Ultrastructural study on adhesions in internal derangement of the temporomandibular joint

Senga, Katsuhiro; Mizutani, Hideki; Kobayashi, Miya

doi:10.1016/s0278-2391(99)90233-1

Cited by 23 publications

(10 citation statements)

References 13 publications

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“…MURAKAMI et al 25 suggested that the distribution of intraarticular FA is more important in limiting TMJ mobility than the severity itself. SENGA et al 29 studied arthroscopically obtained biopsies from TMJs with FA and found that those FA having highest resistance consisted of orderly arranged collagen bundles. These band-like FA or pseudowall-like FA, may strongly inhibit the movement of the disc and joint.…”

Section: Discussionmentioning

confidence: 99%

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Influence of arthroscopically observed fibrous adhesions before and after joint irrigation on clinical outcome in patients with chronic closed lock of the temporomandibular joint

Hamada

Kondoh

Holmlund

et al. 2005

International Journal of Oral and Maxillofacial Surgery

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Section: Discussionmentioning

confidence: 99%

“…It has been suggested that fibrous adhesions (FA) in the upper compartment (UC) of temporomandibular joint (TMJ) is a possible cause for restricted joint movements 4,5,25,29 . Arthroscopic methods for breaking up or removal of such FA have also been presented 21,28 .…”

mentioning

confidence: 99%

Influence of arthroscopically observed fibrous adhesions before and after joint irrigation on clinical outcome in patients with chronic closed lock of the temporomandibular joint

Hamada

Kondoh

Holmlund

et al. 2005

International Journal of Oral and Maxillofacial Surgery

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“…This appears to be due to the loose arrangement of the connective tissue and absence of an enclosing sheath (Fig 7) rather than the presence of elastic fibres. 8 These structures are still easily stretched and do not primarily restrict motion of the joint. This structure was usually observed in patients with a history of reduced opening less than two years.…”

Section: Arthroscopic Findingsmentioning

confidence: 99%

“…A different adhesion pattern is also seen in the anterior recess with the formation of a much thicker structure positioned on the anterior wall. 8 This forms the pseudo-wall of the anterior joint compartment (Fig 10). Once this wall is sectioned there is an immediate increase in volume of the anterior recess.…”

Section: Figmentioning

confidence: 99%

“…There was rarely a chance to correlate the findings in these specimens with appropriate clinical data. [1][2][3][4][5] The introduction of arthroscopy to the TMJ has allowed this region to now be studied [6][7][8] and managed surgically if appropriate with minimal morbidity to the patient. This technique does require special training and strict attention to surgical precautions.…”

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confidence: 99%

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Adhesions in the Temporomandibular Joint: Formation and Significance

Hase¹

2002

Australian Dental Journal

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Background: Adhesions are frequently seen in the deranged temporomandibular joint (TMJ). In the early stage of the degenerative process the adhesion does not seem to be a significant factor in reduced mandibular movement. This is reversed in advanced degenerative joint disease where the adhesion requires release to achieve a satisfactory clinical result. Correlation of clinical history and findings within the joint should increase understanding of limited jaw movement. Methods: Arthroscopic examination of deranged TMJs was performed on 75 patients with limited jaw opening and correlated with the history of the derangement. Results: A progressive maturation of adhesion formation was observed with longer standing symptoms. A different adhesion pattern was noted with derangement caused by direct trauma on the joint. Conclusions: Internal derangement of the TMJ is associated with formation of intra-articular adhesions. These are unlikely to be associated with reduced condyle movement in the early phase of the derangement. Later stage adhesions are more substantial and require release to achieve a satisfactory clinical outcome.

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Alteration of structural and mechanical properties of the temporomandibular joint disc following elastase digestion

et al. 2020

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The temporomandibular joint disc is a fibrocartilaginous structure, composed of collagen fibers, elastin fibers, and proteoglycans. Despite the crucial role of elastin fibers in load-bearing properties of connective tissues, its contribution in temporomandibular joint disc biomechanics has been disregarded. This study attempts to characterize the structural-functional contribution of elastin in the temporomandibular joint disc. Using elastase, we selectively perturbed the elastin fiber network in porcine temporomandibular joint discs and investigated the structural, compositional, and mechanical regional changes through: (a) analysis of collagen and elastin fibers by immunolabeling and transmission electron microscopy; (b) quantitative analysis of collagen tortuosity, cell shape, and disc volume; (c) biochemical quantification of collagen, glycosaminoglycan and elastin content; and (d) cyclic compression test. Following elastase treatment, microscopic examination revealed fragmentation of elastin fibers across the temporomandibular joint disc, with a more pronounced effect in the intermediate regions. Also, biochemical analyses of the intermediate regions showed significant depletion of elastin (50%), and substantial decrease in collagen (20%) and glycosaminoglycan (49%) content, likely due to non-specific activity of elastase. Degradation of elastin fibers affected the homeostatic configuration of the disc, reflected in its significant volume enlargement accompanied by remarkable reduction of collagen tortuosity and cell elongation. Mechanically, elastase treatment nearly doubled the maximal energy dissipation across the intermediate regions while the instantaneous modulus was not significantly affected. We conclude that elastin fibers contribute to the restoration and maintenance of the disc resting shape and actively interact with collagen fibers to provide mechanical resilience to the temporomandibular joint disc.

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Ultrastructural study on adhesions in internal derangement of the temporomandibular joint

Cited by 23 publications

References 13 publications

Influence of arthroscopically observed fibrous adhesions before and after joint irrigation on clinical outcome in patients with chronic closed lock of the temporomandibular joint

Influence of arthroscopically observed fibrous adhesions before and after joint irrigation on clinical outcome in patients with chronic closed lock of the temporomandibular joint

Adhesions in the Temporomandibular Joint: Formation and Significance

Alteration of structural and mechanical properties of the temporomandibular joint disc following elastase digestion

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