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Relationship of TMJ articular soft tissue to underlying bone in young adult condyles.

This investigation used a histological model to study the relationship of articular soft-tissue thickness and contour to the underlying bone in the TMJ condyle of young adults. The usefulness of selected dental and demographic factors in the prediction of the articular soft-tissue thickness and contour was also tested. One sagittal histological section was studied from the lateral, central, and medial thirds of 53 left mandibular condyles. Outline tracings of the articular and compact bone surface were divided into anterior, superior, and posterior sectors for the study of curvature measured by the overlaying of a template of a harmonic series of arcs. The thickness and composition of the articular tissues were measured in each sector by light microscopy. The fibrous connective tissue layer always maintained the articular surface, even in the absence of a cartilage layer. The histological character, including the presence or absence of cartilage, rather than the overall tissue thickness, was considered to be a more useful marker of functionally thickness was not related to surface deviation in form and was not correlated with age in this young adult sample. Reduced soft-tissue thickness in the anterior part of the condyle was more common in cases with lack of molar support. Dental attrition was not a useful predictor of soft-tissue thickness. Compact bone contour correlated with soft-tissue contour in the superior (r = 0.816) and posterior (r = 0.808) sectors, explaining only 64% of the variance, but not in the anterior sector (r = 0.265). Thicker or thinner articular soft tissue was not predictable by the underlying compact bone contour or thickness. Therefore, the clinician should not automatically assume that the radiographic osseous image represents the actual articular surface.

Adolescent↗

Biochemical characterization of a virus-induced osteosarcoma-like osseous lesion in vitro.

Chondroprogenitor cells present in the apical and lateral parts of the mandibular condyle from neonatal mice differentiate towards the osteoblastic lineage and form bone within 7 days in culture. Infection of condylar explants with the FBR osteosarcoma virus (FBR MSV) results in the transformation of cells in the progenitor zone, previously identified as the target for the virus, and the formation of a transplantable osteosarcoma-like lesion. Morphological and biochemical changes in this system were investigated in the course of tumor development. Virus infection was followed by a significant increase in cell density and 3H-thymidine incorporation within the progenitor zone at the early stage of culture. In later stages, cell density and 3H-thymidine incorporation were lower than in control tissue. The 3H-thymidine labeling index gave similar results in infected and control tissues until day 7. Then, a significantly higher labeling index was found in the progenitor zone of infected condyles. At this stage, the proliferative effect of the virus even affected the cartilagenous core of the tissue. Quantitative alkaline phosphatase activity increased between day 3 and day 7 and was particularly high in the zone of infected cells. In addition, infected tissues consistently revealed a higher uptake of 45Ca, and deposition of the radioisotope along irregularly formed bone trabecules in the transformed tissue. The results suggest that there is an enhancement of tissue maturation following infection with the FBR osteosarcoma virus. Although biochemical investigations of whole condyles showed few differences in the total values of alkaline phosphatase activity, 3H-thymidine incorporation, DNA content, and 45Ca uptake, the histochemical assays revealed clear differences in the distributional pattern of these parameters within infected and control condyles.

Alkaline Phosphatase↗

Geometric morphometric assessment of treatment effects of maxillary protraction combined with chin cup appliance on the maxillofacial complex.

The aim of this study was to investigate the treatment effects on the maxillofacial complex by maxillary protraction combined with chin cup therapy among growing children. An effective geometric morphometric assessment of cephalometric radiographs, using Procrustes analysis and thin-plate spline analysis, was applied to evaluate shape change in the craniofacial and midfacial configurations of a treated sample of 20 children with skeletal Class III malocclusion. This was compared with matched untreated skeletal Class III controls. Marked treatment induced change involved the maxilla and the mandible. Major deformation consisted of forward advancement of the maxillary complex with negligible rotation of the palatal plane and a forward direction of growth of the mandibular condyle associated with a restriction in sagittal advancement of the chin. Considerable dentoalveolar components contributed to the correction of anterior crossbite. Further detailed study of skeletofacial remodelling in response to maxillary protraction in other skeletal components, including the cranial base and the mandibular complex that contribute to Class III skeletal discrepancies, is warranted.

Cephalometry↗

Bite force and temporomandibular disorder in juvenile chronic arthritis.

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

Adolescent↗

Condylar position recorded using leaf gauges and specific closure forces.

