TMJ imaging: more pictures, less talk

2011 ◽  
Vol 2 (4) ◽  
pp. 172-182 ◽  
Author(s):  
Jimmy Makdissi de C Williams
Keyword(s):  
Rheumatoid Arthritis ◽  
Skull Base ◽  
Temporomandibular Joint ◽  
Temporal Bone ◽  
Mandibular Condyle ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Number Of Factors ◽  
Muscles Of Mastication ◽  
Anatomical Area

The temporomandibular joint (TMJ) is a complex anatomical area consisting of the mandibular condyle and the temporal bone of the skull base. It comes under the influence of a number of factors including the muscles of mastication, teeth, occlusion and the contralateral joint and thus there exists a spectrum of conditions. Internal derangement and degenerative joint disease remain the most common although there are a range of other less frequently occurring conditions such as rheumatoid arthritis, trauma and ankylosis.

scholarly journals Mechanobehavior and Ontogenesis of the Temporomandibular Joint

2018 ◽  
Vol 97 (11) ◽  
pp. 1185-1192 ◽  
Author(s):  
J.C. Nickel ◽  
L.R. Iwasaki ◽  
Y.M. Gonzalez ◽  
L.M. Gallo ◽  
H. Yao
Keyword(s):  
Temporomandibular Joint ◽  
Degenerative Change ◽  
Mandibular Condyle ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Recording Time ◽  
Mechanical Environment ◽  
Age Related ◽  
Tmj Disc

Craniofacial secondary cartilages of the mandibular condyle and temporomandibular joint (TMJ) eminence grow in response to the local mechanical environment. The intervening TMJ disc distributes normal loads over the cartilage surfaces and provides lubrication. A better understanding of the mechanical environment and its effects on growth, development, and degeneration of the TMJ may improve treatments aimed at modifying jaw growth and preventing or reversing degenerative joint disease (DJD). This review highlights data recorded in human subjects and from computer modeling that elucidate the role of mechanics in TMJ ontogeny. Presented data provide an approximation of the age-related changes in jaw-loading behaviors and TMJ contact mechanics. The cells of the mandibular condyle, eminence, and disc respond to the mechanical environment associated with behaviors and ultimately determine the TMJ components’ mature morphologies and susceptibility to precocious development of DJD compared to postcranial joints. The TMJ disc may be especially prone to degenerative change due to its avascularity and steep oxygen and glucose gradients consequent to high cell density and rate of nutrient consumption, as well as low solute diffusivities. The combined effects of strain-related hypoxia and limited glucose concentrations dramatically affect synthesis of the extracellular matrix (ECM), which limit repair capabilities. Magnitude and frequency of jaw loading influence this localized in situ environment, including stem and fibrocartilage cell chemistry, as well as the rate of ECM mechanical fatigue. Key in vivo measurements to characterize the mechanical environment include the concentration of work input to articulating tissues, known as energy density, and the percentage of time that muscles are used to load the jaws out of a total recording time, known as duty factor. Combining these measurements into a mechanobehavioral score and linking these to results of computer models of strain-regulated biochemical events may elucidate the mechanisms responsible for growth, maintenance, and deterioration of TMJ tissues.

Immuno-biological Assessments of Temporomandibular Joint Disease in Patients with Immune-mediated Rheumatic Conditions. A cross sectional study of 273 cases

2018 ◽  
Vol 68 (12) ◽  
pp. 2987-2991
Author(s):  
Cristina Iordache ◽  
Bogdan Vascu ◽  
Eugen Ancuta ◽  
Rodica Chirieac ◽  
Cristina Pomirleanu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Psoriatic Arthritis ◽  
Temporomandibular Joint ◽  
Final Analysis ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Sectional Study ◽  
Cross Sectional ◽  
Immune Parameters ◽  
Immune Mediated

