidic Protein (GFAP), Leu-7, Myelin Basic Protein (MBP), Neurofilaments 68 kD (NF), Neuron Specific Enolase (NSE), S-100 protein (S-100) and Synaptophysin (SYN). This study revealed that Ruffini's-like, Pacini's-like and Golgi's-like receptors can be demonstrated in TMJ periarticular tissues and that free nervous endings are present in the subsynovial but not within the articular disk. In the latter, elongated cytoplasmic processes of chondrocytes demonstrated strong S-100 immunoreactivity but they were unreactive with all other antibodies. These cytoplasmic processes were more abundant and thicker in the samples obtained from patients with diseased TMJ. The results of this study confirm that different NRec are detectable in TMJ periarticular tissues but they are absent within the articular disk. In the latter site, only chondrocytic processes are evident, especially in diseased TMJ, and they might have been confused with nervous endings in previous morphological studies. Nevertheless the absence of immunoreactivity for NF, NSE and SYN proves that they are not of neural origin.

  16. Therapeutic effect of hyaluronic acid on experimental osteoarthrosis of ovine temporomandibular joint.

    PubMed

    Kim, C H; Lee, B J; Yoon, J; Seo, K M; Park, J H; Lee, J W; Cho, E S; Hong, J J; Lee, Y S; Park, J H

    2001-10-01

    A symptomatic relief by hyaluronic acid (HA, MW: 3.5 x 10(6)), which is synthesized by Streptococcus spp, was investigated in experimental ovine osteoarthrosis. Bilateral osteoarthrosis (OA) of the temporo-mandibular joints (TMJs) was induced by perforating discs and by scrapping subchondral condylar surface. HA was intra-articularly injected into the left joints of 6 sheep on 7, 10, 14, 17 and 21 days after the operation and physiological saline as the control was injected into the contralateral (right) joints on the same day. Three sheep were killed at I month post-operation (MPO) and the remaining three sheep were killed at 3 MPO. Various responses such as proliferation of fibrous tissue, denudation, erosion, osteophyte formation, subcortical cyst formation and ankylosis were observed radiographically and histopathologically. The treatment of HA ameliorated the degenerative changes and lowered the osteoarthrotic score in the left joints at I MPO (9.96 vs 5.81) and 3 MPO (10.86 vs 5.29) compared to the right joints. These results indicate that a repeated intra-articular injection of HA inhibits the progression of OA in ovine TMJs by inducing the development of articular cartilage and by reducing the proliferation of fibrotic tissue.

  17. A repetitive, steady mouth opening induced an osteoarthritis-like lesion in the rabbit temporomandibular joint.

    PubMed

    Fujisawa, T; Kuboki, T; Kasai, T; Sonoyama, W; Kojima, S; Uehara, J; Komori, C; Yatani, H; Hattori, T; Takigawa, M

    2003-09-01

    Although excessive mechanical stress is assumed to be one of the factors contributing to pathogenesis of temporomandibular joint (TMJ) osteoarthritis (OA), no pure mechanical-stress-induced OA model has been developed without surgical manipulation or puncture of the joint cavity. The purpose of this study was to establish a genuine mechanical-stress-induced OA model of the rabbit TMJ. In the experimental rabbits, repetitive, forced jaw-opening, 3 hrs/day for 5 days, was applied with the use of a general anesthesia protocol. By histological assessment of the TMJ articular tissues, partial eburnation of the articular cartilage, reactive marginal proliferation of the articular cartilage chondrocytes, and nested proliferation of chondrocytes in the subchondral bone area were observed at 7 days after the repetitive, forced-jaw-opening period. These results suggest that the repetitive, forced-jaw-opening protocol without surgical intervention can induce evident OA-like lesions in the rabbit TMJ, and this OA model may greatly contribute to the elucidation of the cartilage degradation mechanism in TMJ OA. PMID:12939359

  18. 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

  19. [Kinetic radiography and functional analysis of the temporomandibular joint (TMJ)].

    PubMed

    Bandai, Natsuko; Sanada, Shigeru; Ueki, Koichiro; Funabasama, Shintaro; Matsui, Takeshi; Tsuduki, Shinji

    2003-03-01

    To develop a method of kinetic radiography and a computer-aided diagnosis (CAD) system for quantitative evaluation of the temporomandibular joint (TMJ), dynamic images of the TMJ from one healthy volunteer were obtained by fluoroscopy in the lateral view on the right and left sides. The accumulated image subtraction technique extracted the condyle in each image. A sequential similarity detection algorithm (SSDA) was employed to trace the movement path and the velocity of the condyle. The shape of the path of the right condyle was smoother than that of the left condyle. The size of the maximum vertical and horizontal movements of the condyle were 4.6+/-0.1 mm and 15.0+/-0.2 mm, respectively. The velocity of the movement of the condyle was higher in the area close to the articular eminence than in any other area during the opening and closing of the mouth. This CAD system will contribute to the kinetic analysis of the TMJ for screening, follow-up study, and informed consent, providing speed, quantitation, and cost-effectiveness.

  20. [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

  1. 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

  2. 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.

  3. 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

  4. 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

  5. 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...

  6. 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...

  7. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 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...

  8. 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.

  9. 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

  10. 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

  11. 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.

  12. Changes in urinary bone resorption markers (pyridinoline, deoxypyridinoline) resulting from experimentally-induced osteoarthritis in the temporomandibular joint of rats.

    PubMed

    Imada, Masae; Tanimoto, Kotaro; Ohno, Shigeru; Sasaki, Akiko; Sugiyama, Hiroki; Tanne, Kazuo

    2003-01-01

    The purpose of this study was to quantify the urinary bone resorption markers, pyridinoline (Pyr) and deoxypyridinoline (Dpyr), excreted from experimentally-induced osteoarthritis (OA) in the temporomandibular joint (TMJ) of rats. Osteoarthritic lesions were induced by intra-articular injection of collagenase into the right TMJs of 16-week-old male rats. The whole day's urine was collected from each animal one day before the injection and 5, 7, 11 and 14 days after the injection. Urine samples were analyzed by high-perfomance liquid chromatography and fluorescence spectroscopy. Histological changes in condyle were examined by using paraffin sections with toluidine blue staining. Degenerative changes were observed in the articular cartilage of the experimental group on day 7 and day 14 after the injection of collagenase. The concentration of Pyr was remarkably high in the experimental group, and consequently the Pyr to Dpyr ratio was significantly higher (p<0.05) in the experimental group than in the control group from 7-14 days after the injection. These findings suggest that a urinary Pyr/Dpyr ratio would be available for the detection of degenerative changes in condyle relevant to temporomandibular joint osteoarthritis (TMJ OA). PMID:12555930

  13. Management of Temporomandibular Joint Reankylosis in Syndromic Patients Corrected with Joint Prostheses: Surgical and Rehabilitation Protocols

    PubMed Central

    Clauser, Luigi C.; Consorti, Giuseppe; Elia, Giovanni; Tieghi, Riccardo; Galiè, Manlio

    2013-01-01

    Temporomandibular joint ankylosis (TMJA) is a severe disorder described as an intracapsular union of the disc-condyle complex to the temporal articular surface with bony fusion. The management of this disability is challenging and rarely based on surgical and rehabilitation protocols. We describe the treatment in two young adults affected by Goldenhar syndrome and Pierre Robin sequence with reankylosis after previous surgical treatments. There are three main surgical procedures for the treatment of TMJA: gap arthroplasty, interpositional arthroplasty, and joint reconstruction. Various authors have described reankylosis as a frequent event after treatment. Treatment failure could be associated with surgical errors and/or inadequate intensive postoperative physiotherapy. Surgical treatment should be individually tailored and adequate postoperative physiotherapy protocol is mandatory for success. PMID:24624260

  14. Tensorial electrokinetics in articular cartilage.

    PubMed

    Reynaud, Boris; Quinn, Thomas M

    2006-09-15

    Electrokinetic phenomena contribute to biomechanical functions of articular cartilage and underlie promising methods for early detection of osteoarthritic lesions. Although some transport properties, such as hydraulic permeability, are known to become anisotropic with compression, the direction-dependence of cartilage electrokinetic properties remains unknown. Electroosmosis experiments were therefore performed on adult bovine articular cartilage samples, whereby fluid flows were driven by electric currents in directions parallel and perpendicular to the articular surface of statically compressed explants. Magnitudes of electrokinetic coefficients decreased slightly with compression (from approximately -7.5 microL/As in the range of 0-20% compression to -6.0 microL/As in the 35-50% range) consistent with predictions of microstructure-based models of cartilage material properties. However, no significant dependence on direction of the electrokinetic coupling coefficient was detected, even for conditions where the hydraulic permeability tensor is known to be anisotropic. This contrast may also be interpreted using microstructure-based models, and provides insights into structure-function relationships in cartilage extracellular matrix and physical mediators of cell responses to tissue compression. Findings support the use of relatively simple isotropic modeling approaches for electrokinetic phenomena in cartilage and related materials, and indicate that measurement of electrokinetic properties may provide particularly robust means for clinical evaluation of cartilage matrix integrity.

  15. 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

  16. 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

  17. Outcomes of temporomandibular joint arthroscopy in patients with painful but otherwise normal joints.

    PubMed

    Dimitroulis, George

    2015-07-01

    The aim of this retrospective clinical study was to assess the clinical outcomes of temporomandibular joint (TMJ) arthroscopy in patients who presented with category 1 normal joints. The null hypothesis being tested was that patients with normal joints do not respond to TMJ arthroscopy. The clinical records of 116 patients who had undergone TMJ arthroscopy by the author from 2010 to 2013 were retrieved and individually analysed for inclusion in this retrospective, cohort clinical study. The inclusion criteria used to select patients for this study were those who had arthroscopically proven category 1 normal joints, free of intra-articular pathology. Of the 14 patients who were found to have normal joints, only 10 could be contacted for a follow-up survey. Despite the fact that all patients were informed that no joint pathology was found, six out of the 10 patients reported improvement in their temporomandibular disorder (TMD) symptoms that lasted for more than 6 months following TMJ arthroscopy. The results of this investigation indicate that we can reject the null hypothesis, and that patients with normal TMJs do indeed respond to TMJ arthroscopy. What this limited study has highlighted is the pervasive effects of the placebo that all surgeons need to keep in mind when formulating treatment plans for patients with TMD.

  18. Emotional factors in temporomandibular joint disorders.

    PubMed

    Glaros, A G

    The chronic pain of many temporomandibular disorders is associated with multiple changes in emotional function and activities of daily living. Temporomandibular disorders (TMD) are similar to other chronic pain disorders in their impact on patients. Depression is probably the most common emotional state associated with chronic pain, although anxiety disorders also can be associated with TMD. The probability of emotional problems appears to be greatest in those individuals diagnosed with myofascial pain and least in those with disk displacement. Dental practitioners are encouraged to seek professional liaisons with mental health professionals who can assist them in managing chronic pain patients. PMID:11314076

  19. Clinical findings in temporomandibular disorders.

    PubMed

    Ozaki, Y; Shigematsu, T; Takahashi, S

    1990-08-01

    71 patients (16 males and 55 females) with temporomandibular (TM) disorders were examined for clinical symptoms of mandibular dysfunction. The frequency of TM disorders in the present study was higher in females (55 females, 77.5%) than in males (16 males, 22.5%); the ratio of females to males was about 3.4:1. The most frequent chief complaint was pain; limitation of opening movement was the next most common. Many patients had several of the major symptoms simultaneously. TM joint sounds were noted in 47 patients, including reciprocal clicking in 35 patients and crepitation in 12 patients. Tenderness with palpation of the TM joint and muscles were found in 46 patients; most of them complaining at two positions or more. Occlusal interferences were noted in various occlusal positions, and occlusal wear was found in 30 patients (42.3%). In recording the frequency of parafunction and bad habits, grinding of the teeth was found in 6 patients (8.5%), clenching of the teeth in 10 (14.1%), and unilateral mastication in 24 (33.8%).

  20. 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

  1. 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

  2. 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

  3. [Temporomandibular joint disorders: Physiotherapy and postural approaches].

    PubMed

    Breton-Torres, I; Trichot, S; Yachouh, J; Jammet, P

    2016-09-01

    Rehabilitation of temporomandibular joint dysfunctions has for a long time tried to treat symptoms: pain relief, joint kinetics restoration, disk re-capture by manual maneuvers. The authors present their own therapeutic approach, which is no longer limited to symptoms, but addresses the causes and identifies risk factors to prevent relapse. PMID:27522242

  4. 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

  5. Principles of treatment for temporomandibular joint ankylosis.

    PubMed

    Freedus, M S; Ziter, W D; Doyle, P K

    1975-10-01

    An understanding of the growth and development of the temporomandibular joint (TMJ) is necessary for successful treatment of TMJ ankylosis. The concept of a growth center in the condyle is probably misleading; instead, the soft tissues of the orofacial region seem to provide the primary growth forces. As a result of this concept, methods of treatment should be reexamined.

  6. Magnetic resonance imaging features of the temporomandibular joint in normal dogs.

    PubMed

    Macready, Dawn M; Hecht, Silke; Craig, Linden E; Conklin, Gordon A

    2010-01-01

    Evaluation of the canine temporomandibular joint (TMJ) is important in the clinical diagnosis of animals presenting with dysphagia, malocclusion and jaw pain. In humans, magnetic resonance imaging (MRI) is the modality of choice for evaluation of the TMJ. The objectives of this study were to establish a technical protocol for performing MRI of the canine TMJ and describe the MRI anatomy and appearance of the normal canine TMJ. Ten dogs (one fresh cadaver and nine healthy live dogs) were imaged. MRIs were compared with cadaveric tissue sections. T1-weighted (T1-W) transverse closed-mouth, T1-W sagittal closed-mouth, T1-W sagittal open-mouth, and T2-W sagittal open-mouth sequences were obtained. The condylar process of the mandible and the mandibular fossa of the temporal bone were hyperintense to muscle and isointense to hypointense to fat on T1-W images, mildly hyperintense to muscle on T2-W images, and were frequently heterogeneous. The articular disc was visible in 14/20 (70%) TMJs on T1-W images and 13/20 (65%) TMJs on T2-W images. The articular disc was isointense to hyperintense to muscle on T1-W images and varied from hypointense to hyperintense to muscle on T2-W images. The lateral collateral ligament was not identified in any joint. MRI allows evaluation of the osseous and certain soft tissue structures of the TMJ in dogs. PMID:20806876

  7. Development of temporomandibular joint ankylosis in rats: a preliminary experimental study.

    PubMed

    Porto, G; Vasconcelos, B; Silva, V

    2008-03-01

    The objective of this study was to evaluate a model for the development of temporomandibular joint ankylosis in rats using disc removal and articular damage. In 30 adult male Wistar rats, articular damage was induced and disc removal performed in the right joint to induce ankylosis. The rats were divided into groups according to the time of killing (7, 15, 30, 60 and 90 days). Maximal mouth opening, mandibular deviation, initial and final weights, and duration of surgery were recorded and evaluated. After death, the joints were submitted to histological study in order to score the ankylosis. The mean duration of surgery was 14.23 min. Mean difference between initial and final maximal mouth opening was 3.38 mm, being greatest at the 15-day evaluation and lowest at 90 days, and was statistically significant at 15 days (p=0.043), 30 days (p=0.027) and 60 days (p=0.027). No mandibular deviation was observed at any of the evaluation times. Histological scores increased with time of evaluation from 7 to 30 days, when they started to fall. This study model permitted the development of fibrous ankylosis in the majority of the animals, and no bony bridge was observed between the mandibular condyle and the temporal bone.

  8. Mice deficient in biglycan and fibromodulin as a model for temporomandibular joint osteoarthritis.

    PubMed

    Wadhwa, Sunil; Embree, Mildred; Ameye, Laurent; Young, Marian F

    2005-01-01

    The temporomandibular joint (TMJ) within the craniofacial complex is unique. In humans, the TMJ can become diseased resulting in severe and disabling pain. There are no cures for TMJ disease at this time. Animal models of TMJ disease are scarce, but some exist, and they are described in this paper. We present in greater detail one animal model that is deficient in two extracellular matrix (ECM) proteoglycans, biglycan (BGN) and fibromodulin (FMOD). Doubly deficient BGN/FMOD mice develop premature TMJ osteoarthritis (OA). In order to explore the mechanistic basis of TMJ-OA, tissues from the condyle of mutant mice were examined for their relative capacity to differentiate and undergo apoptosis. Our data show that there is a redistribution of the critical ECM protein, type II collagen, in mutant mice compared with controls. Mutant mice also have increased apoptosis of the chondrocytes embedded in the articular cartilage. We speculate that the overall imbalance in apoptosis may be the cellular basis for the abnormal production of structural ECM proteins. The abnormal production of the ECM could, in turn, lead to premature erosion and degradation of the articular surface resulting in TMJ-OA. These data underscore the importance of the ECM in controlling the structural integrity of the TMJ. PMID:16612079

  9. 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

  10. 1,25(OH)2D deficiency induces temporomandibular joint osteoarthritis via secretion of senescence-associated inflammatory cytokines.

    PubMed

    Shen, Ming; Luo, Yuqian; Niu, Yuming; Chen, Lulu; Yuan, Xiaoqin; Goltzman, David; Chen, Ning; Miao, Dengshun

    2013-08-01

    1,25-Dihydroxyvitamin D [1,25(OH)(2)D] insufficiency appears to be associated with several age-related diseases. Insufficient levels of serum 25-hydroxyvitamin D has been shown to lead to the progression of osteoarthritis (OA) while underlying biological mechanisms remain largely unknown. In this study, we sought to determine whether 1,25(OH)(2)D deficiency has a direct effect on the process of murine temporomandibular joint (TMJ) OA in 25-hydroxyvitamin D 1α-hydroxylase knockout [1α(OH)ase(-/-)] mice that had been fed a rescue diet (high calcium, phosphate, and lactose) from weaning until 6 or 18 months of age. Our results showed that the bone mineral density and subchondral bone volume were reduced in mandibular condyles, articular surfaces were collapsed, the thickness of articular cartilage and cartilage matrix protein abundance were progressively decreased and eventually led to an erosion of articular cartilage of mandibular condyles. We also found that DNA damage, cellular senescence and the production of senescence-associated inflammatory cytokines were increased significantly in 1α(OH)ase(-/-) mice. This study demonstrates that 1,25(OH)(2)D deficiency causes an erosive TMJ OA phenotype by inducing DNA damage, cellular senescence and the production of senescence-associated inflammatory cytokines. Our results indicate that 1,25(OH)(2)D plays an important role in preventing the development and progression of OA. PMID:23624390

  11. 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

  12. 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

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

    PubMed

    Terhune, Claire E

    2011-11-01

    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.

  14. [An attempt to use ultrasonic technique for confirming the diagnosis, planning and observation of long-term treatment results of painful temporo-mandibular joint dysfunction].

    PubMed

    Ey-Chmielewska, H

    1998-01-01

    The author presents an attempt of using ultrasonographic technique in diagnosis, planning and observation of treatment results of temporo-mandibular joint pain dysfunctions. Temporo-mandibular joint pain dysfunctions are interchangeably also called temporo-mandibular joint functional disorders. The assessment of pain symptoms in temporo-mandibular joint dysfunctions pain symptoms is principally based on a subjective estimation by the examining practitioner. There is no univocal definition of the disease or a simple index evidencing important symptoms in decision making. Additionally X-ray technique examinations, being hitherto used, in early stages of the disorder do not allow to diagnose it, and are also burdensome to a patient. The aim of this study was to confirm visibility of anatomical elements of the temporo-mandibular joint in an ultrasound examination, assess the mobility of the articular disc before, during and after prosthetic treatment with and without the use of ultrasound technique, and to determine the period of time necessary to obtain a therapeutic effect. The study material consisted of 180 patients, 128 women and 52 men, aged 20 to 60 years, treated by applying prostheses because of temporo-mandibular joint pain dysfunction, in the Department of Prosthetic Dentistry of the Pomeranian Medical Academy. The patients were divided into 2 groups, control and study group. The control group consisted of 90 patients, 63 women and 27 men. In this group prosthetic treatment planning and observation of results was based on a subjective estimation of the practitioner. The study group here comprised 90 patients, 65 women and 25 men, aged 26 to 60 years. In this group prosthetic treatment planning and observation of treatment results were carried on with the use of ultrasound technique. Data from both groups concerning history, results of examinations carried out by ultrasound technique, and the assessment of ultrasound examination were noted on standard

  15. Insulin-like growth factor-1 suspended in hyaluronan improves cartilage and subchondral cancellous bone repair in osteoarthritis of temporomandibular joint.

    PubMed

    Liu, X-W; Hu, J; Man, C; Zhang, B; Ma, Y-Q; Zhu, S-S

    2011-02-01

    This study sought to evaluate the effects of intra-articular injection of insulin-like growth factor-1 (IGF-1) suspended in hyaluronan (HA) on the cartilage and subchondral cancellous bone repair in osteoarthritis (OA) of the temporomandibular joint (TMJ). Disc perforation was performed bilaterally in rabbit TMJs to induce OA. Four groups of animals (n=12) received OA induction only, and either intra-articular HA injection alone, intra-articular IGF-1 injection alone, or a combination of HA and IGF-1 injection. All therapy was begun 4 weeks after OA induction. The animals were killed 12 or 24 weeks after the first injection, for histology and micro-CT examinations. Two additional animals were used as normal controls. Typical cartilage and subchondral cancellous bone lesions were observed in the OA group. No protective effect on cartilage and subchondral cancellous bone was found in the HA or IGF-1 alone groups. Better histological repair and nearly normal micro-architectural properties of the subchondral cancellous bone were observed in the HA+IGF-1 group compared with the HA or IGF-1 alone groups. HA may be used as an effective carrier for intra-articular injection of IGF-1 and the combination of HA/IGF-1 shows promise as a new rational approach to therapy of TMJ OA. PMID:21055904

  16. Gnathological splint therapy in temporomandibular joint disorder.

    PubMed

    Gnanashanmugham, K; Saravanan, B; Sukumar, M R; Tajir, T Faisal

    2015-04-01

    Temporomandibular joint (TMJ) forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD) is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic reasons to systemic disorders. The option of Gnathological splint is a conservative, safe and an effective mode of therapy for TMDs caused by occlusal discrepancies (fulcrum/interferences). This article presents a case report of a patient with TMD caused by occlusal discrepancy.

  17. 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

  18. Temporomandibular disorders. Part 2: conservative management.

    PubMed

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

    2014-02-01

    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.

  19. Gnathological splint therapy in temporomandibular joint disorder

    PubMed Central

    Gnanashanmugham, K.; Saravanan, B.; Sukumar, M. R.; Tajir, T. Faisal

    2015-01-01

    Temporomandibular joint (TMJ) forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD) is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic reasons to systemic disorders. The option of Gnathological splint is a conservative, safe and an effective mode of therapy for TMDs caused by occlusal discrepancies (fulcrum/interferences). This article presents a case report of a patient with TMD caused by occlusal discrepancy PMID:26015741

  20. 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

  1. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Total temporomandibular joint prosthesis. 872.3940 Section 872.3940 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular...

  2. 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

  3. 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

  4. 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

  5. Human stem cells and articular cartilage regeneration.

    PubMed

    Inui, Atsuyuki; Iwakura, Takashi; Reddi, A Hari

    2012-11-05

    The regeneration of articular cartilage damaged due to trauma and posttraumatic osteoarthritis is an unmet medical need. Current approaches to regeneration and tissue engineering of articular cartilage include the use of chondrocytes, stem cells, scaffolds and signals, including morphogens and growth factors. Stem cells, as a source of cells for articular cartilage regeneration, are a critical factor for articular cartilage regeneration. This is because articular cartilage tissue has a low cell turnover and does not heal spontaneously. Adult stem cells have been isolated from various tissues, such as bone marrow, adipose, synovial tissue, muscle and periosteum. Signals of the transforming growth factor beta superfamily play critical roles in chondrogenesis. However, adult stem cells derived from various tissues tend to differ in their chondrogenic potential. Pluripotent stem cells have unlimited proliferative capacity compared to adult stem cells. Chondrogenesis from embryonic stem (ES) cells has been studied for more than a decade. However, establishment of ES cells requires embryos and leads to ethical issues for clinical applications. Induced pluripotent stem (iPS) cells are generated by cellular reprogramming of adult cells by transcription factors. Although iPS cells have chondrogenic potential, optimization, generation and differentiation toward articular chondrocytes are currently under intense investigation.

  6. Growth factor transgenes interactively regulate articular chondrocytes.

    PubMed

    Shi, Shuiliang; Mercer, Scott; Eckert, George J; Trippel, Stephen B

    2013-04-01

    Adult articular chondrocytes lack an effective repair response to correct damage from injury or osteoarthritis. Polypeptide growth factors that stimulate articular chondrocyte proliferation and cartilage matrix synthesis may augment this response. Gene transfer is a promising approach to delivering such factors. Multiple growth factor genes regulate these cell functions, but multiple growth factor gene transfer remains unexplored. We tested the hypothesis that multiple growth factor gene transfer selectively modulates articular chondrocyte proliferation and matrix synthesis. We tested the hypothesis by delivering combinations of the transgenes encoding insulin-like growth factor I (IGF-I), fibroblast growth factor-2 (FGF-2), transforming growth factor beta1 (TGF-β1), bone morphogenetic protein-2 (BMP-2), and bone morphogenetic protien-7 (BMP-7) to articular chondrocytes and measured changes in the production of DNA, glycosaminoglycan, and collagen. The transgenes differentially regulated all these chondrocyte activities. In concert, the transgenes interacted to generate widely divergent responses from the cells. These interactions ranged from inhibitory to synergistic. The transgene pair encoding IGF-I and FGF-2 maximized cell proliferation. The three-transgene group encoding IGF-I, BMP-2, and BMP-7 maximized matrix production and also optimized the balance between cell proliferation and matrix production. These data demonstrate an approach to articular chondrocyte regulation that may be tailored to stimulate specific cell functions, and suggest that certain growth factor gene combinations have potential value for cell-based articular cartilage repair.

  7. 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

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

    PubMed

    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.

  9. 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.

  10. 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

  11. Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders.

    PubMed

    Blanco Aguilera, A; Gonzalez Lopez, L; Blanco Aguilera, E; De la Hoz Aizpurua, J L; Rodriguez Torronteras, A; Segura Saint-Gerons, R; Blanco Hungría, A

    2014-08-01

    The aim of this study was to evaluate the association between self-reported sleep bruxism and the age, gender, clinical subtypes of temporomandibular disorders (TMD), pain intensity and grade of chronic pain in patients previously diagnosed with TMD. Thousand two-hundred and twenty patients of the Andalusian Health Service were examined using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) questionnaire. The inclusion and exclusion criteria were those included in the RDC/TMD criteria. The bruxism diagnosis was drawn from the question, 'Have you been told, or do you notice that you grind your teeth or clench your jaw while sleeping at night?' in the anamnestic portion of the questionnaire. A bivariate analysis was conducted, comparing the presence of perceived parafunctional activity with age (over age 60 and under age 60), gender, different subtypes of TMD, pain intensity, grade of chronic pain and presence of self-perceived locked joints. The overall prevalence of self-reported sleep bruxism (SB) was 54.51%. A statistically significant association was found between the presence of SB and patients under age 60, women, greater pain intensity, greater pain interference with activities of daily living, and the axis-I groups affected by both muscular and articular pathology. There is a statistically significant association between self-reported sleep bruxism and women under age 60 who have painful symptoms of TMD. There is also a positive association between this parafunctional habit and the presence of chronic pain. However, more studies that cover larger samples and differentiate between sleep bruxism and awake bruxism are needed.

  12. Articular Cartilage Changes in Maturing Athletes

    PubMed Central

    Luria, Ayala; Chu, Constance R.

    2014-01-01

    Context: Articular cartilage has a unique functional architecture capable of providing a lifetime of pain-free joint motion. This tissue, however, undergoes substantial age-related physiologic, mechanical, biochemical, and functional changes that reduce its ability to overcome the effects of mechanical stress and injury. Many factors affect joint function in the maturing athlete—from chondrocyte survival and metabolism to structural composition and genetic/epigenetic factors governing cartilage and synovium. An evaluation of age-related changes for joint homeostasis and risk for osteoarthritis is important to the development of new strategies to rejuvenate aging joints. Objective: This review summarizes the current literature on the biochemical, cellular, and physiologic changes occurring in aging articular cartilage. Data Sources: PubMed (1969-2013) and published books in sports health, cartilage biology, and aging. Study Selection: Keywords included aging, athlete, articular cartilage, epigenetics, and functional performance with age. Study Design: Systematic review. Level of Evidence: Level 3. Data Extraction: To be included, research questions addressed the effect of age-related changes on performance, articular cartilage biology, molecular mechanism, and morphology. Results: The mature athlete faces challenges in maintaining cartilage health and joint function due to age-related changes to articular cartilage biology, morphology, and physiology. These changes include chondrocyte loss and a decline in metabolic response, alterations to matrix and synovial tissue composition, and dysregulation of reparative responses. Conclusion: Although physical decline has been regarded as a normal part of aging, many individuals maintain overall fitness and enjoy targeted improvement to their athletic capacity throughout life. Healthy articular cartilage and joints are needed to maintain athletic performance and general activities. Genetic and potentially reversible

  13. 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.

  14. 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

  15. 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.

  16. [Temporo-mandibular joints and orthognathic surgery].

    PubMed

    Bouletreau, P

    2016-09-01

    Temporo-Mandibular Joints (TMJ) and orthognathic surgery are closely linked. In the past, some authors have even described (with mixed results) the correction of some dysmorphosis through direct procedures on the TMJs. Nowadays, performing orthognathic surgery involves the TMJ in three different occasions: (1) TMJ disorders potentially responsible for dento-maxillary dysmorphosis, (2) effects of orthognathic surgery on TMJs, and (3) condylar positioning methods in orthognathic surgery. These three chapters are developed in order to focus on the close relationships between TMJ and orthognathic surgery. Some perspectives close this article.

  17. [Surgical treatment of temporomandibular joint ankylosis].

    PubMed

    Worsaae, N; Hjørting-Hansen, E; Jensen, B; Seidler, B; Praetorius, F

    1992-09-14

    Surgical treatment of temporo-mandibular joint (TMJ) ankylosis may be a particularly difficult procedure due to unfavourable anatomic configurations and the proximity of vital structures. Postoperatively, it is followed by an often long and painful period of physiotherapy. The results of treatment of eight patients with TMJ ankylosis are reported. Different methods were used according to age of the patient and the extent of the ankylotic changes. The importance of early treatment is emphasized. This results in less extensive surgery and reduces secondary growth anomalies of the jaws.

