Temporalis Myofascial Flap and Conchal Bowl Cartilage Grafting for Temporomandibular Joint Arthritis
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ABSTRACT:
SUBMITTER: DeLeonibus A
PROVIDER: S-EPMC10125437 | biostudies-literature | 2023 Apr
REPOSITORIES: biostudies-literature
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Project description:Background: Temporomandibular joint osteoarthritis (TMJOA) is a degenerative disease marked by the progressive degeneration of cartilage and underlying bone, resulting in pain and functional impairment. Despite current conservative treatments such as physical therapy and NSAIDs, the etiology and pathophysiology of TMJOA are unclear, making effective management difficult. Finding reliable biomarkers for early identification and new therapeutic targets is crucial to improve treatment outcomes.
2025-03-06 | GSE289871 | GEO
Project description:The canonical Wnt pathway participates in inflammatory diseases and it is involved in neuropathic pain. This study evaluated the immunoexpression of the canonical Wnt signaling pathway in the articular cartilage of the temporomandibular joint (TMJ) and along the nociceptive trigeminal pathway in arthritic rats. For this, male Wistar rats were divided into Control (C) and Arthritic (RA) groups. Arthritis induction was performed through subcutaneous injection of methylated bovine serum albumin (mBSA) and complete Freund Adjuvant (CFA)/ Incomplete Freund Adjuvant (IFA) on the first 14 days (once a week), followed by 3 weekly intra-articular injections of mBSA (10 μl/joint; left TMJ). The following parameters were evaluated: nociceptive threshold, inflammatory infiltrate, type I and III collagen birefringence, immunohistochemistry for IL-1β, TNF-α, IL-6, Wnt10b, β-catenin, cyclin-D1 in articular cartilage, c-Myc in synovial membrane, and immunofluorescence analysis for c-Fos, Wnt-10b and β-catenin in the trigeminal ganglion and the trigeminal subnucleus caudalis. The RA group showed intense articular cartilage damage with proliferation of type III collagen, increased immunoexpression of proinflammatory cytokines and Wnt-10b, β-catenin and cyclin-D1 in the articular cartilage and c-Myc in the synovial membrane. In the RA group, a reduction in the nociceptive threshold was observed, followed by a significant increase in the expression of Wnt-10b in neurons and β-catenin in satellite cells of the trigeminal ganglion. c-Fos immunoexpression was observed in neurons, peripherally and centrally, in arthritic rats. Our data demonstrated that TMJ arthritis in rats causes articular cartilage damage and nociceptive behavior, with increased immunoexpression of canonical Wnt pathway in the articular cartilage and trigeminal ganglion.
| S-EPMC9869417 | biostudies-literature
Project description:BackgroundRepair of traumatic alar defect is challenging because poor blood supply is caused by contracture scars, which sometimes extend beyond the alar groove. However, few studies have investigated the reconstruction results of severe traumatic cases. This study aimed to examine the clinical outcomes of severe traumatic alar defect reconstruction using either pedicled nasolabial or forehead flaps combined with conchal cartilage.MethodsThis retrospective study investigated the clinical characteristics and treatment effects of 17 patients with severe traumatic alar defects treated in a single plastic surgery center from March 1, 2015, to September 1, 2018. All cases were scored and graded with regard to the size and depth of the alar defect and the surrounding scar according to the Alar Defect Severity Score (ADSS). Surgical outcomes were evaluated on the basis of the severity of defect before repair, donor site distortion, and postoperative nasal symmetry, especially shape and color.ResultsThe average ADSS of the cases was 8.1±0.8 (highest score, 9.0). No flap necrosis or any complications were observed postoperatively. The symmetry of the bilateral alae was satisfactory. No color distinction between grafts and surrounding tissues, retraction, or inferior displacement of the ala was observed at an average follow-up of 24.2±10.4 months (range, 8-42 months). The average postoperative surgeon-based evaluation score was 4.3±0.2 (highest score, 5.0). Esthetic and functional results were satisfactory in all cases.ConclusionsA pedicled flap combined with conchal composite grafts should be considered for the treatment of severe traumatic alar defect. This is a reproducible technique that enables a predictably decent outcome for severe traumatic alar defect, especially in Asian patients.
