Synovial fluid dynamics with small disc perforation in temporomandibular joint

Abstract

The articular disc plays an important role as a stress absorber in joint movement, resulting in stress reduction and redistribution in the temporomandibular joint (TMJ). The flow of synovial fluid in the TMJ may follow a regular pattern during movement of the jaw. We hypothesised that the regular pattern is disrupted when the TMJ disc is perforated. By computed tomography arthrography, we studied the upper TMJ compartment in patients with small disc perforation during jaw opening-closing at positions from 0 to 3 cm. Finite element fluid dynamic modelling was accomplished to analyse the pattern of fluid flow and pressure distribution during the movements. The results showed that the fluid flow in the upper compartment generally formed an anticlockwise circulation but with local vortexes with the jaw opening up to 2 cm. However, when the jaw opening-closing reached 3 cm, an abnormal flow field and the fluid pressure change associated with the perforation may increase the risk of perforation expansion or rupture and is unfavourable for self-repair of the perforated disc.

Synovium Fragment-Derived Cells Exhibit Characteristics Similar to Those of Dissociated Multipotent Cells in Synovial Fluid of the Temporomandibular Joint

“…Synovial fluid plays an important role in maintaining the normal physiological function of joints[12]. In recent years, many studies have investigated synovial fluid-derived mesenchymal stem cells (SFMSCs), primarily focusing on the knee joint.…”

Mandibular asymmetry: a three-dimensional quantification of bilateral condyles

“…Its unique structure and complex function contribute to the distinguished pattern of stress distribution in the joint [11,12]. The surface configuration (e.g.…”

A Comparative Study between Use of Arthroscopic Lavage and Arthrocentesis of Temporomandibular Joint Based on Computational Fluid Dynamics Analysis

“…Computed tomography (CT) arthrography was performed for each patient and sections in axial and sagittal planes of the TMJ zone (on the symptomatic side) were obtained prior to joint lavage. Based on the findings and recommendations of our previous works [16,17], the boundary was extracted from the transverse slices of the TMJ using an interactive medical image system (3D-DOCTOR; Able Software, Lexington, MA, USA) and four polygon-based models for different lavage processes of the closed-jaw position were reconstructed. The needle of smaller diameter, 0.8mm, was represented by the capital letter “N”, while the cannula of 2.4 mm inner diameter was denoted by “K”.…”

“…The inflow fluid pressure was set at 27.57 kPa in the closed-jaw position [15]. We referred to our previous modeling works [16,17] for constructing the upper compartment of TMJ and simulating the lavage fluid flow in the compartment. Commercial flow modeling software (GAMBIT 2.1.30; ANSYS Inc., New York, NY, USA) was used to mesh the model and set up the boundary conditions and fluid-solid conditions.…”