Temporal stability of tongue microbiota in older patients - A pilot study.

Background/purpose: Healthy states of human microbiota depend on a stable community of symbiotic microbes irrespective of external challenges from the environment. Thus, long-term stability of the oral microbiota is of importance, particularly for older patient populations. Materials and methods: We used next-generation sequencing (NGS) to examine the tongue microbiota of 18 individuals receiving long-term care over a 10-month period. Results: Beta diversity analysis demonstrated temporal stability of the tongue microbiota, as microbial compositions from all time points were indistinguishable from each other (P = 0.0887). However, significant individual variation in microbial composition (P = 0.0001) was observed, underscoring the presence of a unique microbial profile for each patient. Conclusion: The temporal dynamics of tongue microbiota exhibit long-term stability, providing diagnostic implications for oral diseases within older patient populations.

Age-Related Gene and Protein Expression in Mouse Mandibular Condyle Analyzed by Cap Analysis of Gene Expression and Immunohistochemistry.

INTRODUCTION: Aging, an inevitable physiological process, leads to morphological and histological degenerative changes in the mandibular condylar cartilage (MCC); however, the molecular mechanism has not yet been elucidated, and little information is available on age-related factors. Therefore, this study was designed to identify age-related factors by investigating the age-related differentially expressed genes (DEGs) and localization of their translated protein expression in the mandibular condyle. METHODS: Mandibular condyles were collected from 10- and 50-week-old mice. Total RNA was extracted from the samples and then analyzed using cap analysis of gene expression (CAGE) to identify age-related DEGs. Gene ontology (GO) enrichment analysis was performed to determine which biological processes were most affected by aging in terms of gene expression using Metascape. The mandibular condyle samples were processed for histology to investigate morphological changes caused by aging and for immunohistochemistry to localize the protein expression encoded by age-related genes identified with CAGE. Semi-quantitative immunohistochemistry was performed to assess age-related extracellular matrix (ECM) protein levels in the MCC. The histological sections were also used for Alcian blue histochemistry to detect glycosaminoglycans (GAGs). RESULTS: GO enrichment analysis revealed that the genes related to "extracellular matrix organization," including Acan, Col1a1, Col1a2, Col2a1, Mmp3, Mmp9, and Mmp13, were most differentially expressed in the aged mandibular condyle. Among these seven genes, Mmp3 was upregulated, and the others were downregulated with aging. Histological examination showed the age-related morphological and histological changes in the MCC. Immunohistochemical investigation showed the localization of matrix metalloproteinases (MMPs)-3, -9, and -13 and their substrate proteins, aggrecan, type I collagen, and type II collagen, in the mandibular condyle at 10 and 50 weeks, indicating different localizations between the young and the aged. In the aged MCC, semi-quantitative immunohistochemistry showed a significant decrease in the aggrecan protein level, and Alcian blue histochemistry showed a decrease in GAGs. CONCLUSION: MMP-3, MMP-9, and MMP-13 contribute to the remodeling of the ECM of the MCC and subchondral bone during aging by degrading ECM proteins at specific times and sites under the regulation of their production and secretion.

Visualization of the localization of phospholipids in developing rat teeth by matrix-assisted laser desorption/ionization imaging mass spectrometry.

Matrix-assisted laser desorption/ionization imaging mass spectrometry (IMS) is used to comprehensively visualize the spatial distribution of numerous biomolecules. The present study was designed to investigate the distribution of phospholipids in developing rat teeth by IMS to identify the characteristic phospholipid molecules for tooth development, and to evaluate the suitability of tissue preparation methods. Rats at postnatal day 3 were euthanized, and the resected head specimens were either fixed or not fixed with 4% paraformaldehyde (PFA), and decalcified or not decalcified in 10% ethylenediaminetetraacetic acid (EDTA) before being frozen. Subsequently, sections were prepared and mounted on glass slides coated with indium tin oxide, and analyzed by IMS. The mass spectra showed the highest peaks around m/z 706, 732, and 734 in the region of interest. Characteristic localization of signals in the tooth buds was seen around m/z 706 and 732, and a database search indicated that the corresponding molecules were phosphatidylcholines. The signals were localized to the dental papillae and enamel epithelia in the tooth buds. The PFA-fixed specimens with or without EDTA decalcification showed preserved IMS signals, while the non-fixed specimens showed fewer signals. Thus, PFA fixation with EDTA decalcification appears to be suitable for IMS analysis of calcified tissues.