  18. Augmented Indian hedgehog signaling in cranial neural crest cells leads to craniofacial abnormalities and dysplastic temporomandibular joint in mice

    PubMed Central

    Yang, Ling; Gu, Shuping; Ye, Wenduo; Song, Yingnan; Chen, YiPing

    2016-01-01

    Extensive studies have pinpointed the crucial role of Indian hedgehog (Ihh) signaling in the development of the appendicular skeleton and the essential function of Ihh in the formation of the temporomandibular joint (TMJ). In this study, we have investigated the effect of augmented Ihh signaling in TMJ development. We took a transgenic gain-of-function approach by overexpressing Ihh in the cranial neural crest (CNC) cells using a conditional Ihh transgenic allele and the Wnt1-Cre allele. We found that Wnt1-Cre-mediated tissue-specific overexpression of Ihh in the CNC lineage caused severe craniofacial abnormalities, including cleft lip/palate, encephalocele, anophthalmos, micrognathia, and defective TMJ development. In the mutant TMJ, the glenoid fossa was completely absent, whereas the condyle and the articular disc appeared relatively normal with slightly delayed chondrocyte differentiation. Our findings thus demonstrate that augmented Ihh signaling is detrimental to craniofacial development, and that finely tuned Ihh signaling is critical for TMJ formation. Our results also provide additional evidence that the development of the condyle and articular disc is independent of the glenoid fossa. PMID:26553654

  19. Intra-articular fractures of the hand.

    PubMed

    Oak, Nikhil; Lawton, Jeffrey N

    2013-11-01

    Fractures of the hand are common injuries and in particular, fractures involving the articular surfaces can present difficulties to the orthopedic surgeon in practice. Although the treatment of these fractures needs to be individualized based on fracture pattern and location, the goals for these fractures are to restore the alignment, stability, and congruity and to allow for early motion to prevent stiffness and traumatic arthritis. This article classifies the various types of intra-articular hand fractures as well as the workup and management of these injuries. PMID:24209952

  20. 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

  1. Features of temporomandibular disorders in fibromyalgia syndrome.

    PubMed

    Pimentel, Marcele Jardim; Gui, Maisa Soares; Martins de Aquino, Luana Maria; Rizzatti-Barbosa, Célia Marisa

    2013-01-01

    This study aimed to investigate the prevalence of clinical features of temporomandibular disorders (TMD) in patients with fibromyalgia. The test group (FMG) consisted of 40 women with fibromyalgia (FM) compared to the control group of 40 healthy subjects using the research diagnostic criteria for temporomandibular disorders (RDC/TMD). The variables were compared using Fisher's exact test and a Mann-Whitney test. Facial pain was reported by 85% of the FM group, and 77.5% were diagnosed with myofascial TMD. Muscle pain during jaw movements, daytime bruxism/clenching, and limited mouth opening were significantly higher in the test group. There was no difference between groups in: (1) joint noises; (2) sleep bruxism/clenching; and (3) excursive or non-excursive movements. Classic signs of TMD, such as joint noise and self-reporting of clenching at night, are not associated with fibromyalgia syndrome as demonstrated in the current study. However, the self-reported daytime parafunctions, muscle pain in jaw movements, and limited mouth opening are features of the patients in the current study. This study revealed specific muscle involvement of TMD is also presence in FM.

  2. Preparation of Articular Cartilage Specimens for Scanning Electron Microscopy.

    PubMed

    Stupina, T A

    2016-08-01

    We developed and adapted a technology for preparation of articular cartilage specimens for scanning electron microscopy. The method includes prefixation processing, fixation, washing, and dehydration of articular cartilage specimens with subsequent treatment in camphene and air-drying. The technological result consists in prevention of deformation of the articular cartilage structures. The method is simpler and cheaper than the known technologies. PMID:27591865

  3. Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis

    PubMed Central

    Felstead, Andrew M.; Revington, Peter J.

    2011-01-01

    Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition. PMID:21547039

  4. 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

  5. Effect of Herbst treatment on temporomandibular joint morphology: a systematic literature review.

    PubMed

    Popowich, Kurt; Nebbe, Brian; Major, Paul W

    2003-04-01

    The purpose of this systematic review was to evaluate the effect of Herbst appliance therapy on temporomandibular joint (TMJ) morphology, with special reference to glenoid fossa remodeling, condylar remodeling, condylar position, and articular disc position. Publications of controlled trials of Herbst treatment of Class II patients using magnetic resonance imaging (MRI), computerized tomography scans, or tomography to assess TMJ morphology were identified with Medline (1966-2001), Best Evidence (1991-2001), Cochrane Database of Systematic Reviews (second quarter, 2001), and Embase (1998-2001). Case reports were excluded. Based on our search, only 5 studies met the selection criteria. All studies used internal controls with pretreatment and posttreatment imaging. Four studies used MRI, and 1 used tomograms. The 4 MRI studies used overlapping patient samples and were not considered as independent evidence. The MRI studies did not provide conclusive evidence of osseous remodeling or condyle position change. The tomography study demonstrated minor condyle position change. Methodological deficiencies prevented major conclusions regarding disc position. The reviewed studies highlight the importance of further research. Prospective controlled studies using serial MRI and tomography are required to establish the effect of Herbst treatment on TMJ morphology.

  6. Histological study of the human temporo-mandibular joint and its surrounding muscles.

    PubMed

    Bravetti, P; Membre, H; El Haddioui, A; Gérard, H; Fyard, J P; Mahler, P; Gaudy, J F

    2004-10-01

    This is a histological study of the human temporo-mandibular joint and its surrounding muscles. Using a microscopic study of serial sections from anatomical specimens from six subjects, the detailed anatomy of the joint is presented with particular regard to the histology. This study has allowed, in particular, the description of the ligaments and capsule as well as the insertions of the masticatory muscles (temporalis, masseter, lateral pterygoid) on this joint. These observations are then compared with the anatomical and histological data already reported on this subject. This study shows that the bulk of the muscular fibres of the lateral pterygoid passes under the foot of the disc is attached over the whole height of the condylar, unite and extend as far as the medial pole of the joint under the insertion of the articular disc. An insertion of the temporo-masseter musculo-tendinous complex on the anterior and lateral capsulo-discal structures was observed. The lateral pterygoid is composed of a succession of tendinous and fleshy fibres. This study confirms the thickening of the lateral capsule that corresponds to a lateral collateral ligament, and the absence of a medial collateral ligament. Medial stability is conferred by the lateral ligament of the contralateral joint.

  7. 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

  8. Osteoarthritis in Temporomandibular Joint of Col2a1 Mutant Mice

    PubMed Central

    Ricks, M. L.; Farrell, J.T.; Falk, D. J.; Holt, D W.; Rees, M.; Carr, J.; Williams, T.; Nichols, B.A.; Bridgewater, L. C.; Reynolds, P. R.; Kooyman, D L; Seegmiller, R. E.

    2013-01-01

    Objective Col2a1 gene mutations cause premature degeneration of knee articular cartilage in disproportionate micromelia (Dmm) and spondyloepiphesial dysplasia congenita (sedc) mice. The present study analyzes the temporomandibular joint (TMJ) in Col2a1 mutant mice in order to provide an animal model of TMJ osteoarthritis (OA) that may offer better understanding of the progression of this disease in humans. Design Dmm/+ mice and controls were compared at two, six, nine and 12 months. Craniums were fixed, processed to paraffin sections, stained with Safranin-O/Fast Green, and analyzed with light microscopy. OA was quantified using a Mankin scoring procedure. Unfolded protein response (UPR) assay was performed and immunohistochemistry (IHC) was used to assay for known OA biomarkers. Results Dmm/+ TMJs showed fissuring of condylar cartilage as early as 6 months of age. Chondrocytes were clustered, leaving acellular regions in the matrix. Significant staining of HtrA1, Ddr2 and Mmp-13 was observed in Dmm/+ mice (p< 0.01). We detected upregulation of the UPR in knee but not TMJ. Conclusions Dmm/+ mice are subject to early-onset OA in the TMJ. We observed upregulation of biomarkers and condylar cartilage degradation concomitant with OA. An upregulated UPR may exacerbate the onset of OA. The Dmm/+ mouse TMJ is a viable model for the study of the progression of OA in humans. PMID:23518238

  9. 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

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

    PubMed

    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

  11. 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

  12. Effect of functional shift of the mandible on lubrication of the temporomandibular joint.

    PubMed

    Kure-Hattori, Ikuko; Watari, Ippei; Takei, Maki; Ishida, Yuji; Yonemitsu, Ikuo; Ono, Takashi

    2012-07-01

    Lubrication of synovial joints reduces the coefficient of friction of the articular cartilage surface. To investigate the effect of malocclusion on the lubrication of the temporomandibular joint (TMJ), we evaluated lubricin expression in the rat TMJ immunohistochemically, under conditions of functional lateral shift of the mandible, during period of growth. Thirty 5-week-old male Wistar rats were divided into experimental, recovery, and control groups. Each rt in the experimental and recovery groups was fitted with an acrylic-plate guiding appliance. The rats in the experimental and control groups were killed at 14 and 28 days after the appliance was attached. Each rat in the recovery group was detached from the appliance at 14 days, and was killed 14 days after the appliance was removed. In the experimental group, the expression of lubricin staining in TMJ cartilage was significantly decreased during the experimental period. In the recovery group, the expression of lubricin staining in TMJ cartilage was significantly greater than in the experimental group, and there was no significant difference at 28 days between the control and recovery groups. Analysis of these data suggests that a functional lateral shift of the mandible during the growth period influences lubrication of the TMJ.

  13. 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

  14. 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

  15. Evaluation of Pneumatization in the Articular Eminence and Roof of the Glenoid Fossa with Cone-Beam Computed Tomography

    PubMed Central

    İlgüy, Mehmet; Dölekoğlu, Semanur; Fişekçioğlu, Erdoğan; Ersan, Nilüfer; İlgüy, Dilhan

    2015-01-01

    Background: Detection of air cavities, so called pneumatizations, nearby to the temporomandibular joint (TMJ) area is important, as they represent sites of minimal resistance and facilitate the spread of various pathologies into the joint as inflammation, tumor or fractures and serve as a possible complicating factor in TMJ surgery. Aims: To determine the prevalence of pneumatization of the articular eminence (PAT) and roof of the glenoid fossa (PRGF) using cone-beam computed tomography (CBCT). Study Design: Cross-sectional study. Methods: Acquired images of 111 patients (222 TMJs) were evaluated. The presence of pneumatization was recorded at the articular eminence and roof of the glenoid fossa. Age and gender were recorded for all patients and type (unilocular or multilocular) and laterality were noted for the cases of pneumatization. Results: The mean age of the study group was 48.86±18.31 years. Among all the patients, 73 (65.8%) had PAT, while 13 (11.7%) had PRGF. Forty-two (37.8%) of the patients had PAT bilaterally; whereas 3 of them (2.7%) presented PRGF bilaterally. The percentage of PAT was higher for females (73.6%) than males (51.3%) (p<0.05). Conclusion: CBCT images are an accurate and reliable means of detection of the exact size and type of pneumatization and the relationship of pneumatization to the adjacent tissues. This is especially significant before a surgical intervention is planned in this region, in order to make a sound diagnosis. PMID:25759774

  16. [Psychosocial factors in patients with temporomandibular pain].

    PubMed

    Nilges, P

    2002-09-01

    The significance of psychosocial factors (pain concepts, psychological distress eg. depression and anxiety, disability) in patients with temporomandibular pain is increasingly noticed. The major diagnostic domains as well as the appropriate diagnostic procedures are described. Management should be based on a model elaborated in cooperation with patients, as to the formation and maintenance of the pain condition. It should be individualized as much as possible. For the majority of patients, symptomatic treatment in combination with clear behavioral directions is sufficient. However, some studies show that improvement is more stable and faster in patients with combined treatment conditions (e.g.occlusal appliance, stress management, relaxation training) than in patients receiving only singular treatment. PMID:12235500

  17. [Pharmacological therapy of temporomandibular joint pain].

    PubMed

    Hugger, Alfons; Schindler, Hans J; Türp, Jens C; Hugger, Sybille

    2013-01-01

    Pharmacological interventions in temporomandibular joint (TMJ) pain differ from corresponding therapeutic interventions of jaw muscle (myofascial) pain. An actual systematic literature search lists and evaluates available articles on randomised controlled trials for treatment of arthralgia of the TMJ. On the basis of the few available trial reports, non-steroidal anti-inflammatory drugs (NSAIDs) seem to be effective, but side effects and drug interactions need to be considered. In relation to other therapeutic modalities, the rapidity of the onset of action of NSAIDs seems to be different, and the extension of side effects can be varied or reduced by changing the application route (oral versus topical). Palmitoylethanolamide (PEA) as dietary supplement for special medical purposes can apparently evoke positive therapeutic effects in TMJ arthralgia which need to be analysed in further studies.

  18. Family Therapy in Complex Temporomandibular Joint Dysfunction

    PubMed Central

    Boll, Pamela G.; Mercuri, Louis G.

    1988-01-01

    The purpose of this paper is to offer the oral and maxillofacial surgeon a collaborative approach to the treatment of complex temporomandibular joint (TMJ) dysfunction. Through a positive relationship with a family therapist, the oral and maxillofacial surgeon in this case reports family therapy intervention as an additive solution to resolving apparent recurrent surgical failures. After three surgical procedures, the oral and maxillofacial surgeon noted continued muscle hyperactivity brought on by family environmental stress and arranged for family therapy treatment before a fourth surgical procedure. This paper presents a complicated TMJ case history, documentation for including the family in treatment of pain problems, collaborative efforts necessary for acceptance of referral for psychological intervention, and a family therapy approach to treatment in complex TMJ dysfunction. PMID:3166348

  19. Attenuation of the progression of articular cartilage degeneration by inhibition of TGF-β1 signaling in a mouse model of osteoarthritis.

    PubMed

    Chen, Rebecca; Mian, Michelle; Fu, Martin; Zhao, Jing Ying; Yang, Liang; Li, Yefu; Xu, Lin

    2015-11-01

    Transforming growth factor beta 1 (TGF-β1) is implicated in osteoarthritis. We therefore studied the role of TGF-β1 signaling in the development of osteoarthritis in a developmental stage-dependent manner. Three different mouse models were investigated. First, the Tgf-β receptor II (Tgfbr2) was specifically removed from the mature cartilage of joints. Tgfbr2-deficient mice were grown to 12 months of age and were then euthanized for collection of knee and temporomandibular joints. Second, Tgfbr2-deficient mice were subjected to destabilization of the medial meniscus (DMM) surgery. Knee joints were then collected from the mice at 8 and 16 weeks after the surgery. Third, wild-type mice were subjected to DMM at the age of 8 weeks. Immediately after the surgery, these mice were treated with the Tgfbr2 inhibitor losartan for 8 weeks and then euthanized for collection of knee joints. All joints were characterized for evidences of articular cartilage degeneration. Initiation or acceleration of articular cartilage degeneration was not observed by the genetic inactivation of Tgfbr2 in the joints at the age of 12 months. In fact, the removal of Tgfbr2 and treatment with losartan both delayed the progression of articular cartilage degeneration induced by DMM compared with control littermates. Therefore, we conclude that inhibition of Tgf-β1 signaling protects adult knee joints in mice against the development of osteoarthritis. PMID:26355014

  20. 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

  1. The quality of healing: articular cartilage.

    PubMed

    Gomoll, Andreas H; Minas, Tom

    2014-05-01

    Articular cartilage lacks an intrinsic capacity for self-repair, and once damaged, it never heals. This creates an opportunity for surgical intervention, whether to stimulate a healing response that results in the formation of a lower-quality fibrocartilaginous scar or formal cartilage repair in the form of cartilage transplants. This article will review the nature of cartilage injury and discuss indications and techniques for repair.

  2. Inducing articular cartilage phenotype in costochondral cells

    PubMed Central

    2013-01-01

    Introduction Costochondral cells may be isolated with minimal donor site morbidity and are unaffected by pathologies of the diarthrodial joints. Identification of optimal exogenous stimuli will allow abundant and robust hyaline articular cartilage to be formed from this cell source. Methods In a three factor, two level full factorial design, the effects of hydrostatic pressure (HP), transforming growth factor β1 (TGF-β1), and chondroitinase ABC (C-ABC), and all resulting combinations, were assessed in third passage expanded, redifferentiated costochondral cells. After 4 wks, the new cartilage was assessed for matrix content, superficial zone protein (SZP), and mechanical properties. Results Hyaline articular cartilage was generated, demonstrating the presence of type II collagen and SZP, and the absence of type I collagen. TGF-β1 upregulated collagen synthesis by 175% and glycosaminoglycan synthesis by 75%, resulting in a nearly 200% increase in tensile and compressive moduli. C-ABC significantly increased collagen content, and fibril density and diameter, leading to a 125% increase in tensile modulus. Hydrostatic pressure increased fibril diameter by 30% and tensile modulus by 45%. Combining TGF-β1 with C-ABC synergistically increased collagen content by 300% and tensile strength by 320%, over control. No significant differences were observed between C-ABC/TGF-β1 dual treatment and HP/C-ABC/TGF-β1. Conclusions Employing biochemical, biophysical, and mechanical stimuli generated robust hyaline articular cartilage with a tensile modulus of 2 MPa and a compressive instantaneous modulus of 650 kPa. Using expanded, redifferentiated costochondral cells in the self-assembling process allows for recapitulation of robust mechanical properties, and induced SZP expression, key characteristics of functional articular cartilage. PMID:24330640

  3. Global Body Posture Evaluation in Patients with Temporomandibular Joint Disorder

    PubMed Central

    Saito, Eliza Tiemi; Akashi, Paula Marie Hanai; de Camargo Neves Sacco, Isabel

    2009-01-01

    AIM: To identify the relationship between anterior disc displacement and global posture (plantar arches, lower limbs, shoulder and pelvic girdle, vertebral spine, head and mandibles). Common signs and symptoms of anterior disc displacement were also identified. INTRODUCTION: Global posture deviations cause body adaptation and realignment, which may interfere with the organization and function of the temporomandibular joint. METHODS : Global posture evaluation was performed in a group of 10 female patients (20 to 30 years of age) with temporomandibular joint disc displacement and in a control group of 16 healthy female volunteers matched for age, weight and height. Anterior disc displacement signs, symptoms and the presence of parafunctional habits were also identified through interview. RESULTS: Patients with disc displacement showed a higher incidence of pain in the temporomandibular joint area, but there were no differences in parafunctional habits between the groups. In the disc displacement group, postural deviations were found in the pelvis (posterior rotation), lumbar spine (hyperlordosis), thoracic spine (rectification), head (deviation to the right) and mandibles (deviation to the left with open mouth). There were no differences in the longitudinal plantar arches between the groups. CONCLUSION: Our results suggest a close relationship between body posture and temporomandibular disorder, though it is not possible to determine whether postural deviations are the cause or the result of the disorder. Hence, postural evaluation could be an important component in the overall approach to providing accurate prevention and treatment in the management of patients with temporomandibular disorder. PMID:19142549

  4. Polarized IR microscopic imaging of articular cartilage.

    PubMed

    Ramakrishnan, Nagarajan; Xia, Yang; Bidthanapally, Aruna

    2007-08-01

    The objective of this spectroscopic imaging study is to understand the anisotropic behavior of articular cartilage under polarized infrared radiation at 6.25 microm pixel resolution. Paraffin embedded canine humeral cartilage-bone blocks were used to obtain 6 microm thick tissue sections. Two wire grid polarizers were used to manipulate the polarization states of IR radiation by setting them for various polarizer/analyzer angles. The characteristics of the major chemical components (amide I, amide II, amide III and sugar) of articular cartilage were investigated using (a) a polarizer and (b) a combination of a polarizer and an analyzer. These results were compared to those obtained using only an analyzer. The infrared anisotropy (variation in infrared absorption as a function of polarization angles) of amide I, amide II and amide III bands correlates with the orientation of collagen fibrils along the tissue depth in different histological zones. An 'anisotropic flipping' region of amide profiles indicates the possibility of using Fourier transform infrared imaging (FTIRI) to determine the histological zones in cartilage. Cross-polarization experiment indicates the resolution of overlapping peaks of collagen triple helix and/or proteoglycan in articular cartilage.

  5. Articular Cartilage Injury and Potential Remedies.

    PubMed

    Chubinskaya, Susanna; Haudenschild, Dominik; Gasser, Seth; Stannard, James; Krettek, Christian; Borrelli, Joseph

    2015-12-01

    Osteoarthritis affects millions of people worldwide, is associated with joint stiffness and pain, and often causes significant disability and loss of productivity. Osteoarthritis is believed to occur as a result of ordinary "wear and tear" on joints during the course of normal activities of daily living. Posttraumatic osteoarthritis is a particular subset of osteoarthritis that occurs after a joint injury. Developing clinically relevant animal models will allow investigators to delineate the causes of posttraumatic osteoarthritis and develop means to slow or prevent its development after joint injury. Chondroprotectant compounds, which attack the degenerative pathways at a variety of steps, are being developed in an effort to prevent posttraumatic osteoarthritis and offer great promise. Often times, cartilage degradation after joint injury occurs despite our best efforts. When this happens, there are several evolving techniques that offer at least short-term relief from the effects of posttraumatic osteoarthritis. Occasionally, these traumatic lesions are so large that dramatic steps must be taken in an attempt to restore articular congruity and joint stability. Fresh osteochondral allografts have been used in these settings and offer the possibility of joint preservation. For patients presenting with neglected displaced intra-articular fractures that have healed, intra-articular osteotomy techniques are being developed in an effort to restore joint congruity and function. This article reviews the results of a newly developed animal model of posttraumatic osteoarthritis, several promising chondroprotectant compounds, and also cartilage techniques that are used when degenerative cartilage lesions develop after joint injury. PMID:26584267

  6. Polarized IR microscopic imaging of articular cartilage

    NASA Astrophysics Data System (ADS)

    Ramakrishnan, Nagarajan; Xia, Yang; Bidthanapally, Aruna

    2007-08-01

    The objective of this spectroscopic imaging study is to understand the anisotropic behavior of articular cartilage under polarized infrared radiation at 6.25 µm pixel resolution. Paraffin embedded canine humeral cartilage-bone blocks were used to obtain 6 µm thick tissue sections. Two wire grid polarizers were used to manipulate the polarization states of IR radiation by setting them for various polarizer/analyzer angles. The characteristics of the major chemical components (amide I, amide II, amide III and sugar) of articular cartilage were investigated using (a) a polarizer and (b) a combination of a polarizer and an analyzer. These results were compared to those obtained using only an analyzer. The infrared anisotropy (variation in infrared absorption as a function of polarization angles) of amide I, amide II and amide III bands correlates with the orientation of collagen fibrils along the tissue depth in different histological zones. An 'anisotropic flipping' region of amide profiles indicates the possibility of using Fourier transform infrared imaging (FTIRI) to determine the histological zones in cartilage. Cross-polarization experiment indicates the resolution of overlapping peaks of collagen triple helix and/or proteoglycan in articular cartilage.

  7. A serial study on the development of the temporomandibular joint in the fetal mouse--in particular on the fibrous component in the condylar cartilage.

    PubMed

    Kagawa, M

    1990-06-01

    The development of the temporomandibular joint of 400 fetal mice at stages ranging from the 13th to the 20th day after insemination was investigated under the light, scanning (SEM) and transmission electron (TEM) microscopes. The differentiation and development of a cartilaginous tissue were observed at the supero-posterior end of the mandible at the 13 days after insemination. This tissue grew backward, upward and lateralward continuously and maintained a constant articulation with the squamosal part of the temporal bone. Seventeen days after insemination, cell layers in the condylar process and articular disc were arranged regularly. An supero- and inferno-directional cellular differentiation initiated from the subfibrous (SF) layer toward the articular spaces and cartilaginous layer was observed. The perichondrial ossification had taken place with the invasion of capillaries and the differentiation of osteoblasts in the SF layer, and was followed with a hypertrophic degeneration and endochondral ossification in the condylar process. Such a bi-directional growth of collagen and elastic fibers starting from the SF layer was also observed. Observation under SEM and TEM on the autoclaved condylar process revealed a complicated network consisted of main elastic fibers running in the sagittal direction. These fibers as well as the proteoglycan which contributes to the resilient property of the condylar cartilage and the ability to endure tensile or compressive stress from surrounding tissues during the growth and development of the mandibular condyle. The developing cartilaginous tissue was stimulated with the pressure from the masticatory muscles to initiate an active differentiation of the fibrous layer, which was invaded by the blood capillary system closely related with the subsequent endochondral ossification. These results elucidate that the development of the temporomandibular joint has closely kept relations with the functional influences from surrounding

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

    PubMed

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

    2012-06-01

    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 and

  9. Temporomandibular dysfunction syndrome associated with scuba diving mouthpieces.

    PubMed

    Hobson, R S

    1991-03-01

    As previous reports have highlighted that temporomandibular joint dysfunction syndrome can occur during scuba diving due to the use of a diving mouthpiece, 74 divers of varied experience (62 male, 12 female) were asked to evaluate the efficiency of the mouthpiece for the ease of grip, insertion into the mouth, clearing of water, air sharing, comfort and overall efficiency. They also recorded the level of muscle and joint discomfort experienced during diving and non-diving activities. The results indicate that temporomandibular joint problems unrelated to diving are compounded by the use of a diving mouthpiece. The diver's assessment of muscle tension and comfort while using the mouthpiece was found to be a good predictor of whether temporomandibular dysfunction would occur and the assessment scores have been used in a formula to aid selection of a mouthpiece.

  10. Temporomandibular joint vibration before and after exercises and occlusal splints.

    PubMed

    Turcio, Karina Helga Leal; Garcia, Alício Rosalino; Zuim, Paulo Renato Junqueira; Goiato, Marcelo Coelho; dos Santos, Daniela Micheline; Sundefeld, Maria Lucia Marçal Mazza

    2011-11-01

    Temporomandibular joint (TMJ) sounds are frequent in patients. The aim of this study was to analyze patients with clicking at the end of opening and at the beginning of closing their mouths treated by muscular exercises through chewing and by occlusal splints. Fifteen patients with clinically verified clicking and TMJ and 15 patients without sounds were selected by the Research Diagnostic Criteria for Temporomandibular Disorders. They were submitted to electrovibratography at consultation and 60 and 120 days of treatment by occlusal splints and exercises. Patients demonstrated significant reduction of TMJ sounds after treatment, but vibration intensity was not similar with that of the control group after 120 days. PMID:22134308

  11. Septic Arthritis of the Temporomandibular Joint in an Infant.

    PubMed

    Chuk, Raymond; Arvier, John; Laing, Barbara; Coman, David

    2015-04-24

    Infantile temporomandibular joint septic arthritis is an uncommon paediatric infection, but one which carries the potential for severe morbidity and mortality. Early diagnosis and aggressive medical and possibly surgical management is indicated for the best outcomes. The presenting clinical features are non-specific in a neonate and an infant; as such a high degree of clinical suspicion is required. We present the case of an eleven-month-old boy who has made a full recovery from an acute temporomandibular joint septic arthritis and review the relevant literature.

  12. Evaluation of aural manifestations in temporo-mandibular joint dysfunction.

    PubMed

    Sobhy, O A; Koutb, A R; Abdel-Baki, F A; Ali, T M; El Raffa, I Z; Khater, A H

    2004-08-01

    Thirty patients with temporo-mandibular joint dysfunction were selected to investigate the changes in otoacoustic emissions before and after conservative treatment of their temporo-mandibular joints. Pure tone audiometry, transient-evoked otoacoustic emissions (TEOAE), distortion-product otoacoustic emissions (DPOAE) as well as a tinnitus questionnaire were administered to all patients before and after therapy. Therapy was conservative in the form of counselling, physiotherapy, anti-inflammatory agents, muscle relaxants, and occlusal splints. Results indicated insignificant changes in the TEOAEs, whereas there were significant increases in distortion product levels at most of the frequency bands. These results were paralleled to subjective improvement of tinnitus.

  13. [Septic arthritis of the temporomandibular joint: report of one case].

    PubMed

    Pintor, Fernanda; Carrasco, Rolando; Verdugo-Avello, Francisco; Landaeta, Mirtha

    2015-06-01

    Septic arthritis of the temporomandibular joint (TMJ) is an uncommon condition, caused by hematic bacterial migration or direct migration of other head and neck infections. We report a 41 year old female who presented a right temporomandibular joint involvement, with bone destruction of the mandibular condyle and an infectious process spreading to the temporal space, following a necrotizing medial and external otitis with associated mastoiditis. A septic arthritis of the TMJ by continuity was diagnosed and treated with antimicrobials, TMJ arthrocentesis and occlusal stabilization, with a positive evolution. However, the patient remains in control due a secondary TMJ osteoarthritis caused by the septic arthritis.

  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. Temporomandibular joint ankylosis consequent to ear suppuration.

    PubMed

    Kumar, Rajeev; Hota, Ashutosh; Sikka, Kapil; Thakar, Alok

    2013-12-01

    The objective of this study is to describe the complication of temporomandibular joint (TMJ) ankylosis consequent to otitis media. The method applied is prospective case series and data collection done in tertiary referral centre from April 2012 to April 2013. Case description of three adolescent male patients with unilateral TMJ ankylosis consequent to ipsilateral chronic suppurative otitis media. Further literature review of TMJ ankylosis in relation to otitis media for evaluation for predisposing conditions. Surgical treatment by ipsilateral canal wall down mastoidectomy and concurrent TMJ gap arthroplasty. Surgical exposure confirmed ipsilateral bony ankylosis in all three. Two cases with long standing trismus had developed contralateral disuse fibrous ankylosis and required bilateral gap arthroplasty. Relief of trismus achieved in all three cases. Literature review indicated three similar cases secondary to otitis media. A universal feature among all previous case reports and the current case series was the age at onset of trismus, being at 10 years or less in all. TMJ ankylosis is a rare but potential complication of paediatric ear suppuration. Dehiscence along the tympanosquamosal fissure, tympanic plate and the foraminae of Huschke and Santorini in the paediatric population may predispose to extension of tympanic suppuration to the TMJ.

  16. 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

  17. Use of cervical collar in temporomandibular dislocation.

    PubMed

    Jaisani, Mehul R; Pradhan, Leeza; Sagtani, Alok

    2015-06-01

    Dislocation of the temporomandibular joint represents 3 % of all reported dislocated joints. In the last 3 decades many cases of TMJ dislocation have been reported with a wide variety of treatment options ranging from non-surgical conservative approaches to open joint procedures. The question remains whether one method is superior to the others. Conservative treatments are still the option in this part of the continent due to financial constraints and as well as due to availability of skilled manpower. A variety of conservative techniques have been described for reducing dislocations, all of which require 10-14 days of immobilization of the jaw post reduction so as to prevent further episodes of dislocation. Immobilization of the jaw can be done in the form of barrel bandage, barton bandage, head chin cap or maxillomandibular fixation using arch bars. We suggest the use of a cervical collar as a form of post reduction immobilization technique to overcome the inherent disadvantages of conventional forms of immobilization techniques.