| S-EPMC7729309 | biostudies-literature
Project description:Transcriptomic analysis for temporomandibular joint arthritis
| PRJNA1225221 | ENA
Project description:BackgroundsAbnormal cartilage calcification is one of the pathological changes of temporomandibular joint (TMJ) osteoarthritis (OA). Recent studies have reported that exosomes can regulate the formation of abnormal calcified nodules in diseases including atherosclerosis and chronic kidney disease. However, the influences of chondrocyte-derived exosomes on abnormal cartilage calcification in TMJ OA are still unclear.MethodsTMJ OA was induced by unilateral anterior crossbite (UAC) for 4, 8, or 12 weeks in rats to observe abnormal calcification in TMJ condylar cartilage and exosome formation. Concomitantly, GW4869, the inhibitor of exosome formation, was locally injected to the TMJ of rats under stimulation of UAC, while the exosomes extracted from primary condylar chondrocytes stimulated with fluid flow shear stress (FFSS) were locally injected to rats TMJ.ResultsAbnormal calcification was enhanced in the degenerative cartilage of TMJ OA in UAC rats, and a large number of exosome-like structures with diameters of 50-150 nm were found in the calcified cartilage together with decreased expression of matrix Gla protein (MGP) and increased expression of CD63, tissue-nonspecific alkaline phosphatase (TNAP) and nucleotide pyrophosphatase/phosphodiesterase-1 (NPP1). After FFSS stimulation, the number of exosomes secreted by chondrocytes and the numbers of calcified nodules were increased in cultured cells, and the protein levels of MGP, TNAP, and NPP1 in exosomes were changed. Inhibition of exosome formation, TNAP, and NPP1 or supplementation with exogenous MGP effectively alleviated FFSS-induced chondrocyte calcification. Local injection of GW4869, the exosome inhibitor, alleviated TMJ OA-related cartilage degeneration and calcification in UAC rats. Local injection of exosomes obtained from chondrocytes stimulated by FFSS to the TMJs of normal rats induced cartilage degeneration and calcification similar to that in TMJ OA.ConclusionsAbnormal biomechanical loading leads to enhanced formation of chondrocyte-derived exosomes, in which promoters of calcification increased and inhibitors decreased, resulting in accelerating abnormal cartilage calcification in TMJ OA. The inhibition of degenerative chondrocyte-derived exosomes is expected to be a new way to prevent and treat TMJ OA.
| S-EPMC8842872 | biostudies-literature
Project description:The aim of this study was to investigate characteristic MRI findings of rheumatoid arthritis (RA) in the temporomandibular joints (TMJs).61 patients (122 TMJs) with RA in the TMJ and 50 patients (100 TMJs) with temporomandibular disorder (TMD) were included in this study. MR images of these patients were assessed by two oral radiologists for the presence or absence of osseous changes, disc displacement, joint effusion and synovial proliferation. These findings were compared between the two patient groups.Osseous changes in the condyle and articular eminence/fossa in the RA patient group were significantly more frequent than in the TMD patient group, and were often very severe. Joint effusion was also significantly more frequent in the RA patient group. Synovial proliferation was found in all TMJs in the RA patient group, whereas it was very uncommon in the TMD patient group.Severe osseous changes in the condyle and synovial proliferation were considered characteristic MRI findings of RA in the TMJs.
| S-EPMC3667508 | biostudies-other
Project description:ObjectiveJuvenile idiopathic arthritis (JIA) frequently affects the temporomandibular joints (TMJs) and is often undetected by history, examination, and plain imaging. Qualitative assessment of gadolinium-enhanced magnetic resonance images (MRIs) is currently the standard for diagnosis of TMJ synovitis associated with JIA. The purpose of this study is to apply a quantitative analysis of synovial enhancement to MRIs of patients with and without JIA to establish a disease threshold and sensitivity and specificity for the technique.MethodsThis is a retrospective case-control study of children (age ≤16 years) who had MRIs with gadolinium including the TMJs. Subjects were divided into a JIA group and a control group. From a coronal T1-weighted image, a ratio (enhancement ratio [ER]) of the average pixel intensity within three 0.2-mm2 regions of interest (ROIs) in the TMJ synovium to that of a 50-mm2 ROI of the longus capitis muscle was calculated. Receiver operating characteristic curves were used to determine the sensitivity and specificity. The inter- and intraexaminer reliability was evaluated with Bland-Altman plots and 2-way mixed, absolute agreement intraclass correlation coefficients.ResultsThere were 187 and 142 TMJs included in the JIA and control groups, respectively. An ER threshold of 1.55 had a sensitivity and specificity for detecting synovitis of 91% and 96%, respectively. The inter- and intraexaminer reliability was excellent.ConclusionCalculating a ratio of pixel intensity between the TMJ synovium and the longus capitis muscle is a reliable way to quantify synovial enhancement. An ER of 1.55 differentiates normal TMJs from those affected by inflammatory arthritis.