Immunohistochemical characterization of the mandibular condyle for type I and II collagen, aggrecan, MMP-9, and MMP-13 in MMP-2-deficient mice.

Mice devoid of matrix metalloproteinase (MMP)-2 due to gene targeting have been reported to show articular cartilage destruction in the knee joint; however, the phenotype of the mandibular condylar cartilage remains unknown. Thus, in the present study, we investigated the mandibular condyle in Mmp2-/- mice. We obtained and bred Mmp2-/- mice from the same source as the previous study, and performed genotyping using genomic DNA extracted from finger snips. The mandibular condyle of Mmp2-/- mice and wild-type (WT) mice was immunohistochemically examined for the localization of extracellular matrix (ECM) proteins (type I and II collagen, and aggrecan), and MMP-9 and MMP-13. No cartilage destruction was observed in the mandibular condyle of Mmp2-/- mice, and no difference was found in the localization of the ECM proteins between the Mmp2-/- mice and WT mice. However, the bone marrow cavity in the subchondral bone of the mandibular condyle was more distinct in Mmp2-/- mice than in WT mice at the age of 50 weeks. Of note, MMP-9 characteristically localized in multinucleated cells in the mandibular condyle in 50-week-old Mmp2-/- mice. MMP-2 may be involved in the regulation of osteoclast differentiation and the formation of the bone marrow cavity in aged mice.

Effects of food hardness on temporomandibular joint osteoarthritis: Qualitative and quantitative micro-CT analysis of rats in vivo.

BACKGROUND: Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative joint disease in which quantitative analysis based on magnetic resonance image (MRI) or cone-beam computed tomography (CBCT) remains limited. Moreover, the long-term effects of soft food on the adaptive condylar remodeling process in TMJ-OA remain unclear. This study aimed to assess the effects of food hardness on adaptive condylar remodeling in a healthy TMJ, TMJ-OA, and controlled TMJ-OA. METHODS: Complete Freund's adjuvant (CFA) was used for TMJ-OA induction and Link-N (LN) for TMJ repair. Eighteen mature rats were randomly divided into six groups: (1) control/normal diet (Ctrl-N); (2) control/soft diet (Ctrl-S); (3) TMJ-OA/normal diet (CFA-N); (4) TMJ-OA/soft diet (CFA-S); (5) Link-N-controlled TMJ-OA/normal diet (LN-N); and (6) Link-N-controlled TMJ-OA/soft diet (LN-S). Micro-CT was performed 14, 21, and 28 days after CFA injection to analyze the bone volume, bone volume fraction (BVF), bone mineral density (BMD), and trabecular bone number and thickness (Tb.N, Tb.Th). MRI and histological imaging were performed to support the analysis. RESULTS: Under CFA treatment, the BVF and BMD decreased significantly (p < 0.01) and later recovered to normal. However, more significant improvements occurred in normal-diet groups than soft-diet groups. Additionally, bone volume changes were more predictable in the normal-diet groups than in the soft-diet groups. The normal-diet groups presented a significant decrease and increase in the Tb.N and Tb.Th, respectively (p < 0.05), while the Tb.N and Tb.Th in the soft-diet groups remained largely unchanged. Furthermore, a significantly higher frequency of irregularities on the condylar articular surface was found in the soft-diet groups. CONCLUSIONS: Compared with a soft diet, a normal diet may be beneficial for preserving condyle articular surface and directing bone remodeling in TMJ-OA rats.