  18. 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

  19. Extra-articular deformity is always correctable intra-articularly: to the contrary.

    PubMed

    Hungerford, David S

    2009-09-01

    The operative word in this debate is "always." In my opinion, there are some cases better served by extra-articular correction. The question then becomes which ones, and how does the surgeon determine? There are 4 considerations: the magnitude of the deformity, the relationship of the deformity to the knee, the side of the deformity (varus or valgus), and whether the femur or the tibia is affected by the deformity. A larger deformity is more important, but just as important is its relationship to the knee. Large deformities distant to the knee have little impact on the knee. Varus deformities require lateral intra-articular overresection, which produces lateral instability. Valgus deformities require medial overresection, which produces medial instability. Lateral instability is stabilized by the dynamic lateral stabilizers (popliteus, lateral head of the gastrocnemius, biceps femoris, and iliotibial tract) and is better tolerated than medial instability. The best way to determine the consequence of the malalignment in question is to template the knee by drawing the mechanical axis from the femoral head or ankle to the center of the knee, and then the resection level that will be required. This will demonstrate the amount of overresection required to correct the extra-articular deformity, and in some cases will indicate the advantage of an extra-articular correction.

  20. [Intra-articular infiltrations in rheumatology: update].

    PubMed

    Chevalier-Ruggeri, Paola; Zufferey, Pascal

    2016-01-13

    Intra-articular treatments are very useful in the daily practice of rheumatology, although their survival in the joint cavity is short and their mode of action still widely misunderstood. Corticosteroids were first used in fifty's, and are still the most widely used, despite potential local and systemic side effects. In recentyears, other molecules have been developed, especially in the treatment of osteoarthritis, but their effectiveness is controversial. Therapeutic trials were conducted with biological treatments in inflammatory arthritis, without success so far In the area of biotechnology, molecules to increase the survival of drugs into the joint are in preparation.

  1. Effect of diazepam on temporomandibular joints in rats with increased occlusal vertical dimension.

    PubMed

    Figueroba, S R; Desjardins, M P; Nani, B D; Ferreira, L E N; Rossi, A C; Santos, F A; Venâncio, P C; Aguiar, F H B; Groppo, F C

    2014-05-01

    Anxiolytic agents, mainly benzodiazepines, have been used to treat symptomatic disorders of the temporomandibular joint (TMJ). Our aim was to evaluate the effect of diazepam on the TMJ of rats with increased occlusal vertical dimension (iOVD). Forty male rats were randomly assigned to 4 groups: control rats were given sham iOVD plus saline solution daily for 7 days. The first experimental group was given sham iOVD plus diazepam 2.5mg/kg/intramuscularly daily for 7 days (diazepam alone group); the second had iOVD induced in molars for 7 days plus saline daily for 7 days (iOVD alone group); and the third had iOVD induced in molars for 7 days plus diazepam 2.5mg/kg/intramuscularly daily for 7 days (iOVD plus diazepam group). At the end of each experiment the animals were killed and their bilateral TMJs were removed, randomly stained with haematoxylin and eosin and sirius-red, and immunoassayed. The thickness of condylar cartilage and of fibrous, proliferating, mature, and hypertrophic layers, number of collagen fibres, and the articular area were measured. Proinflammatory cytokines (interleukin (IL)-1α, IL-1β, IL-6, and tumour necrosis factor (TNF)-α) were also measured. ANOVA and Tukey's tests or the Kruskal-Wallis test were used to compare data among groups (α=5%). Condylar cartilage was thicker in the control group than in the other groups, the diazepam alone group being thicker than the other 2 experimental groups. There were fewer collagen fibres in the 2 groups given diazepam than in the other 2 groups, and there were no significant differences in the area of cartilage among groups. The controls had lower concentrations of all cytokines (p<0.05) than the 3 experimental groups, except for IL-6. Both iOVD groups had higher concentrations of IL-1α, IL-1β, and IL-6 than the diazepam alone group. Diazepam alone was associated with increased concentrations of all cytokines except IL-6. We conclude that both iOVD and diazepam induced significant changes in rats

  2. Effects of age on the ability of the rat temporomandibular joint to respond to changing functional demands.

    PubMed

    Bouvier, M

    1988-09-01

    This investigation examined the ability of the tissues of the temporomandibular joint (TMJ) to adapt to changing functional demands in young, growing rats compared with mature rats. Functional demands on the TMJ were varied by feeding diets with different physical consistencies. The first group was fed a soft diet for the experimental period. The second group was fed a hard diet, and the third group was initially fed the soft diet, then switched to the hard diet at the mid-point of the experimental period. Gross dimensions of the condyle, mandible, and maxilla were measured with calipers. Thickness of the articular, proliferative, transitional, and hypertrophic zones of the condylar cartilage, and the amount of bone in the subcondylar region and condylar neck were measured on histological sections. Gross dimensions of the condyle were significantly smaller in the soft-diet group compared with the hard- and soft/hard-diet groups in both growing and mature rats. The individual zones of the condylar cartilage were also significantly narrower in the soft-diet group in both growing and mature rats. However, the soft/hard-diet group of mature rats showed only a significant reduction in the thickness of the articular zone of the condylar cartilage compared with the hard-diet group. There were also narrower proliferative and transitional zones in the mature rats fed a soft/hard diet. In contrast, all of these zones showed full recovery in the young rats fed a soft/hard diet. The data presented here suggest that increasing age may diminish the capacity of the TMJ to adapt to altered function and consequently may play a significant role in the development of degenerative joint disease.

  3. 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

  4. Condylar distances in hypermobile temporomandibular joints of patients with excessive mouth openings by using computed tomography

    PubMed Central

    Haghigaht, Abbas; Rybalov, Oleg; Hatami, Amin

    2014-01-01

    Objectives: hypermobility in Temporomandibular joint (TMJ) can manifest higher range of motions in mandible. The aim of this study was to compare the position and distances of the head of condyle to glenoid fossa in TMJs of healthy individuals and patients with mild, moderate and severe TMJ hypermobility. Material and Methods: In this clinical study, 69 patients (between the ages of 22 to 42) with manifestation of joint hypermobility were included and Computed tomography were administered for both TMJs. The patients were divided into three groups based on their maximum mouth opening (MMO): (A) with MMO of 50-55 mm; (B) with MMO between 55 to 65 mm; and (C) with MMO >65 mm. Also, 15 healthy people with profiled tomography in the last 6 months were assumed as control group (N) with normal MMO (<50 mm). The position of condyle from articular eminence while MMO; and the distances from anterior, superior and posterior border of condyle and facing wall of glenoid fossa were measured in closed mouth from the tomography of all contributors. The collected data were analyzed by one-way ANOVA, Post Hoc and Chi-Square tests using SPSS software version 15 at significant level of 0.05. Results: The superior and posterior distances were significantly higher in groups A, B and C than healthy individuals (all P values<0.01). The anterior distance was significant between groups B and N only in right TMJ (P=0.013). Conclusions: TMJ hypermobility showed the characteristic of increased condylar distance in posterior and superior specially in higher excessive mouth opening. Key words:Computed tomography, joint hypermobility, mandibular condyle, mouth opening. PMID:25674317

  5. 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.

  6. Mandibulofacial adaptations in a juvenile animal model of temporomandibular joint arthritis.

    PubMed

    Tavakkoli-Jou, M; Miller, A J; Kapila, S

    1999-08-01

    Juvenile rheumatoid arthritis (JRA) is a chronic systemic disease of childhood that affects synovial joints including the temporomandibular joint (TMJ). Individuals with JRA of the TMJ frequently show aberrations in mandibulofacial development. Since the basis for these developmental perturbations is poorly understood, they remain a perplexing clinical problem to manage. To begin dissecting the mechanisms for altered craniofacial development in JRA of the TMJ, we characterized the gross morphologic adaptations in the facial skeleton in a juvenile animal model of TMJ arthritis. Arthritis was induced in ten 87-day-old male rabbits by intra-articular challenge with ovalbumin. Eight sham-challenged and 4 unchallenged rabbits were used as controls. Serial lateral head cephalograms, taken at 73 (T1), 87 (T2), 108 (T3), 129 (T4), and 150 (T5) days of age, were evaluated by linear measures of maxillary, mandibular, and posterior dental height dimensions. Differences in the absolute dimensions and relative percent incremental changes were compared by ANOVA and Fisher's test. The body weights, as well as the absolute measures and incremental changes in maxillary and posterior dental height dimensions, were not significantly different between the antigen-challenged and control groups. In contrast, absolute measures of posterior mandibular height, condylar neck height, and total mandibular length were significantly smaller (P < 0.05) in antigen-challenged rabbits than in both control groups at T5. Furthermore, the antigen-challenged rabbits demonstrated significantly smaller (P < 0.05) relative increases in all measures of mandibular length, and in total posterior mandibular and condylar neck heights. Cephalometric superimpositions on the cranial base and tantalum implants confirmed these quantitative observations. This investigation demonstrates mandibulofacial developmental aberrations in experimental JRA-like disease of the TMJ that are similar to those observed in humans

  7. 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.

  8. 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

  9. 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

  10. 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)

  11. THE RELATIONSHIP BETWEEN TEMPOROMANDIBULAR DYSFUNCTION AND HEAD AND CERVICAL POSTURE

    PubMed Central

    Matheus, Ricardo Alves; Ramos-Perez, Flávia Maria de Moraes; Menezes, Alynne Vieira; Ambrosano, Gláucia Maria Bovi; Haiter, Francisco; Bóscolo, Frab Norberto; de Almeida, Solange Maria

    2009-01-01

    Objective: This study aimed to evaluate the possibility of any correlation between disc displacement and parameters used for evaluation of skull positioning in relation to the cervical spine: craniocervical angle, suboccipital space between C0-C1, cervical curvature and position of the hyoid bone in individuals with and without symptoms of temporomandibular dysfunction. Material and Methods: The patients were evaluated following the guidelines set forth by RDC/TMD. Evaluation was performed by magnetic resonance imaging for establishment of disc positioning in the temporomandibular joints (TMJs) of 30 volunteer patients without temporomandibular dysfunction symptoms and 30 patients with symptoms. Evaluation of skull positioning in relation to the cervical spine was performed on lateral cephalograms achieved with the individual in natural head position. Data were submitted to statistical analysis by Fisher's exact test at 5% significance level. To measure the degree of reproducibility/agreements between surveys, the kappa (K) statistics was used. Results: Significant differences were observed between C0-C1 measurement for both symptomatic (p=0.04) and asymptomatic (p=0.02). No statistical differences were observed regarding craniocervical angle, C1-C2 and hyoid bone position in relation to the TMJs with and without disc displacement. Although statistically significant difference was found in the C0-C1 space, no association between these and internal temporomandibular joint disorder can be considered. Conclusion: Based on the results observed in this study, no direct relationship could be determined between the presence of disc displacement and the variables assessed. PMID:19466252

  12. Temporo-mandibular joint changes in renal osteodystrophy.

    PubMed

    Cappelini, G; Pavlica, P; Stasi, G; Tonti, R; Viglietta, G

    1978-01-01

    The radiologic study of temporo-mandibular joints in patients undergoing long-term haemodialysis has led to documentation of osteodystrophic changes in 6 patients: 2 were asymptomatic and 4 had referred to pain. The roentgenologic picture of this unusual abnormally varies from a simple decrease of bone density to resorption of the condylar head.

  13. Computed tomography of the temporo-mandibular joint.

    PubMed

    Avrahami, E; Horowitz, I; Cohn, D F

    1984-01-01

    Computed tomography (CT) of the temporo-mandibular joint (TMJ) has only been occasionally reported. As CT techniques improve, more detailed information is available. Though conventional radiography of the TMJ can supply sufficient diagnostic detail, it may well be replaced by CT as a preliminary examination, as it is able to offer more information with less radiation and minimal patient discomfort.

  14. [Temporomandibular injury: a cause of limited mouth opening].

    PubMed

    Luz, J G; Seroli, W; Yamamoto, M K; Pereira, M F

    1990-01-01

    A case of limitation of jaw opening caused by an intentional knife wound to the temporomandibular region is presented. The chief complaint was pain and restricted jaw movement. Treatment consisted of the administration of antiinflammatory agent. Recovery was complete and without complications, normal jaw opening being obtained. The possibility that the inflammatory process stimulates muscular spasm is emphasized.

  15. Osteochondritis dissecans affecting the temporo-mandibular joint.

    PubMed

    Olley, S F; Leopard, P J

    1978-07-01

    A case of a single loose body occurring in the temporo-mandibular joint is described. It is probable that this case represents the degenerative process of osteochondritis dissecans, a condition not previously described in this joint. The essential features of this condition are noted as a comparison to the condition of synovial chondromatosis.

  16. Temporomandibular joint dislocation and deafness from a cricket ball injury.

    PubMed

    Murthy, P; Bandasson, C; Dhillon, R S

    1994-05-01

    Cricket is a national sport in some countries and can be potentially hazardous. We report an incident of a cricket ball impact to the chin, which resulted in posterior dislocation of both temporomandibular joints and bilateral mixed deafness. There appear to be no similar case reports in the literature.

  17. Skeletal pattern in subjects with temporomandibular joint disorders

    PubMed Central

    Almăşan, Oana Cristina; Almăşan, Horea Artimoniu; Bran, Simion; Lascu, Liana; Iancu, Mihaela; Băciuţ, Grigore

    2013-01-01

    Introduction To establish the skeletal pattern in subjects with malocclusions and temporomandibular disorders (TMD); to assess the relationship between craniofacial skeletal structures and TMD in subjects with malocclusions. Material and methods Sixty-four subjects with malocclusions, over 18 years of age, were included in the study. Temporomandibular disorders were clinically assessed according to the Helkimo Anamnestic Index. Subjects underwent a lateral cephalogram. Subjects were grouped according to the sagittal skeletal pattern (ANB angle) into class I, II and III. Parametric Student tests with equal or unequal variations were used (variations were previously tested with Levene test). Results Twenty-four patients with TMD (experimental sample); 40 patients without TMD (control group); interincisal angle was higher in class I and II (p < 0.05) experimental subjects; overjet was larger in experimental subjects; midline shift and Wits appraisal were broader in the experimental group in all three classes. In class III subjects, the SNB angle was higher in the experimental group (p = 0.01). Joint noises followed by reduced mandible mobility, muscular pain and temporomandibular joint (TMJ) pain were the most frequent symptoms in subjects with TMD and malocclusions. Conclusions Temporomandibular joint status is an important factor to consider when planning orthodontic treatment in patients with severe malocclusions; midline shift, large overjet and deep overbite have been associated with signs and symptoms of TMD. PMID:23515361

  18. Technological methods in the diagnosis and treatment of temporomandibular disorders.

    PubMed

    Laskin, D M; Greene, C S

    1990-01-01

    Although there have been numerous technological devices introduced for the diagnosis and treatment of temporomandibular disorders, many are either ineffective or are research tools without direct clinical application. This article reviews the various modalities and makes recommendations regarding their effectiveness based on the available clinical and scientific evidence.

  19. 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

  20. Temporomandibular joint ankylosis: the Egyptian experience.

    PubMed Central

    el-Sheikh, M. M.

    1999-01-01

    This is a review of 204 patients with temporomandibular joint (TMJ) ankylosis treated according to a definitive protocol in the Cranio-Maxillo-Facial Department of the Alexandria University Hospital during the period 1990-1996 with a follow-up varying from 1.5 to 7 years. A history of trauma was confirmed in 98% of cases. Patients were grouped into: (1) Those with ankylosis not associated with facial deformities. The management involves release of the ankylosed joint(s) and reconstruction of the condyle ramus unit(s) (CRUs) using costochondral graft(s) (CCGs). (2) Those with mandibular ankylosis complicated by facial bone deformities, either asymmetric or bird face. The treatment consists of release of the ankylosis, reconstruction of the CRUs, and correction of jaw deformities--all performed simultaneously. Respiratory embarrassment was an important presenting symptom in the second group, all of whom complained of night snoring, eight of whom had obstructive sleep apnoea (OSA). In this latter group, respiratory obstruction improved dramatically after surgical intervention. The degree of mouth opening, monitored as the interincisal distance (IID) improved from a range of 0-12 mm to over 30 mm in 62% of patients and to 20-30 mm in 29% of patients. However, reankylosis was still around 8% and was attributed to lack of patient compliance in 75% and to iatrogenic factors in 25% of patients. CCGs resorption, whether partial or complete, occurred in 27% of patients, resulting in retarded growth, relapse of deformities and night snoring. Images Figure 1 Figure 2 Figure 3 PMID:10325678

  1. 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

  2. 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

  3. Lucigenin-dependent chemiluminescence in articular chondrocytes.

    PubMed

    Rathakrishnan, C; Tiku, M L

    1993-08-01

    We were recently able to measure intracellular levels of hydrogen peroxide within normal articular chondrocytes using the trapped indicator 2',7'-dichlorofluorescein diacetate. Further studies have shown that stimulated chondrocytes produce luminol-dependent chemiluminescence, suggesting that these cells produce hydrogen peroxide and singlet oxygen. In the present study, we have investigated the lucigenin-dependent chemiluminescence response in normal articular chondrocytes. Chondrocytes either in suspension or adhered to cover slips showed lucigenin-dependent chemiluminescence. There was a dose-dependent increase in chemiluminescence response when chondrocytes were incubated with soluble stimuli like phorbol-myristate-acetate, concanavalin A, and f-met-leu-phe. Catalase and the metabolic inhibitor, sodium azide, which inhibits the enzyme myeloperoxidase, had no inhibitory effect on lucigenin-dependent chemiluminescence production. Only the antioxidant, superoxide dismutase, prevented lucigenin-dependent chemiluminescence, indicating that this assay measures the production of superoxide anions by chondrocytes. We confirmed that chondrocytes release superoxide radicals using the biochemical assay of ferricytochrome c reduction. Since cartilage tissue is semi-transparent, we were able to measure chemiluminescence response in live cartilage tissue, showing that chondrocytes which are embedded within the matrix can also generate superoxide anion radicals. Reactive oxygen intermediates have been shown to play a significant role in the degradation of matrix in arthritis. Our previous and present studies suggest that oxygen radicals produced by chondrocytes may be an important mechanism by which chondrocytes induce cartilage matrix degradation.

  4. 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

  5. Toward patient-specific articular contact mechanics.

    PubMed

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

    2015-03-18

    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.

  6. Characterization of degenerative changes in the temporomandibular joint of the bengal tiger (Panthera tigris tigris) and siberian tiger (Panthera tigris altaica).

    PubMed

    Murphy, M K; Arzi, B; Vapniarsky-Arzi, N; Athanasiou, K A

    2013-11-01

    The articulation of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally and a fibrous articular disc. The TMJ disc plays an essential role in distributing load between the two articular surfaces. Degeneration of the disc in the presence of joint pathology has been shown in man; however, TMJ pathology has not been documented previously in tigers (Panthera tigris). The mandibular condyle and TMJ disc of a Bengal tiger (P. tigris tigris) and a Siberian tiger (P. tigris altaica) were evaluated grossly and the TMJ disc was characterized biochemically and mechanically. Characterization of the TMJ disc verified region- and direction-dependent biochemical and mechanical properties, reflective of the functional demands on the joint. Degenerative joint disease was observed in both cases and this was more severe in the Siberian tiger. Simultaneous evaluation of joint pathology, biochemical composition and mechanical properties of the TMJ disc revealed a loss in functional properties (tensile anisotropy) of the disc as joint pathology advanced from moderate to severe. TMJ degeneration may compromise the ability of the animal to eat and thrive and may be a factor contributing to the endangered status of these species.

  7. Characterization of degenerative changes in the temporomandibular joint of the bengal tiger (Panthera tigris tigris) and siberian tiger (Panthera tigris altaica).

    PubMed

    Murphy, M K; Arzi, B; Vapniarsky-Arzi, N; Athanasiou, K A

    2013-11-01

    The articulation of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally and a fibrous articular disc. The TMJ disc plays an essential role in distributing load between the two articular surfaces. Degeneration of the disc in the presence of joint pathology has been shown in man; however, TMJ pathology has not been documented previously in tigers (Panthera tigris). The mandibular condyle and TMJ disc of a Bengal tiger (P. tigris tigris) and a Siberian tiger (P. tigris altaica) were evaluated grossly and the TMJ disc was characterized biochemically and mechanically. Characterization of the TMJ disc verified region- and direction-dependent biochemical and mechanical properties, reflective of the functional demands on the joint. Degenerative joint disease was observed in both cases and this was more severe in the Siberian tiger. Simultaneous evaluation of joint pathology, biochemical composition and mechanical properties of the TMJ disc revealed a loss in functional properties (tensile anisotropy) of the disc as joint pathology advanced from moderate to severe. TMJ degeneration may compromise the ability of the animal to eat and thrive and may be a factor contributing to the endangered status of these species. PMID:23809909

  8. Characterization of Degenerative Changes in the Temporomandibular Joint of the Bengal Tiger (Panthera tigris tigris) and Siberian Tiger (Panthera tigris altaica)

    PubMed Central

    Murphy, M. K.; Arzi, B.; Vapniarsky-Arzi, N.; Athanasiou, K. A.

    2013-01-01

    Summary The articulation of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally and a fibrous articular disc. The TMJ disc plays an essential role in distributing load between the two articular surfaces. Degeneration of the disc in the presence of joint pathology has been shown in man; however, TMJ pathology has not been documented previously in tigers (Panthera tigris). The mandibular condyle and TMJ disc of a Bengal tiger (P. tigris tigris) and a Siberian tiger (P. tigris altaica) were evaluated grossly and the TMJ disc was characterized biochemically and mechanically. Characterization of the TMJ disc verified region- and direction-dependent biochemical and mechanical properties, reflective of the functional demands on the joint. Degenerative joint disease was observed in both cases and this was more severe in the Siberian tiger. Simultaneous evaluation of joint pathology, biochemical composition and mechanical properties of the TMJ disc revealed a loss in functional properties (tensile anisotropy) of the disc as joint pathology advanced from moderate to severe. TMJ degeneration may compromise the ability of the animal to eat and thrive and may be a factor contributing to the endangered status of these species. PMID:23809909

  9. Histopathological features of hypertrophic bone mass of temporomandibular joint ankylosis (TMJA): An explanation of pathogenesis of TMJA.

    PubMed

    Duan, Denghui; Li, Jiangming; Xiao, E; He, Linhai; Yan, Yingbin; Chen, Yan; Zhang, Yi

    2015-07-01

    Temporomandibular joint ankylosis (TMJA) is a severe organic disease with progressive limitation of the mouth opening. Histopathologically, a residual joint space is reported to consist of fibrous tissue and/or cartilage, indicating two types of interface (osteo-fibrous and osteo-chondral) of residual joint space. It is well known that adverse mechanical stress results in pathological changes of osteoarthritis and enthesopathy in these interfaces. What would happen pathologically in these interfaces of TMJA under repeated mandible movement has not been elucidated. Fourteen tissue samples of residual joint space and temporal and condylar bone were stained with hematoxylin and eosin and evaluated by collagen I and II immunohistochemistry. A pathological study of 14 TMJA patients showed that the residual joint space presented a fibrocartilage entheses structure and an articular cartilage structure. Moreover, these two structures were associated with pathological alterations of both osteoarthritis and enthesopathy, including degenerated and necrotized tissue, chondrocyte cloning, crack and fissure, various bone scleroses, and inflammatory granulation tissue. It is suggested that the pathological alterations of both osteoarthritis and enthesopathy occurred in TMJA, which hints at mechanical stress on TMJA development. PMID:26026887

  10. 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

  11. 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.

  12. Articular and abarticular manifestations in type 2 diabetes mellitus

    PubMed Central

    Abourazzak, Fatima Ezzahra; Akasbi, Nessrine; Houssaini, Ghita Sqalli; Bazouti, Sabah; Bensbaa, Salma; Hachimi, Hicham; Ajdi, Farida; Harzy, Taoufik

    2014-01-01

    Objective Diabetes mellitus (DM), a worldwide high-prevalence disease, is associated with a large variety of rheumatic manifestations. It affects the connective tissues in many ways and causes alterations in the periarticular and the musculoskeletal systems. In most cases, these manifestations are associated with functional disability and pain, affecting the quality of life of the diabetic patient. The aim of our study is to review the different articular and abarticular manifestations in diabetic patients and the associated factors of these rheumatic manifestations. Material and Methods A cross-sectional study that includes all patients suffering from type 2 DM who present with articular or abarticular manifestations. Results We included 116 diabetic patients presenting with articular or abarticular manifestations. Our study showed four important findings. First, a large variety of articular and abarticular manifestations were present in patients with type 2 DM. Second, osteoarthritis (OA) of the knee was the most frequent articular manifestations. It was seen in 49% of our patients. Third, the most common manifestations in diabetic Moroccan patients were carpal tunnel syndrome (CTS), adhesive capsulitis of the shoulder, and diabetic cheiroarthropathy (29%, 23%, and 16%, respectively). Fourth, there was a significant association between vascular complications and the development of articular and abarticular manifestations. Conclusion This study shows that the articular and abarticular manifestations in diabetic Moroccan patients are dominated by CTS, adhesive capsulitis of the shoulder, and diabetic cheiroarthropathy, with a significant association between vascular complications and the development of some of these manifestations. PMID:27708897

  13. Osteoarthritis and articular chondrocalcinosis in the elderly.

    PubMed Central

    Wilkins, E; Dieppe, P; Maddison, P; Evison, G

    1983-01-01

    One hundred consecutive admissions to an acute geriatric unit were examined for clinical and radiographic evidence of osteoarthritis (OA) and articular chondrocalcinosis (ACC). Thirty-four patients had ACC. This was age related, the prevalence rising from 15% in patients aged 65-74 years to 44% in patients over 84 years. The commonly involved joints were the knee (25%), public symphysis (15%), and wrist (9%). No other aetiological factors predisposing to ACC were found. Of the 25 patients with ACC in the knee 7 had no symptoms or signs and no radiographic evidence of OA at that site. However, the combination of ACC and radiographic OA was characterised by an increase in clinical joint disease. Features of inflammation (joint swelling and joint line tenderness) involving the knee, wrist, and elbow were particularly common in ACC. It is concluded that ACC is common in the elderly and is associated with an increased incidence of joint disease. PMID:6859960

  14. Temporomandibular Disorders in Psoriasis Patients with and without Psoriatic Arthritis: An Observational Study

    PubMed Central

    Crincoli, Vito; Di Comite, Mariasevera; Di Bisceglie, Maria Beatrice; Fatone, Laura; Favia, Gianfranco

    2015-01-01

    AIMS: Psoriasis is a chronic, remitting and relapsing inflammatory disorder, involving the skin, nails, scalp and mucous membranes, that impairs patients' quality of life to varying degrees. Psoriatic arthritis is a chronic seronegative, inflammatory arthritis, usually preceded by psoriasis. Temporomandibular disorders is a generic term referred to clinical conditions involving the jaw muscles and temporomandibular joint. The aim of this study was to assess symptoms and signs of temporomandibular disorders in psoriasis patients with and without psoriatic arthritis. METHODS: The study group included 112 patients (56 men, 56 women; median age 49.7±12 years) with psoriasis, 25 of them were affected by psoriatic arthritis. A group of 112 subjects without psoriasis (56 men, 56 women; median age 47.7±17 years) served as controls. Signs and symptoms of temporomandibular disorders were evaluated according to the standardized Research Diagnostic Criteria for Temporomandibular Disorders. Psoriasis patients were subgrouped according to the presence/absence of psoriatic arthritis and by gender, to assess the prevalence of traditional symptoms and signs of temporomandibular disorders. RESULTS: Patients with psoriasis, and to an even greater extent those with psoriatic arthritis, were more frequently affected by symptoms and signs of temporomandibular disorders, including an internal temporomandibular joint opening derangement than healthy subjects. A statistically significant increase in symptoms of temporomandibular disorders, in opening derangement, bruxism and sounds of temporomandibular joint was found in patients with psoriatic arthritis as compared with psoriasis patients without arthritis and controls. CONCLUSIONS: psoriasis seems to play a role in temporomandibular joint disorders, causing an increase in orofacial pain and an altered chewing function. PMID:26019683

  15. Rationale of arthroscopic surgery of the temporomandibular joint.

    PubMed

    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.

  16. 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

  17. Therapy of the osteoarthritis of the temporomandibular joint.

    PubMed

    Machon, Vladimir; Hirjak, Dusan; Lukas, Jindrich

    2011-03-01

    Osteoarthritis is a common condition of the mandible. The treatment of osteoarthritis primarily consists of rest therapy (restricting jaw movements), the use of pharmaceuticals (analgesics, antiinflammatories), splint therapy, thermotherapy or mini-invasive therapy. Our study investigated the effectiveness of the various therapeutic options in the treatment of osteoarthritis. We compared the effectiveness of rest therapy (restricting mouth opening, analgesic therapy), splints, arthrocentesis of the upper joint space, and arthrocentesis in combination with splint therapy. We looked at 80 patients diagnosed with osteoarthritis of the temporomandibular joint. We only included patients with symptoms in one temporomandibular joint (TMJ). This 3 months long-term study shows that arthrocentesis combined with the use of a splint is an effective first-stage treatment method for patients with osteoarthritis of the TMJ (80% patients with good outcome 3 months after commencement of therapy).

  18. Patients' Priorities and Attitudes Towards Their Temporo-Mandibular Disorders.

    PubMed

    Kelleher, Martin; Ray-Chaudhuri, Arijit; Khawaja, Noman

    2015-08-01

    The diagnosis and appropriate management of temporo-mandibular disorders (TMDs) remains controversial. Current scientific evidence highlights the importance of psychosocial factors in sufferers and the reducing emphasis on occlusal or dental/prosthetic factors. This paper describes the findings of a survey of 211 patients reporting pain from their temporo-mandibular joint area and associated structures. This article offers busy primary dental care practitioners a cost effective questionnaire for obtaining relevant information from patients about the history of their condition and highlights what patients hope to achieve through the management of their disorder. It also emphasises the importance of communicating effectively with patients and offers practical tips for the management of TMDs in primary care.

  19. [Surgical treatment results of 52 cases of temporomandibular ankylosis].

    PubMed

    Kimura-Fujikami, Takao

    2003-01-01

    We courried out a retrospective study of 52 surgical cases of temporomandibular joint ankylosis, fibrous types I and II in 19 patients (36.4%) and osseous type III-IV in 33 patients (63.6%). Forty two children and teenagers at the Hospital de Pediatria (1983-1985/1989-1998) and Hospital General La Raza (1985-1989) were included also, 10 adults including those operated on at the Hospital de Especialidades, CMN Siglo XXI (IMSS) from 1998 to 2001 were included. We used Dunn modified method en 37 cases (67%) and 17 patients were with Risdon operated on technique (33%). Etiology of ankylosis were direct trauma to jaw, which affected temporomandibular joint mainly in children, while in adults causes were more varied and included as osteomyelitis, middle ear infection, sequels of hemifacial microsomy, and trauma results were considered as good upon obtaining mouth opening of 35 mm without neo-ankylosis during 1-year postoperative control.

