Temporomandibular joint fibrocartilage degeneration from unilateral dental splints

Henderson, Sarah; Lowe, Jesse; Tudares, Mauro A.; Gold, Michael S.; Almarza, Alejandro J.

doi:10.1016/j.archoralbio.2014.08.022

Cited by 16 publications

(11 citation statements)

References 34 publications

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“…Changes in the ratio of type I/III collagen impact the material properties of the extracellular matrix [ 47 ]. This may explain why overloaded MCC is associated with a low compliance, high stiffness matrix [ 48 ]. In silico modeling predicts that the superficial layer promotes interstitial fluid pressurization during loading, lowering the deformation of the cartilage, and lowering the frictional forces on the condyle [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Two-photon fluorescence and second harmonic generation characterization of extracellular matrix remodeling in post-injury murine temporomandibular joint osteoarthritis

et al. 2019

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End stage temporomandibular joint osteoarthritis (TMJ-OA) is characterized by fibrillations, fissures, clefts, and erosion of the mandibular condylar cartilage. The goal of this study was to define changes in pericellular and interterritorial delineations of the extracellular matrix (ECM) that occur preceding and concurrent with the development of this end stage degeneration in a murine surgical instability model. Two-photon fluorescence (TPF) and second harmonic generation (SHG) microscopy was used to evaluate TMJ-OA mediated changes in the ECM. We illustrate that TPF/SHG microscopy reconstructs the three-dimensional network of key fibrillar and micro-fibrillar collagens altered during the progression of TMJ-OA. This method not only generates spatially distinct pericellular and interterritorial delineations of the ECM but distinguishes early and end stage TMJ-OA by signal organization, orientation, and composition. Early stage TMJ-OA at 4- and 8-weeks post-injury is characterized by two structurally distinct regions containing dense, large fiber collagens and superficial, small fiber collagens rich in types I, III, and VI collagen oriented along the mesiodistal axis of the condyle. At 8-weeks post-injury, type VI collagen is locally diminished on the central and medial condyle, but the type I/III rich superficial layer is still present. Twelve- and 16-weeks post-injury mandibular cartilage is characteristic of end-stage disease, with hypocellularity and fibrillations, fissures, and clefts in the articular layer that propagate along the mediolateral axis of the MCC. We hypothesize that the localized depletion of interterritorial and pericellular type VI collagen may signify an early marker for the transition from early to end stage TMJ-OA, influence the injury response of the tissue, and underlie patterns of degeneration that follow attritional modes of failure.

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Section: Discussionmentioning

confidence: 99%

Two-photon fluorescence and second harmonic generation characterization of extracellular matrix remodeling in post-injury murine temporomandibular joint osteoarthritis

et al. 2019

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“…The persistent change in kinematics likely resulted from the abnormal occlusion and degeneration of the condylar fibrocartilage observed in our previous studies. 7,19 The kinematics of the rabbit TMJ at the condyles and the incisors were easily measured using our noninvasive system before and after splint placement to determine the changes in the joint movement. The decreased range in incisal movement after splinting was comparable to a previous TMJ disc injury study.…”

Section: Discussionmentioning

confidence: 99%

“…The altered occlusion model used in the present study has been shown to produce condylar fibrocartilage degeneration that would likely not be detected using conventional magnetic resonance imaging. 7,19 Understanding the changes in joint movement that occur from various types of TMJDs could allow for earlier diagnosis and treatment; for example, if a certain signature of changes in movement are observed earlier before the onset of severe joint degeneration. As such, our findings suggest that decreases in 20% anteroposterior displacement of the working condyle might be indicative of condylar degeneration and early-stage TMJ-OA.…”

Section: Discussionmentioning

confidence: 99%

“…As a potential explanation for the relatively limited efficacy of interventions focused on the TMJ disc, the results from our rabbit TMJ-OA model have shown that condylar cartilage remodeling (stiffening and loss of the subchondral layer) occurs with a disc in its proper anatomic position. 7 Because the condylar cartilage resembles the early stages of OA, it is not known whether the TMJ kinematics were altered. If the joint kinematics do not return to normal, they could be a primary driver for additional joint degeneration and end-stage OA.…”

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confidence: 99%

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Decreased Temporomandibular Joint Range of Motion in a Model of Early Osteoarthritis in the Rabbit

