Skeletal maturation and predicted adult height in adolescents with temporomandibular joint osteoarthritis

Abstract

| BACKG ROU N DTemporomandibular disorders (TMDs) encompass a collection of musculoskeletal and neuromuscular conditions which affect the temporomandibular joint (TMJ), the masticatory muscles and associated structures. 1 Osteoarthritis (OA) of the TMJ is the most severe type of manifestation of TMD and featured by deterioration and abrasion of the articular cartilage and concomitant remodelling of the underlying subchondral bone. 2 TMJ OA is epidemiologically different from OA of the hip, hand or knee joints, the development of which is closely related to ageing. 3 Early onset of condition, especially during the pubertal phases has already been described in previous reports. 4,5 The exact pathophysiology of TMJ OA in adolescents, however, has not been clearly revealed.Adolescence is a unique life stage during which an individual undergoes a biopsychological transition from childhood to adulthood, SummaryBackground: The occurrence of osteoarthritis (OA) of the temporomandibular joint (TMJ) in juveniles could be associated with fluctuating levels of oestrogen and growth hormone (GH) during adolescence.Objective: To investigate extent of skeletal maturation and predicted adult height in adolescents with TMJ OA. Method:In total, 155 adolescents (54 males, 101 females; mean age, 14.1 ± 2.0 years) were enrolled. Among them, 19 adolescents (CON) showed no sign of TMD, 50 adolescents exhibited signs of disc displacement but did not have TMJ OA (TMDnoOA), 23 adolescents exhibited the initial stage of TMJ OA (TMJOAini) and 63 adolescents exhibited the severe stage of TMJ OA (TMJOApro). TMJ OA was diagnosed based on the Research Diagnostic Criteria axis I and bone age was estimated using the Greulich-Pyle method. The height, weight and body mass index of participated adolescents were measured and statistically converted to z-scores. The predicted adult height and age of peak height velocity (APHV) were calculated using the BoneXpert® software. Results:In female adolescents, the differences between the chronological and bone ages were significantly higher and the z-score for height was significantly lower in the TMJOApro. Female adolescents with TMJOA exhibited a significantly shorter predicted adult height and earlier APHV than those in the CON and TMDnoOA. Conclusion:The adolescents with TMJ OA exhibited premature skeletal maturations and short predicted adult stature, particularly the female adolescents. K E Y W O R D Sadolescent, female, growth, height, osteoarthritis, temporomandibular joint disorders

Osteoarthritis of the Temporomandibular Joint: A Narrative Overview

“…In addition, TMJOA affects not only adults but also adolescents [ 3 ]. Previous reports have described the early onset of TMJOA, especially during the pubertal phase [ 24 ].…”

“…Changes in estrogen levels are considered as a cause of TMJOA in women [ 13 ], and previous estrogen studies have reported conflicting results [ 13 , 44 ]. However, high estrogen levels appear to be destructive to the condylar cartilage but protective to the subchondral bone [ 24 , 44 ]. Adequate estrogen concentrations are important for TMJ homeostasis [ 13 ].…”

“…The etiology of TMJOA in adolescents is not well understood. Female sex hormones and growth hormones play a role in female preponderance as well as the occurrence of TMJOA during the circumpubertal stages [ 24 ]. In addition, a study by Lei et al suggested that TMJOA in young populations could be attributed to TMD such as disc displacement without reduction, and the prevalence of TMD in children and adolescents is increasing, which could partly explain the occurrence of TMJOA in adolescents [ 3 ].…”

An Update on Mesenchymal Stem Cell-Centered Therapies in Temporomandibular Joint Osteoarthritis

“…Due to the unique structure of the TMJ and its distinct composition of fibrocartilage, which predominantly contains type I collagen, the pathogenesis of TMJOA differs from the general OA that occurs in other joints, composed of hyaline cartilage to some extent [16]. The etiology of TMJOA is multifactorial [17], including risk factors from microtrauma, mechanical overload, malocclusion, bruxism, estrogen influence on systemic illness, and genetic variations [17][18][19][20][21]. Moreover, the pathogenesis of this disease is highly complicated and remains poorly understood, thus leading to current research focusing on underlying mechanisms (Figure 1).…”

Temporomandibular Disorders and Vitamin D Deficiency: What Is the Linkage between These Conditions? A Systematic Review

“…Although TMDs are considered to be a sub-classification of musculoskeletal disorders, the aetiological factors are not clearly understood, but are thought to involve anatomical factors. Mechanical displacement; prolonged use of mastication muscles; altered skeletal maturity; malocclusion; repetitive trauma at the TMJ; psychological disorders (e.g., anxiety and depressive syndrome); postural deviation; trauma; and general hypermobility of the joints could be potential risk factors [ 5 , 6 , 7 , 8 , 9 , 10 ]. However, it should be taken into consideration that a painful TMD might be considered as one of the main causes of orofacial pain [ 11 , 12 ], in the case of the exclusion of odontogenic causes [ 13 , 14 , 15 ].…”