Retruded interocclusal records were made for 40 subjects after deprogramming using leaf gauges and controlled incisal forces, which were exerted on a specially constructed occlusal force sensor. These records were used to assess the resulting displacements of the mandibular condyles from their positions in centric occlusion. The leaf gauges were found not to position the condyles inferiorly and posteriorly as has been previously reported.

Adult↗

Synovial chondromatosis of the temporomandibular joint with condylar extension.

Synovial chondromatosis is a benign disease that rarely affects the temporomandibular joint (TMJ). It can be seen commonly in the superior joint space and presents with various signs and symptoms according to the stage of progression. Sometimes it presents as a large swelling in the preauricular area with or without cranial extension, and the clinical and radiographic findings may be misdiagnosed as other benign or malignant diseases of TMJ. Therefore, we report an uncommon case of synovial chondromatosis presenting as a large preauricular mass arising from the inferior joint space of the TMJ with bony resorption of the mandibular condyle, which mimicked osteochondroma.

Aged↗

Craniofacial growth in bone marrow transplant recipients treated with growth hormone after total body irradiation.

The effect of growth hormone (GH) treatment on craniofacial development was studied in five children exhibiting growth retardation following bone marrow transplantation. Linear and angular measurements were made on lateral radiographic cephalograms taken prior to the start of GH treatment and after an average treatment time of 1.2 yr. The results showed that the mean growth increments of mandibular length in the GH treated children, exceeded the corresponding values of the control group by 150% during the period of investigation. It is suggested that this dimensional increase in the patients was due to GH stimulation on the chondral growth process in the mandibular condyles.

Adolescent↗

Relation of the glenoid fossa to craniofacial morphology, studied on dry human skulls.

The purpose of this work was to compare glenoid fossa dimensions and craniofacial morphology on the basis of standard lateral roentgenograms. To overcome the difficulties encountered in making exact measurements on living subjects, 59 dry skulls were used. Eight angular measurements were taken to describe the form of the skull base, mandible, and articulating surface of the glenoid fossa, four linear measurements to describe the position of the fossa, and one to describe the size of the whole skull. A close relationship was observed between the morphology of the articulating surface of the glenoid fossa and the mandibular morphology. The skull base angulation was associated with the position of glenoid fossa in two ways. Basically, the position of the fossa is related to skull base characteristics, but the location of the articular eminence in relation to the clival plane suggests that the mandibular condyle may cause a remodeling of the eminence anteriorly when the glenoid fossa otherwise is translocated posteriorly in association with the flat skull base.

Adult↗

Asymmetry of normal mandibular condylar shape.

Morphological studies of the facial skeleton in human beings are usually made from radiographs (frontal and lateral projections and orthopantomographs). The conventional linear and angular measurements provide quantitative information only about size, and fail to define the shape and form of the skeletal features and their variations. Mathematical methods such as the Fourier series allow a correct quantitative analysis of the shape and its variations. The outlines of the mandibular condyles in the orthopantomographs of 20 men and 20 women (mean age 29 years) were traced and digitized. All subjects had a good dentition, no temporomandibular joint problems, and were referred to a dental surgery for periodontal problems. A Fourier analysis of the outlines was performed. Fourier coefficients and reconstructed outlines were compared to analyze the condylar symmetry of shape on an intra- and intersubject basis. A significant condylar asymmetry for shape as distinct from size was found on an intrasubject basis, i.e. the left and right condyles of a single individual had a different shape with a large interindividual variability. Conversely, the mean condyle shape of the male and female groups was symmetric.

Adolescent↗

Electron microscopic observations on the fate of hypertrophic chondrocytes in condylar cartilage of rat mandible.

The present study focused on the hypertrophic cell zone and the adjacent region of primary spongiosa in the mandibular condylar cartilage in growing rats (3 to 7 weeks old). In this cartilage, chondrocytes were not arranged in columns, and there was no clear distinction between longitudinal and transverse septum. The hypertrophic chondrocytes were not surrounded entirely by calcified matrix, and capillaries were in close contact with cartilage cells. The staining intensity of the pericellular matrix decreased in the lower hypertrophic cell zone in comparison with that in the upper part of the hypertrophic cell zone. Electron microscopic examinations indicated that the lowest hypertrophic cells contained lysosomes and pinocytotic vesicles. Some hypertrophic chondrocytes appeared to have been released from their lacunae and were observed in the region of the primary spongiosa. Hence it is suggested that the lowest hypertrophic chondrocytes in the rat mandibular condyle do not die but are released from their lacunae into the bone marrow. Further study is needed to determine whether or not these cells do indeed become osteoblasts and/or chondroclasts.

