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Most older adults have TMJ degeneration, which affects women more than men. In most older adults, the symptoms of TMD are mild and self-limiting and can usually be treated with self management.

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Objectives The generation of transgenic mice expressing green fluorescent proteins (GFPs) has greatly aided our understanding of the development of connective tissues such as bone and cartilage. Perturbation of a biological system such as the temporomandibular joint (TMJ) within its adaptive remodeling capacity is particularly useful in analyzing cellular lineage progression. The objectives of this study were to determine: (i) if GFP reporters expressed in the TMJ indicate the different stages of cell maturation in fibrocartilage and (ii) how mechanical loading affects cellular response in different regions of the cartilage. Design/Methods Four-week-old transgenic mice harboring combinations of fluorescent reporters (Dkk3-eGFP, Col1a1(3.6kb)-GFPcyan, Col1a1(3.6kb)-GFPtpz, Col2a1-GFPcyan, and Col10a1-RFPcherry) were used to analyze the expression pattern of transgenes in the mandibular condylar cartilage. To study the effect of TMJ loading, animals were subjected to forced mouth opening with custom springs exerting 50 grams force for 1 hour/day for 5 days. Dynamic mineralization and cellular proliferation (EdU-labeling) were assessed in loaded vs control mice. Results Dkk3 expression was seen in the superficial zone of the mandibular condylar cartilage, followed by Col1 in the cartilage zone, Col2 in the prehypertrophic zone, and Col10 expression hypertrophic zone at and below the tidemark. TMJ loading increased expression of the GFP reporters and EdU-labeling of cells in the cartilage, resulting in a thickness increase of all layers of the cartilage. In addition, mineral apposition increased resulting in Col10 expression by unmineralized cells above the tidemark. Conclusion The TMJ responded to static loading by forming thicker cartilage through adaptive remodeling.

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Mini-implants provided absolute anchorage to bring about significant dental and soft tissue changes in moderate to severe Class II division 1 patients and can be considered as possible alternatives to orthognathic surgery in select cases.

Objective: To compare the treatment effects of maxillary anterior teeth retraction with mini-implant anchorage in young adults with Class II division 1 malocclusion undergoing extraction of the maxillary first premolars with similar patients treated by a fixed functional appliance. Materials and Methods: Thirty-four young adult female patients (mean age 16.5 6 3.2 years, overjet $ 6 mm) with a Class II division 1 malocclusion were divided into two groups: group 1 (G1), in which overjet correction was obtained with a fixed functional appliance (FFA), and group 2 (G2), in which upper first premolars were extracted, followed by space closure with MIs as anchor units. Dentoskeletal and soft tissue changes were analyzed on lateral cephalograms taken before (T1) and after (T2) correction of the overjet. Results: Both methods were useful in improving the overjet and interincisal relationships. Extrusion and mesial movement of the lower molar, together with lower incisor proclination, were noted in G1. G2 showed distalization and intrusion of the upper molar. The nasio-labial angle became more obtuse in G2, while lower lip protrusion was seen for G1. Conclusions: The two treatment protocols provided adequate dental compensation for the Class II malocclusion, but did not correct the skeletal discrepancy. There were significant differences in the dental and soft tissue treatment effects between the two treatment protocols. (Angle Orthod. 2012;82:294-303.)