  20. Ultrasound Backscattering Is Anisotropic in Bovine Articular Cartilage.

    PubMed

    Inkinen, Satu I; Liukkonen, Jukka; Tiitu, Virpi; Virén, Tuomas; Jurvelin, Jukka S; Töyräs, Juha

    2015-07-01

    Collagen, proteoglycans and chondrocytes can contribute to ultrasound scattering in articular cartilage. However, anisotropy of ultrasound scattering in cartilage is not fully characterized. We investigate this using a clinical intravascular ultrasound device with ultrasound frequencies of 9 and 40 MHz. Osteochondral samples were obtained from intact bovine patellas, and cartilage was imaged in two perpendicular directions: through articular and lateral surfaces. At both frequencies, ultrasound backscattering was higher (p < 0.05) when measured through the lateral surface of cartilage. In addition, the composition and structure of articular cartilage were investigated with multiple reference methods involving light microscopy, digital densitometry, polarized light microscopy and Fourier infrared imaging. Reference methods indicated that acoustic anisotropy of ultrasound scattering arises mainly from non-uniform distribution of chondrocytes and anisotropic orientation of collagen fibers. To conclude, ultrasound backscattering in articular cartilage was found to be anisotropic and dependent on the frequency in use. PMID:25933711

  1. Ultrasound Backscattering Is Anisotropic in Bovine Articular Cartilage.

    PubMed

    Inkinen, Satu I; Liukkonen, Jukka; Tiitu, Virpi; Virén, Tuomas; Jurvelin, Jukka S; Töyräs, Juha

    2015-07-01

    Collagen, proteoglycans and chondrocytes can contribute to ultrasound scattering in articular cartilage. However, anisotropy of ultrasound scattering in cartilage is not fully characterized. We investigate this using a clinical intravascular ultrasound device with ultrasound frequencies of 9 and 40 MHz. Osteochondral samples were obtained from intact bovine patellas, and cartilage was imaged in two perpendicular directions: through articular and lateral surfaces. At both frequencies, ultrasound backscattering was higher (p < 0.05) when measured through the lateral surface of cartilage. In addition, the composition and structure of articular cartilage were investigated with multiple reference methods involving light microscopy, digital densitometry, polarized light microscopy and Fourier infrared imaging. Reference methods indicated that acoustic anisotropy of ultrasound scattering arises mainly from non-uniform distribution of chondrocytes and anisotropic orientation of collagen fibers. To conclude, ultrasound backscattering in articular cartilage was found to be anisotropic and dependent on the frequency in use.

  2. 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.

  3. [Structure of the articular cartilage in the middle aged].

    PubMed

    Kop'eva, T N; Mul'diiarov, P Ia; Bel'skaia, O B; Pastel', V B

    1983-10-01

    In persons 17-83 years of age having no articular disorders 39 samples of the patellar articular cartilage, the articulated surface and the femoral head have been studied histochemically, histometrically and electron microscopically. Age involution of the articular cartilage is revealed after 40 years of age as a progressive decrease in chondrocytes density in the superficial and (to a less degree) in the intermediate zones. This is accompanied with a decreasing number of 3- and 4-cellular lacunae and with an increasing number of unicellular and hollow lacunae. In some chondrocytes certain distrophic and necrotic changes are revealed. In the articular matrix the zone with the minimal content of glycosaminoglycans becomes thicker and keratansulfate content in the territorial matrix of the cartilage deep zone grows large.

  4. 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

  5. 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

  6. A truly endaural approach to the temporo-mandibular joint.

    PubMed

    Dias, A D

    1984-01-01

    This paper presents 12 cases of temporo-mandibular joint arthroplasty done through an endaural incision which lies strictly within the confines of the ear. No scar is seen in profile view. Adequate exposure of the joint is achieved and safe excision of the head and coronoid process is possible. There is no possibility of danger to the branches of the facial nerve. The post-operative results are satisfactory and are tabulated.

  7. 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

  8. 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

  9. 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

  10. 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

  11. [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.

  12. Temporomandibular disorders in fibromyalgia syndrome: a short-communication.

    PubMed

    Gui, Maísa Soares; Pimentel, Marcele Jardim; Rizzatti-Barbosa, Célia Marisa

    2015-01-01

    Fibromyalgia syndrome (FMS) is a chronic painful syndrome and the coexistence of a painful condition caused by Temporomandibular Disorders (TMD) and FMS has been frequently raised for several studies, however, more likely hypothesis is that a set of FMS characteristics may lead to the onset of TMD symptoms and they are not merely coexisting conditions. Therefore, our aim is presenting a review of literature about the relation between fibromyalgia and the signs and symptoms of temporomandibular disorders. For this purpose, a bibliographic search was performed of the period of 1990-2013, in the Medline, Pubmed, Lilacs and Scielo databases, using the keywords fibromyalgia, temporomandibular disorders and facial pain. Here we present a set of findings in the literature showing that fibromyalgia can lead to TMD symptoms. These studies demonstrated greater involvement of the stomatognathic system in FMS and myogenic disorders of masticatory system are the most commonly found in those patients. FMS appears to have a series of characteristics that constitute predisposing and triggering factors for TMD.

  13. Pendulum mass affects the measurement of articular friction coefficient.

    PubMed

    Akelman, Matthew R; Teeple, Erin; Machan, Jason T; Crisco, Joseph J; Jay, Gregory D; Fleming, Braden C

    2013-02-01

    Friction measurements of articular cartilage are important to determine the relative tribologic contributions made by synovial fluid or cartilage, and to assess the efficacy of therapies for preventing the development of post-traumatic osteoarthritis. Stanton's equation is the most frequently used formula for estimating the whole joint friction coefficient (μ) of an articular pendulum, and assumes pendulum energy loss through a mass-independent mechanism. This study examines if articular pendulum energy loss is indeed mass independent, and compares Stanton's model to an alternative model, which incorporates viscous damping, for calculating μ. Ten loads (25-100% body weight) were applied in a random order to an articular pendulum using the knees of adult male Hartley guinea pigs (n=4) as the fulcrum. Motion of the decaying pendulum was recorded and μ was estimated using two models: Stanton's equation, and an exponential decay function incorporating a viscous damping coefficient. μ estimates decreased as mass increased for both models. Exponential decay model fit error values were 82% less than the Stanton model. These results indicate that μ decreases with increasing mass, and that an exponential decay model provides a better fit for articular pendulum data at all mass values. In conclusion, inter-study comparisons of articular pendulum μ values should not be made without recognizing the loads used, as μ values are mass dependent. PMID:23122223

  14. The surface of articular cartilage contains a progenitor cell population.

    PubMed

    Dowthwaite, Gary P; Bishop, Joanna C; Redman, Samantha N; Khan, Ilyas M; Rooney, Paul; Evans, Darrell J R; Haughton, Laura; Bayram, Zubeyde; Boyer, Sam; Thomson, Brian; Wolfe, Michael S; Archer, Charles W

    2004-02-29

    It is becoming increasingly apparent that articular cartilage growth is achieved by apposition from the articular surface. For such a mechanism to occur, a population of stem/progenitor cells must reside within the articular cartilage to provide transit amplifying progeny for growth. Here, we report on the isolation of an articular cartilage progenitor cell from the surface zone of articular cartilage using differential adhesion to fibronectin. This population of cells exhibits high affinity for fibronectin, possesses a high colony-forming efficiency and expresses the cell fate selector gene Notch 1. Inhibition of Notch signalling abolishes colony forming ability whilst activated Notch rescues this inhibition. The progenitor population also exhibits phenotypic plasticity in its differentiation pathway in an embryonic chick tracking system, such that chondroprogenitors can engraft into a variety of connective tissue types including bone, tendon and perimysium. The identification of a chondrocyte subpopulation with progenitor-like characteristics will allow for advances in our understanding of both cartilage growth and maintenance as well as provide novel solutions to articular cartilage repair. PMID:14762107

  15. Morphological characteristics of posterolateral articular fragments in tibial plateau fractures.

    PubMed

    Xiang, Gao; Zhi-Jun, Pan; Qiang, Zheng; Hang, Li

    2013-10-01

    Treatment of posterolateral tibial plateau fractures is controversial, and information regarding this specific fracture pattern is lacking. The purpose of this study was to elucidate the frequency and morphological features of posterolateral articular fragments in tibial plateau fractures. A retrospective radiographic and chart review was performed on a consecutive series of patients who sustained tibial plateau fractures between May 2008 and August 2012. The articular surface area, maximum posterior cortical height, sagittal fracture angle, and amount of displacement were measured on computed tomography scans using the Picture and Archiving Communication System. Thirty-six (15%) of 242 injuries demonstrated a posterolateral fracture fragment comprising a mean 14.3% of the articular surface of the total tibial plateau (range, 8% to 32%). Mean major articular fragment angle was 23° (range, 62° to -43°), mean maximum posterior cortical height was 29 mm (range, 18 to 42 mm), and mean sagittal fracture angle was 77° (range, 58° to 97°). The posterolateral plateau articular fracture fragment has morphological characteristics of a conically shaped fragment with a relatively small articular surface area and sagittal fracture angle. Recognizing these morphological features will help the clinician formulate an effective surgical plan.

  16. Pendulum mass affects the measurement of articular friction coefficient.

    PubMed

    Akelman, Matthew R; Teeple, Erin; Machan, Jason T; Crisco, Joseph J; Jay, Gregory D; Fleming, Braden C

    2013-02-01

    Friction measurements of articular cartilage are important to determine the relative tribologic contributions made by synovial fluid or cartilage, and to assess the efficacy of therapies for preventing the development of post-traumatic osteoarthritis. Stanton's equation is the most frequently used formula for estimating the whole joint friction coefficient (μ) of an articular pendulum, and assumes pendulum energy loss through a mass-independent mechanism. This study examines if articular pendulum energy loss is indeed mass independent, and compares Stanton's model to an alternative model, which incorporates viscous damping, for calculating μ. Ten loads (25-100% body weight) were applied in a random order to an articular pendulum using the knees of adult male Hartley guinea pigs (n=4) as the fulcrum. Motion of the decaying pendulum was recorded and μ was estimated using two models: Stanton's equation, and an exponential decay function incorporating a viscous damping coefficient. μ estimates decreased as mass increased for both models. Exponential decay model fit error values were 82% less than the Stanton model. These results indicate that μ decreases with increasing mass, and that an exponential decay model provides a better fit for articular pendulum data at all mass values. In conclusion, inter-study comparisons of articular pendulum μ values should not be made without recognizing the loads used, as μ values are mass dependent.

  17. Arthroscopic transtendinous repair of articular-sided pasta (partial articular supraspinatus tendon avulsion) injury

    PubMed Central

    Wang, Yi; Lu, Liangyu; Lu, Zhe; Xiao, Lei; Kang, Yifan; Wang, Zimin

    2015-01-01

    Objective: To evaluate clinical efficacy of arthroscopic transtendinous repair of partial articular-sided PASTA (partial articular supraspinatus tendon avulsion) injury. Methods: From February 2011 to July 2014, 12 cases of PASTA, aged 29 to 72 years with an average of 52.9 ± 13.3 years, were treated arthoscopically. To repair PASTA, articular-sided rotator cuff tear was explored, injury site was punctured and labeled with PDS absorbable monofilament suture (Ethicon, Somerville, NJ, USA) suture, subacromial bursa was cleaned up with acromioplasty, and integrity of bursa-side rotator cuff was assessed. Then with arthroscope in glenohumeral joint, footprint of the bursa-side supraspinatus tendon was preserved, rivets were introduced into the joint through supraspinatus tendon, joint-side partial tear was sutured, and anatomical reconstruction of the rotator cuff footprint was established. The patients were followed up post-operatively for 12-36 months, average 22 ± 7.3 months. The clinical outcomes were emulated with ASES (American Shoulder and Elbow Surgeons) Shoulder Score system and UCLA (University of California at Los Angeles) Shoulder rating scale. Results: The post-operative ASES score was 89.7 ± 5.6, higher than the pre-operative one 49.8 ± 9.8 (t = 12.25, P <0.0001). While UCLA scale increased from the pre-operative 17.3, ± 3.3 to the post-operative 30.4 ± 3.2 points (t = 9.87, P <0.0001), with a satisfaction rate of 11/12 (91.7%). Conclusion: Trans-tendon repair is ideal for PASTA with advantage of maximal preservation of the normal rotator cuff tissue, anatomical reconstruction of the rotator cuff footprint and stable fixation of tendon-bone interface. PMID:25784979

  18. 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

  19. 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

  20. 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

  1. 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

  2. [The temporomandibular joint of the domestic cat (Felis silvestris catus)].

    PubMed

    Knospe, C; Roos, H

    1994-06-01

    The mandibular joint of the cat is an incongruent cylindrical joint, which works as a hinge or screw joint. The course of motion is unilateral in the plane of the cutting edge of the molar/premolar border [symbol: see text]. The articular disc is a connective tissue membrane; its new function is decreasing the friction. PMID:7978349

  3. Extra-articular Mimickers of Lateral Meniscal Tears

    PubMed Central

    Barker, Joseph U.; Strauss, Eric J.; Lodha, Sameer; Bach, Bernard R.

    2011-01-01

    Context: Lateral meniscus tears are a common entity seen in sports medicine. Although lateral-side knee pain is often the result of a meniscus injury, several extra-articular pathologies share signs and symptoms with a meniscus tear. It is critical for the clinician to be able to identify and understand extra-articular pathologies that can present similar to a lateral meniscus tear. Evidence Acquisition: Data were collected through a thorough review of the literature conducted through a MEDLINE search for all relevant articles between 1980 and February 2010. Study Type: Clinical review. Results: Common extra-articular pathologies that can mimic lateral meniscal tears include iliotibial band syndrome, proximal tibiofibular joint instability, snapping biceps femoris or popliteus tendons, and peroneal nerve compression syndrome or neuritis. The patient history, physical examination features, and radiographic findings can be used to separate these entities from the more common intra-articular knee pathologies. Conclusions: In treating patients who present with lateral-sided knee pain, clinicians should be able to recognize and treat extra-articular pathologies that can present in a similar fashion as lateral meniscus tears. PMID:23015995

  4. 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

  5. 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

  6. 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

  7. Effect of jaw opening on the stress pattern in a normal human articular disc: finite element analysis based on MRI images

    PubMed Central

    2014-01-01

    Introduction Excessive compressive and shear stresses are likely related to condylar resorption and disc perforation. Few studies have reported the disc displacement and deformation during jaw opening. The aim of this study was to analyze stress distribution in a normal articular disc during the jaw opening movement. Methods Bilateral MRI images were obtained from the temporomandibular joint of a healthy subject for the jaw opening displacement from 6 to 24 mm with 1 mm increments. The disc contour for the jaw opening at 6 mm was defined as the reference state, and was used to establish a two dimensional finite element model of the disc. The contours of the disc at other degrees of jaw opening were used as the displacement loading. Hyperelastic material models were applied to the anterior, intermediate and posterior parts of the disc. Stress and strain trajectories were calculated to characterize the stress/strain patterns in the disc. Results Both the maximum and minimum principal stresses were negative in the intermediate zone, therefore, the intermediate zone withstood mainly compressive stress. On the contrary, the maximum and minimum principal stresses were most positive in the anterior and posterior zones, which meant that the anterior and posterior bands suffered higher tensile stresses. The different patterns of stress trajectories between the intermediate zone and the anterior and posterior bands might be attributed to the effect of fiber orientation. The compression of the intermediate zone and stretching of the anterior and posterior bands caused high shear deformation in the transition region, especially at the disc surfaces. Conclusions The stress and strain remained at a reasonable level during jaw opening, indicating that the disc experiences no injury during functional opening movements in a healthy temporomandibular joint. PMID:24943463

  8. 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

  9. [Update on current care guideline: temporomandibular disorders (TMD)].

    PubMed

    2013-01-01

    Temporomandibular disorders (TMD) are common. Usual symptoms are joint noises and pain, pain in masticatory muscles, difficulties in jaw movements and headache. Treatment of TMD includes information on the background and good response to treatment of these disorders. The patient is advised on self-care routines, including relaxing the lower jaw, massaging the masticatory muscles and hot or cold packs on painful sites. Pharmacotherapy consists of paracetamol or anti-inflammatory analgesics. Occlusal appliances, physiotherapy, cognitive therapies and acupuncture are recommended. Complicated cases not responding to treatment are referred to specialized care.

  10. Temporo-mandibular joint disease in ankylosing spondylitis.

    PubMed

    Davidson, C; Wojtulewski, J A; Bacon, P A; Winstock, D

    1975-02-01

    The occurrence of temporo-mandibular joint (TMJ) disease in ankylosing spondylitis is not widely recognized and its incidence is disputed. Seventy-nine patients attending two routine rheumatology clinics were therefore examined by dental surgeon and nine (11-5 per cent) were considered to have specific TMJ involvement. These patients were older than the remainder, and had more extensive spinal and peripheral joint disease. Symptoms were mild and the predominant clinical feature was restricted mouth opening, which could present considerable difficulties during emergency anaesthesia. Bilateral condylectomy was undertaken in one patient with some benefit.

  11. [Comparative evolution surgical accesses to temporo-mandibular joint].

    PubMed

    Sysoliatin, P G; Novikov, A I; Sysoliatin, S P; Bobylev, N G; Brega, I N

    2007-01-01

    In experiment on 30 corpses of adult people criteria of an operational wound (depth of a wound, a corner of operational action, an axis of operational action, a corner of an inclination of operational action) were studied at preauricularis, intrauricularis, intrauriculo-temporalis and posterior mandibullaris access to temporo-mandibular joint (TMJ). New surgical intrauriculo-temporalis access to the joint is substantrated. On the basis of the analysis of 289 operations at 268 patients the indications to a choice of surgical access were developed at various diseases and damages of TMJ.

  12. Reconstruction of the temporomandibular joint autogenous compared with alloplastic.

    PubMed

    Saeed, N; Hensher, R; McLeod, N; Kent, J

    2002-08-01

    The aims of and indications for temporomandibular joint (TMJ) reconstruction are well-established but the method of reconstruction is controversial. We describe a retrospective, two-centre audit of 49 patients treated with costochondral grafting and 50 patients treated with alloplastic joints. The characteristics of the patients were similar in both centres and the minimum follow-up period was 2 years. For each patient a number of variables were recorded including both subjective scores (pain and interference with eating) and objective data (interincisal distance). Patients in both groups showed an improvement in symptoms but more patients required reoperation in the autogenous group. PMID:12175828

  13. Differential diagnosis of orofacial pain and temporomandibular disorder.

    PubMed

    Kumar, Anil; Brennan, Michael T

    2013-07-01

    When a patient complains of orofacial pain, health care providers must make a correct diagnosis. Doing this can be difficult, since various signs and symptoms may not be specific for 1 particular problem or disorder. One initially should formulate a broad differential diagnosis that can be narrowed after analysis of the history and examination. In this article, orofacial pain is categorized as being caused by: intracranial pain, headaches, neuropathic pain, intraoral pain, temporomandibular disorder, cervical pain, pain related to anatomically associated structures, referred pain, or mental illness.

  14. [Temporo-mandibular joint pain dysfunction syndrome in children].

    PubMed

    Gagnon, P P

    1978-12-01

    Otalgia is a common symptom in children. Otological examination usually reveals a local pathology as the causative agent. However, it does occur that otoscopy reveals normal ear drums and canals. The otologist must then review the causes of referred otalgia. We know that the ear is a nervous crossroad: vagus, trigeminal and third cervical nerve. The most common causes of referred otalgia are the teeth, the sinus, the mouth, the pharynx, and the larynx. If none of these factors is involved, one must then think about the painful temporomandibular dysfunction syndrome.

  15. General joint hypermobility and temporomandibular joint derangement in adolescents.

    PubMed Central

    Westling, L; Mattiasson, A

    1992-01-01

    Joint mobility was assessed in each member of an epidemiological sample of 96 girls and 97 boys, 17 years old, and graded by means of the hypermobility score of Beighton et al. Twenty two per cent of the girls and 3% of the boys could perform five or more of the nine manoeuvres. The prevalence of symptoms and signs of internal derangement in the temporomandibular joint was higher in adolescents with hypermobility of joints (score greater than or equal to 5/9). In subjects with a high mobility score oral parafunctions (overuse) correlated more strongly with several signs and symptoms of craniomandibular disorder than in those with a low score. PMID:1540046

  16. Tophaceous calcium pyrophosphate dihydrate deposition disease of the temporomandibular joint.

    PubMed

    Reynolds, Jennifer L; Matthew, Ian R; Chalmers, Andrew

    2008-04-01

    Tophaceous pseudogout is a rare manifestation of calcium pyrophosphate dihydrate (CPPD) deposition disease that particularly affects the temporomandibular joint (TMJ). We describe a case of tophaceous pseudogout and review the literature. Thirty-four cases of chronic CPPD deposition disease affecting the TMJ are described. Symptoms usually included pain and swelling. Most patients required surgery because of extensive crystal deposits, usually localized to the joint and adjacent structures but occasionally invasive. For many patients, malignancy was the preoperative diagnosis. Although patients with acute pseudogout of the TMJ may have involvement of other joints, tophaceous pseudogout was predominantly isolated to the TMJ.

  17. Symptoms resembling temporomandibular joint disorder caused by a pleomorphic adenoma.

    PubMed

    Marchese, Nadia; Witterick, Ian; Freeman, Bruce V

    2013-01-01

    Pleomorphic adenoma is a benign neoplasm of the salivary glands. It is the most common type of salivary gland tumour and the tumour most commonly found in the parotid gland. Clinical diagnosis of a parotid gland neoplasm can be difficult, particularly when the lesion is located deep within the gland. Although usually asymptomatic, pleomorphic adenoma may exhibit symptoms mimicking those of conditions such as temporomandibular joint disorder. This case report highlights the difficulties of diagnosing this type of tumour and the importance of communication between physicians and dentists to ensure an accurate diagnosis.

  18. 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

  19. 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

  20. Personality disorders and regulative styles of patients with temporo-mandibular joint pain dysfunction syndrome.

    PubMed

    Baggi, L; Rubino, I A; Zanna, V; Martignoni, M

    1995-02-01

    A sample of 42 women patients with Temporo-mandibular Joint Pain Dysfunction Syndrome was given the Millon Clinical Multiaxial Inventory-II and the Serial Color-Word Test. Compared with sex- and age-matched nonclinical controls, temporo-mandibular patients had significantly (1) higher scores on the Obsessive-Compulsive scale, (2) lower scores of ITa (a pattern concerned with initial times of response), and (3) higher scores of R (linear increase in reading times during the trials). The latter intergroup difference concerned mainly the first subtest, i.e., temporo-mandibular patients were characterized by higher scores of R from the very beginning of the process of adaptation.

  1. 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.

  2. 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

  3. Utility of Intra-articular Hip Injections for Femoroacetabular Impingement

    PubMed Central

    Khan, Wahab; Khan, Moin; Alradwan, Hussain; Williams, Ryan; Simunovic, Nicole; Ayeni, Olufemi R.

    2015-01-01

    Background: Femoroacetabular impingement (FAI) is a condition that is becoming increasingly recognized as a common etiology of hip pain in athletes, adolescents, and adults. However, history and clinical examination are often inconclusive in reaching a diagnosis, while imaging often detects asymptomatic abnormalities. Treatment has traditionally been limited to surgery, with the role of conservative management remaining unclear. Purpose: To evaluate the utility of the intra-articular hip injection in the diagnosis and management of FAI. Study Design: Systematic review; Level of evidence, 4. Methods: MEDLINE, EMBASE, and PubMed databases were screened in duplicate for studies published between January 1946 and January 2014. Search terms included femoroacetabular impingement, hip impingement, and intra-articular injection. Quality assessment using the Methodological Index for Non-Randomized Studies (MINORS) scale was completed for all included studies. Data evaluated included study design, study objectives, number of hips, injected product, duration of pain relief, and outcomes measured. Results: Our search yielded 8 studies involving 281 hips. Studies were categorized into diagnostic (4 studies), therapeutic (3 studies), and prognostic (1 study) applications. Patients with FAI and its degenerative sequelae obtained greater relief from diagnostic intra-articular hip injection than those without (P < .05). The diagnostic intra-articular injection performed under ultrasound guidance was better tolerated than injections performed under fluoroscopic guidance (pain rating, 5.6 vs 3.0; P < .1). Intra-articular injection of hyaluronic acid was the most effective at providing pain relief (in 23 patients), with significant improvements of functional outcome measures (Harris Hip Score, visual analog scale) present at 12 months. Pooled results with corticosteroid injection resulted in improvement in only 15% (9/60) of patients at 6 weeks. A negative response to intra-articular

  4. 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

  5. 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

  6. 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

  7. Automobilization intervention and exercise for temporomandibular joint open lock

    PubMed Central

    Hoglund, Lisa T; Scott, Brian W

    2012-01-01

    Temporomandibular joint disorders (TMDs) are common and may cause temporomandibular joint (TMJ) locking, pain, and disability. Evidence supports use of manual therapy and exercise for treatment of TMDs including disk displacement limiting full mouth opening, TMJ ‘closed lock’. Only limited case studies describe management of TMJ ‘open lock’, a condition due to posterior disk displacement (PDD) or TMJ anterior dislocation (TMJ-AD). Reported treatment for open lock includes splinting and intraoral joint manipulation. This case report describes a novel extraoral automobilization using the mandibular elevator muscles to treat TMJ open lock in a 22-year-old male after intraoral joint mobilization failed. The exercise program used to restore neuromuscular control for post-reduction management is described. Short term results of automobilization were excellent with restored ability to swallow, speak normally, and achieve occlusion. Long term results at 14 months were good: the patient was pain-free, could swallow and speak normally, had no recurrence of TMJ locking, and minimal disability. Limited right lateral excursion range and left mandibular deviation during mouth opening indicated possible persistence of PDD. This case suggests that mandibular elevator automobilization and masticatory muscle exercise may be useful to treat TMJ open lock and should be considered to treat PDD and TMJ-AD. PMID:24179326

  8. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders.

    PubMed

    Peck, C C; Goulet, J-P; Lobbezoo, F; Schiffman, E L; Alstergren, P; Anderson, G C; de Leeuw, R; Jensen, R; Michelotti, A; Ohrbach, R; Petersson, A; List, T

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. The expanded TMDs taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalise and test the proposed taxonomy and diagnostic criteria.

  9. Attributes of tinnitus that may predict temporomandibular joint dysfunction.

    PubMed

    Vernon, J; Griest, S; Press, L

    1992-10-01

    A collection of 1002 patients with severe tinnitus, drawn from the Tinnitus Data Registry, were retrospectively surveyed to determine which traits or attributes of tinnitus could indicate the possibility of temporomandibular joint dysfunction (TMD) as the cause of tinnitus. The patients were divided into two groups: (1) a TMD group, consisting of 69 patients for whom there was no known cause of tinnitus except for one or more temporomandibular joint (TMJ) indicators, and (2) a comparison group with mixed etiologies (n = 860). Seventy-three patients were eliminated due to excessive complications relating to cause. The two groups were compared seeking those attributes of tinnitus that significantly separated them. No single benchmark standard was discovered that exclusively indicated tinnitus from TMJ origins. However, a total of 10 "TMJ Indicators" were discovered. The data for each of these indicators is presented and discussed. In addition, the attributes that did not significantly separate the two groups are listed. The study concludes with a recommendation for TMJ referral for those tinnitus patients with unknown etiology who demonstrate any three or more of the TMJ indicators. PMID:1291101

  10. Temporomandibular disorders: referred cranio-cervico-facial clinic.

    PubMed

    Ramírez, Luis Miguel; Sandoval, German Pablo; Ballesteros, Luis Ernesto

    2005-01-01

    The bond between temporomandibular disorders and referred craniofacial symptomatology is more and more evident. In it subsists the prevailing necessity of understanding the temporomandibular disorders and the cranio-cervico-facial referred symptomatology from a neurophysiologic and muscle-skeletal perspective contained in the stomatognatic system. Diagnosis in head and neck areas is difficult because of its complex anatomy. Some painful craniofacial syndromes exhibit the same symptoms although they don.t seem objectively possible and that is what confuses the specialist and the patient. Pain in the head and the neck is one of the most complex to diagnose because of its varied origins that can be neurological, vascular, muscular, ligamental and bony. This article seeks to show some reasonable anatomical and pathophysiological connections of this muscle-skeletal disorder expressed with symptoms like tinnitus, otic fullness, otalgia and migraine among others. Disciplines in health such as neurology, the otolaryngology and dentistry share common anatomical and pathophysiological roads constructed in an increased muscular activity that generates muscle-skeletal disorders and is difficult to locate referred craniofacial symptomatology. This revision aspires to sensitize the medical specialist and the odontologist in the understanding of the important interdisciplinary handling in the detection of this disorder. This offers better tools in the conservative therapy phase of this craniofacial referred symptomatology. PMID:15800464

  11. 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.

  12. 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

  13. 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

  14. Oral habits of temporomandibular disorder patients with malocclusion.

    PubMed

    Fujita, Yukie; Motegi, Etsuko; Nomura, Mayumi; Kawamura, Sakura; Yamaguchi, Daisuke; Yamaguchi, Hideharu

    2003-11-01

    The purpose of this study was to clarify the relationship between oral habits and symptoms of temporomandibular joint disorder in patients who had sought orthodontic treatment by analyzing their present and past history. The subjects were 57 female patients (average age: 23 years and 6 months old) who had visited the "Temporomandibular Disorder Section" in our orthodontic department. Their chief complaints were the symptom of TMJ and the abnormalities of occlusion such as maxillary protrusion, open bite, crowding, mandibular protrusion, cross bite, deep bite, edge-to-edge bite, and spacing. Their present conditions and past histories were examined and evaluated. The most typical primary symptom was joint sound (23 patients, 40.0%). The second was joint sound and pain (15 patients, 26.3%). Of the symptoms present at the time of examination, the most prevalent were joint sound and pain (20 patients, 35.1%). The 48 patients (82.8%) had significant oral habits. Unilateral chewing was seen in 35 patients (72.9%), bruxism in 27 (56.3%), abnormality of posture in 14 (29.2%), habitual crunching in 10 (20.8%) and resting the check on the hand in 4 (8.3%), respectively. When comparing the primary symptoms to those at the time of examination, the patients with unilateral chewing and bruxism tended to have more complicated symptoms. In conclusion, the TMD symptoms of the patients with notable oral habits did not change or become worse during a period of about 5 years.

  15. 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

  16. 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

  17. 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).

  18. 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

  19. 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)

  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. Pseudomonas arthritis treated with parenteral and intra-articular ceftazidime.

    PubMed Central

    Walton, K; Hilton, R C; Sen, R A

    1985-01-01

    A 73-year-old diabetic presented with septic arthritis of the knee; Pseudomonas aeruginosa was isolated. She was successfully treated with a combination of parenteral and intra-articular ceftazidime, after failure to eradicate the organism with adequate serum levels of gentamicin and full doses of azlocillin. PMID:3896166

  2. ELASTICITY OF ARTICULAR CARTILAGE: EFFECT OF IONS AND VISCOUS SOLUTIONS.

    PubMed

    SOKOLOFF, L

    1963-09-13

    The deformability of articular cartilage is increased by cations, more so by polyvalent than monovalent ones. Trivalent cations also depress elastic recovery. Failure of viscous solutions to alter the elastic behavior suggests ultra-filtration by cartilage as a possible mechanism in synovial lubrication.

