152 research outputs found
Temporomandibular Joint Pain is Negatively Correlated to TNF Alpha and Osteoprotegrin Content in Synovial Fluid in Patients with Juvenile Idiopathic Arthritis.
No full textObjective: Temporomandibular joint (TMJ) involvement occurs in up to 80% of children with juvenile idiopathic arthritis (JIA). Little is known with regard to the complexity of the protein profile in synovial fluid (SF) from JIA arthritis during growth as compared to both JIA and rheumatoid arthritis (RA) of adults.
Design: Synovial fluid was collected from 54 joints/30 patients with TMJ arthritis (JIA 35 joints/20 patients, JIA adults 9 joints/5 patients, RA 10 joints/5 patients). Three cytokines and seven bone markers were quantified using Luminex multiplex assays and compared to demographic and clinical data of function and pain.
Results: Pain (spontaneous and upon palpation) and duration of pain were all negatively correlated with the TMJ SF content of tumor necrosis factor (TNF)-α. The level of Adrenocorticotropic hormone (ACTH) was negatively correlated to TMJ pain upon palpation and post-treatment pain and function. The concentration of ACTH was significantly lower in SF in JIA (1.4 ± 2.8 pg/ml) compared to adults with JIA (4.7 ± 12.2 pg/ml) and significantly higher compared to adults with RA (0.8 ± 1.5 pg/ml). Osteoprotegerin (OPG) was negatively correlated to spontaneous pain.
Conclusions: Our results indicate that the local concentrations of TNF-α, ACTH and OPG in TMJ fluid may not contribute to TMJ pain and tissue destruction in JIA/RA patients.
© 2014 Olsen-Bergem H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
(A) study on the lateral cephalometric tomography of TMJ arthrosis
No full text치의학과/박사[한글]
저자는 악관절증의 진단 및 치료에 다소나마 도움을 주고자 정상군 23명과 환자군 20명을 선정하여 두부축방향 사진분석에 따라서 좌·우측의 측방두부계측 단층방사선사진을 중심교위와 중심교합 상태에서 각각 촬영하여 분석하였으며, 또한 악골내 기능적인 측정
항목들의 상관관계를 비교 분석하여 다음과 같은 결론을 얻었다.
1. 하악과두의 수평경사도의 평균치는 정상군에서 우측부위는 20.348°±6.358°, 좌측부위는 18.870°±7.777°였으며 환자군에서 우측부위는 19.350°±7.576°, 좌측부위는17.750°± 6.146°로서 각각 우측부위의 평균치가 좌측부위의 평균치보다 크게 나타내었
다.
2. 관절와에 대한 하악과두의 위치는 정상TMJ군, 환자증상TMJ군에서 모두 하악이 중심교합에서 중심교위로 이동시 후상방으로 위치하였다.
3. 전방관절공폭에 대한 후방관절공폭의 비율은 중심교위에서 정상TMJ군에서 1.593, 환자무증상TMJ군에서 1.604, 환자증상TMJ군에서는 1.671 이었다. 중심교합에서는 정상TMJ군
에서 1.390, 환자무증상TMJ군에서 1.539, 환자증상TMJ군에서 1.196이었다.
4.중심교위에서의 교합평면선과 구치부폐쇄로가 이루는 각(∠C^^2) 항목에서만이 정상TMJ군, 환자무증상TMJ군, 환자증상TMJ군은 P<0.05수준에서 유의성을 나타내었다.
5. 관절와외 고경 (Fh),중심교합에서의 안이평면과 구치부폐쇄로가 이루는 각 (∠C^^1), 중심교위에서의 교합평면선과 구치부폐쇄로가 이루는 각 (∠C^^2), 항목에서 정상TMJ군과 환자TMJ군은 P<0.05수군에서 유의성을 나타내었다.
6. 모든 계측치들 사이에서의 상관계수(r)는 0.8771≥ r≥ -0.9039에 존재하였으며, 이가운데 최고치는 정상TMJ군에서는 제 1대구치의 교합간 거리 (Fm)대 제 1소구치의 교합간 거리 (Fp) 항목에서 관찰되었고, 환자무증상TMJ군에서는 과두중심정이동거리 (O^^0∼O^^2)대 과두중심절이동각(∠A) 항목에서 관찰되었고, 환자증상TMJ군에서는 안이평면과 구치부폐쇄로가 이루는 각 (∠C^^l ) 대 중심교위에서의 교합평면과 구치부폐쇄로가 이루는
각(∠C^^2) 항목에서 각각 관찰되었다.
[영문]
The author obtained individualized lateral cephalometric tomograms from 23 young adults(46 of left and right normal TMJ) with normal occlusion and 20 patients (14 of patient asymptomatic TMJ and 26 of patient symptomatic TMJ) with clicking and painful TMJ after the analysis of submental vertex view.