Animals↗

Influence of growth hormone on the mandibular condylar cartilage of rats.

UNLABELLED: Growth hormone (GH) stimulates mandibular growth but its effect on the mandibular condylar cartilage is not well understood. OBJECTIVE: This study was designed to understand the influence of GH on mitotic activity and on chondrocytes maturation. The effect of GH on cartilage thickness was also determined. DESIGN: An animal model witt differences in GH status was determined by comparing mutant Lewis dwarf rats with reduced pituitary GH synthesis (dwarf), with normal rats and dwarf animals treated with GH. Six dwarf rats were injected with GH for 6 days, while other six normal rats and six dwarf rats composed other two groups. Mandibular condylar tissues were processed and stained for Herovici's stain and immunohistochemistry for proliferating cell nuclear antigen (PCNA) and alkaline phosphatase (ALP). Measurements of cartilage thickness as well as the numbers of immunopositive cells for each antibody were analysed by one-way analysis of variance. RESULTS: Cartilage thickness was significantly reduced in the dwarf animals treated with GH. PCNA expression was significant lower in the dwarf rats, but significantly increased when these animals were treated with GH. ALP expression was significant higher in the dwarf animals, while it was significantly reduced in the dwarf animals treated with GH. CONCLUSIONS: The results from this study showed that GH stimulates mitotic activity and delays cartilage cells maturation in the mandibular condyle. This effect at the cellular level may produce changes in the cartilage thickness.

Alkaline Phosphatase↗

Prognostic factors in arthrocentesis of the temporomandibular joint: evaluation of 100 patients with internal derangement.

PURPOSE: The goal of this study was to analyze the prognostic factors for successful arthrocentesis for internal derangement (ID) of the temporomandibular joint (TMJ). PATIENTS AND METHODS: Arthrocentesis was carried out as the initial treatment in 103 TMJs of 100 patients with ID. The effectiveness of the treatment was evaluated in terms of the postoperative range of maximal mouth opening (MMO) and the degree of preoperative pain on a visual analog scale (VAS). Prognostic factors analyzed were age, sex, duration of painful locking, preoperative and postoperative range of MMO, preoperative degree of pain, preoperative clicking on opening mouth before becoming locked, and magnetic resonance imaging (MRI) findings. These factors were statistically analyzed. RESULTS: Seventy-three cases (71%) satisfied the criteria for success. One week after the procedure, the mean range of MMO in the successful cases (43.8 +/- 5.5 mm) was significantly greater than that in unsuccessful cases (36.9 +/- 6.6 mm) (P <.05). The mean preoperative degree of pain on a VAS in successful cases (4.7 +/- 2.9) was significantly smaller than that in unsuccessful cases (6.2 +/- 2.1) (P <.05). The preoperative incidence of morphologic changes in the mandibular condyle seen on MRI of successful cases was significantly less than that in unsuccessful cases (P <.05). CONCLUSION: Severe preoperative pain, relapse in the amount of mouth opening within 1 week after arthrocentesis, and preoperative bony changes in the condyle may be predictors of the effectiveness of arthrocentesis for ID of the TMJ.

Adolescent↗

Cartilage in the face.

Cartilaginous influence in the face begins with the formation of the early chondrocranium and continues into the postnatal life with the persisting derivatives of the chondrocranium, the cranial base synchondroses and the nasal septum, and with the secondary cartilage of the mandibular condyle. A review of available data indicates that the cartilages should be considered as integral parts of a holistic system, and that their role within this system most likely diminishes with age.

Cartilage↗

Cranial base considerations between apnoeics and non-apnoeic snorers, and associated effects of long-term mandibular advancement on condylar and natural head position.