  3. 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

  4. Human patellar articular proportions: recent and Pleistocene patterns

    PubMed Central

    TRINKAUS, ERIK

    2000-01-01

    The degrees of mediolateral asymmetry of the patellar articular facet, as well as the median and lateral articular angles of the facet, were compared across samples of recent humans and of Pleistocene archaic and modern fossil humans. All samples exhibit considerable variability in these patellar proportions. The articular angles are similar across the different samples, but there is a trend towards decreasing lateral angles with decreasing robusticity. The archaic humans exhibit significantly more symmetry of the medial and lateral facets than do any of the recent human samples. However, given the variability in medial versus lateral patellofemoral contact forces documented for extant humans and the roles of the distal oblique portions of vastus medialis and vastus lateralis in patellar stabilisation, it is unclear to what extent this variation in patellar articular proportions may affect knee kinesiology. The contrasts may be related to different levels of patellar stability and/or musculoskeletal hypertrophy, but they appear unlikely to have affected primary knee function. PMID:10853969

  5. In vivo cartilage formation from growth factor modulated articular chondrocytes.

    PubMed

    Bradham, D M; Horton, W E

    1998-07-01

    Recent procedures for autologous repair of cartilage defects may be difficult in elderly patients because of the loss of stem cells and chondrocytes that occurs with age and the slow in vitro proliferation of chondrocytes from aged cartilage. In this study secondary chondroprogenitor cells were obtained by modulating the phenotype of articular chondrocytes with growth factors and stimulating the proliferation of these cells in culture. Chondrocytes isolated from the articular cartilage of mature New Zealand White rabbits were exposed to a combination of transforming growth factor beta and basic fibroblast growth factor treatment. These cells ceased the production of Collagen II (a marker for the chondrocyte phenotype) and underwent a 136-fold increase in cell number. Next, the cells were placed in high density culture and reexpressed the chondrocyte phenotype in vitro and formed hyaline cartilage in an in vivo assay. Primary chondrocytes obtained from articular cartilage of elderly humans could be manipulated in a similar fashion in vitro. These human secondary chondroprogenitor cells formed only cartilage tissue when assayed in vivo and in tissue bioreactors. This approach may be essential for autologous repair of degenerated articular cartilage in elderly patients with osteoarthritis.

  6. Chondrocyte distribution in the articular cartilage of human femoral condyles.

    PubMed Central

    Gilmore, R S; Palfrey, A J

    1988-01-01

    The distribution of chondrocytes throughout the total thickness of articular cartilage from the femoral condyles of infants, children and adults has been studied using serial sections cut parallel as well as perpendicular to the articular surface. The thickness of the articular cartilage was estimated in fixed sections. In one of the adult specimens, the thickness of the articular cartilage was estimated firstly by direct measurement of the cut surfaces of a series of blocks cut from both condyles and then from the number of parallel sections of the cartilage prepared from those blocks. Cell density was highest in the superficial zone of all specimens examined, declining to lower values in the deep zone of the cartilage. Within this pattern the infant specimens had the highest values for cell density and the adults the lowest, with values for children in an intermediate range. There was no significant variation in cell density across the condyles of the selected adult specimen. The absolute values for cartilage thickness depended on the method used, but in general total thickness was found to approximately double from late gestation to maturity. In the selected adult specimen, the cartilage was thickest just anterior and posterior to the main weight-bearing area of the condyles. PMID:3198480

  7. 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

  8. Evaluation of apparent fracture toughness of articular cartilage and hydrogels

    PubMed Central

    Xiao, Yinghua; Rennerfeldt, Deena A.; Friis, Elizabeth A.; Gehrke, Stevin H.; Detamore, Michael S.

    2014-01-01

    Recently, biomaterials-based tissue-engineering strategies, including the use of hydrogels, have offered great promise for repairing articular cartilage. Mechanical failure testing in outcome analyses is of crucial clinical importance to the success of engineered constructs. Interpenetrating networks (IPNs) are gaining more attention, due to their superior mechanical integrity. This study provided a combination testing method of apparent fracture toughness, which was applied to both articular cartilage and hydrogels. The apparent fracture toughnesses of two groups, hydrogels and articular cartilage, were evaluated based on the modified single-edge notch test and ASTM standards on the single-edge notch test and compact tension test. The results demonstrated that the toughness for articular cartilage (348 ± 43 MPa/mm½) was much higher than that for hydrogels. With a toughness value of 10.8 ± 1.4 MPa/mm½, IPNs of agarose and poly(ethylene glycol) diacrylate (PEG-DA) looked promising. The IPNs were 1.4 times tougher than PEG-DA alone, although still over an order of magnitude less tough than cartilage. A new method was developed to evaluate hydrogels and cartilage in a manner that enabled a more relevant direct comparison for fracture testing of hydrogels for cartilage tissue engineering. Moreover, a target toughness value for cartilage of using this direct comparison method has been identified (348 ± 43 MPa/mm½), and the toughness discrepancy to be overcome between hydrogels and cartilage has been quantified. PMID:24700577

  9. Computational aspects in mechanical modeling of the articular cartilage tissue.

    PubMed

    Mohammadi, Hadi; Mequanint, Kibret; Herzog, Walter

    2013-04-01

    This review focuses on the modeling of articular cartilage (at the tissue level), chondrocyte mechanobiology (at the cell level) and a combination of both in a multiscale computation scheme. The primary objective is to evaluate the advantages and disadvantages of conventional models implemented to study the mechanics of the articular cartilage tissue and chondrocytes. From monophasic material models as the simplest form to more complicated multiscale theories, these approaches have been frequently used to model articular cartilage and have contributed significantly to modeling joint mechanics, addressing and resolving numerous issues regarding cartilage mechanics and function. It should be noted that attentiveness is important when using different modeling approaches, as the choice of the model limits the applications available. In this review, we discuss the conventional models applicable to some of the mechanical aspects of articular cartilage such as lubrication, swelling pressure and chondrocyte mechanics and address some of the issues associated with the current modeling approaches. We then suggest future pathways for a more realistic modeling strategy as applied for the simulation of the mechanics of the cartilage tissue using multiscale and parallelized finite element method.

  10. Biphasic surface amorphous layer lubrication of articular cartilage.

    PubMed

    Graindorge, Simon; Ferrandez, Wendy; Jin, Zhongmin; Ingham, Eileen; Grant, Colin; Twigg, Peter; Fisher, John

    2005-12-01

    The biphasic nature of articular cartilage has been acknowledged for some time and is known to play an important role in many of the biomechanical functions performed by this unique tissue. From the lubrication point of view however, a simple biphasic model is unable to account for the extremely low friction coefficients that have been recorded experimentally, particularly during start-up. In addition, research over the last decade has indicated the presence of a surface amorphous layer on top of articular cartilage. Here, we present results from a finite element model of articular cartilage that includes a thin, soft, biphasic surface amorphous layer (BSAL). The results of this study show that a thin BSAL, with lower elastic modulus, dramatically altered the load sharing between the solid and liquid phases of articular cartilage, particularly in the near-surface regions of the underlying bulk cartilage and within the surface amorphous layer itself where the fluid load support exceeded 85%. By transferring the load from the solid phase to the fluid phase, the biphasic surface layer improves lubrication and reduces friction, whilst also protecting the underlying cartilage surface by 'shielding' the solid phase from elevated stresses. The increase in lubrication effectiveness is shown to be greatest during short duration loading scenarios, such as shock loads.

  11. Evidence for a negative Pasteur effect in articular cartilage.

    PubMed

    Lee, R B; Urban, J P

    1997-01-01

    Uptake of external glucose and production of lactate were measured in freshly-excised bovine articular cartilage under O2 concentrations ranging from 21% (air) to zero (N2-bubbled). Anoxia (O2 concentration < 1% in the gas phase) severely inhibited both glucose uptake and lactate production. The decrease in lactate formation correlated closely with the decrease in glucose uptake, in a mole ratio of 2:1. This reduction in the rate of glycolysis in anoxic conditions is seen as evidence of a negative Pasteur effect in bovine articular cartilage. Anoxia also suppressed glycolysis in articular cartilage from horse, pig and sheep. Inhibitors acting on the glycolytic pathway (2-deoxy-D-glucose, iodoacetamide or fluoride) strongly decreased aerobic lactate production and ATP concentration, consistent with the belief that articular cartilage obtains its principal supply of ATP from substrate-level phosphorylation in glycolysis. Azide or cyanide lowered the ATP concentration in aerobic cartilage to approximately the same extent as did anoxia but, because glycolysis (lactate production) was also inhibited by these treatments, the importance of any mitochondrial ATP production could not be assessed. A negative Pasteur effect would make chondrocytes particularly liable to suffer a shortage of energy under anoxic conditions. Incorporation of [35S]sulphate into proteoglycan was severely curtailed by treatments, such as anoxia, which decreased the intracellular concentration of ATP.

  12. Effect of unilateral condylectomy on the sheep temporomandibular joint.

    PubMed

    Miyamoto, K; Vickers, R; Ishimaru, J I; Ogi, N; Kurita, K; Goss, A N

    1999-10-01

    Unilateral condylectomy was performed on five young adult sheep. The animals were killed at three months and both joints and the excised condyles were examined macroscopically and histologically. All five showed pronounced regeneration of the condylar head on the operated side. The articular surface was fibrous and fused to the disc. Four of the five opposite joints showed medial remodelling. Young sheep have a higher regenerative capability than human adults of equivalent age, and similar reactions to those of children. PMID:10577756

  13. Prevalence of different temporomandibular joint sounds, with emphasis on disc-displacement, in patients with temporomandibular disorders and controls.

    PubMed

    Elfving, Lars; Helkimo, Martti; Magnusson, Tomas

    2002-01-01

    Temporomandibular joint (TMJ) sounds are very common among patients with temporomandibular disorders (TMD), but also in non-patient populations. A variety of different causes to TMJ-sounds have been suggested e.g. arthrotic changes in the TMJs, anatomical variations, muscular incoordination and disc displacement. In the present investigation, the prevalence and type of different joint sounds were registered in 125 consecutive patients with suspected TMD and in 125 matched controls. Some kind of joint sound was recorded in 56% of the TMD patients and in 36% of the controls. The awareness of joint sounds was higher among TMD patients as compared to controls (88% and 60% respectively). The most common sound recorded in both groups was reciprocal clickings indicative of a disc displacement, while not one single case fulfilling the criteria for clicking due to a muscular incoordination was found. In the TMD group women with disc displacement reported sleeping on the stomach significantly more often than women without disc displacement did. An increased general joint laxity was found in 39% of the TMD patients with disc displacement, while this was found in only 9% of the patients with disc displacement in the control group. To conclude, disc displacement is probably the most common cause to TMJ sounds, while the existence of TMJ sounds due to a muscular incoordination can be questioned. Furthermore, sleeping on the stomach might be associated with disc displacement, while general joint laxity is probably not a causative factor, but a seeking care factor in patients with disc displacement.

  14. Women with more severe degrees of temporomandibular disorder exhibit an increase in temperature over the temporomandibular joint

    PubMed Central

    Dibai-Filho, Almir Vieira; Costa, Ana Cláudia de Souza; Packer, Amanda Carine; de Castro, Ester Moreira; Rodrigues-Bigaton, Delaine

    2014-01-01

    Aim The purpose of the present study was to correlate the degree of temporomandibular disorder (TMD) severity and skin temperatures over the temporomandibular joint (TMJ) and masseter and anterior temporalis muscles. Materials and methods This blind cross-sectional study involved 60 women aged 18–40 years. The volunteers were allocated to groups based on Fonseca anamnestic index (FAI) score: no TMD, mild TMD, moderate TMD, and severe TMD (n = 15 each). All volunteers underwent infrared thermography for the determination of skin temperatures over the TMJ, masseter and anterior temporalis muscles. The Shapiro–Wilk test was used to determine the normality of the data. The Kruskal–Wallis test, followed by Dunn’s test, was used for comparisons among groups according to TMD severity. Spearman’s correlation coefficients were calculated to determine the strength of associations among variables. Results Weak, positive, significant associations were found between FAI score and skin temperatures over the left TMJ (rs = 0.195, p = 0.009) and right TMJ (rs = 0.238, p = 0.001). Temperatures over the right and left TMJ were significantly higher in groups with more severe TMD (p < 0.05). Conclusion FAI score was associated with skin temperature over the TMJ, as determined by infrared thermography, in this sample. Women with more severe TMD demonstrated a bilateral increase in skin temperature. PMID:25544814

  15. Change of Range of Motion of the Temporomandibular Joint after Correction of Mild Scoliosis

    PubMed Central

    Park, Yongnam; Bae, Youngsook

    2014-01-01

    [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

  16. Preliminary optical coherence tomography investigation of the temporo-mandibular joint disc

    NASA Astrophysics Data System (ADS)

    Mărcăuteanu, Corina; Demjan, Enikö; Sinescu, Cosmin; Negrutiu, Meda; Motoc, Adrian; Lighezan, Rodica; Vasile, Liliana; Hughes, Mike; Bradu, Adrian; Dobre, George; Podoleanu, Adrian G.

    2010-02-01

    Aim and objectives. The morphology and position of the temporo-mandibular disc are key issues in the diagnosis and treatment of arthrogenous temporo-mandibular disorders. Magnetic resonance imaging and arthroscopy are used today to identify: flattening of the pars posterior of the disc, perforation and/or adhesions in the pars intermedia of the disc and disc displacements. The present study proposes the investigation of the temporo-mandibular joint disc by optical coherence tomography (OCT). Material and methods. 8 human temporo-mandibular joint discs were harvested from dead subjects, under 40 year of age, and conserved in formalin. They had a normal morphology, with a thicker pars posterior (2,6 mm on the average) and a thinner pars intermedia (1mm on the average). We investigated the disc samples using two different OCT systems: an en-face OCT (time domain (TD)-OCT) system, working at 1300 nm (C-scan and B-scan mode) and a spectral OCT system (a Fourier domain (FD)-OCT) system , working at 840 nm (B-scan mode). Results. The OCT investigation of the temporo-mandibular joint discs revealed a homogeneous microstructure. The longer wavelength of the TD-OCT offers a higher penetration depth (2,5 mm in air), which is important for the analysis of the pars posterior, while the FD-OCT is much faster. Conclusions: OCT is a promising imaging method for the microstructural characterization of the temporo-mandibular disc.

  17. 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

  18. 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

  19. Expressing human SHOX in Shox2SHOX KI/KI mice leads to congenital osteoarthritis-like disease of the temporomandibular joint in postnatal mice

    PubMed Central

    Liang, Wenna; Li, Xihai; Chen, Houhuang; Shao, Xiang; Lin, Xuejuan; Shen, Jianying; Ding, Shanshan; Kang, Jie; Li, Candong

    2016-01-01

    The temporomandibular joint (TMJ), a unique synovial joint whose development differs from that of other synovial joints, develops from two distinct mesenchymal condensations that grow toward each other and ossify through different mechanisms. The short stature homeobox 2 (Shox2) gene serves an important role in TMJ development and previous studies have demonstrated that Shox2SHOX KI/KI mice display a TMJ defective phenotype, congenital dysplasia and premature eroding of the articular disc, which is clinically defined as a TMJ disorder. In the present study, Shox2SHOX KI/KI mouse models were used to investigate the mechanisms of congenital osteoarthritis (OA)-like disease during postnatal TMJ growth. Shox2SHOX KI/KI mice were observed to develop a severe muscle wasting syndrome from day 7 postnatal. Histological examination indicated that the condyle and glenoid fossa of Shox2SHOX KI/KI mice was reduced in size in the second week after birth. The condyles of Shox2SHOX KI/KI mice exhibited reduced expression levels of collagen type II and Indian hedgehog, and increased expression of collagen type I. A marked increase in matrix metalloproteinase 9 (MMP9) and MMP13 in the condyles was also observed. These cellular and molecular defects may contribute to the observed (OA)-like phenotype of Shox2SHOX KI/KI mouse TMJs. PMID:27601064

  20. Modified internal mandibular distraction osteogenesis in the treatment of micrognathia secondary to temporomandibular joint ankylosis: 4-year follow-up of a case.

    PubMed

    Shang, Hongtao; Xue, Yang; Liu, Yanpu; Zhao, Jinlong; He, Lisheng

    2012-06-01

    Micrognathia and obstructive sleep apnoea syndrome (OSAS) are problems subsequent to temporomandibular joint ankylosis (TMJa) in growing patients. For patients with micrognathia and OSAS secondary to TMJa, it is important to restore proper mandibular form and dimension, achieve occlusal stability and recover satisfactory joint movement. We report a 4-year follow-up of a patient with micrognathia and OSAS secondary to bilateral TMJa. The treatment of this patient involved (1) a modified internal mandibular distraction osteogenesis without altering the pre-existing occlusion; (2) TMJ arthroplasty in which the dislocated disc was found and repositioned and the shape of the glenoid fossa and articular head was formed without removing bone in vertical dimension; (3) passive mouth-opening exercise with an individualized occlusal pad postoperatively for one month; and (4) orthodontic treatment for the occlusal disturbance and active mouth-opening exercise for one year. After the treatment the micrognathia was corrected; the oropharyngeal airway was increased significantly; mouth-opening increased to 40mm intraoperatively was maintained at 36.66mm 4 years after surgery. Satisfactory occlusion was achieved after orthodontic treatment. Through the 4-year follow-up, no signs of reankylosis were found. In conclusion, this new clinical protocol is a safe, effective and quick way to treat micrognathia and OSAS secondary to TMJa.

  1. 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

  2. Dynamic properties of bovine temporomandibular joint disks change with age.

    PubMed

    Tanaka, E; Aoyama, J; Tanaka, M; Murata, H; Hamada, T; Tanne, K

    2002-09-01

    The temporomandibular joint disk exhibits morphological and biochemical age-related changes. However, the possible age-related changes of the dynamic viscoelasticity in the disk are unclear. We tested the hypothesis that the dynamic viscoelastic properties of the disk change with age. Thirty-six disks from young-adult, adult, and mature-adult cattle were used for dynamic tensile tests. In all disks, the magnitudes of the complex modulus, the storage modulus, and the loss modulus increased as the frequency increased. The mature-adult disks had higher values of these moduli than did the younger disks. The loss tangent ranged from 0.1 to 0.3, which means that the disk has relatively large elasticity and relatively small viscosity. It was concluded that both the elasticity and viscosity of the disk increase with age. This may reflect age-related changes in biochemical composition.

  3. 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

  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. Treatment of temporomandibular joint ankylosis with temporalis superficial fascia flap.

    PubMed

    Karasu, Hakan Alpay; Okcu, Kemal Murat; Ortakoglu, Kerim; Bayar, Gurkan Rasit; Aydintug, Yavuz Sinan

    2005-02-01

    Temporomandibular joint (TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation and limitation of mouth opening. This study aims to determine the efficacy of arthroplasty and interpositional fascia flap in the treatment of unilateral and bilateral TMJ ankylosis in three young adult men. Our operative protocol for unilateral and bilateral TMJ ankylosis entailed resection of ankylotic mass, intraoral ipsilateral and bilateral arthroplasty, interpositional tissue transfer to the TMJ with temporalis superficial fascia flap, maxillomandibular fixation, and early mobilization and aggressive physiotherapy. Early postoperative initial exercise, physiotherapy, and strict follow-up play an important role in preventing postoperative adhesions. The temporalis superficial facia flap is an autogenous graft that has the advantages of close proximity to the TMJ minimal surgical morbidity, and successful clinical results. It was found to be a valuable option for TMJ ankylosis reconstruction. PMID:15782841

  6. 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

  7. Gout of the Temporomandibular Joint: Report of a Case

    PubMed Central

    Oliveira, Isaac Nilton Fernandes; Gomes, Renata Caroline Ferreira; dos Santos, Raiane Rodrigues; Oliveira, Thiago de Paula; Pereira, Larissa Loiuse Cândida; Mainenti, Pietro

    2014-01-01

    Introduction Gout is an illness characterized by the deposition of monosodium urate crystals in the joints or in soft tissues. The clinical manifestation results from inflammation of limb joints and pain with a rare presentation in the temporomandibular joint (TMJ). Case Report This study describes a 66-year-old white man with a chief complaint of “occasional pain in the left temporal muscle region.” The case disclosed a gout manifestation in the TMJ after physical, radiographic, and ultrasonographic exams, and the patient was referred to proper treatment. Conclusion Gout manifestation in the TMJ is an unusual presentation, and few reports in the English literature address to the subject. Gout in the TMJ should be included as a differential diagnosis for joint disorders. PMID:25992112

  8. Management of temporo-mandibular joint ankylosis in growing children.

    PubMed

    Shashikiran, N D; Reddy, S V V; Patil, R; Yavagal, C

    2005-03-01

    Although temporo-mandibular joint (TMJ) ankylosis is one of the most common pathologies afflicting the facial skeleton, it is also the most overlooked and under-managed problem in children. The TMJ forms the very cornerstone of cranio-facial integrity and hence its ankylosis in growing children adversely affects the growth and development of the jaws and occlusion. Impairment of speech, difficulty in mastication, poor oral hygiene, rampant caries and acute compromise of the airway pose a severe psychologic burden on the tender minds of children. The aim of this article is to present an overview of efficient management strategies, based on a case report, so as to increase its awareness among all dental surgeons involved in the treatment of children.

  9. 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

  10. Biomechanics of the human temporomandibular joint during chewing.

    PubMed

    Naeije, M; Hofman, N

    2003-07-01

    Experimental data on the loading of the human temporomandibular joint during chewing are scarce. Coincidence of the opening and closing chewing strokes of the condyles probably indicates compression in the joint during chewing. Using this indication, we studied the loading of the joint during chewing and chopping of a latex-packed food bolus on the left or right side of the mouth. Mandibular movements of ten healthy subjects were recorded. Distances traveled by the condylar kinematic centers were normalized with respect to the distances traveled during maximum opening. We judged coincidence of the opening and closing condylar movement traces without knowing their origin. When subjects chewed, the ipsilateral condyles traveled shorter distances than did the contralateral condyles. During chewing and chopping, all contralateral condyles showed a coincident movement pattern, while a significantly smaller number of ipsilateral condyles did. These results suggest that the ipsilateral joints were less heavily loaded during chewing and chopping than were the contralateral joints.

  11. 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

  12. [Temporomandibular joint symptoms in orthognathic surgery: a retrospective study].

    PubMed

    Declercq, C; Neyt, L; Mommaerts, M; Abeloos, J; De Mot, B

    1993-06-01

    The records of 152 consecutive patients who underwent orthognathic surgery in the Division of Maxillofacial Surgery A.Z. St.-Jan, Brugge, between 1/10/90 and 1/10/91 were evaluated for pre- and postoperative temporo-mandibular joint (TMJ) symptoms. Fewer TMJ symptoms were found postoperatively, than preoperatively (14.4% versus 19.7%). In the mandibular retrognathism group there were twice as much TMJ symptoms preoperatively in the low and normal mandibular angle patient group than in the high mandibular angle group (26% versus 13%). After surgery, there was a decrease of TMJ symptoms in the low and normal angle patient group (83% improvement). In the high angle absolute mandibular retrognathism group however, more new TMJ symptoms were seen postoperatively (21%). Bimaxillary surgical correction of a high angle absolute mandibular retrognathism case may provoke condylar resorption. Advice for follow-up and suggestions to reduce this annoying complication are given.

  13. Prevalence of temporomandibular dysfunction in a group of scuba divers

    PubMed Central

    Aldridge, R; Fenlon, M

    2004-01-01

    Background: Temporomandibular dysfunction (TMD) has been reported to be a common problem in divers, with a prevalence of up to 68%. No evidence for this is available. Objective: To investigate the prevalence of TMD in divers. Method: Sixty three subjects were asked to retrospectively complete a questionnaire on symptoms of TMD after diving in warm and cold water areas and in daily life. Results: The prevalence of TMD was greater in female divers. The prevalence of TMD while diving was about 26%, comparable to that experienced in daily life. Conclusion: Improvements in mouthpiece design and lighter demand valves mean that TMD is now probably exacerbated by diving rather than caused by it. PMID:14751950

  14. 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

  15. [The transverse movement of the temporo-mandibular joint (translation movement) of the dog, also with reference to dysplasia of this joint in the dachshund].

    PubMed

    Vollmerhaus, B; Roos, H

    1996-09-01

    Contrary to the accepted opinion, transverse movement is possible in the temporo-mandibular joint of the dog. This movement is arched and is important for mastication. Analysis of transverse movement of the temporo-mandibular joint was done in 20 dog breeds. Accidentally dysplasia of the temporo-mandibular joint was found in the dachshund, a phenomenon which has not been described before.

  16. Pseudotumors and tumors of the temporomandibular joint. A review

    PubMed Central

    Bagán, José V.; Sanchis, José M.; Margaix, María

    2013-01-01

    Objective: To review the pseudotumors and tumors of the temporomandibular joint (TMJ) published in journals included in Journal Citation Reports (JCR), and to evaluate whether there are clinical and radiological signs capable of differentiating between pseudotumors and tumors and between malignant and benign tumors. Material and Methods: A systematic Medline search was made of clinical cases of tumors and pseudotumors of the TMJ covering a 20-year period and published in journals included in JCR. Only cases with histological confirmation were included. A description is provided of the general characteristics of TMJ tumors, with comparison of the clinical, diagnostic, therapeutic and evolutive variables referred to pseudotumors, benign tumors and malignant tumors. Results: We identified 285 TMJ tumors published in 181 articles of 15 journals. The most frequent lesions were pseudotumors (synovial chondromatosis, pigmented villonodular synovitis, eosinophilic granuloma and osteochondroma). The mean age was 42 years and one month ± 16 years and two months. Tumors were more common in females. The mean time from symptoms onset to consultation was 30 months and 8 days ± 41 months and 9 days, and almost 19.6% of the cases initially had been diagnosed and treated as TMJ dysfunction. The most frequent clinical manifestations were pain, swelling and the limitation of joint movements. The most common radiological findings in the case of benign and malignant lesions were radiopacities and radiotransparencies, respectively. No panoramic X-ray alterations were observed in 14.6% of the benign tumors and in 7.7% of the malignant lesions. Surgery was the usual form of treatment. Sequelae were recorded in 18.2% of the cases, with tumor relapse in 9.1%. The four-year survival rate in the case of malignant tumors was 72.2%. Key words:Tumor, temporomandibular joint, metaplasia, pseudotumor, condyle. PMID:23385515

  17. Clinical Signs and Subjective Symptoms of Temporomandibular Disorders in Instrumentalists

    PubMed Central

    Jang, Jae-Young; Kwon, Jeong-Seung; Lee, Debora H.; Bae, Jung-Hee

    2016-01-01

    Purpose Most of the reports on instrumentalists' experiences of temporomandibular disorders (TMD) have been reported not by clinical examinations but by subjective questionnaires. The aim of this study was to investigate the clinical signs and subjective symptoms of TMD in a large number of instrumentalists objectively. Materials and Methods A total of 739 musicians from a diverse range of instrument groups completed a TMD questionnaire. Among those who reported at least one symptom of TMD, 71 volunteers underwent clinical examinations and radiography for diag-nosis. Results Overall, 453 participants (61.3%) reported having one or more symptoms of TMD. The most frequently reported symptom was a clicking or popping sound, followed by temporomandibular joint (TMJ) pain, muscle pain, crepitus, and mouth opening limitations. Compared with lower-string instrumentalists, a clicking or popping sound was about 1.8 and 2 times more frequent in woodwind and brass instrumentalists, respectively. TMJ pain was about 3.2, 2.8, and 3.2 times more frequent in upper-string, woodwind, and brass instrumentalists, respectively. Muscle pain was about 1.5 times more frequent in instrumentalists with an elevated arm position than in those with a neutral arm position. The most frequent diagnosis was myalgia or myofascial pain (MFP), followed by disc displacement with reduction. Myalgia or MFP was 4.6 times more frequent in those practicing for no less than 3.5 hours daily than in those practicing for less than 3.5 hours. Conclusion The results indicate that playing instruments can play a contributory role in the development of TMD. PMID:27593881

  18. 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

  19. [Our physiotherapy treatment of articular fractures of the mandibular condyle].

    PubMed

    Lemière, E; Sicre, A; Vereecke, F; Brygo, A; Nicola, J; Ferri, J

    2003-04-01

    Physical therapy greatly contributes to improved function of the injured temporomandibular joint, particularly after trauma. In our unit, we use the Delaire rehabilitation method for patients presenting a fracture of the mandibular condyles. This method involves active mobilization, first with assistance, then with facilitation, and finally against resistance. A rehabilitation session starts with a preparation of the teguments and muscles associated with relaxation exercises. The joint is first mobilized by assisted movements if needed. When unassisted motion becomes possible, propulsion, diduction and open-close exercises are then performed with neuromuscular facilitation. When sufficient amplitudes have been achieved, the program proceeds with opposed exercises. By inducing propulsion and diduction (lateral pterygoid muscle) movements, physical therapy stimulates regeneration of the condylar unit, thus facilitating optimal functional rehabilitation. Posture and passive motion methods, which in our opinion are poorly adapted to the temporomandibular joint, are used little in our unit. Since condylar regeneration is controlled by functional factors, the lateral pterygoid muscle is an important element. Good functional outcome, and the absence of ankylosis, depends directly on the quality of active rehabilitation.

  20. Application of stem cells for articular cartilage regeneration.

    PubMed

    Hwang, Nathaniel S; Elisseeff, Jennifer

    2009-01-01

    Articular cartilage is a highly organized tissue lacking self-regeneration capacity upon lesion. Current surgical intervention by application of in vitro-expanded autologous chondrocytes transplantation procedure is associated with several disadvantages, including donor-site morbidity and inferior fibrocartilage formation at the defect site. However, recent advancements in tissue engineering have provided notable strategies for stem cell-based therapies and articular cartilage tissue engineering. In this review, we discuss the current strategies to engineer cartilage tissues from adult stem cells and human embryonic stem cell-derived cells. The characteristics of adult stem cells, the microenvironmental control of cell fate determination, and the limitation imposed by the intrinsic nature of stem cells are discussed. The strategy to commit the stem cells for functional cartilage tissues in vivo is also discussed.

  1. 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

  2. 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

  3. Molecular conformational changes in articular cartilage using NMR spectroscopy

    NASA Astrophysics Data System (ADS)

    Barone, Justin; Schmidt, Walter

    2004-03-01

    NMR spectroscopy is used to study the conformational changes of the collagen and glycosaminoglycan molecules in bovine articular cartilage. Molecular conformation will change with the charge on each molecule. The charge on each molecule varies spatially throughout the cartilage. For a given point in space, the charge on each molecule can be screened by placing the cartilage in an increasingly ionic environment. The conformational changes are noted through changes in the chemical shifts in the NMR spectrum as a function of salt concentration.

  4. Reconstruction of the zygoma, temporo-mandibular joint and mandible using a compound pectoralis major osteo-muscular flap.