Temporomandibular joint (TMJ) is commonly involved in various immune-mediated rheumatic disorders accounting for significant disability and impaired quality of life. The aim of our study was to assess inflammatory and immune parameters in patients with TMJ arthritis related to rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) and to identify potential relation with severity and dysfunction of TMJ pathology. We performed a cross-sectional study in a cohort of 433 consecutive RA, 32 JIA, 258 AS, and 103 PsA. Only patients presenting with clinically significant TMJ involvement (273) related to their rheumatic condition were included in the final analysis. TMJ involvement is traditionally described in chronic inflammatory rheumatic disorders, particularly in patients with higher levels of inflammation as detected in rheumatoid arthritis and psoriatic arthritis. Disease activity and severity, as well as biological and positive serological assessments (rheumatoid factor, anti-cyclic citrullinated peptide, IL-1) remain significant determinants of the severity of TMJ arthritis.

Effect of Mechanical Stress on Rheumatoid Arthritis of the Temporomandibular Joint: a Morphological and Histological Evaluation

2021 ◽  
Author(s):  
Kohei Nagai ◽  
Takenobu Ishii ◽  
Yasushi Nishii
Keyword(s):  
Rheumatoid Arthritis ◽  
T Cell ◽  
Mechanical Stress ◽  
Temporomandibular Joint ◽  
Mandibular Condyle ◽  
Γδ T Cells ◽  
Histological Evaluation ◽  
Control Group ◽  
Condylar Cartilage ◽  
Layer Width

Abstract Background Rheumatoid arthritis of the temporomandibular joint (TMJ-RA) has been reported to have a larger incidence range than systemic rheumatoid arthritis (RA). The presence or absence of mechanical stress (MS) is considered a factor in this. In this study, we hypothesized that TMJ-RA develops or worsens when excessive MS is applied to the temporomandibular joint of RA mouse models. We aimed to clarify the relationship between TMJ-RA and MS through morphological and histological evaluation. Methods Collagen antibody-induced arthritis (CAIA) was induced in male DBA/1JNCrlj 9–12 weeks old mice by administering Type II collagen antibody and lipopolysaccharide to produce RA model mice. MS was applied to the mandibular condyle. The group was separated into non-RA (control group (N = 5) and MS group (N = 5)), and RA group (CAIA group (N = 5)and CAIA MS group (N = 5)). To confirm the morphological changes in the mandibular condyle, micro-CT imaging was performed. Histological evaluation of the TMJ was performed by hematoxylin and eosin staining for condylar cartilage cell layer thickness, Safranin O staining for proteoglycans, and tartrate-resistant acidic phosphatase staining for osteoclast count. Immunohistochemical evaluation was performed to assess the localization of cartilage destruction enzymes using ADAMTS-5 (a disintegrin and metalloproteinase with thrombospondin motifs) antibody. Additionally, CD3 (cluster of differentiation), CD45, and γδ TCR (T cell receptor) antibodies were used to localize and identify the type of lymphocytes. Results In the CAIA MS model, a three-dimensional analysis of the temporomandibular joint by microcomputer tomography showed a crude change in the surface of the mandibular condyle. Histological examination revealed a decrease in the chondrocyte layer width and an increase in the number of osteoclasts in the mandibular condyle. T cell accumulation was observed, and γδ T cell involvement was confirmed. Conclusions In the CAIA model, the TMJ was less sensitive to the initiation of RA. However, the results suggested that it was exacerbated by MS, and that γδ T cells may be involved in TMJ-RA.

scholarly journals Optimal Use of a Panoramic Radiograph as a Screening Tool for Condylar Resorption in Patients Undergoing Active Orthodontic Treatment: A Case Series

2020 ◽  
Vol 10 ◽  
pp. 65
Author(s):  
Shaima Malik ◽  
Shilpa Singh ◽  
Robby T. George ◽  
Mayank Kakkar ◽  
Nikhilesh R. Vaid
Keyword(s):  
Orthodontic Treatment ◽  
Behavioral Therapy ◽  
Mandibular Condyle ◽  
Case Series ◽  
Panoramic Radiograph ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Initial Examination ◽  
Panoramic Radiographs ◽  
Specific Medication