Individualized lateral cephlometric tomogram analysis and TMJ space analysis were per-formed after tracing each film.
All data from these analysis was recorded and statistically processed with CYBER computer system.
The results were obtained as fellows.
1. In submental vertex view, the mean condylar angulation of Rt. side in normal group was 20.348°±6.358°, Lt. side was 18.870°±7.777° and Rt. side in patient group was 19.350°±7.576°, Lt. side was 17.750°±6.146° respectively. The mean condylar angulation of Rt. side was larger than Lt. side in normal and patient group.
2. When the mandible was moved from centric occlusion to centric relation, condylar position relating to the glenoid fossa was placed posteriorly and superiorly in normal TMJ group and patient symptomatic TMJ group.
3. In centric relation position, the proportion of anterior space to posterior space was 1.593 for normal TMJ group, 1.604 for patient asymptomatic TMJ group and 1.671 for patient symptomatic TMJ group. In centric occlusion position, 1.370 for
normal TMJ group, 1.539 for patient asymptomatic TMJ group and 1.176 for patient symptomatic group.
4. Normal TMJ group, patient asymptomatic TMS group and patient symptomatic TMJ group and patient symptomatic TMJ group revealed significant difference in ∠C^^2 measurement.(ANOVA-tet, p<0.05)
5. Normal group and patient group revealed significant difference in Fh, ∠C^^1 and ∠C^^2 measurement. (T-test. p<0.05)
6. There were strong positive correlation (0.8771) between Fp and Fm, and strong negative correlation (-0.9039) belween ∠C^^2 and ∠C^^1 from the lateral cephalometric tomogram analysis.restrictio
Estradiol upregulates voltage-gated sodium channel 1.7 in trigeminal ganglion contributing to hyperalgesia of inflamed TMJ.
No full textBackgroundTemporomandibular disorders (TMDs) have the highest prevalence in women of reproductive age. The role of estrogen in TMDs and especially in TMDs related pain is not fully elucidated. Voltage-gated sodium channel 1.7 (Nav1.7) plays a prominent role in pain perception and Nav1.7 in trigeminal ganglion (TG) is involved in the hyperalgesia of inflamed Temporomandibular joint (TMJ). Whether estrogen could upregulate trigeminal ganglionic Nav1.7 expression to enhance hyperalgesia of inflamed TMJ remains to be explored.MethodsEstrous cycle and plasma levels of 17β-estradiol in female rats were evaluated with vaginal smear and enzyme linked immunosorbent assay, respectively. Female rats were ovariectomized and treated with 17β-estradiol at 0 μg, 20 μg and 80 μg, respectively, for 10 days. TMJ inflammation was induced using complete Freund's adjuvant. Head withdrawal thresholds and food intake were measured to evaluate the TMJ nociceptive responses. The expression of Nav1.7 in TG was examined using real-time PCR and western blot. The activity of Nav1.7 promoter was examined using luciferase reporter assay. The locations of estrogen receptors (ERα and ERβ), the G protein coupled estrogen receptor (GPR30), and Nav1.7 in TG were examined using immunohistofluorescence.ResultsUpregulation of Nav1.7 in TG and decrease in head withdrawal threshold were observed with the highest plasma 17β-estradiol in the proestrus of female rats. Ovariectomized rats treated with 80 μg 17β-estradiol showed upregulation of Nav1.7 in TG and decrease in head withdrawal threshold as compared with that of the control or ovariectomized rats treated with 0 μg or 20 μg. Moreover, 17β-estradiol dose-dependently potentiated TMJ inflammation-induced upregulation of Nav1.7 in TG and also enhanced TMJ inflammation-induced decrease of head withdrawal threshold in ovariectomized rats. In addition, the estrogen receptor antagonist, ICI 182,780, partially blocked the 17β-estradiol effect on Nav1.7 expression and head withdrawal threshold in ovariectomized rats. ERα and ERβ, but not GPR30, were mostly co-localized with Nav1.7 in neurons in TG. In the nerve growth factor-induced and ERα-transfected PC12 cells, 17β-estradiol dose-dependently enhanced Nav1.7 promoter activity, whereas mutations of the estrogen response element at -1269/-1282 and -1214/-1227 in the promoter completely abolished its effect on the promoter activity.ConclusionEstradiol could upregulate trigeminal ganglionic Nav1.7 expression to contribute to hyperalgesia of inflamed TMJ
Deterioration of Mechanical Properties of Discs in Chronically Inflamed TMJ
No full textTemporomandibular joint (TMJ) discs frequently undergo degenerative changes in arthritis. However, the biomechanical properties of pathogenic discs remain to be explored. In this study, we evaluated the effects of chronic inflammation on the biomechanical properties of TMJ discs in rats. Chronic inflammation of TMJs was induced by double intra-articular injections of complete Freund's adjuvant for 5 weeks, and biomechanical properties and ultrastructure of the discs were examined by mechanical testing, scanning electron microscopy, and transmission electron microscopy. The instantaneous compressive moduli of the anterior and posterior bands of discs in inflamed TMJs were decreased significantly compared with those in the control group. The instantaneous tensile moduli of the discs of inflamed TMJs also showed significant decreases in both the anterior-posterior and mesial-lateral directions. The relaxation moduli of the discs of inflamed TMJs showed nearly the same tendency as the instantaneous moduli. The surfaces of the discs of inflamed TMJs became rough and porous due to the loss of the superficial gel-like stratum, with many collagen fibers exposed and degradation of the sub-superficial collagen fibrils. Our results suggested that chronic inflammation of TMJ could lead to deterioration of mechanical properties and alteration of disc ultrastructure, which might contribute to TMJ disc displacement.