| S-EPMC5573997 | biostudies-literature
Project description:Introduction: Pain is an emotional experience. As a subjective feeling, it is associated with pathophysiological processes occurring in the central nervous system, which in turn may negatively affect the psychophysical function, cognitive abilities, level of functioning and quality of life. The Aim: The aim of the study was to assess orofacial and general pain location in patients with temporomandibular joint disorder-myofascial pain with referral. Materials and Methods: The study group consisted of 50 randomly selected, generally healthy people with complete natural dentition (37 women and 13 men) at the age of 23.36 ± 2.14 years, referred to the Department of Prosthodontics of the Medical University. All patients underwent clinical examination according to the Diagnostic Criteria for Temporomandibular Disorders (Axes I and II). The subjects were classified as people with myofascial pain with referral. The evaluation of severity of temporomandibular disorders was based on the Temporomandibular Disorder Pain Screener and the Graded Chronic Pain Scale. In order to assess orofacial and general pain location, a bodychart drawing of pain was used. Results: The study group indicated 40 different areas of the body affected by pain. 2-3 isolated pain locations were declared by a total of six subjects. One person identified 17 affected areas. Forty four people reported pain in at least four regions of the body. 70% of patients suffered from pain within the right masseter muscle. Pain of the left masseter muscle was noted in 68% of cases. Cervical ailments were reported by 56% of people. Pain of the left temporomandibular joint was observed in 68% of patients, and of the right one in 54%. Conclusion: The patients with myofascial pain with referral suffer from general ailments in different regions of the body. Only the frequency of pain in the right masseter muscle and right temporomandibular joint differed with respect to gender. The suggestion that the prevalence of pain in other areas of the body varies between men and women has not been confirmed. Due to a small sample size, such differences cannot be excluded. Further studies in this area are needed.
| S-EPMC6549135 | biostudies-literature
Project description:To investigate the indication, site, techniques, and complications at the donor and recipient sites of temporalis fascia grafting in rhinoplasty, and patients' satisfaction with the surgical outcomes. This retrospective cohort study was performed at King Abdulaziz University Hospital, Saudi Arabia, between January 2015 and January 2020. The predictor variable was the temporalis fascia in different forms. Reported variables comprised individuals' satisfaction, dorsal nasal irregularities, and contour definitions. Moreover, further variables were considered, including age, gender, the reason behind surgery, surgical type, and graft size and site. A rhinoplasty doctor, other than a surgeon, has assessed the dorsal augmentation findings by inspecting and palpating the dorsum. Data analyses were achieved through SPSS. A total of 69 patients were enrolled in this study; 44.9% of them underwent rhinoplasty with the temporalis fascia in cartilage wrapped by the temporalis fascia form, 43.5% in a blanket form, and 11.6% in a ball form. The average subject satisfaction outcome score was 10.44 preoperatively and 19.72 postoperatively (P = 0.001).No dorsal irregularities were detected by inspection in all forms of the temporalis fascia, whereas 3 patients with the blanket and 2 patients with the cartilage wrapped by the temporalis fascia had irregularities, which were detected on palpation. In rhinoplasty, the temporalis fascia is a favorable choice for nasal reconstruction since it is simple in harvesting and can be made in different forms and shapes for many purposes.
| S-EPMC9518967 | biostudies-literature
Project description:BackgroundIt remains unclear etiology of cartilaginous tissues in osteoarthritis (OA) lesions. In this study, we hypothesized the accumulation of hypoxia-inducible factor (HIF) and activated apoptosis relate to condylar cartilage degeneration in vivo.MethodsMalocclusion stress was applied for 2 weeks, 4 weeks and 8 weeks to induce an OA-like lesion animal model in rats. Histological analysis was performed by H&E staining and Safranin O/fast green staining. The expression levels of protein in condylar cartilage were examined by immunostaining to evaluate cartilage degeneration.ResultsWe found apparent histological phenotypes associated with degeneration in the occlusion disorder (OD) stress group. The OD group at 4 weeks and 8 weeks had obviously reduced expression of Aggrecan (Acan) and type II collagen (Col II) in cartilage. In contrast, the OD groups had higher levels of ADAM metallopeptidase with thrombospondin type 5 (ADAMTS5) and matrix metallopeptidase 13 (MMP13) in the condylar cartilage than the control group. Moreover, the OD group cartilage had prominent degenerative changes with reduced levels of hypoxia inducible factor 1 alpha (HIF1α) and increased levels of hypoxia inducible factor 2 alpha (HIF2α) and the apoptosis factor Caspase3 in condylar cartilage at 8 weeks.ConclusionThus, abnormal hypoxic conditions inducing Occlusion disorder stress results in cartilage degeneration. opposite expression patterns of HIF1α and HIF2α could be involved in the pathogenesis of condylar cartilage degeneration and chondrocyte apoptosis. HIF2α may provide a potential negative feedback mechanism for HIF1α during cartilage damage.
| S-EPMC9202126 | biostudies-literature