Condylar resorption of temporomandibular joint findings in the panoramic radiographs is an indication of bone resorption suggesting possible degenerative joint disease that warrants early screen and subsequent referral to a dedicated specialist. This case series reports three patients that underwent the active orthodontic treatment for the duration of approximately 24–36 months. The patients were asymptomatic at the initial examination. The clinical examination was negative for clicking; the range of motion on opening, lateral excursion, and protrusion was normal. Neither of these patients had a history of rheumatic disease or bruxism. During the later stages of orthodontic treatment, two of the three patients reported mild pain and clicking during mastication, which was also confirmed chairside on clinical evaluation. Patients were referred to the orofacial pain specialist, were they were prescribed specific medication for the symptoms, along with cognitive behavioral therapy, and were further evaluated for splint therapy. Panoramic radiographs taken before the start of the treatment, during the treatment and at the completion of the orthodontic treatments indicate the progression in the resorption of mandibular condyle in all three patients suggesting possible degeneration that warrants further investigation and therapy.

Temporomandibular Joint Arthrocentesis in Patients with Degenerative Joint Disease: A 10- to 22-year Follow-up

2021 ◽  
Vol 35 (2) ◽  
pp. 113-118
Author(s):  
Luca Nardini ◽  
Maddalena Meneghini ◽  
Sayma Zegdene ◽  
Daniele Manfredini
Keyword(s):  
Temporomandibular Joint ◽  
Degenerative Joint Disease ◽  
Joint Disease

The temporomandibular joints, muscles of mastication, and the infratemporal and pterygopalatine fossae

2013 ◽  
Author(s):  
Martin E. Atkinson
Keyword(s):  
Temporal Bone ◽  
Articular Surface ◽  
Mandibular Condyle ◽  
Jaw Movements ◽  
Synovial Joints ◽  
Articular Surfaces ◽  
Temporomandibular Joints ◽  
Mandibular Fossa ◽  
Muscle Groups ◽  
Muscles Of Mastication

It is essential that dental students and practitioners understand the structure and function of the temporomandibular joints and the muscles of mastication and other muscle groups that move them. The infratemporal fossa and pterygopalatine fossa are deep to the mandible and its related muscles; many of the nerves and blood vessels supplying the structures of the mouth run through or close to these areas, therefore, knowledge of the anatomy of these regions and their contents is essential for understanding the dental region. The temporomandibular joints (TMJ) are the only freely movable articulations in the skull together with the joints between the ossicles of the middle ear; they are all synovial joints. The muscles of mastication move the TMJ and the suprahyoid and infrahyoid muscles also play a significant role in jaw movements. The articular surfaces of the squamous temporal bone and of the condylar head (condyle) of the mandible form each temporomandibular joint. These surfaces have been briefly described in Chapter 22 on the skull and Figure 24.1A indicates their shape. The concave mandibular fossa is the posterior articulating surface of each squamous temporal bone and houses the mandibular condyle at rest. The condyle is translated forwards on to the convex articular eminence anterior to the mandibular fossa during jaw movements. The articular surfaces of temporomandibular joints are atypical; they covered by fibrocartilage (mostly collagen with some chondrocytes) instead of hyaline cartilage found in most other synovial joints. Figures 24.1B and 24.1C show the capsule and ligaments associated with the TMJ. The tough, fibrous capsule is attached above to the anterior lip of the squamotympanic fissure and to the squamous bone around the margin of the upper articular surface and below to the neck of the mandible a short distance below the limit of the lower articular surface. The capsule is slack between the articular disc and the squamous bone, but much tighter between the disc and the neck of the mandible. Part of the lateral pterygoid muscle is inserted into the anterior surface of the capsule. As in other synovial joints, the non-load-bearing internal surfaces of the joint are covered with synovial membrane.