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000343975100018&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Dentistry, Oral Surgery & MedicineSCI(E)[email protected]; [email protected]
Hippocampal Nerve Growth Factor Potentiated by 17 beta-Estradiol and Involved in Allodynia of Inflamed TMJ in Rat
No full textThe hippocampus is believed to play an important role in sex-based differences of pain perception. Whether estrogen potentiates allodynia in the inflamed temporomandibular joint (TMJ) through affecting the expressions of pain-related genes in the hippocampus remains largely unknown. Because the nerve growth factor (NGF) is an important gene related to inflammatory pain, we tested whether hippocampal NGF may be involved in TMJ inflammatory pain. Here we showed that the rat hippocampal NGF was upregulated by TMJ inflammation induced by complete Freund adjuvant. NGF upregulation was further potentiated by estradiol in a dose-dependent manner. In contrast, NGF transcription in the amygdala, prefrontal cortex, and thalamus was not affected by TMJ inflammation and estradiol. An intrahippocampal injection of NGF antibody or NGF receptor inhibitor K252a (inhibitor for tropomyosin receptor kinase A, TrkA) reduced the allodynia of inflamed TMJ in proestrous rats. Our data suggest that the hippocampal NGF is involved in estradiol-sensitized allodynia of inflammatory TMJ pain. Perspective: We report that complete Freund adjuvant induced temporomandibular joint (TMJ) inflammation upregulated hippocampal nerve growth factor (NGF) expression, and estradiol replacement potentiated this upregulation. These results propose that estradiol could modulate TMJ pain through the NGF signaling pathway in the hippocampus to exacerbate TMJ pain and offer a possible mechanism of sexual dimorphism of temporomandibular disorder pain. (C) 2012 by the American Pain Societyhttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000305366400006&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Clinical NeurologyNeurosciencesSCI(E)PubMed4ARTICLE6555-5631
The TMJ Troubles and Their Nutritional Consequences
No full textThe term temporomandibular disorder (TMD) refers to a heterogeneous group of pathologies affecting the stomatognathic system, characterized by pain and functional limitation within the temporomandibular joint (TMJ) area, the muscles of mastication, and the related structures. TMDs are considered the most common cause of orofacial pain of nondental origin and are currently included within the musculoskeletal disorders. They are characterized by a classically described triad of clinical signs: muscle and/or TMJ pain; TMJ sounds; and restriction, deviation, or deflection of the mouth opening path. TMD symptoms have always been considered to have a broad prevalence peak between 20 and 40 years of age, with a lower prevalence in younger and older people. For specific TMD conditions, distinct peaks were recently identified in patient populations: one around the age of 30 years for subjects with disc displacements and another over the age of 50 years for inflammatory-degenerative joint disorders. The etiology of TMD is complex, multifactorial and consistent with the biopsychosocial model of illness. Negative emotional states such as depression and anxiety are known contributing factors to TMD.
Clinical studies agree that chronic medical conditions have strong negative effects on quality of life.
TMD that run a chronic course are more likely associated with psychological and somatic complaints as well as sleep disturbances. Stressful and dynamic academic, work or family environments can also sufficiently.
The most common symptoms observed in patients with temporomandibular disorders are: chronic pain; loss of energy; activity restriction (inability) of physical ailments and emotional disorders; emotional state; general health problems; anxiety/depression; voice changes; taste changes, discomfort when eating, owing to limited mandibular opening and pain and discomfort with biting and chewing. Consequently, painful TMD may affect dietary intake and nutritional status.
Management of painful TMD is multifaceted and involves pharmacologic, physical, and cognitive behavior and dietary therapies. There is a lack of evidence‐based dietary guidelines for patients that clinicians can use to assess and manage diet and nutritional well-being in patients with this disorder. The Author presents recommendations to guide clinicians on how to help the neglected patients with painful TMD improve the quality of their diets and avoid or minimize eating-related pain.