    PubMed

    Jones, N F; Sommerlad, B C

    1983-10-01

    A method of reconstruction of the zygoma, temporo-mandibular joint and hemi-mandible utilising a segment of the outer table of the sternum, sterno-costal joint and rib vascularised by an ipsilateral pectoralis major muscle flap is described. The mobility of an isolated sterno-coastal joint is compared with movements of the temporo-mandibular joint.

  5. 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

  6. 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

  7. Genesis and morphogenesis of limb synovial joints and articular cartilage.

    PubMed

    Decker, Rebekah S; Koyama, Eiki; Pacifici, Maurizio

    2014-10-01

    Limb synovial joints are intricate structures composed of articular cartilage, synovial membranes, ligaments and an articular capsule. Together, these tissues give each joint its unique shape, organization and biomechanical function. Articular cartilage itself is rather complex and organized in distinct zones, including the superficial zone that produces lubricants and contains stem/progenitor cells. For many years there has been great interest in deciphering the mechanisms by which the joints form and come to acquire such unique structural features and diversity. Decades ago, classic embryologists discovered that the first overt sign of joint formation at each prescribed limb site was the appearance of a dense and compact population of mesenchymal cells collectively called the interzone. Work carried out since then by several groups has provided evidence that the interzone cells actively participate in joint tissue formation over developmental time. This minireview provides a succinct but comprehensive description of the many important recent advances in this field of research. These include studies using various conditional reporter mice to genetically trace and track the origin, fate and possible function of joint progenitor cells; studies on the involvement and roles in signaling pathways and transcription factors in joint cell determination and functioning; and studies using advanced methods of gene expression analyses to uncover novel genetic determinants of joint formation and diversity. The overall advances are impressive, and the findings are not only of obvious interest and importance but also have major implications in the conception of future translational medicine tools to repair and regenerate defective, overused or aging joints.

  8. DEXAMETHASONE PROMOTES CPPD CRYSTAL FORMATION BY ARTICULAR CHONDROCYTES

    PubMed Central

    Fahey, Mark; Mitton, Elizabeth; Muth, Emily; Rosenthal, Ann K.

    2008-01-01

    Objective Calcium pyrophosphate dihydrate crystals (CPPD) are commonly found in osteoarthritic joints and correlate with a poor prognosis. Intra-articular corticosteroids, such as dexamethasone (Dxm), are commonly used therapies for osteoarthritis with or without CPPD deposition. Dxm has variable effects in mineralization models. We investigated the effects of Dxm on CPPD crystal formation in a well established tissue culture model. Methods Porcine articular chondrocytes were incubated with ATP to generate CPPD crystals. Chondrocytes incubated with or without ATP were exposed to 1–100 nM Dxm in the presence of 45Ca. Mineralization was measured by 45Ca uptake in the cell layer. We also investigated the effect of Dxm on mineralization-regulating enzymes such as alkaline phosphatase, NTPPPH and transglutaminase. Results Dxm significantly increased ATP-induced mineralization by articular chondrocytes. While alkaline phosphatase and NTPPPH activities were unchanged by Dxm, transglutaminase activity increased in a clear dose responsive manner. Levels of factor XIIIA mRNA and protein were increased by Dxm, while type II Tgase protein was unchanged. Transglutaminase inhibitors suppressed Dxm-induced increases in CPPD crystal formation. Conclusion These findings suggest a potential for Dxm to contribute to pathologic mineralization in cartilage and reinforce a central role for the transglutaminase enzymes in CPPD crystal formation. PMID:19132782

  9. A vision on the future of articular cartilage repair.

    PubMed

    Cucchiarini, M; Madry, H; Guilak, F; Saris, D B; Stoddart, M J; Koon Wong, M; Roughley, P

    2014-05-06

    An AO Foundation (Davos, Switzerland) sponsored workshop "Cell Therapy in Cartilage Repair" from the Symposium "Where Science meets Clinics" (September 5-7, 2013, Davos) gathered leaders from medicine, science, industry, and regulatory organisations to debate the vision of cell therapy in articular cartilage repair and the measures that could be taken to narrow the gap between vision and current practice. Cell-based therapy is already in clinical use to enhance the repair of cartilage lesions, with procedures such as microfracture and articular chondrocyte implantation. However, even though long term follow up is good from a clinical perspective and some of the most rigorous randomised controlled trials in the regenerative medicine/orthopaedics field show beneficial effect, none of these options have proved successful in restoring the original articular cartilage structure and functionality in patients so far. With the remarkable recent advances in experimental research in cell biology (new sources for chondrocytes, stem cells), molecular biology (growth factors, genes), biomaterials, biomechanics, and translational science, a combined effort between scientists and clinicians with broad expertise may allow development of an improved cell therapy for cartilage repair. This position paper describes the current state of the art in the field to help define a procedure adapted to the clinical situation for upcoming translation in the patient.

  10. Depth Dependence of Shear Properties in Articular Cartilage

    NASA Astrophysics Data System (ADS)

    Buckley, Mark; Gleghorn, Jason; Bonassar, Lawrence; Cohen, Itai

    2007-03-01

    Articular cartilage is a highly complex and heterogeneous material in its structure, composition and mechanical behavior. Understanding these spatial variations is a critical step in designing replacement tissue and developing methods to diagnose and treat tissue affected by damage or disease. Existing techniques in particle image velocimetry (PIV) have been used to map the shear properties of complex materials; however, these methods have yet to be applied to understanding shear behavior in cartilage. In this talk, we will show that confocal microscopy in conjunction with PIV techniques can be used to determine the depth dependence of the shear properties of articular cartilage. We will show that the shear modulus of this tissue varies by over an order of magnitude over its depth, with the least stiff region located about 200 microns from the surface. Furthermore, our data indicate that the shear strain profile of articular cartilage is sensitive to both the degree of compression and the total applied shear strain. In particular, we find that cartilage strain stiffens most dramatically in a region 200-500 microns below the surface. Finally, we will describe a physical model that accounts for this behavior by taking into account the local buckling of collagen fibers just below the cartilage surface and present second harmonic generation (SHG) imaging data addressing the collagen orientation before and after shear.

  11. 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

  12. 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.

  13. [Present status and perspective of articular cartilage regeneration].

    PubMed

    Wakitani, Shigeyuki

    2007-05-01

    Because the capacity of articular cartilage for repair is limited, defects are a major clinical problem, and there is at present no satisfactory clinical technique to regenerate cartilage defects. Current clinical practice involves the bone stimulation technique, which breaks subchondral bone to facilitate cartilage repair from bone marrow derived cells and cytokines. This consists of multiple perforations, abrasions, and micro-fractures. However, with this procedure, cartilage defects are repaired with fibrocartilage, which is known to be biochemically and biomechanically different from normal hyaline cartilage and degeneration occurs in the reparative tissue. Autologous chondrocyte implantation (ACI) for repair of human articular cartilage was reported in 1994, and approved by the USA Food and Drug Association in 1997. This procedure has been performed for more than 20000 people all over the world, but its effectiveness is still controversial. Mosaic plasty was explored in the 1990s. Using this procedure, we can repair defects with hyaline cartilage, but the donor site morbidity is unsolved. To explore a new method for cartilage repair, we transplanted autologous culture-expanded bone marrow mesenchymal cells into articular cartilage defects. Clinical symptoms were improred but the repair cartilage was not hyaline cartilage. Further improvement is required. Many investigations have been made in the search for better means of repair, including gene transduction and the addition of growth factors during cell culture. In addition to bone marrow mesenchymal cells, synovial cells, adipocytes, muscle cells, etc. have been evaluated.

  14. Management of articular cartilage defects of the knee.

    PubMed

    Bedi, Asheesh; Feeley, Brian T; Williams, Riley J

    2010-04-01

    Articular cartilage has a poor intrinsic capacity for healing. The goal of surgical techniques to repair articular cartilage injuries is to achieve the regeneration of organized hyaline cartilage. Microfracture and other bone marrow stimulation techniques involve penetration of the subchondral plate in order to recruit mesenchymal stem cells into the chondral defect. The formation of a stable clot that fills the lesion is of paramount importance to achieve a successful outcome. Mosaicplasty is a viable option with which to address osteochondral lesions of the knee and offers the advantage of transplanting hyaline cartilage. However, limited graft availability and donor site morbidity are concerns. Transplantation of an osteochondral allograft consisting of intact, viable articular cartilage and its underlying subchondral bone offers the ability to address large osteochondral defects of the knee, including those involving an entire compartment. The primary theoretical advantage of autologous chondrocyte implantation is the development of hyaline-like cartilage rather than fibrocartilage in the defect, which presumably leads to better long-term outcomes and longevity of the healing tissue. Use of synthetic scaffolds is a potentially attractive alternative to traditional cartilage procedures as they are readily available and, unlike allogeneic tissue transplants, are associated with no risk of disease transmission. Their efficacy, however, has not been proven clinically.

  15. Effect of methotrexate on the temporomandibular joint and facial morphology in juvenile rheumatoid arthritis patients.

    PubMed

    Ince, D O; Ince, A; Moore, T L

    2000-07-01

    Juvenile rheumatoid arthritis is a disease characterized by chronic inflammation in one or more joints; it affects children and adolescents up to 18 years of age. This disease may cause significant skeletal joint destruction, and the temporomandibular joint, like other joints, may become severely affected resulting in aberrant mandibular growth, abnormal dentofacial development, and/or altered orofacial muscle function. Methotrexate is the most common remittive agent used in juvenile rheumatoid arthritis to modify the course of inflammatory destruction of peripheral joints. The purpose of this study was: (1) to evaluate the effect of methotrexate therapy on the prevalence of temporomandibular joint lesions and aberration in craniofacial development in children afflicted with juvenile rheumatoid arthritis; (2) to further examine the relationship between the temporomandibular joint/cephalometric findings and rheumatologic data (ie, age at onset, duration of disease); and (3) to evaluate further pauciarticular- and polyarticular-onset disease in juvenile rheumatoid arthritis and the prevalence of temporomandibular joint lesions and facial dysmorphology. The following information was obtained from 45 patients with juvenile rheumatoid arthritis: (1) routine rheumatologic clinical examination data; (2) anamnestic temporomandibular joint evaluation data; (3) clinical temporomandibular joint examination data; (4) lateral cephalometric measurement data; (5) posteroanterior cephalometric measurement data; and (6) individually corrected axial tomographic data. The results demonstrated the following: (1) radiographic evidence of condylar degeneration was apparent in 63% of all patients with juvenile rheumatoid arthritis with pauciarticular patients showing less temporomandibular involvement than polyarticular patients; (2) polyarticular juvenile rheumatoid arthritis patients receiving methotrexate showed less severe temporomandibular joint involvement than the polyarticular

  16. Anxiety and personality traits in patients with muscle related temporomandibular disorders.

    PubMed

    Pallegama, R W; Ranasinghe, A W; Weerasinghe, V S; Sitheeque, M A M

    2005-10-01

    This study tested the hypothesis that muscle related temporomandibular disorder patients with cervical muscle pain exhibit greater degree of psychological distress compared with patients without cervical muscle pain and controls. Thirty-eight muscle related temporomandibular disorder patients including 10 patients with cervical muscle pain and 41 healthy individuals as controls participated in the study. State and trait anxiety levels were assessed with the Spielberger's state and trait anxiety inventory. Personality traits (extroversion, neuroticism, psychoticism and social desirability) were assessed using the Eysenck's personality questionnaire, and the pain intensities described over the muscles were recorded using a 100 mm visual analogue scale. The muscle related temporomandibular disorder patients, in general, exhibited significantly higher degrees of neuroticism and trait anxiety. The patients with cervical muscle pain demonstrated a significantly higher level of psychoticism compared with the patients without cervical muscle pain and the controls and a significantly higher state anxiety level than the controls. They also demonstrated higher pain intensities in masseter and temporalis muscles compared with patients without cervical muscle pain. It has been suggested that either subjects with psychological distress are prone to temporomandibular disorders, or psychological distress is a manifestation of existing chronic pain conditions. The present findings demand further investigations and broader approach in management, as muscle related temporomandibular disorder patients with cervical muscle pain were both physically and psychologically compromised to a greater degree compared with patients without cervical muscle pain. PMID:16159346

  17. The use of surface electromyography as a tool in differentiating temporomandibular disorders from neck disorders.

    PubMed

    Ferrario, Virgilio F; Tartaglia, Gianluca M; Luraghi, Francesca E; Sforza, Chiarella

    2007-11-01

    The aim of this study was to assess the electromyographic characteristics of the masticatory muscles (masseter and temporalis) of patients with either "temporomandibular joint disorder" or "neck pain". Surface electromyography of the right and left masseter and temporalis muscles was performed during maximum teeth clenching in 38 patients aged 21-67 years who had either (a) temporomandibular joint disorder (24 patients); (b) "neck pain" (13 patients). Ninety-five control, healthy subjects were also examined. During clenching, standardized total muscle activities (electromyographic potentials over time) were significantly different in the three groups: 75 microV/microVs% in the temporomandibular joint disorder patients, 124 microV/microVs% in the neck pain patients, and 95 microV/microVs% in the control subjects (analysis of variance, P<0.001). The temporomandibular joint disorder patients also had significantly (P<0.001) more asymmetric muscle potentials (78%) than either neck pain patients (87%) or control subjects (92%). A linear discriminant function analysis allowed a significant separation between the two patient groups, with a single patient error of 18.2%. Surface electromyographic analysis during clenching allowed to differentiate between patients with a temporomandibular joint disorder and patients with a neck pain problem.

  18. En bloc joystick reduction of a comminuted intra-articular distal radius fracture: a technical trick.

    PubMed

    Siegall, Evan; Ziran, Bruce

    2014-08-01

    A patient with a 1-month-old intra-articular distal radius fracture (treated closed in a splint) presented with an unacceptable degree of pain and stiffness caused by shortening and dorsal angulation of the distal radius. The fracture was comminuted with 4 or 5 distinct fragments, several involving the articular surface. Surgical correction was attempted. During the procedure, it was noted that, though the distal radius was shortened and angulated, there was actually acceptable congruity of the articular surface itself, despite the intra-articular nature of the fracture. Bone quality was poor and healing incomplete. Thus, we were concerned the currently congruous articular surface would fall apart with manipulation. Given this situation, we used a unique scaffolding technique with Kirschner wires placed in perpendicular fashion to both hold the articular surface intact and manipulate it en bloc. This technique is a simple way to turn a complex fracture into an easily reduced 2-part fracture.

  19. 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

  20. Intra-articular osteoid osteoma at the femoral trochlea treated with osteochondral autograft transplantation

    PubMed Central

    Leeman, Joshua J; Motamedi, Daria; Wildman-Tobriner, Ben; O’Donnell, Richard J; Link, Thomas M

    2016-01-01

    We present the case of an intra-articular osteoid osteoma at the femoral trochlea. Intra-articular osteoid osteoma can present a diagnostic challenge both clinically and with imaging because it presents differently from the classic cortical osteoid osteoma. Given the lesion’s proximity to overlying cartilage, the patient underwent resection of the lesion with osteochondral autograft transplantation at the surgical defect. A comprehensive literature review and discussion of intra-articular osteoma will be provided. PMID:27761182

  1. Intra-articular haemangioma of the knee in the skeletally immature.

    PubMed

    Wong, Kai Ann; Singh, Vivek Ajit; Pailoor, Jayalakshmi

    2013-11-01

    Intra-articular haemangioma is a rare and uncommon condition that sometimes presents in infants. The lesion can be a diagnostic challenge, with misdiagnosis often leading to delayed diagnosis and treatment. It is essential to establish and treat the condition early, as intra-articular haemangioma can lead to destruction of the joint and secondary arthrosis. Herein, we report the case of a five-year-old boy who presented with intra-articular haemangioma and discuss the management of his condition.

  2. Autologous chondrocyte repair of an articular defect in the humeral head.

    PubMed

    Romeo, Anthony A; Cole, Brian J; Mazzocca, Augustus D; Fox, Jeff A; Freeman, Kevin B; Joy, Edward

    2002-10-01

    Articular cartilage lesions remain a difficult problem for the patient and physician. A variety of procedures and treatments have been proposed to lessen symptoms and restore the articular surface. The knee joint has been the focus of the vast majority of these cartilage restoration procedures. Articular cartilage lesions of the humerus are significantly less common, and their management remains poorly defined. This paper presents a case report of a young athlete with a large full-thickness articular cartilage defect of the proximal humerus and subsequent treatment using autologous chondrocyte implantation.

  3. 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

  4. 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

  5. Condylectomy for temporomandibular joint dysfunction. A survey of seventeen postoperative patients.

    PubMed

    Nelson, C L; Hutton, C E

    1981-04-01

    Seventeen patients were asked to make a subjective evaluation of their condition after having had a mandibular condylectomy performed. Fourteen of seventeen felt that the surgical procedure had cured their symptoms of pain and limitation of motion. Surgical procedures on the temporomandibular joint are valid when there is organic disease of the temporomandibular joint. However, care must be taken to differentiate between organic disease and the so-called myofascial pain dysfunction syndrome, since surgery is considered inappropriate for the myofascial pain dysfunction syndrome. Even in cases of organic joint disease, care must be taken to identify any existing emotional problems that the patient may have. In cases of organic joint disease with strong psychological overtones, surgical intervention alone may not be enough to relieve the patients of their temporomandibular joint symptoms. PMID:6940070

  6. [Inferior hemiarthroplasty of the temporo-mandibular joint with articulated condylar prosthesis type Stryker].

    PubMed

    Bucur, A; Dincă, O; Totan, C; Ghită, V

    2007-01-01

    The optimal reconstruction of the mandible and of the temporo-mandibular joint after mandibular hemi-resection with disarticulation is still controversial in literature. This paperwork presents our experience on four cases in the reconstruction of the mandible together with the inferior arthroplasty of the temporo-mandibular joint, after the resection of extended benign tumors of the mandible, based on fibular free vascularized grafts having attached a Stryker titanium condylar prosthesis reconstructing the inferior segment of the temporo-mandibular joint. Our results for the this technique were excellent, with a functional rehabilitation very close to normal. After reviewing the various techniques and their arguments in literature, with accent on the TMJ reconstruction, we consider this method to be optimal for the reconstruction of mandibular defects in patients with neoplastic conditions.

  7. 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

  8. Effect of Mandibular Advancement Device Therapy on the Signs and Symptoms of Temporomandibular Disorders

    PubMed Central

    Raunio, Antti; Sipilä, Kirsi; Raustia, Aune

    2012-01-01

    ABSTRACT Objectives Mandibular advancement device therapy is effectively used in the treatment of obstructive sleep apnea, but also several side effects in the masticatory system have been reported. The aim of this study was to evaluate the subjective symptoms and clinical signs of temporomandibular disorders connected to mandibular advancement device therapy. Material and Methods The material consisted of 15 patients (9 men and 6 women, mean age 51.1 years, range 21 to 70 years) diagnosed with obstructive sleep apnea (OSA). Subjective symptoms and clinical temporomandibular disorders (TMD) signs were recorded at the beginning of the treatment (baseline) and at 1-month, 3-month, 6-month and 24-month follow-ups. The degree of TMD was assessed using the anamnestic (Ai) and the clinical dysfunction index (Di) of Helkimo. For assessing the effect of TMD the patients were divided in discontinuing and continuing groups. Results According to Ai and Di, the severity of TMD remained unchanged during the follow-up in most of the patients. Temporomandibular joint (TMJ) crepitation was found more frequently in discontinuing patients at all follow-ups. The difference was statistically significant (P < 0.05) at the six-month follow-up. Masticatory muscle pain during palpation was a frequent clinical sign at the baseline and during the follow-up period but the difference between discontinuing and continuing patients was not significant. Conclusions It seems that signs and symptoms of temporomandibular disorders do not necessarily increase during long-term mandibular advancement device therapy. However, it seems that patients with clinically assessed temporomandibular joint crepitation may discontinue their mandibular advancement device therapy due to temporomandibular disorders. PMID:24422023

  9. Elongated styloid process in a temporomandibular disorder sample: prevalence and treatment outcome.

    PubMed

    Zaki, H S; Greco, C M; Rudy, T E; Kubinski, J A

    1996-04-01

    An elongated styloid process is an anatomic anomaly present in 2% to 30% of adults; it is occasionally associated with pain. Its prevalence among patients with classic temporomandibular disorder pain symptoms is unknown. The effect of conservative treatment on patients who have symptoms of temporomandibular disorders and an elongated styloid process is also unknown. The objectives of this study were to determine the prevalence of the elongated styloid process in a sample of patients with temporomandibular disorders and to compare patients with and without the elongated styloid process on initial presenting signs and symptoms and treatment outcome. A total of 100 panoramic radiographs of patients with symptomatic temporomandibular disorders were examined to ascertain the presence or absence of an elongated styloid process. All patients participated in a conservative treatment program of biofeedback and stress management and a flat-plane intraoral appliance. Initial symptoms and treatment outcome of patients with and without an elongated styloid process were compared by use of multivariate analysis of variance on several oral-paraoral and psychosocial-behavioral methods. The prevalence of an elongated styloid process in this clinic sample of temporomandibular disorders was 27%. The patients with or without an elongated styloid process were not significantly different in pretreatment symptoms, and both groups exhibited substantial treatment gains. However, patients with an elongated styloid process showed significantly less improvement on unassisted mandibular opening without pain than did patients who did not have an elongated styloid process. This suggests that an elongated styloid process may place structural limitations on pain-free maximum mandibular opening. The results support conservative management of patients with symptoms of temporomandibular disorders when an elongated styloid process is present.

  10. Isometric exercises and a simple appliance for temporomandibular joint dysfunction: a case report.

    PubMed

    Santiesteban, A J

    1989-06-01

    This case report presents a treatment approach for a patient with temporomandibular joint (TMJ) dysfunction signs and symptoms. Temporomandibular joint pain, jaw clicking and locking, and postural abnormalities were treated with gentle isometric (static) exercises, coordination exercises, and an easily fitted and readily available appliance. After treatment, the patient showed reduced TMJ pain, no jaw locking, and improved TMJ mobility. The patient also showed improved postural awareness. The results of treatment and the relatively minor cost of the appliance make the sharing of this case study potentially worthwhile for those clinicians treating patients with TMJ dysfunction. PMID:2727070

  11. The current role and the future of minimally invasive temporomandibular joint surgery.

    PubMed

    González-García, Raúl

    2015-02-01

    Several open surgeries have been proposed for the treatment of internal derangement (ID) of the temporomandibular joint (TMJ), although minimally invasive temporomandibular joint surgery (MITMJS) plays a major role in the treatment of ID and has been widely used for the treatment of ID of the TMJ. Arthrocentesis, arthroscopic lysis and lavage, and operative or advanced arthroscopy are the 3 most relevant techniques for MITMJS; clear indications for their application and a detailed description of each technique are presented. Also, clinical outcomes for each technique from the most relevant studies in the literature are reported.

  12. [The para-clinic investigation of temporo-mandibular joint changes in patients with acromegaly].

    PubMed

    Morăraşu, C; Burlui, V; Olaru, C; Boza, C; Bortă, C; Morăraşu, G; Brînză, M

    2001-01-01

    The Acromegaly is an endocrinological disease determined by the hypersecretion of STH in a certain period of the body evolution and it causes the hypertrophy of bones in general and of mandible and cranio-facial bones, determining a disorder due to this development of bones, associated with troubles in the activity of muscles and of the phospho-calcium metabolism. This study was made on a group of 33 acromegaly patients. Their temporo-mandibular joint was investigated by ortopantomography, tomography, computer tomography and scintigraphy. All of these exams shows the changes in temporo-mandibular joint due to the cells hyperactivity determined by the hypersecretion of STH. PMID:12092142

  13. Magnetic resonance imaging of the temporo-mandibular joint and meniscus dislocation.

    PubMed

    Avrahami, E; Schreiber, R; Benmair, J; Paltiel, Z; Machtey, J; Horowitz, I

    1986-12-01

    A preliminary study of the temporo-mandibular joint (TMJ) by magnetic resonance imaging (MRI) was performed. Ten asymptomatic volunteers with no clinical history of TMJ disorder and five patients with a recent history of trauma to the TMJ were examined using a special surface coil. The meniscus, which is only slightly brighter than the surrounding tissue, gave a high signal and was demonstrated very clearly in its normal position in the controls and shown to be dislocated in the post-trauma cases. Four criteria for identification of the temporo-mandibular meniscus were established in the normal cases and compared with the findings in the pathological cases.

  14. 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.

  15. [The para-clinic investigation of temporo-mandibular joint changes in patients with acromegaly].

    PubMed

    Morăraşu, C; Burlui, V; Olaru, C; Boza, C; Bortă, C; Morăraşu, G; Brînză, M

    2001-01-01

    The Acromegaly is an endocrinological disease determined by the hypersecretion of STH in a certain period of the body evolution and it causes the hypertrophy of bones in general and of mandible and cranio-facial bones, determining a disorder due to this development of bones, associated with troubles in the activity of muscles and of the phospho-calcium metabolism. This study was made on a group of 33 acromegaly patients. Their temporo-mandibular joint was investigated by ortopantomography, tomography, computer tomography and scintigraphy. All of these exams shows the changes in temporo-mandibular joint due to the cells hyperactivity determined by the hypersecretion of STH.

  16. Orthognathic surgery in the presence of temporomandibular dysfunction: what happens next?

    PubMed

    Nadershah, Mohammed; Mehra, Pushkar

    2015-02-01

    One of the most well-known yet perhaps controversial conditions affecting temporomandibular dysfunction (TMD) and the signs and symptoms of facial pain and clinical outcomes after orthognathic surgery procedures is temporomandibular joint internal derangement. This article provides an overview of the mutual relationship between orthognathic surgery and TMD, with especial consideration to internal derangement. The existing literature is reviewed and analyzed and the pertinent findings are summarized. The objective is to guide oral and maxillofacial surgeons in their clinical decision making when contemplating orthognathic surgery in patients with preexisting TMD.

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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.

  2. Nasopharyngeal carcinoma mimicking a temporomandibular disorder: a case report.

    PubMed

    Reiter, Shoshana; Gavish, Anat; Winocur, Ephraim; Emodi-Perlman, Alona; Eli, Ilana

    2006-01-01

    Patients referred from an otorhinolaryngologist with a chief complaint of earache or other ear symptoms are common in a temporomandibular disorders (TMD) clinic. These patients often complain of other symptoms, such as headache, facial pain, and limited mouth opening, all of which can be present in a patient suffering from a nasopharyngeal carcinoma (NPC). The aim of this case report was to describe the signs and symptoms of NPC and discuss possible causes for the misdiagnosis of NPC as TMD. The characteristics of 8 NPC patients reported in the literature whose cancer was initially misdiagnosed as TMD and those of an NPC patient with TMD-like symptoms treated at the clinic of 1 of the authors are described, and the reasons for misdiagnosis are discussed. A revision of Trotter's syndrome for the differential diagnosis of TMD is proposed. There is a need for detailed exclusion criteria to be applied prior to the assignment of a clinical diagnosis based on the Research Diagnostic Criteria for TMD.

  3. 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.

  4. 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

  5. Research Diagnostic Criteria for Temporomandibular Disorders: Future Directions

    PubMed Central

    Anderson, Gary C.; Gonzalez, Yoly M.; Ohrbach, Richard; Truelove, Edmond L.; Sommers, Earl; Look, John O.; Schiffman, Eric L.

    2011-01-01

    The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Validation Project provided the first comprehensive assessment of reliability and validity of the original Axis I and II. In addition, Axis I of the RDC/TMD was revised with estimates of reliability and validity. These findings are reported in previous papers. Further revisions for Axis I and II are presented for consideration by the TMD research and clinical communities. Potential Axis I revisions include addressing concerns with orofacial pain differential diagnosis and changes in nomenclature in an attempt to provide improved consistency with other musculoskeletal diagnostic systems. In addition, expansion of the RDC/TMD to include the less common TMD conditions and disorders would make it more comprehensive and clinically useful. The original standards for diagnostic sensitivity (≤0.70) and specificity (≤0.95) should be reconsidered to reflect changes in the field since the RDC/TMD was published in 1992. Pertaining to Axis II, current recommendations for all chronic pain conditions include standardized instruments and expansion of the domains assessed. In addition there is need for improved clinical efficiency of Axis II instruments and exploring methods to better integrate Axis I and II in clinical settings. To that end, this paper recommends an international symposium to provide future direction. PMID:20213033

  6. Incidental findings on MRI of the temporomandibular joint

    PubMed Central

    Makdissi, J; Pawar, R R; Radon, M; Holmes, S B

    2013-01-01

    Objectives: The aim of this study was to determine the prevalence of incidental findings in MRI of the temporomandibular joint (TMJ). Methods: MRI reports of 730 patients were assessed. The reports were analysed by one consultant and one clinical lecturer in dental and maxillofacial radiology. The prevalence of intracranial and extracranial incidental findings was recorded and categorized. Results: There were 53 (7.3%) incidental findings, of which 11 (1.5%) were intracranial and 42 (5.7%) were extracranial (divided into paranasal sinuses, mastoid air cells, muscle hypertrophy, lymphadenopathy and salivary glands). A total number of eight intracranial findings needed further dedicated imaging and/or specialist clinical opinion. Only one tumour (a meningioma) was found and required surgical intervention. Conclusions: Incidental findings on TMJ MRI are rare but not unheard of. The clinical relevance of incidental findings can be significant, and it is therefore important to ensure that the full data set of images is inspected, including any scout slices. A close working relationship between the areas of dental and maxillofacial radiology and neuroradiology is essential in expediting a second opinion relating to intracranial findings. All incidental findings should be communicated to referring clinicians in a timely manner, based on their urgency and clinical significance. PMID:24005059

  7. An association between temporomandibular disorder and gum chewing.

    PubMed

    Correia, Diana; Real Dias, Maria Carlos; Castanho Moacho, Antonio; Crispim, Pedro; Luis, Henrique; Oliveira, Miguel; Carames, Joao

    2014-01-01

    This single center, randomized, small study sought to investigate the prevalence and frequency of chewing gum consumption, and whether there is a relationship between these factors and the presence of symptoms associated with temporomandibular disorder (TMD). Subjects were divided into 7 groups based on their parafunctional oral habits. Of these, subjects who chewed gum were divided into 5 subgroups (A-E) based on their gum chewing habits. Group A chewed gum <1 hour/day (n = 12), Group B chewed gum 1-2 hours/day (n = 11), Group C chewed gum 3 hours/day (n = 6), and Group D chewed gum >3 hours at a time (n = 8); the frequency of gum chewing in Groups A-D was once a week. Group E subjects chewed gum 1-3 times/week for at least 1 hour each occurrence (n = 2). Sixty-three percent of the subjects in Group D reported TMD symptoms of arthralgia and myofascial pain. Thirty-three percent of the subjects in Group C showed symptoms of arthralgia. Eighty-three percent of the subjects in Group A and 27% in Group B reported myofascial pain. All subjects in Group E reported masseter hypertrophy. The remaining 2 groups were Group F, subjects that didn't chew gum but had other parafunctional oral habits (n = 2), and Group G, subjects who didn't have parafunctional oral habits (n = 12).