Prevalence of degenerative joint disease of the temporomandibular joint: a systematic review

2018 ◽  
Vol 23 (5) ◽  
pp. 2475-2488 ◽  
Author(s):  
Leticia Lopes Quirino Pantoja ◽  
Isabela Porto de Toledo ◽  
Yasmine Mendes Pupo ◽  
André Luís Porporatti ◽  
Graziela De Luca Canto ◽  
...  
Keyword(s):  
Systematic Review ◽  
Temporomandibular Joint ◽  
Degenerative Joint Disease ◽  
Joint Disease

scholarly journals Arthritis and the role of endogenous glucocorticoids

Bone Research ◽  
2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Eugenie Macfarlane ◽  
Markus J. Seibel ◽  
Hong Zhou
Keyword(s):  
Rheumatoid Arthritis ◽  
Joint Destruction ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Current Evidence ◽  
Inflammatory Microenvironment ◽  
Glucocorticoid Signaling ◽  
Anti Inflammatory ◽  
Fibroblast Like Synoviocytes

Abstract Rheumatoid arthritis and osteoarthritis, the most common forms of arthritis, are chronic, painful, and disabling conditions. Although both diseases differ in etiology, they manifest in progressive joint destruction characterized by pathological changes in the articular cartilage, bone, and synovium. While the potent anti-inflammatory properties of therapeutic (i.e., exogenous) glucocorticoids have been heavily researched and are widely used in clinical practice, the role of endogenous glucocorticoids in arthritis susceptibility and disease progression remains poorly understood. Current evidence from mouse models suggests that local endogenous glucocorticoid signaling is upregulated by the pro-inflammatory microenvironment in rheumatoid arthritis and by aging-related mechanisms in osteoarthritis. Furthermore, these models indicate that endogenous glucocorticoid signaling in macrophages, mast cells, and chondrocytes has anti-inflammatory effects, while signaling in fibroblast-like synoviocytes, myocytes, osteoblasts, and osteocytes has pro-inflammatory actions in rheumatoid arthritis. Conversely, in osteoarthritis, endogenous glucocorticoid signaling in both osteoblasts and chondrocytes has destructive actions. Together these studies provide insights into the role of endogenous glucocorticoids in the pathogenesis of both inflammatory and degenerative joint disease.

scholarly journals Chronic Skull Base Erosion from Temporomandibular Joint Disease Causes Generalized Seizure and Profound Lactic Acidosis

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Mark A. Dobish ◽  
David A. Wyler ◽  
Christopher J. Farrell ◽  
Hermandeep S. Dhami ◽  
Victor M. Romo ◽  
...  
Keyword(s):  
Lactic Acidosis ◽  
Skull Base ◽  
Temporomandibular Joint ◽  
Case Series ◽  
Type A ◽  
Oxidative Capacity ◽  
Joint Disease ◽  
Rare Presentation ◽  
Cellular Energy ◽  
Ph Range

This report displays a rare presentation of lactic acidosis in the setting of status epilepticus (SE). The differential diagnosis of lactic acidosis is broad and typically originates from states of shock; however, this report highlights an alternative and rare etiology, SE, due to chronic skull base erosion from temporomandibular joint (TMJ) disease. Lactic acidosis is defined by a pH below 7.35 in the setting of lactate values greater than 5 mmol/L. Two broad classifications of lactic acidosis exist: a type A lactic acidosis which stems from global or localized tissue hypoxia or a type B lactic acidosis which occurs once mitochondrial oxidative capacity is unable to match glucose metabolism. SE is an example of a type A lactic acidosis in which oxygen delivery is unable to meet increased cellular energy requirements. This report is consistent with a prior case series that consists of five patients experiencing generalized tonic-clonic (GTC) seizures and lactic acidosis. These patients presented with a pH range of 6.8-7.41 and lactate range of 3.8-22.4 mmol/L. Although severe lactic acidosis following GTC has been described, this is the first report in the literature of chronic skull base erosion from TMJ disease causing SE.

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