The areas of discussion will include reviewing the following: potential impact of painful TMD on eating and nutritional status; potential role of diet and nutrition in the TMD management; and dietary guidance for patients with TMD
Finite Element Analysis of Asymptomatic TMJ Disc during Mouth Opening
No full textIn the temporomandibular joint (TMJ), overloading induced by big mouth opening appears to be important in the casade of events leading to temporomandibular disorders (TMD). In this study, the stress distribution of the disc was explored during big mouth opening. For this purpose, finiteelement models of the disc of different mouth opening degree were used. The disc was loaded with its real displacement for 18 different states of mouth opening. In the model, the posterior zone suffered higher tensile stress, and the stress level increased with the progress of the opening movement. The compressive stress level in the intermediate zone is much smaller, and kept unchanged through mouth opening. Lower tangential stresses were found in the healthy articular disc during mouth opening. This indicates that stress distribution in the articular disc changed with the progress of the opening movement. Excessive mouth opening can induce tissue damage.Computer Science, Information SystemsComputer Science, Theory & MethodsEICPCI-S(ISTP)
A new hypothesis of sex-differences in temporomandibular disorders: Estrogen enhances hyperalgesia of inflamed TMJ through modulating voltage-gated sodium channel 1.7 in trigeminal ganglion?
No full textObjective: Temporomandibular disorders (TMD) are an assorted set of clinical conditions characterized mainly by pain in the temporomandibular joint (TMJ). TMJ inflammation or synovitis is frequently observed in TMD patients and is the major reason for TMD pain. TMD is prevalent in women of childbearing age, at least twice than in men, implying that estrogen may be involved in TMD pain processing. Estrogen affects a cell mainly through the estrogen receptors (ER). The estrogen-ER complex binds to estrogen response element sequences (ERE) in the promoter region of specific genes and then exerts its regulatory potential. The voltage-gated sodium channel 1.7 (Nav1.7), whose single disruption leads to a complete loss of pain, amplifies weak stimuli in the neurons and acts as the threshold channel for firing action potentials and plays a prominent role in pain perception, including inflammatory pain. Furthermore, our previous study showed that trigeminal ganglionic Nav1.7 was involved in the hyperalgesia of the inflamed TMJ. We propose that estrogen may enhance hyperalgesia of inflamed TMJ through decrease nociceptive threshold of TMJ or inflamed TMJ by modulating both expression and channel threshold of Nav1.7 in trigeminal ganglion. (c) 2014 Elsevier Ltd. All rights reserved.http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000349507200005&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=8e1609b174ce4e31116a60747a720701Medicine, Research & ExperimentalSCI(E)[email protected]; [email protected]
Synovial chondromatosis of the temporomandibular joint accompanied by loose bodies in both the superior and inferior joint compartments : case report
No full textSynovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a benign lesion characterized by the formation of metaplastic cartilaginous nodules. SC of the TMJ usually only affects the superior joint compartment of the TMJ. We report a rare case of SC of the TMJ affecting the inferior as well as superior joint compartments
Prevalence of the huschke foramen in colombian population: an important anatomic alteration for the planning of tmj arthroscopy
No full textBackground: Ignoring this anatomic structure would have implications for iatrogenic perforation with the trocar toward the FH during the initial blind drilling or due to the diffusion of the infusion liquid toward the middle ear. Purpose: To analyze the prevalence of the FH in an institutional population with a high incidence of TMD to provide further guidelines in diagnosing this anomaly and the planification of TMJ arthroscopy. Materials and Methods: A retrospective tomographic study was conducted at the ENT¿Oral and Maxillofacial and Radiology Department of the Hospital Universitario la Samaritana in Bogotá, Colombia. Inclusion criteria were patients over 18 years of age who had complementary exams such as ear, face, paranasal sinus, and/or TMJ tomography. Exclusion criteria were history of direct trauma to the external auditory canal in the medical history, patients with craniofacial syndromes, congenital anomalies, and/or history of cranial, mandibular, or temporal fractures. Two radiologists were part of the evaluators of the CT images who conducted the measures in the axial tomographic section and established the presence of the tympanic defect. Results: A sample size of 139 medical records of patients, where females represent n: 101 (72.6%) and males represent n: 38 (27.4%). The average age was 43 years ± 18 years. Among the studied population, a total of five FH were detected, corresponding to a prevalence of 3.6% (95% CI 1.5¿8.1%). The average size of the defect was 3.52 mm ± 1.1 mm. All the patients had TMJ-related symptoms, but none of them reported otalgia. Conclusion: The initial evaluation of each patient must be addressed to assess the integrity of the tympanic bone. In this study, the defects size was smaller than others previously reported. However, diffusion through the tympanic defect could spread the lavage substance into the middle ear during TMJ arthroscopic surgery. © The Author(s) 2024
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