Henderson

Tudares

Tashman

et al. 2015

Journal of Oral and Maxillofacial Surgery

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Purpose Analysis of mandibular biomechanics could help with understanding the mechanisms of temporomandibular joint (TMJ) disorders (TMJDs), such as osteoarthritis (TMJ-OA), by investigating the effects of injury or disease on TMJ movement. The objective of the present study was to determine the functional kinematic implications of mild TMJ-OA degeneration caused by altered occlusion from unilateral splints in the rabbit. Materials and Methods Altered occlusion of the TMJ was mechanically induced in rabbits by way of a unilateral molar dental splint (n = 3). TMJ motion was assessed using 3-dimensional (3D) skeletal kinematics twice, once before and once after 6 weeks of splint placement with the splints removed, after allowing 3 days of recovery. The relative motion of the condyle to the fossa and the distance between the incisors were tracked. Results An overall decrease in the range of joint movement was observed at the incisors and in the joint space between the condyle and fossa. The incisor movement decreased from 7.0 ± 0.5 mm to 6.2 ± 0.5 mm right to left, from 5.5 ± 2.2 mm to 4.6 ± 0.8 mm anterior to posterior, and from 13.3 ± 1.8 mm to 11.6 ± 1.4 mm superior to inferior (P < .05). The total magnitude of the maximum distance between the points on the condyle and fossa decreased from 3.6 ± 0.8 mm to 3.1 ± 0.6 mm for the working condyle and 2.8 ± 0.4 mm to 2.5 ± 0.4 mm for the balancing condyle (P < .05). The largest decreases were seen in the anteroposterior direction for both condyles. Conclusion Determining the changes in condylar movement might lead to a better understanding of the early predictors in the development of TMJ-OA and determining when the symptoms become a chronic, irreversible problem.

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“…The rabbit is a larger animal, and provides large enough tissues for reliable mechanical testing such as compression, tensile, shear, and friction. 24 It is important to note that the altered loading models are designed to understand the impact of a large change in the distribution of loads. These models do not replicate clenching or bruxism, but give insight into the mechanisms by which these behaviors could give rise to degeneration of the joint.…”

Section: Mechanical Methodsmentioning

confidence: 99%

Preclinical Animal Models for Temporomandibular Joint Tissue Engineering

Almarza

Brown

Arzi

et al. 2018

Tissue Engineering Part B: Reviews

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There is a paucity of in vivo studies that investigate the safety and efficacy of temporomandibular joint (TMJ) tissue regeneration approaches, in part due to the lack of established animal models. Review of disease models for study of TMJ is presented herein with an attempt to identify relevant preclinical animal models for TMJ tissue engineering, with emphasis on the disc and condyle. Although degenerative joint disease models have been mainly performed on mice, rats, and rabbits, preclinical regeneration approaches must employ larger animal species. There remains controversy regarding the preferred choice of larger animal models between the farm pig, minipig, goat, sheep, and dog. The advantages of the pig and minipig include their well characterized anatomy, physiology, and tissue properties. The advantages of the sheep and goat are their easier surgical access, low cost per animal, and its high tissue availability. The advantage of the dog is that the joint space is confined, so migration of interpositional devices should be less likely. However, each species has limitations as well. For example, the farm pig has continuous growth until about 18 months of age, and difficult surgical access due to the zygomatic arch covering the lateral aspect of joint. The minipig is not widely available and somewhat costly. The sheep and the goat are herbivores, and their TMJs mainly function in translation. The dog is a carnivore, and the TMJ is a hinge joint that can only rotate. Although no species provides the gold standard for all preclinical TMJ tissue engineering approaches, the goat and sheep have emerged as the leading options, with the minipig as the choice when cost is less of a limitation; and with the dog and farm pig serving as acceptable alternatives. Finally, naturally occurring TMJ disorders in domestic species may be harnessed on a preclinical trial basis as a clinically relevant platform for translation.

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Temporomandibular joint fibrocartilage degeneration from unilateral dental splints

Cited by 16 publications

References 34 publications

Two-photon fluorescence and second harmonic generation characterization of extracellular matrix remodeling in post-injury murine temporomandibular joint osteoarthritis

Two-photon fluorescence and second harmonic generation characterization of extracellular matrix remodeling in post-injury murine temporomandibular joint osteoarthritis

Decreased Temporomandibular Joint Range of Motion in a Model of Early Osteoarthritis in the Rabbit

Preclinical Animal Models for Temporomandibular Joint Tissue Engineering

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