Involvement of an FTO gene polymorphism in the temporomandibular joint osteoarthritis.

OBJECTIVES: The FTO gene has been reported as an obesity-associated gene and is also considered a risk gene for osteoarthritis (OA). However, its exact function is unclear, and there is conflicting evidence on the involvement of FTO polymorphisms in OA via obesity. The purpose of this study was to determine the effects of FTO polymorphism rs8044769 alleles on OA in the temporomandibular joint (TMJ), which is minimally affected by body weight. MATERIALS AND METHODS: A total of 324 TMJs (113 with OA and 211 without OA, serving as controls) from 162 Japanese patients with temporomandibular disorders and undergoing MRI examination were analyzed. Genotyping was conducted, and multivariate analysis was performed after adjusting for the effects of age, sex, body mass index, and TMJ disc abnormalities. RESULTS: Mean age, BMI, and sex did not differ between the TMJs with OA and the TMJs without OA, but a significant difference was found for positional and dynamic disc abnormalities (P < 0.05). The allele frequency of FTO polymorphisms also differed significantly between the TMJs with OA and the TMJs without OA (P = 0.011). Moreover, logistic regression analysis showed no significant association between BMI (P = 0.581) and the occurrence of TMJOA but also indicated that the CC allele of rs8044769 is a risk factor for TMJOA (P = 0.040). CONCLUSIONS: Our results show that rs8044769 in the FTO gene might be involved in TMJOA. CLINICAL RELEVANCE: The present study provides a basis for a deeper understanding of the mechanism underlying degenerative skeletal diseases and the more effective selection and development of treatment strategies based on the patients' genetic characteristics.

Relative risk of positional and dynamic temporomandibular disc abnormality for osteoarthritis-magnetic resonance imaging study.

Dynamic articular disc abnormality (wR, with reduction; woR, without reduction) is well known as the risk factor for temporomandibular joint osteoarthritis (TMJOA). However, there are few speculations on the potential risk of positional disc abnormalities for TMJOA. The purpose of this study was to investigate the relative risk of positional abnormality and dynamic abnormality of the temporomandibular disc for OA after the three-dimensional interpretation of all the sagittal and coronal planes of magnetic resonance (MR) data in a large dataset of consecutive subjects. Experimental samples consisted of images of 1356 TMJs of patients. A diagnosis of disc state was established in each TMJ utilising a 1.5T MR imaging scanner. A binary logistic regression analysis was performed to identify the significant associations between the outcome (dependent variable: the presence of OA) and the predictors (covariates: age, sex, dynamic disc state [the presence of woR], and 5 categories of the positional disc state [NA, no abnormality; SW, sideways; pADD, partial anterior; cADD, complete anterior; PDD, posterior]). Based on the result of the binary logistic regression analysis, the presence of woR showed an odds ratio of 14.1 (P < .05). In addition, compared with the joints NA, those with SW and cADD showed odds ratios of 5.62 and 10.88, respectively (P < .05). Despite the limitations of the study, in the positional disc abnormalities, sideways disc displacement and complete anterior disc displacement could be associated with the occurrence of TMJOA. All the coronal and sagittal MR images should be evaluated to assess intra-articular joint disorders accurately.

Cross-sectional and longitudinal assessment of subchondral cysts in temporomandibular joints: Clinical and MRI study with a mean follow-up of 66 months.

PURPOSE: This observational study aimed to elucidate the pathophysiology of subchondral cysts (SC) in the temporomandibular joint (TMJ) and examine the results of conservative therapy administered to patients with SCs in the TMJ. METHODS: The study included 41 patients with SCs, extracted from 684 consecutive patients who underwent magnetic resonance imaging (MRI). The anatomical features of SCs and positional abnormalities of the articular disc were initially evaluated using MRI. A second MRI examination was performed for 28/41 patients at 40-107 months (mean, 66 months) after the first MRI. The joint space, anteroposterior width of the condylar head (WiC), articular eminence angle (AEA), and visual analog scale of jaw pain (VAS) were assessed alongside the MRI examinations. RESULTS: Most SCs were present in the anterosuperior and central condyle. Disc displacement was observed in 100% of 42 TMJs with SCs. Of the 29 joints in 28 patients, SCs in 19 joints resolved with time, whereas SCs in 10 joints persisted. A significant increase in the WiC and a significant decrease in AEA and VAS scores were observed on the second MRI scan. CONCLUSIONS: SCs tended to form in the anterosuperior and central parts of the condyle, where mechanical loading was likely to be applied. SCs are strongly associated with articular disc displacement. Two-thirds of SCs resolved over time, accompanied by resorption and osteophytic deformation of the condyle. SC might not be an indicator for the start of surgical treatment, and nonsurgical treatment could improve the clinical symptoms of patients with SCs.

Clinical identification of the stimulus intensity to measure temporal summation of second pain.

Temporal summation of second pain (TSSP) has been suggested as a psychophysical index for central sensitization, one of the critical mechanisms in the chronification of pain. However, there is no gold standard for protocols to measure TSSP. The purpose was to establish the stimulus intensity for measuring TSSP. Female patients with chronic myofascial temporomandibular disorders pain (n = 16) and healthy female volunteers with no pain (n = 15) participated. Pain thresholds (PT °C) were measured, and repetitive heat stimuli at three stimulus intensities (PT °C, PT + 1 °C, PT + 2 °C) were applied. TSSP parameters were quantified as TSSP magnitude (TSm) and TSSP frequency (TSf). In healthy female volunteers, pain ratings significantly decreased at PT °C (p < 0.050), besides TSm and TSf at PT + 2 °C were significantly higher than those at PT °C (p < 0.025). In chronic pain patients, pain ratings significantly increased at PT + 1 °C and PT + 2 °C (p < 0.050). At PT + 2 °C, TSm and TSf in chronic pain patients were significantly higher than those in healthy volunteers (p < 0.050). It could be helpful to measure TSSP with the stimulus intensity adjusted individually to the patient's pain thresholds + 2 °C for assessing central sensitization.