  8. An interspecies comparison of the temporomandibular joint disc.

    PubMed

    Kalpakci, K N; Willard, V P; Wong, M E; Athanasiou, K A

    2011-02-01

    The temporomandibular joint (TMJ) disc plays a critical role in normal function of the joint, and many disorders of the TMJ are a result of disc dysfunction. Previous quantitative TMJ characterization studies examined either the human or a specific animal model, but no single study has compared different species, in the belief that differences in joint morphology, function, and diet would be reflected in the material properties of the disc. In this study, we examined topographical biochemical (collagen, glycosaminoglycan, and DNA content) and biomechanical (tensile and compressive) properties of the human TMJ disc, and also discs from the cow, goat, pig, and rabbit. Regional and interspecies variations were identified in all parameters measured, and certain disc characteristics were observed across all species, such as a weak intermediate zone under mediolateral tension. While human discs possessed properties distinct from those of the other species, pig discs were most similar to the human, suggesting that the pig may be a suitable animal model for TMJ bioengineering efforts.

  9. Impaired orofacial motor functions on chronic temporomandibular disorders.

    PubMed

    Ferreira, Cláudia Lúcia Pimenta; Machado, Bárbara Cristina Zanandréa; Borges, Carina Giovana Pissinatti; Rodrigues Da Silva, Marco Antonio M; Sforza, Chiarella; De Felício, Cláudia Maria

    2014-08-01

    Because temporomandibular disorders (TMDs) rehabilitation continues to be a challenge, a more comprehensive picture of the orofacial functions in patients with chronic pain is required. This study assessed the orofacial functions, including surface electromyography (EMG) of dynamic rhythmic activities, in patients with moderate-severe signs and symptoms of chronic TMD. It was hypothesized that orofacial motor control differs between patients with moderate-severe chronic TMD and healthy subjects. Seventy-six subjects (46 with TMD and 30 control) answered questionnaires of severity of TMD and chewing difficulties. Orofacial functions and EMG during chewing were assessed. Standardized EMG indices were obtained by quantitative analysis of the differential EMG signals of the paired masseter and temporal muscles, and used to describe muscular action during chewing. TMD patients showed significant greater difficulty in chewing; worse orofacial scores; longer time for free mastication; a less accurate recruitment of the muscles on the working and balancing sides, reduced symmetrical mastication index (SMI) and increased standardized activity during EMG test than healthy subjects. SMI, TMD severity and orofacial myofunctional scores were correlated (P<0.01). Impaired orofacial functions and increased activity of the muscles of balancing sides during unilateral chewing characterized the altered orofacial motor control in patients with moderate-severe chronic TMD. Implications for rehabilitation are discussed.

  10. 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

  11. 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

  12. Orthodontic risk factors for temporomandibular disorders (TMD). I: Premolar extractions.

    PubMed

    Kremenak, C R; Kinser, D D; Harman, H A; Menard, C C; Jakobsen, J R

    1992-01-01

    Concern about claims that premolar extractions may put patients at risk for temporomandibular disorders (TMD) led to this study. We report first findings from a longitudinal study of orthodontic patients begun in 1983. By using the methods of Helkimo, we collected TMD data before initiation of orthodontic treatment, between 0 and 12 months after debanding, and 12 to 24 months after debanding. Analyses related Helkimo scores with premolar extractions in 65 patients for whom orthodontic treatment had been completed. Twenty-six patients were treated without premolar extractions, 25 had four premolars extracted, and 14 had two upper premolars extracted. Tests for significance of differences between mean Helkimo scores were conducted for the nonextraction group compared with the extraction groups, and between pretreatment and posttreatment Helkimo scores for each group. Results included: (1) no significant intergroup differences between mean pretreatment or posttreatment scores, and (2) small but statistically significant (p less than 0.05) differences (in the direction of improvement) between mean pretreatment and posttreatment scores for both the nonextraction group and for the four premolar extraction group.

  13. Orthodontics as a risk factor for temporomandibular disorders (TMD). II.

    PubMed

    Kremenak, C R; Kinser, D D; Melcher, T J; Wright, G R; Harrison, S D; Ziaja, R R; Harman, H A; Ordahl, J N; Demro, J G; Menard, C C

    1992-01-01

    Debate about orthodontic treatment as a risk factor for temporomandibular disorders (TMD) led to this study. This report, the second in a series, concerns findings from a longitudinal study in which 30 new orthodontic patients have been enrolled annually since 1983. The method of Helkimo was used to collect TMD data before initiation of orthodontic treatment, and at annual intervals after debanding. Treatment was by fixed edgewise appliances. Data from a pretreatment and at least one posttreatment Helkimo examination were available for 109 patients. Follow-up data were available for 92 patients in the first year after debanding, with the corresponding sample sizes declining to 56, 33, 19, 11, and 7 for the second through the sixth posttreatment years, respectively. Primary analyses involved comparison of mean scores from the Helkimo 25-point dysfunction index scale. There were no significant differences between mean pretreatment and posttreatment Helkimo scores for any of the various groupings except for small, clinically unimportant improvements seen in the 12 to 24 month subgroup of 55 patients and in the 48 to 60 month subgroup of 11 patients. With average follow-up time of about 2 years for the 109 patients, 90% had Helkimo scores that stayed the same or improved, and 10% had scores that increased or worsened from 2 to 5 Helkimo points. We conclude that the orthodontic treatment experienced by our sample was not an important etiologic factor for TMD.

  14. Occlusal effects on longitudinal bone alterations of the temporomandibular joint.

    PubMed

    Zhang, J; Jiao, K; Zhang, M; Zhou, T; Liu, X-D; Yu, S-B; Lu, L; Jing, L; Yang, T; Zhang, Y; Chen, D; Wang, M-Q

    2013-03-01

    The pathological changes of subchondral bone during osteoarthritis (OA) development in the temporomandibular joint (TMJ) are poorly understood. In the present study, we investigated the longitudinal alterations of subchondral bone using a rat TMJ-OA model developed in our laboratory. Changes in bone mass were examined by micro-CT, and changes in osteoblast and osteoclast activities were analyzed by real-time PCR, immunohistochemistry, and TRAP staining. Subchondral bone loss was detected from 8 weeks after dental occlusion alteration and reached the maximum at 12 weeks, followed by a repair phase until 32 weeks. Although bone mass increased at late stages, poor mechanical structure and lower bone mineral density (BMD) were found in these rats. The numbers of TRAP-positive cells were increased at 12 weeks, while the numbers of osteocalcin-expressing cells were increased at both 12 and 32 weeks. Levels of mRNA expression of TRAP and cathepsin K were increased at 12 weeks, while levels of ALP and osteocalcin were increased at both 12 and 32 weeks. These findings demonstrated that there is an active bone remodeling in subchondral bone in TMJs in response to alteration in occlusion, although new bone was formed with lower BMD and poor mechanical properties. PMID:23340211

  15. Temporomandibular joint ankylosis contributing to coronoid process hyperplasia.

    PubMed

    Wang, W H; Xu, B; Zhang, B J; Lou, H Q

    2016-10-01

    The purpose of this study was to investigate the association between coronoid process hyperplasia and temporomandibular joint (TMJ) ankylosis and to analyze the pathological mechanism and clinical significance of coronoid process hyperplasia. Forty-four patients treated for TMJ ankylosis between January 2007 and December 2014 were studied retrospectively; 176 patients with normal TMJs served as controls. The original DICOM data were used to reconstruct the jaw, and a three-dimensional cephalometric analysis (SimPlant Pro software version 11.04) was performed to assess the association between the severity of TMJ ankylosis and the height of the coronoid process. The height of the coronoid process was 20.41±5.00mm in the case group and 14.86±2.67mm in the control group; there was a significant difference between the two groups (P<0.001). Long-standing TMJ ankylosis contributes to coronoid process hyperplasia. Therefore, attention should be drawn to the coronoid process in patients with TMJ ankylosis. A coronoidectomy together with arthroplasty is recommended in patients with TMJ ankylosis.

  16. Calcium pyrophosphate deposition disease of the temporomandibular joint.

    PubMed

    Srinivasan, Vasisht; Wensel, Andrew; Dutcher, Paul; Newlands, Shawn; Johnson, Mahlon; Vates, George Edward

    2012-10-01

    Calcium pyrophosphate dihydrate deposition disease (CPDD, tophaceous pseudogout) is a rare crystal arthropathy characterized by calcium pyrophosphate crystal deposition in joint spaces, episodes of synovitis, and radiological features of chondrocalcinosis. We present a case of 61-year-old woman who presented with left temporomandibular joint (TMJ) pain, difficulty chewing, left facial numbness, left-sided hearing loss, and left TMJ swelling. Imaging of the temporal fossa revealed a large mass emanating from the temporal bone at the TMJ, extending into the greater wing of the sphenoid and involving the mastoid bone and air cells posteriorly. Fine needle aspiration demonstrated polarizable crystals with giant cells. Intraoperatively, the TMJ was completely eroded by the mass. Final pathology was consistent with tophaceous pseudogout. CPDD has rarely been reported involving the skull base. None of the cases originally described by McCarty had TMJ pseudogout. Symptoms are generally pain, swelling, and hearing loss. Management is nearly always surgical with many patients achieving symptomatic relief with resection. CPDD is associated with many medical problems (including renal failure, gout, and hyperparathyroidism), but our patient had none of these risk factors. This case demonstrates that CPDD can involve the skull base and is best treated with skull base surgical techniques.

  17. 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

  18. 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

  19. 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.

  20. Gene Mutations Associated with Temporomandibular Joint Disorders: A Systematic Review

    PubMed Central

    Sangani, Dhruvee; Suzuki, Akiko; VonVille, Helena; Hixson, James E.

    2016-01-01

    Background The temporomandibular joint (TMJ) is a bilateral synovial joint between the mandible and the temporal bone of the skull. TMJ disorders (TMDs) are a set of complicated and poorly understood clinical conditions, in which TMDs are associated with a number of symptoms including pain and limited jaw movement. The increasing scientific evidence suggests that genetic factors play a significant role in the pathology of TMDs. However, the underlying mechanism of TMDs remains largely unknown. Objective The study aimed to determine the associated genes to TMDs in humans and animals. Methods The literature search was conducted through databases including Medline (Ovid), EMBASE (Ovid), and PubMed (NLM) by using scientific terms for TMDs and genetics in March 2015. Additional studies were identified by searching bibliographies of highly relevant articles and Scopus (Elsevier). Results Our systematic analyses identified 31 articles through literature searches. A total of 112 genes were identified to be significantly and specifically associated with TMDs. Conclusion Our systematic review provides a list of accurate genes associated with TMDs and suggests a genetic contribution to the pathology of TMDs. PMID:27695703

  1. 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

  2. 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

  3. 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

  4. Biochemical composition of the superficial layer of articular cartilage.

    PubMed

    Crockett, R; Grubelnik, A; Roos, S; Dora, C; Born, W; Troxler, H

    2007-09-15

    To gain more information on the mechanism of lubrication in articular joints, the superficial layer of bovine articular cartilage was mechanically removed in a sheet of ice that formed on freezing the cartilage. Freeze-dried samples contained low concentrations of chondroitin sulphate and protein. Analysis of the protein by SDS PAGE showed that the composition of the sample was comparable to that of synovial fluid (SF). Attenuated total reflection infrared (ATR-IR) spectroscopy of the dried residue indicated that the sample contained mostly hyaluronan. Moreover, ATR-IR spectroscopy of the upper layer of the superficial layer, adsorbed onto silicon, showed the presence of phospholipids. A gel could be formed by mixing hyaluronan and phosphatidylcholine in water with mechanical properties similar to those of the superficial layer on cartilage. Much like the superficial layer of natural cartilage, the surface of this gel became hydrophobic on drying out. Thus, it is proposed that the superficial layer forms from hyaluronan and phospholipids, which associate by hydrophobic interactions between the alkyl chains of the phospholipids and the hydrophobic faces of the disaccharide units in hyaluronan. This layer is permeable to material from the SF and the cartilage, as shown by the presence of SF proteins and chondroitin sulphate. As the cartilage dries out after removal from the joint, the phospholipids migrate towards the surface of the superficial layer to reduce the surface tension. It is also proposed that the highly efficient lubrication in articular joints can, at least in part, be attributed to the ability of the superficial layer to adsorb and hold water on the cartilage surface, thus creating a highly viscous boundary protection.

  5. [Symptomatic and evolutive characteristics of articular destruction noted in chondrocalcinosis].

    PubMed

    Villiaumey, J; Larget-Piet, B; Menza, C D; Rotterdam, M

    1975-04-01

    Referring to 17 personal observations, the authors endeavour to clarify the main clinical and radiological traits of the destructive arthropathies occuring in patients suffering from diffuse, articular chondrocalcinosis. These arthropathies appear to be relatively frequent and older, obese women suffering from demineralization are more readily affected. The knees, coxo-femoral joints and the shoulders are principally concerned, and to a lesser extent the wrists, the trapezo-metacarpal joints and even the spine. The lesions can be polyarticular and symmetrical, be grouped in more or less random oligoarticular combinations or may occur in only a single joint space. Clinically, these destructive arthropathies give rise to severe pain and very marked functional impotence. The joints are swollen without any signs of inflammation. The joint movements are painful, stiff, and limited. Axial deviations are frequent. Radiologically, the lesions occur throughout the cartilage sheath, the inter-chondrial bone, and in the underlying epiphysary bone, in the form of massive geodes and massives loss of tissue substance. On the other hand, the process of reconstruction is very limited. In the patients studied, chondrocalcinosis was proved by the very characteristic pictures of calcic incrustations of the cartilage sheath and the fibro-cartilages, by the discovery of micro-crystals of calcium pyrophosphate in the articular fluid or, at biopsy, by the thickness of the synovial fluid. This chondrocalcinosis was primary in the cases. These destructive lesions were easily distinguishable from nervous or diabetic osteo-arthropathies, and from tumoral, infectious, rheumatic, or vascular changes. Thus, chondrocalcinosis is among the most common causes of osteo-articular destruction. It should be looked for systematically in all patients with lytic arthropathies of unknown etiology.

  6. 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

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

    PubMed

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

    2016-04-01

    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 Ca(2+) 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

  8. 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

  9. 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

  10. 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

  11. Biochemical effects of estrogen on articular cartilage in ovariectomized sheep.

    PubMed

    Turner, A S; Athanasiou, K A; Zhu, C F; Alvis, M R; Bryant, H U

    1997-01-01

    Cartilage is a sex-hormone-sensitive tissue but the role of estrogen in the pathogenesis of osteoarthritis (OA) remains controversial. In this study, intrinsic material properties and thickness of articular cartilage of the knee joint of ovariectomized (OVX) and estrogen-treated sheep were measured. Skeletally mature ewes (N = 36, same breed, same housing 4-5 years old) were divided into; sham treated (n = 9), OVX (N = 13), OVX plus one estradiol implant (OVXE; N = 10) and OVX plus two estradiol implants (OVX2E; N = 4). Twelve months following sham procedure or OVX, sheep were euthanized and articular cartilage from a total of 216 points in the left femorotibial (knee) joints was tested for aggregate modulus, Poisson's ratio, permeability, thickness and shear modulus (six sites per sheep). When all of the sites in each knee were grouped together, OVX had a significant effect on articular cartilage. The sham cartilage of all sites grouped together had a larger aggregate modulus (P = 0.001) and a larger shear modulus (P = 0.054) than the OVX tissue. No statistically significant differences were seen for permeability and thickness between OVX, sham, OVXE and OVX2E. Differences existed in biomechanical properties at the different sites that were tested. Overall, no one location tended to be lowest or highest for all variables. This biomechanical study suggests that OVX may have a detrimental effect on the intrinsic material properties of the articular cartilage of the knee, even though the cartilage of the OVX animals appeared normal. Treatment with estradiol implants ameliorated these deleterious effects and may have helped maintain the tissue's structural integrity. Our study supports epidemiological studies of OA in women after menopause. The protective effect of estrogen and it's therapeutic effect remain to be further defined. This model may allow the relationship of estrogen and estrogen antagonists to be studied in greater detail, and may be valuable for the

  12. 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

  13. 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

  14. [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

  15. Temporomandibular joint osteoarthritis and crystal deposition diseases: a study of crystals in synovial fluid lavages in osteoarthritic temporomandibular joints.

    PubMed

    Dijkgraaf, L C; Liem, R S; de Bont, L G

    1998-08-01

    To study the presence of crystals in synovial fluid lavages of osteoarthritic temporomandibular joints (TMJs), in order to evaluate the possible role of these crystals in the osteoarthritic (OA) process, synovial fluid lavage samples of the upper joint compartment from 44 TMJs were obtained prior to arthroscopy. The OA group consisted of 32 TMJs. The control group consisted of 12 TMJs that had been diagnosed with other nonosteoarthritic conditions. The lavage samples were analysed as wet preparations, unstained and stained, with ordinary light, polarized light and compensated polarized light for the presence of crystals and white blood cells. One sample was prepared for subsequent electron microscopic (EM) examination. Synovial fluid lavage analysis of osteoarthritic TMJs did not show any monosodium urate monohydrate or calcium pyrophosphate dihydrate crystals. However, in three lavages, particles which possibly contained calcium were identified with alizarin red S staining. White blood cells were occasionally seen. Synovial fluid analysis of the lavages of the control TMJs did not reveal any crystals. EM examination of synovial fluid lavage from an osteoarthritic TMJ failed to clearly show crystal formation. Concurrence of TMJ crystal deposition and OA appears less prominent than in other synovial joints. We conclude that crystals probably do not play an important role in TMJ OA. PMID:9698172

  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. Pseudomonas aeruginosa septic arthritis of knee after intra-articular ozone injection.

    PubMed

    Seyman, Derya; Ozen, Nevgun Sepin; Inan, Dilara; Ongut, Gozde; Ogunc, Dilara

    2012-07-01

    We describe a case of septic arthritis caused by Pseudomonas aeruginosa in an immunocompetent patient following intra-articular ozone injection into the knee. To the best of our knowledge, and after considering the current literature,we believe this case is unique as no other reports of septic arthritis caused by P. aeruginosa following intra-articular ozone injection has been made.

  18. [Systematization of the articular surfaces of the carpometacarpal joints (author's transl)].

    PubMed

    el Bacha, A; Maillot, C

    1977-01-01

    A study, done on 100 hands, of the systematization of the articular surfaces of the carpometacarpal joints, clearly delineates the variability of circumference, dimesions, and relief of the articular facets. An attempt to draw general conclusions from this morphological study, in terms of arthrokinetics, leads to an understanding of the nature of the joints and the movements that are performed at this site.

  19. [Myoarthropathy of the temporomandibular joint and masticatory muscles. Pain therapy management and relaxation instead of aggressive surgery].

    PubMed

    Türp, J C

    2003-05-01

    Temporomandibular pain is often characterized by a mismatch between symptoms and findings. The dentist's well-established therapeutic strategies for the management of acute pain are therefore frequently not effective in patients with painful temporomandibular disorders (TMD). Instead, dentists should apply the tried and tested principles that are applied in general medicine to the diagnosis and treatment of musculoskeletal pain (e.g. arthritic pain or fibromyalgia). When consulted by patients with rheumatic diseases, physicians should routinely enquire whether they also experience temporomandibular pain.

  20. 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

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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.

  6. Articular to diaphyseal proportions of human and great ape metatarsals.

    PubMed

    Marchi, Damiano

    2010-10-01

    This study proposes a new way to use metatarsals to identify locomotor behavior of fossil hominins. Metatarsal head articular dimensions and diaphyseal strength in a sample of chimpanzees, gorillas, orangutans, and humans (n = 76) are used to explore the relationships of these parameters with different locomotor modes. Results show that ratios between metatarsal head articular proportions and diaphyseal strength of the hallucal and fifth metatarsal discriminate among extant great apes and humans based on their different locomotor modes. In particular, the hallucal and fifth metatarsal characteristics of humans are functionally related to the different ranges of motion and load patterns during stance phase in the forefoot of humans in bipedal locomotion. This method may be applicable to isolated fossil hominin metatarsals to provide new information relevant to debates regarding the evolution of human bipedal locomotion. The second to fourth metatarsals are not useful in distinguishing among hominoids. Further studies should concentrate on measuring other important qualitative and quantitative differences in the shape of the metatarsal head of hominoids that are not reflected in simple geometric reconstructions of the articulation, and gathering more forefoot kinematic data on great apes to better understand differences in range of motion and loading patterns of the metatarsals.

  7. 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

  8. 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.

  9. 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

  10. 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

  11. 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

  12. Non-linear model for compression tests on articular cartilage.

    PubMed

    Grillo, Alfio; Guaily, Amr; Giverso, Chiara; Federico, Salvatore

    2015-07-01

    Hydrated soft tissues, such as articular cartilage, are often modeled as biphasic systems with individually incompressible solid and fluid phases, and biphasic models are employed to fit experimental data in order to determine the mechanical and hydraulic properties of the tissues. Two of the most common experimental setups are confined and unconfined compression. Analytical solutions exist for the unconfined case with the linear, isotropic, homogeneous model of articular cartilage, and for the confined case with the non-linear, isotropic, homogeneous model. The aim of this contribution is to provide an easily implementable numerical tool to determine a solution to the governing differential equations of (homogeneous and isotropic) unconfined and (inhomogeneous and isotropic) confined compression under large deformations. The large-deformation governing equations are reduced to equivalent diffusive equations, which are then solved by means of finite difference (FD) methods. The solution strategy proposed here could be used to generate benchmark tests for validating complex user-defined material models within finite element (FE) implementations, and for determining the tissue's mechanical and hydraulic properties from experimental data.

  13. 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

  14. Experience with carprofen in extra-articular inflammatory processes.

    PubMed

    Gotter, G

    1982-01-01

    Carprofen is a new non-steroidal compound with analgesic, anti-inflammatory and anti-pyretic properties. Eighty patients with different types of extra-articular inflammatory processes such as periarthritis humero-scapularis, tendinitis, bursitis, etc., were studied by means of two double-blind protocol designs comparing carprofen 150 and 300 mg daily, either as a b.i.d. or a t.i.d. administration, for two weeks. The criteria to determine the therapeutic properties of the compound was based on the improvement of spontaneous pain, pain with movement and functional limitation. Evolution of symptoms showed that either 150 or 300 mg carprofen administered as a b.i.d. schedule, were equally effective (chi 2 test between groups was not significant). According to a t.i.d. schedule results were better with 300 mg. General tolerance was excellent and only 15% of the patients receiving 300 mg complained of side-effects, such as nausea, mild dermatitis, acidity and insomnia. In conclusion, carprofen 150 or 300 mg has a good therapeutical activity in extra-articular inflammatory processes, employing either a b.i.d. or a t.i.d. schedule. PMID:6983966

  15. 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

  16. A Semi-Degradable Composite Scaffold for Articular Cartilage Defects

    PubMed Central

    Scholten, Paul M.; Ng, Kenneth W.; Joh, Kiwon; Serino, Lorenzo P.; Warren, Russell F.; Torzilli, Peter A.; Maher, Suzanne A.

    2010-01-01

    Few options exist to replace or repair damaged articular cartilage. The optimal solution that has been suggested is a scaffold that can carry load and integrate with surrounding tissues; but such a construct has thus far been elusive. The objectives of this study were to manufacture and characterize a non-degradable hydrated scaffold. Our hypothesis was that the polymer content of the scaffold can be used to control its mechanical properties, while an internal porous network augmented with biological agents can facilitate integration with the host tissue. Using a two-step water-in-oil emulsion process a porous poly-vinyl alcohol (PVA) hydrogel scaffold combined with alginate microspheres was manufactured. The scaffold had a porosity of 11–30% with pore diameters of 107–187 μm, which readily allowed for movement of cells through the scaffold. Alginate microparticles were evenly distributed through the scaffold and allowed for the slow release of biological factors. The elastic modulus (Es) and Poisson’s ratio (υ), Aggregate modulus (Ha) and dynamic modulus (ED) of the scaffold were significantly affected by % PVA, as it varied from 10% to 20% wt/vol. Es and υ were similar to that of articular cartilage for both polymer concentrations, while Ha and ED were similar to that of cartilage only at 20% PVA. The ability to control scaffold mechanical properties, while facilitating cellular migration suggest that this scaffold is a potentially viable candidate for the functional replacement of cartilage defects. PMID:21308980

  17. Role of NMDA receptors in the trigeminal pathway, and the modulatory effect of magnesium in a model of rat temporomandibular joint arthritis.

    PubMed

    Cavalcante, André L C; Siqueira, Rafaelly M P; Araujo, Joana C B; Gondim, Delane V; Ribeiro, Ronaldo A; Quetz, Josiane S; Havt, Alexandre; Lima, Aldo A M; Vale, Mariana L

    2013-12-01

    Temporomandibular joint (TMJ) arthritis is a common cause of orofacial pain. In the present study, the modulatory effects of N-methyl-d-aspartate receptors (NMDA-Rs) and magnesium were investigated in TMJ arthritis hypernociception. Male Wistar rats received an intra-articular injection of carrageenan (Cg) in the TMJ, and mechanical hypernociception was measured. The NMDA-R antagonist, MK-801, and magnesium chloride (MgCl₂ ) were administered before arthritis induction. Magnesium deficiency was promoted by feeding rats a synthetic magnesium-free diet for 9 d before injection of Cg. The Cg induced mechanical hypernociception that lasted for 120 h. MK-801 inhibited this hypernociceptive state. MgCl₂ pretreatment prevented Cg-induced hypernociception and altered the nociceptive threshold in the absence of Cg. Magnesium deficiency increased hypernociception and induced spontaneous hypernociceptive behavior. TMJ arthritis increased the expression of mRNA for all NMDA-R subunits and immunostaining of phosphorylated NR1 (phospho-NR1). MgCl₂ inhibited expression of NR2B mRNA and phospho-NR1 immunostaining and increased expression of NR3 mRNA. Magnesium deficiency increased expression of both NR1 and NR3 mRNAs and phospho-NR1 immunostaining in the trigeminal subnucleus caudalis. We found that magnesium modulates nociceptive behavior and induces NMDA-R subunit rearrangement in the subnucleus caudalis. The present results may lead to a better understanding of central processing in the nociceptive trigeminal pathway and the development of new approaches to treat orofacial pain with a TMJ origin.

  18. 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

  19. Mandibular condylectomy in a cow with a chronic luxation of the temporomandibular joint

    PubMed Central

    Sparks, Holly D.; Roquet, Imma; MacKay, Angela; Barber, Spencer

    2014-01-01

    A cow, presented after being struck by a motor vehicle, continued to have difficulty eating after mandibular fracture repair. Imaging showed a temporomandibular luxation and a mandibular condylectomy was performed. Mastication improved greatly but the cow was euthanized due to infection. This is the first report of mandibular condylectomy in cattle. PMID:24891643

  20. 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)

  1. Mandibular condylectomy in a cow with a chronic luxation of the temporomandibular joint.

    PubMed

    Sparks, Holly D; Roquet, Imma; MacKay, Angela; Barber, Spencer

    2014-06-01

    A cow, presented after being struck by a motor vehicle, continued to have difficulty eating after mandibular fracture repair. Imaging showed a temporomandibular luxation and a mandibular condylectomy was performed. Mastication improved greatly but the cow was euthanized due to infection. This is the first report of mandibular condylectomy in cattle. PMID:24891643

  2. Muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction.

    PubMed

    Woźniak, Krzysztof; Lipski, Mariusz; Lichota, Damian; Szyszka-Sommerfeld, Liliana

    2015-01-01

    The aim of this study is to evaluate muscle fatigue in the temporal and masseter muscles in patients with temporomandibular dysfunction (TMD). Two hundred volunteers aged 19.3 to 27.8 years (mean 21.50, SD 0.97) participated in this study. Electromyographical (EMG) recordings were performed using a DAB-Bluetooth Instrument (Zebris Medical GmbH, Germany). Muscle fatigue was evaluated on the basis of a maximum effort test. The test was performed during a 10-second maximum isometric contraction (MVC) of the jaws. An analysis of changes in the mean power frequency of the two pairs of temporal and masseter muscles (MPF%) revealed significant differences in the groups of patients with varying degrees of temporomandibular disorders according to Di (P < 0.0000). The study showed an increase in the muscle fatigue of the temporal and masseter muscles correlated with the intensity of temporomandibular dysfunction symptoms in patients. The use of surface electromyography in assessing muscle fatigue is an excellent diagnostic tool for identifying patients with temporomandibular dysfunction.

  3. Dislocation of temporo-mandibular joint - an uncommon circumstance of occurrence: vaginal delivery.

    PubMed

    El Bouazzaoui, Abderrahim; Labib, Smael; Derkaoui, Ali; Adnane Berdai, Mohammed; Bendadi, Azzeddine; Harandou, Mustapha

    2010-06-25

    Dislocation of temporo-mandibular joint (TMJ) is an infrequent disease but still spectacular. This disease consists of a permanent, to some extent complete disruption of the temporo-mandibular joint. These dislocations often occur in a context of yawning, and less frequently after a burst of laughing or relatively mild facial trauma (slap, punch on the chin). We report a case of TMJ occurring in an uncommon circumstance: vaginal delivery. A woman aged 24-years with no special past medical history; primipara was admitted in the Department of Maternity of the University Hospital Hassan II of Fez for an imminent delivery of a twin pregnancy. Ten minutes after admission, the patient delivered vaginally with episiotomy. She gave birth to twins weighing 2800 g and 2400 g. During labour, and due to efforts of crying, the patient developed a sudden and immediate loss of function of the temporo-mandibular joint, with difficulty of speaking, the mouth permanently opened and with the chin lowered and thrown forward. The examination found an empty glenoid fossa of the temporo-mandibular joint in both sides. The diagnosis of dislocation of the TMJ was established. A CT scan of facial bones was done, objectifying a bilateral dislocation of TMJ. The reduction of this dislocation was performed in the operating room under sedation.

  4. [Trigeminal motor paralysis and dislocation of the temporo-mandibular joints].

    PubMed

    Ohkawa, S; Yoshida, T; Ohsumi, Y; Tabuchi, M

    1996-07-01

    A 64-year-old woman with diabetes mellitus was admitted to our hospital with left hemiparesis of sudden onset. A brain MRI demonstrated a cerebral infarction in the ventral part of the right lower pons. When left hemiparesis worsened, she had dislocation of the temporo-mandibular joints repeatedly. Then, her lower jaw deviated to the right when she opened her mouth. Also, there was decreased contraction of the right masseter when she clenched her teeth. These findings suggest that there was trigeminal motor paralysis on the right side resulting from involvement of the intrapontine trigeminal motor nerve. She has no history of dislocation of the temporo-mandibular joints. An X-ray film showed that the temporo-mandibular joints were intact. Thus, it is possible that deviation of the lower jaw was the cause of this dislocation. We suspect that dislocation of the temporo-mandibular joints may occur as a complication of unilateral trigeminal motor paralysis. This has not been reported to our knowledge.