One hundred consecutively medically referred patients (58 apnoeic and 42 asymptomatic snorers) were reviewed cephalometrically at six-monthly intervals (6-30 months) following treatment for obstructive sleep apnoea (OSA) and/or habitual snoring by mandibular advancement. Eighty-seven males and 13 females (mean age 49 years, SD 8.5, range 33-74) were included in this study. Reference points and planes in the cranial base, nasopharynx, and mandibular condyle were digitized with a Reflex Metrograph and their means converted to linear and angular measurements. No statistically significant differences were observed between the apnoeic and non-apnoeic groups in either their skeletal or cranial base measurements. All linear cranial base dimensions were, however, reduced in the apnoeic group, with the exception of the distance (S-SE). Following mandibular advancement, statistically significant changes were observed in vertical condylar position (Cd-vert) with changes occurring at 6 (P < 0.012), 18 (P < 0.043), and 24 months (P < 0.007). No changes in horizontal condylar position (Cd-horiz) were found. Significant changes were observed in natural head position (NHP) with a reduction from an extended (NSL-vert 99.7 degrees) to a more upright NHP (NSL-vert 93.0, P < 0.001).

Adult↗

Experimental occlusal interferences. Part IV. Mandibular rotations induced by a pliable interference.

In 12 subjects, a pliable, yet unbreakable, intercuspal interference (aluminum shim onlay splint; uniform height of 0.25 mm) was placed between either the right or left maxillary and mandibular second premolars and first molars. During brief and forceful biting (dynamic chewing stroke of about 20 kg force) the interference emulated a semisoft food bolus, and at the end of biting (subsequent static clenching stroke of about 20 kg force) it emulated a rigid metal interference. During dynamic/static biting, rotational electrognathography measured maximum frontal and horizontal plane torque of the right and left mandibular condyles. Eleven subjects (92%) showed frontal plane upward rotation (mean of 1.0 degree) of the condyle contralateral to the interference, and one subject (8%) showed frontal plane upward rotation (0.4 degree) of the condyle ipsilateral to the interference. Two subjects (17%) showed no horizontal plane rotation; seven subjects (58%) showed backward rotation (mean of 0.4 degree) of the condyle contralateral to the interference; and three subjects (25%) showed backward rotation (mean of 0.3 degree) of the condyle ipsilateral to the interference. It is suggested that, in the presence of an occlusal interference, mastication may have both short- and long-term detrimental effects.

Adult↗

[Involvement of the temporomandibular joint in rheumatoid arthritis].

The rheumatoid arthritis is a systemic connective tissue disease, that most of the cases involve the temporomandibular joint. The diagnosis of local involvement is usually not difficult because the disease often starts in other peripheral small joints. The radiographic signs can be observed more frequently than clinical and subjective symptoms. The local symptoms are pain, opening difficulty, stiffness in the morning and swelling. The maximal mouth opening is restricted by the reduced translatory movement of the mandibular condyle. The aim of this case presentation is to describe the temporomandibular aspects of the rheumatoid arthritis and to suggest the usefulness of the condylar movement registration in the diagnostic procedure of the disease.

Arthritis, Rheumatoid↗

[Early effects of the cyclic uniaxial compressive stress on Stress70/GRP75 in the rat condylar chondrocytes].

PURPOSE: The purpose of this study was to investigate the early effects of the cyclic uniaxial compressive stress on Stress70/GRP75 in the rat condylar chondrocyte. METHODS: The third-passage chondrocytes were harvested from the mandibular condyles of 2-day-old rats for this study, and a cellular compressive stress device (self-made four-point bending system, Patent No.01129166.4 & 01256849.x) was used to apply stress on cells at 4000 microstrain (0.5 Hz frequency) for 0, 15, 30, 60, 120, 240 minutes respectively. The early effects of the cyclic uniaxial compressive stress on Stress70/GRP75 in the rat mandibular condylar chondrocytes were examined by Western blot and image analysis. One-way ANOVA was used for statistical analysis. RESULTS: The results showed that the expression of Stress70/GRP75 changed significantly with 4000 microstrain compressive stress loading. The gray scale value of protein band at 0 minute was 114.2+/-5.08, significantly decreased to 86.1+/-5.09 (P<0.001) after 30 minutes, and then gradually increased to 104.0+/-4.41 (P<0.01) at 60 minutes. The expression of Stress70/GRP75 up-regulated to 134.5+/-3.74 (P<0.001) at 120 minutes, and continued to increase within 240 minutes. CONCLUSION: There is time-dependent response between the 4000 microstrain compressive stress stimulate and Stress70/GRP75. The expression of Stress70/GRP75 inhibited initially under the compressive stress, and then increased by feedback with the increased loading time.

Animals↗