Calcification and resorption of mouse Meckel's cartilage analyzed by von Kossa and tartrate-resistant acid phosphatase histochemistry and scanning electron microscopy/energy-dispersive X-ray spectrometry.

Meckel's cartilage is essential for the normal development of the mandible. The fate of the intermediate portion of Meckel's cartilage is unique as most of it disappears soon after birth except for the part that forms the sphenomandibular ligament. The mechanism of the disappearance of Meckel's cartilage is unknown; therefore, this study was designed to investigate the process of Meckel's cartilage degradation, focusing on cartilage matrix calcification and the appearance of chondroclasts. Developing mouse mandibles at embryonic days 15, 16, 17, and 18, and postnatal day 2 were processed for whole-mount staining with alcian blue and alizarin red. The mandibles on embryonic days 15, 16, 17, and 18 were fixed and embedded in paraffin. Adjacent sections were processed for von Kossa and tartrate-resistant acid phosphatase (TRAP) histochemistry and scanning electron microscopy/energy-dispersive X-ray spectrometry (SEM/EDS). Calcification and the element concentrations of calcium, phosphorus, and carbon were examined with von Kossa histochemistry and SEM/EDS. The involvement of chondroclasts was investigated using TRAP histochemistry. The results demonstrated that the intermediate portion of Meckel's cartilage is resorbed by chondroclasts after chondrocyte hypertrophy and cartilage matrix calcification and that the mineral concentration of calcified Meckel's cartilage is comparable to that of the surrounding bone. This study contributes to the understanding of the mechanism of Meckel's cartilage resorption and provides useful insights into the development of the mandible.

Dysphagia and risk of aspiration pneumonia: A nonrandomized, pair-matched cohort study.

BACKGROUND/PURPOSE: Dysphagia was associated with increased prevalence of aspiration pneumonia (AP) in studies that were criticized for either their small sample size or lack of prospective design. Using a considerably larger nationwide, population-based database and a long-term prospective cohort design, our study aimed to explore the relationship between dysphagia and the subsequent development of AP. MATERIALS AND METHODS: From 2000 to 2009, we gathered a study cohort consisting of 6979 newly diagnosed cases of dysphagia from Taiwan's National Health Insurance Research Database. For the control group, another 20,937 individuals without dysphagia were matched for age, sex, and comorbidity. The two cohorts were followed-up to observe the occurrence of AP and correlated mortality. RESULTS: During an average of 3.88 ±â€¯2.73 years of follow-up, we observed 315 cases of new AP [non-dysphagia (193, 0.92%) vs. dysphagia (122, 1.75%), p < 0.0001], and the incidence of AP was significant in the dysphagia group. After adjusting for age, sex, and comorbidity, dysphagia-related AP [hazard ratio (HR) 2.499; 95% confidence interval (CI), 2.089-2.99; p < 0.0001], dysphagia related mortality [HR 3.229; 95% CI, 3.052-3.417; p < 0.0001], and many other systemic diseases were independently associated with a diagnosis of AP. CONCLUSION: Dysphagia was highly associated with an increased risk of AP according to data derived from a large nationwide cohort database. Nonetheless, larger prospective studies or meta-analyses are recommended to confirm our findings.

Correlation of magnetic resonance imaging grades with cytokine levels of synovial fluid of patients with temporomandibular joint disorders: a cross-sectional study.