  5. 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

  6. Temporo-mandibular joint ankylosis and oro-nasal fistula as complications of facial trauma.

    PubMed

    Summers, L; Pearce, R L

    1975-02-01

    Condylar fractures with or without disruption of the temporo-mandibular joint occur commonly with other facial injuries. The subsequent development of ankylosis presents surgical and anaesthetic problems in management and results in severe physical disability to the patient. Oro-nasal fistula is a rare complication of fractures involving the middle third of the facial skeleton, and two cases are reported.

  7. Squamous cell carcinoma invading the right temporomandibular joint in a Belgian mare

    PubMed Central

    Perrier, Melanie; Schwarz, Tobias; Gonzalez, Olga; Brounts, Sabrina

    2010-01-01

    This report describes a rare case of squamous cell carcinoma invading the right temporomandibular joint, right guttural pouch, and calvarium. Radiography, computed tomography, and histopathology were performed in the diagnostic workup. Computed tomography depicted more accurately than radiography the invasive nature, exact location, and extent of the lesion. PMID:21037891

  8. 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

  9. 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

  10. Effects of enzymatic degradation after loading in temporomandibular joint.

    PubMed

    Asakawa-Tanne, Y; Su, S; Kunimatsu, R; Hirose, N; Mitsuyoshi, T; Okamoto, Y; Tanaka, E; Tanne, K; Tanimoto, K

    2015-02-01

    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.

  11. 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.

  12. 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

  13. 3D superimposition and understanding temporomandibular joint arthritis

    PubMed Central

    Cevidanes, LHS; Gomes, LR; Jung, BT; Gomes, MR; Ruellas, ACO; Goncalves, JR; Schilling, J; Styner, M; Nguyen, T; Kapila, S; Paniagua, B

    2015-01-01

    Objectives To investigate the 3D morphological variations in 169 Temporomandibular Joint (TMJ) condyles, using novel imaging statistical modeling approaches. Setting and Sample Population The Department of Orthodontics and Pediatric Dentistry at the University of Michigan. Cone beam CT scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA, mean age 39.1 ± 15.7 years), 15 subjects at initial consult diagnosis of OA (mean age 44.9 ± 14.8 years) and 7 healthy controls (mean age 43 ± 12.4 years). Material & Methods 3D surface models of the condyles were constructed and homologous correspondent points on each model were established. The statistical framework included Direction-Projection-Permutation (DiProPerm) for testing statistical significance of the differences between healthy controls and the OA groups determined by clinical and radiographic diagnoses. Results Condylar morphology in OA and healthy subjects varied widely with categorization from mild to severe bone degeneration or overgrowth. DiProPerm statistics supported a significant difference between the healthy control group and the initial diagnosis of OA group (t=6.6, empirical p-value = 0.006), and between healthy and long term-diagnosis of OA group (t = 7.2, empirical p-value = 0). Compared with healthy controls, the average condyle in OA subjects was significantly smaller in all dimensions, except its anterior surface, even in subjects with initial diagnosis of OA. Conclusion This new statistical modeling of condylar morphology allows the development of more targeted classifications of this condition than previously possible. PMID:25865530

  14. 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

  15. 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

  16. Current status of temporomandibular joint arthroscopy in the United Kingdom.

    PubMed

    Thomas, Sangeetha M; Matthews, N Shaun

    2012-10-01

    In an era during which minimally invasive procedures are increasingly becoming the norm, arthroscopy of the temporomandibular joint (TMJ) seems to be infrequently used for diagnosis and treatment of disorders of the TMJ. The reasons for this are not clear. The purpose of this study was to find out the current state of arthroscopy of the TMJ in the UK and, more specifically, how often it is used, the indications for its use, the level of experience of practising surgeons, and the reasons for not using it. Information was gathered between 2009 and 2010 from a postal and e-mail questionnaire to all oral and maxillofacial consultants in the UK. Of the 346 consultants, 215 (60%) responded to the questionnaire. Forty-two said that they currently used arthroscopy of the TMJ, and 33 of those (81%) have more than 5 years' experience. During the past year, a total of 8 consultants nationally have done 20 arthroscopies or more. Thirty-three of the procedures (81%) were done for both diagnosis and treatment. Lack of perceived need of patients and lack of interest in this specialty were the main reasons given for not doing arthroscopy, lack of training being a key secondary reason. The Storz and Olympus systems were the most commonly used within the UK. Results seem to support the opinion that arthroscopy of the TMJ is under-used, and consideration should be given to ensuring that trainees are instructed in its use, which is important in the diagnosis and treatment of disorders of the TMJ.

  17. Synthesis of hydrophilic intra-articular microspheres conjugated to ibuprofen and evaluation of anti-inflammatory activity on articular explants.

    PubMed

    Bédouet, Laurent; Moine, Laurence; Pascale, Florentina; Nguyen, Van-Nga; Labarre, Denis; Laurent, Alexandre

    2014-01-01

    The main limitation of current microspheres for intra-articular delivery of non-steroidal anti-inflammatory drugs (NSAIDs) is a significant initial burst release, which prevents a long-term drug delivery. In order to get a sustained delivery of NSAIDs without burst, hydrogel degradable microspheres were prepared by co-polymerization of a methacrylic derivative of ibuprofen with oligo(ethylene-glycol) methacrylate and poly(PLGA-PEG) dimethacrylate as degradable crosslinker. Microspheres (40-100 μm) gave a low yield of ibuprofen release in saline buffer (≈2% after 3 months). Mass spectrometry analysis confirmed that intact ibuprofen was regenerated indicating that ester hydrolysis occurred at the carboxylic acid position of ibuprofen. Dialysis of release medium followed by alkaline hydrolysis show that in saline buffer ester hydrolysis occurred at other positions in the polymer matrix leading to the release of water-soluble polymers (>6-8000 Da) conjugated with ibuprofen showing that degradation and drug release are simultaneous. By considering the free and conjugated ibuprofen, 13% of the drug is released in 3 months. In vitro, ibuprofen-loaded MS inhibited the synthesis of prostaglandin E2 in articular cartilage and capsule explants challenged with lipopolysaccharides. Covalent attachment of ibuprofen to PEG-hydrogel MS suppresses the burst release and allows a slow drug delivery for months and the cyclooxygenase-inhibition property of regenerated ibuprofen is preserved.

  18. Transient anabolic effects accompany epidermal growth factor receptor signal activation in articular cartilage in vivo

    PubMed Central

    2013-01-01

    Introduction Signals from the epidermal growth factor receptor (EGFR) have typically been considered to provide catabolic activities in articular cartilage, and accordingly have been suggested to have a causal role in osteoarthritis progression. The aim of this study was to determine in vivo roles for endogenous EGFR signal activation in articular cartilage. Methods Transgenic mice with conditional, limb-targeted deletion of the endogenous intracellular EGFR inhibitor Mig-6 were generated using CreLoxP (Mig-6-flox; Prx1Cre) recombination. Histology, histochemical staining and immunohistochemistry were used to confirm activation of EGFR signaling in the articular cartilage and joints, and to analyze phenotypic consequences of Mig-6 loss on articular cartilage morphology, proliferation, expression of progenitor cell markers, presence of chondrocyte hypertrophy and degradation of articular cartilage matrix. Results The articular cartilage of Mig-6-conditional knockout (Mig-6-cko) mice was dramatically and significantly thicker than normal articular cartilage at 6 and 12 weeks of age. Mig-6-cko articular cartilage contained a population of chondrocytes in which EGFR signaling was activated, and which were three to four times more proliferative than normal Mig-6-flox articular chondrocytes. These cells expressed high levels of the master chondrogenic regulatory factor Sox9, as well as high levels of putative progenitor cell markers including superficial zone protein (SZP), growth and differentiation factor-5 (GDF-5) and Notch1. Expression levels were also high for activated β-catenin and the transforming growth factor beta (TGF-β) mediators phospho-Smad2/3 (pSmad2/3). Anabolic effects of EGFR activation in articular cartilage were followed by catabolic events, including matrix degradation, as determined by accumulation of aggrecan cleavage fragments, and onset of hypertrophy as determined by type × collagen expression. By 16 weeks of age, the articular cartilage of

  19. [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.

  20. [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

  1. 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

  2. Epidemiology and outcome of articular complications in adult onset Still's disease.

    PubMed

    Mahfoudhi, Madiha; Shimi, Rafik; Turki, Sami; Kheder, Adel

    2015-01-01

    The adult onset Still's disease is a rare inflammatory pathology of unknown pathogeny. The clinical features are variable. The diagnosis is difficult since exclusion of infectious, systemic and tumoral pathologies should be done. The articular complications are frequent and can be revelatory of this pathology. The articular prognosis depends on the diagnosis delay and the treatment efficiency. Our study aims to analyze different aspects of articular manifestations complicating adult onset Still disease to define epidemiological, clinical and evolving characteristics of these complications. It was a cross-sectional study concerning 18 cases of adult onset Still disease diagnosed from 1990 to 2014 in the internal medicine A department of Charles Nicolle Hospital in Tunis, meeting Yamaguchi criteria. We identified clinical, radiological, evolving and therapeutic profile of the articular manifestations occurred in these patients. There were 11 women and 7 men. The average age was 27 years. The arthralgias were reported in all cases; while, the arthritis interested thirteen patients. A hand deformation was found in four patients. A wrist ankylosis was noted in one case and a flexion elbow in one patient. The Standard articular radiographs were normal in ten cases. The treatment associated essentially non-steroidal anti-inflammatory and/or corticosteroids and/or methotrexate. Concerning the evolving profile, the monocyclic form was present in 25% of the cases, the intermittent form in 40% and the chronic articular form in 35% of our patients. The adult onset Still's disease is rare and heterogeneous. The articular disturbances are frequent and have various outcomes.

  3. 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

  4. 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.

  5. [Gait analysis after intra-articular calcaneus fractures].

    PubMed

    Siegmeth, A; Petje, G; Mittlmeier, T; Vécsei, V

    1996-01-01

    We retrospectively compared 20 patients with displaced intra-articular calcaneal fractures by clinical assessment and dynamic pedography. Eleven were treated operatively, 9 conservatively. The purpose was to identify differences in post-traumatic gait performance and to correlate the pedographic data to a clinical score to show its reliability. Twenty individuals without a history of foot injuries were used as a control group. Both groups had restricted motion in the subtalar joint, increased hindfoot and midfoot loading and decreased forefoot loading. Furthermore, they showed prolonged contact phases and an impaired ability to speed up gait during the toe-off phase. Load transfer from the hindfoot to the forefoot showed typical distribution patterns. The operatively treated group showed better functional results with fewer subjective complaints.

  6. Hydrogel-Based Controlled Delivery Systems for Articular Cartilage Repair

    PubMed Central

    Madry, Henning

    2016-01-01

    Delivery of bioactive factors is a very valuable strategy for articular cartilage repair. Nevertheless, the direct supply of such biomolecules is limited by several factors including rapid degradation, the need for supraphysiological doses, the occurrence of immune and inflammatory responses, and the possibility of dissemination to nontarget sites that may impair their therapeutic action and raise undesired effects. The use of controlled delivery systems has the potential of overcoming these hurdles by promoting the temporal and spatial presentation of such factors in a defined target. Hydrogels are promising materials to develop delivery systems for cartilage repair as they can be easily loaded with bioactive molecules controlling their release only where required. This review exposes the most recent technologies on the design of hydrogels as controlled delivery platforms of bioactive molecules for cartilage repair. PMID:27642587

  7. Hydrogel-Based Controlled Delivery Systems for Articular Cartilage Repair.

    PubMed

    Rey-Rico, Ana; Madry, Henning; Cucchiarini, Magali

    2016-01-01

    Delivery of bioactive factors is a very valuable strategy for articular cartilage repair. Nevertheless, the direct supply of such biomolecules is limited by several factors including rapid degradation, the need for supraphysiological doses, the occurrence of immune and inflammatory responses, and the possibility of dissemination to nontarget sites that may impair their therapeutic action and raise undesired effects. The use of controlled delivery systems has the potential of overcoming these hurdles by promoting the temporal and spatial presentation of such factors in a defined target. Hydrogels are promising materials to develop delivery systems for cartilage repair as they can be easily loaded with bioactive molecules controlling their release only where required. This review exposes the most recent technologies on the design of hydrogels as controlled delivery platforms of bioactive molecules for cartilage repair. PMID:27642587

  8. An articular index for the assessment of osteoarthritis.

    PubMed Central

    Doyle, D V; Dieppe, P A; Scott, J; Huskisson, E C

    1981-01-01

    An articular index was devised for the sequential assessment of patients with osteoarthritis (OA). Forty-eight joint units, chosen to reflect the characteristic pattern of the disease, were scored for tenderness on pressure or movement on a 4-point scale. Four observers examined patients to assess inter- and intraobserver error. The index was highly reproducible both within and between observers; intraobserver error was, however, significantly smaller. In a double-blind, cross-over trial the index was sufficiently sensitive to detect a statistically significant difference between the responses of patients with OA to an anti-inflammatory agent and to a simple analgesic. It is likely to be a useful addition to current methods of measurement in osteoarthritis. PMID:7008713

  9. Hydrogel-Based Controlled Delivery Systems for Articular Cartilage Repair

    PubMed Central

    Madry, Henning

    2016-01-01

    Delivery of bioactive factors is a very valuable strategy for articular cartilage repair. Nevertheless, the direct supply of such biomolecules is limited by several factors including rapid degradation, the need for supraphysiological doses, the occurrence of immune and inflammatory responses, and the possibility of dissemination to nontarget sites that may impair their therapeutic action and raise undesired effects. The use of controlled delivery systems has the potential of overcoming these hurdles by promoting the temporal and spatial presentation of such factors in a defined target. Hydrogels are promising materials to develop delivery systems for cartilage repair as they can be easily loaded with bioactive molecules controlling their release only where required. This review exposes the most recent technologies on the design of hydrogels as controlled delivery platforms of bioactive molecules for cartilage repair.

  10. Potassium channels of pig articular chondrocytes are blocked by propofol.

    PubMed

    Mozrzymas, J W; Visintin, M; Vittur, F; Ruzzier, F

    1994-07-15

    The effect of propofol on the voltage-activated potassium channels in pig articular chondrocytes was investigated. Propofol was found to reversibly block the potassium channels in a dose-dependent manner. The blocking effect was voltage-independent and the Hill coefficient was 1.85 +/- 0.18. No changes either in the slope conductance or in the single channel kinetics were observed. The half-blocking concentration (Ec50) was 6.0 +/- 0.49 microM which is much lower than the concentrations used to observe the scavenging effect of the drug in an artificial synovial fluid. Interestingly, Ec50 found in our experiments is also smaller than the blood concentration of propofol used in anaesthesia. These results show that propofol may strongly affect the potassium channels in some non-excitable cells.

  11. [Chondrocalcinosis. Clinical impact of intra-articular calcium phosphate crystals].

    PubMed

    Fuerst, M

    2014-06-01

    Calcium pyrophosphate dihydrate (CPPD) crystals are known to cause acute attacks of pseudogout in joints but crystal deposition has also been reported to be associated with osteoarthritis (OA). Aside from CPPD crystals, basic calcium phosphates (BCPs), consisting of carbonate-substituted hydroxyapatite (HA), tricalcium phosphate and octacalcium phosphate, have been found in synovial fluid, synovium and cartilage of patients with OA. Although CPPD crystals have been found to be associated with OA and are an important factor in joint disease, this has also recently been associated with a genetic defect. However, according to the most recent findings, the association of BCP crystals, such as apatite with OA is much stronger, as their presence significantly correlates with the severity of cartilage degeneration. Identification of BCP crystals in OA joints remains problematic due to a lack of simple and reliable methods of detection. The clinical and pathological relevance of cartilage mineralization in patients with OA is not completely understood. It is well established that mineralization of articular cartilage is often found close to hypertrophic chondrocytes. A significant correlation between the expression of type X collagen, a marker for chondrocyte hypertrophy and cartilage mineralization was observed. In the process of endochondral ossification, the link between hypertrophy and matrix mineralization is particularly well described. Hypertrophic chondrocytes in OA cartilage and at the growth line share certain features, not only hypertrophy but also a capability to mineralize the matrix. Recent data indicate that chondrocyte hypertrophy is a key factor in articular cartilage mineralization strongly linked to OA and does not characterize a specific subset of OA patients, which has important consequences for therapeutic strategies for OA. PMID:24924727

  12. Increasing the Dose of Autologous Chondrocytes Improves Articular Cartilage Repair

    PubMed Central

    Guillén-García, Pedro; Rodríguez-Iñigo, Elena; Guillén-Vicente, Isabel; Caballero-Santos, Rosa; Guillén-Vicente, Marta; Abelow, Stephen; Giménez-Gallego, Guillermo

    2014-01-01

    Background: We hypothesized that implanting cells in a chondral defect at a density more similar to that of the intact cartilage could induce them to synthesize matrix with the features more similar to that of the uninjured one. Methods: We compared the implantation of different doses of chondrocytes: 1 million (n = 5), 5 million (n = 5), or 5 million mesenchymal cells (n = 5) in the femoral condyle of 15 sheep. Tissue generated by microfracture at the trochlea, and normal cartilage from a nearby region, processed as the tissues resulting from the implantation, were used as references. Histological and molecular (expression of type I and II collagens and aggrecan) studies were performed. Results: The features of the cartilage generated by implantation of mesenchymal cells and elicited by microfractures were similar and typical of a poor repair of the articular cartilage (presence of fibrocartilage, high expression of type I collagen and a low mRNA levels of type II collagen and aggrecan). Nevertheless, in the samples obtained from tissues generated by implantation of chondrocytes, hyaline-like cartilage, cell organization, low expression rates of type I collagen and high levels of mRNA corresponding to type II collagen and aggrecan were observed. These histological features, show less variability and are more similar to those of the normal cartilage used as control in the case of 5 million cells implantation than when 1 million cells were used. Conclusions: The implantation of autologous chondrocytes in type I/III collagen membranes at high density could be a promising tool to repair articular cartilage. PMID:26069691

  13. 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

  14. Dental and Temporomandibular Joint Pathology of the Walrus (Odobenus rosmarus).

    PubMed

    Winer, J N; Arzi, B; Leale, D M; Kass, P H; Verstraete, F J M

    2016-01-01

    Maxillae and/or mandibles from 76 walruses (Odobenus rosmarus) were examined macroscopically according to predefined criteria. The museum specimens were acquired between 1932 and 2014. Forty-five specimens (59.2%) were from male animals, 29 (38.2%) from female animals and two (2.6%) from animals of unknown sex, with 58 adults (76.3%) and 18 young adults (23.7%) included in this study. The number of teeth available for examination was 830 (33.6%); 18.5% of teeth were absent artefactually, 3.3% were deemed to be absent due to acquired tooth loss and 44.5% were absent congenitally. The theoretical complete dental formula was confirmed to be I 3/3, C 1/1, P 4/3, M 2/2, while the most probable dental formula is I 1/0, C 1/1, P 3/3, M 0/0; none of the specimens in this study possessed a full complement of theoretically possible teeth. The majority of teeth were normal in morphology; only five teeth (0.6% of available teeth) were malformed. Only one tooth had an aberrant number of roots and only one supernumerary tooth was encountered. No persistent deciduous teeth were found in any of the young adult or adult specimens, nor were any specimens affected by enamel hypoplasia. The majority of teeth (85.5%) displayed attrition/abrasion. Of the adult and young adult specimens, 90.8% showed some degree of attrition/abrasion on at least one tooth. Tooth fractures were noted in eight walruses, affecting 10.5% of specimens and 1.3% of the total number of teeth, nearly three-quarters of which were maxillary canine teeth (tusks). Three specimens (3.9%), all adult males, displayed overt periapical disease. The majority (99.2%) of dental alveoli did not have bony changes indicative of periodontitis, with only five specimens (6.6%) affected by periodontitis. Lesions consistent with temporomandibular joint osteoarthritis (TMJ-OA) were found in 46 specimens (60.5%) and TMJ-OA was significantly more common in adults than young adults and males than females. Although the clinical

  15. 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

  16. Dental and Temporomandibular Joint Pathology of the Walrus (Odobenus rosmarus).

    PubMed

    Winer, J N; Arzi, B; Leale, D M; Kass, P H; Verstraete, F J M

    2016-01-01

    Maxillae and/or mandibles from 76 walruses (Odobenus rosmarus) were examined macroscopically according to predefined criteria. The museum specimens were acquired between 1932 and 2014. Forty-five specimens (59.2%) were from male animals, 29 (38.2%) from female animals and two (2.6%) from animals of unknown sex, with 58 adults (76.3%) and 18 young adults (23.7%) included in this study. The number of teeth available for examination was 830 (33.6%); 18.5% of teeth were absent artefactually, 3.3% were deemed to be absent due to acquired tooth loss and 44.5% were absent congenitally. The theoretical complete dental formula was confirmed to be I 3/3, C 1/1, P 4/3, M 2/2, while the most probable dental formula is I 1/0, C 1/1, P 3/3, M 0/0; none of the specimens in this study possessed a full complement of theoretically possible teeth. The majority of teeth were normal in morphology; only five teeth (0.6% of available teeth) were malformed. Only one tooth had an aberrant number of roots and only one supernumerary tooth was encountered. No persistent deciduous teeth were found in any of the young adult or adult specimens, nor were any specimens affected by enamel hypoplasia. The majority of teeth (85.5%) displayed attrition/abrasion. Of the adult and young adult specimens, 90.8% showed some degree of attrition/abrasion on at least one tooth. Tooth fractures were noted in eight walruses, affecting 10.5% of specimens and 1.3% of the total number of teeth, nearly three-quarters of which were maxillary canine teeth (tusks). Three specimens (3.9%), all adult males, displayed overt periapical disease. The majority (99.2%) of dental alveoli did not have bony changes indicative of periodontitis, with only five specimens (6.6%) affected by periodontitis. Lesions consistent with temporomandibular joint osteoarthritis (TMJ-OA) were found in 46 specimens (60.5%) and TMJ-OA was significantly more common in adults than young adults and males than females. Although the clinical

  17. 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

  18. 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

  19. [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

  20. Pathogenesis and prevention of posttraumatic osteoarthritis after intra-articular fracture.

    PubMed

    Schenker, Mara L; Mauck, Robert L; Ahn, Jaimo; Mehta, Samir

    2014-01-01

    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

  1. Condylar osteochondroma treated with total condylectomy and preservation of the articular disc: a case report.

    PubMed

    Dominguez, Manuel Fernandez; Castillo, Jose Luis Del; Guerra, Mario Muñoz; Sanchez, Ruth Sanchez; La Plata, Maria Mancha De

    2015-06-01

    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

  2. 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

  3. Cellular and Molecular Mechanisms of Synovial Joint and Articular Cartilage Formation

    PubMed Central

    Pacifici, Maurizio; Koyama, Eiki; Shibukawa, Yoshihiro; Wu, Changshan; Tamamura, Yoshihiro; Enomoto-Iwamoto, Motomi; Iwamoto, Masahiro

    2009-01-01

    Synovial joints and articular cartilage play crucial roles in skeletal function, but relatively little is actually known about their embryonic development. Here we first focused on the interzone, a thin mesenchymal cell layer forming at future joint sites that is widely thought to be critical for joint and articular cartilage development. To determine interzone cell origin and fate, we microinjected the vital fluorescent dye DiI at several peri-joint sites in chick limbs and monitored behavior and fate of labeled cells over time. Peri-joint mesenchymal cells located immediately adjacent to incipient joints migrated, became part of the interzone, and were eventually found in epiphyseal articular layer and joint capsule. Interzone cells isolated and reared in vitro expressed typical phenotypic markers, including GDF-5, Wnt-14 and CD-44, and differentiated into chondrocytes over time. To determine the molecular mechanisms of articular chondrocyte formation, we carried out additional studies on the ets transcription factor family member ERG and its alternatively-spliced variant C-1-1 that we previously found to be expressed in developing avian articular chondrocytes. We cloned the human counterpart of avian C-1-1 (ERGp55Δ81) and conditionally expressed it in transgenic mice under cartilage-specific Col2 gene promoter-enhancer control. The entire transgenic mouse limb chondrocyte population exhibited an immature articular-like phenotype and a virtual lack of growth plate formation and chondrocyte maturation compared to wild type littermate. Together, our studies reveal that peri-joint mesenchymal cells take part in interzone and articular layer formation, interzone cells can differentiate into chondrocytes, and acquisition of a permanent articular chondrocyte phenotype is aided and perhaps dictated by ets transcription factor ERG. PMID:16831907

  4. 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.

  5. Can intra-articular therapies prior to total knee arthroplasty increase the risk of periprosthetic infection?

    PubMed

    Yeo, Q Y; Lye, D C; Sathappan Ss, S S

    2015-02-01

    Intra-articular therapies, such as steroid injection, viscosupplement injection and acupuncture, are common non-surgical options for patients with osteoarthritis of the knee. With any intra-articular injection or acupuncture procedure, there is a potential for inoculation with bacteria leading to possible knee infection. The authors report a patient who incurred an acute infection found after a total knee arthroplasty attributed to prior acupuncture procedure done as part of conservative treatment.

  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. [Postankylosis condylectomy of the temporomandibular joint in a 5-year old girl. Report of a case].

    PubMed

    Ortega Alejandre, J J; Avila Parrao, J; Piña Velazco, G

    1990-04-01

    A case of post-traumatic temporomandibular joint ankylosis is described, and the technique of the treatment is detailed. Previous review of the literature was made in order to know the advantages of the treatment. There are several reports of children who have suffered facial injuries and fractures of the facial bones that became into ankylosis, characterized by the formation of new temporomandibular joint surfaces. The patient was a five years old girl who presented ankylosis of TMJ due to a car accident six months before. The symptom were: Limitation of motion, persistent close lock of mouth (2 mm) muscle pain that causes the patient to avoid eating foods, and the gradual loose of phonetic function. Condylectomy of the left mandibular condyle was performed to correct the mechanical problems associated to ankylosis. The patient had an uncomplicated postoperative course, and now are waiting the outcome of the treatment by a follow up study. PMID:2132265

  8. 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

  9. Replacement of Missing Anterior Teeth in a Patient with Temporomandibular Disorder

    PubMed Central

    Haralur, Satheesh B.; Saeed Al-Shahrani, Omar

    2014-01-01

    The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD) symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth. PMID:24715993

  10. Bone structure of the temporo-mandibular joint in the individuals aged 18-25.

    PubMed

    Parafiniuk, M; Gutsch-Trepka, A; Trepka, S; Sycz, K; Wolski, S; Parafiniuk, W

    1998-01-01

    Osteohistometric studies were performed in 15 female and 15 male cadavers aged 18-25. Condyloid process and right and left acetabulum of the temporo-mandibular joint have been studied. Density has been investigated using monitor screen linked with microscope (magnification 80x). Density in the spongy part of the condyloid process was 26.67-26.77%; in the subchondrial layer--72.13-72.72%, and in the acetabular wall 75.03-75.91%. Microscopic structure of the bones of the temporo-mandibular joint revealed no differences when compared with images of compact and cancellous bone shown in the histology textbooks. Sex and the side of the body had no influence on microscopic image and proportional bone density. Isles of chondrocytes in the trabeculae of the spongy structure of the condyloid process were found in 4 cases and isles of the condensed bone resembling the compact pattern in 7 cases.

  11. Replacement of missing anterior teeth in a patient with temporomandibular disorder.

    PubMed

    Haralur, Satheesh B; Saeed Al-Shahrani, Omar

    2014-01-01

    The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD) symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth. PMID:24715993

  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. 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

  14. 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

  15. Diagnosis and Management of Extra-articular Causes of Pain After Total Knee Arthroplasty.

    PubMed

    Manning, Blaine T; Lewis, Natasha; Tzeng, Tony H; Saleh, Jamal K; Potty, Anish G R; Dennis, Douglas A; Mihalko, William M; Goodman, Stuart B; Saleh, Khaled J

    2015-01-01

    Postoperative pain, which has been attributed to poor outcomes after total knee arthroplasty (TKA), remains problematic for many patients. Although the source of TKA pain can often be delineated, establishing a precise diagnosis can be challenging. It is often classified as intra-articular or extra-articular pain, depending on etiology. After intra-articular causes, such as instability, aseptic loosening, infection, or osteolysis, have been ruled out, extra-articular sources of pain should be considered. Physical examination of the other joints may reveal sources of localized knee pain, including diseases of the spine, hip, foot, and ankle. Additional extra-articular pathologies that have potential to instigate pain after TKA include vascular pathologies, tendinitis, bursitis, and iliotibial band friction syndrome. Patients with medical comorbidities, such as metabolic bone disease and psychological illness, may also experience prolonged postoperative pain. By better understanding the diagnosis and treatment options for extra-articular causes of pain after TKA, orthopaedic surgeons may better treat patients with this potentially debilitating complication. PMID:25745922

  16. Chondrocyte death in mechanically injured articular cartilage--the influence of extracellular calcium.

    PubMed

    Amin, Anish K; Huntley, James S; Bush, Peter G; Simpson, A Hamish R W; Hall, Andrew C

    2009-06-01

    Calcium is thought to be an important regulator of chondrocyte death associated with articular cartilage injury. Our objective was to determine the influence of extracellular calcium on chondrocyte death following mechanical injury. Using a surgically relevant model of sharp mechanical injury (with a scalpel) and confocal laser scanning microscopy (CLSM), in situ chondrocyte death was quantified within the full thickness of articular cartilage as a function of medium calcium concentration and time (2.5 h and 7 days). Exposure of articular cartilage to calcium-free media (approximately 0 mM) significantly reduced superficial zone chondrocyte death after mechanical injury compared with exposure to calcium-rich media (2-20 mM, ANOVA at 2.5 h, p = 0.002). In calcium-rich media, although the extent of chondrocyte death increased with increasing medium calcium concentration, cell death remained localized to the superficial zone of articular cartilage over 7 days (ANOVA, p < 0.05). However, in calcium-free media, there was an increase in chondrocyte death within deeper zones of articular cartilage over 7 days. The early (within hours) chondroprotective effect in calcium-free media suggests that the use of joint irrigation solutions without added calcium may decrease chondrocyte death from mechanical injury during articular surgery. The delayed (within days) increase in chondrocyte death in calcium-free media supports the use of calcium supplementation in media used during cartilage culture for tissue engineering or transplantation.

  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. 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

  19. 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.

  20. [Diagnosis of the temporomandibular joint dysfunction by graphic reconstruction of mandibular movements].

    PubMed

    Arutiunov, S D; Khvatov, I L; Arutiunov, D S; Nabiev, N V; Tuturov, N S

    2003-01-01

    A total of 974 patients with suspected abnormalities of the temporomandibular joint (TMJ) were examined; diseases were detected in 371 patients. The test group consisted of 40 patients, control group of 18 patients. Analysis of the results of graphic recording of mandibular movements and clinical x-ray data in patients of the main and control groups helped develop the strategy for the diagnosis of TMJ dysfunction, based on the functional methods of examination (oral functionography and non-oral axiography).