OBJECTIVES: Magnetic resonance imaging (MRI) is a standardized method for assisting joint diagnosis. To validate the reliability of different imaging-based grading systems, this study examined (1) the associations between grading systems for osseous change, joint effusion, and the Wilkes classification of temporomandibular joint (TMJ) disorders and (2) the correlation between cytokines in synovial fluid and imaging-based joint scores. MATERIALS AND METHODS: Twenty-seven patients, who routinely received numeric rating scale (NRS) and MRI assessment before TMJ arthrocentesis, were enrolled. Each joint was evaluated through the grading criteria for severity of osseous change and joint effusion by blinded observers using MRI. ImageJ was employed for classifying joint effusion. Joint synovial fluid, collected through arthrocentesis, was examined for cytokine expression by using a Luminex multiplex assay. All data were analyzed using the Pearson correlation analysis. RESULTS: The Wilkes classification was strongly correlated with osseous change scores, but not with joint effusion scores. Joint effusion scores significantly correlated with NRS scores, but not with the Wilkes classification and osseous change scores. Compared with osseous change scores, joint effusion scores had a higher correlation with the levels of inflammatory cytokines (interleukin (IL)-8 and soluble IL-6 receptor (sIL-6R)) and with anti-inflammatory cytokines (soluble tumor necrosis factor receptors I and II (sTNF-RI/II)). CONCLUSIONS: In patients with TMJ disorders, MRI grades are strongly correlated with NRS scores and levels of cytokines (IL-8, sIL-6R, and sTNF-RI/II) in the synovial fluid. CLINICAL RELEVANCE: Joint effusion scoring can be a reliable and valid indicator for pathological assessment of TMJ disorders.

Role of Link N in Modulating Inflammatory Conditions.

AIMS: To elucidate the role of Link N in regulating inflammatory molecules from human mesenchymal stem cells (hMSCs) under interleukin (IL)-1ß stimulation in vitro and under Complete Freund's Adjuvant (CFA)-induced arthritis of the temporomandibular joint (TMJ) in vivo. METHODS: In vitro analysis of inflammatory cytokines and epithelial-mesenchymal transition (EMT) genes in hMSCs treated with Link N, IL-1ß, and co-stimulation of IL-1ß and Link N was undertaken using Luminex multiplex assays and real-time polymerase chain reaction, respectively. To determine the impact of Link N in ameliorating TMJ tissue homeostasis in arthritic conditions, histologic changes in CFA-induced arthritic TMJ tissues followed by application of Link N were examined. All data were analyzed using one-way analysis of variance with Bonferroni post hoc test. RESULTS: Increased levels of IL-6; interferon gamma-inducible protein-10; and regulated upon activation, normal T cell expressed, and secreted (RANTES) were detected in response to IL-1ß treatment, but these levels were significantly decreased in the co-stimulation group. In contrast, secreted IL-4, IL-10, and transforming growth factor ß1- ß3 proteins, as well as intracellular erb-b2 receptor tyrosine kinase 3 and Nodal homolog genes, were increased significantly in the co-stimulation group compared to the IL-1ß group. Histologic analysis showed significant recovery for rat condyle thickness in the Link N-treated group when compared to the CFA-induced arthritis group. CONCLUSION: These findings indicate that Link N could modulate inflammation and EMT in vitro and repair arthritis-mediated TMJ disruption in vivo. Link N could be a potential therapeutic agent for TMJ disorder patients.

Functional disorders of the temporomandibular joints: Internal derangement of the temporomandibular joint.

Temporomandibular joint (TMJ) is one of the most complex joints of the human body. Due to its unique movement, in terms of combination of rotation and translator movement, disc of the joint plays an important role to maintain its normal function. In order to sustain the normal function of the TMJ, disc must be kept in proper position as well as maintain normal shape in all circumstances. Once the disc is not any more in its normal position during function of the joint, disturbance of the joint can be occurred which will lead to subsequent distortion of the disc. Shape of the disc can be influenced by many factors i.e.: abnormal function or composition of the disc itself. Etiology of the internal derangement of the disc remains controversial. Multifactorial theory has been postulated in most of previous manuscripts. Disc is composed of mainly extracellular matrix. Abnormal proportion of collagen type I & III may also leads to joint hypermobility which may be also a predisposing factor of this disorder. Thus it can be recognized as local manifestation of a systemic disorder. Different treatment modalities with from conservative treatment to surgical intervention distinct success rate have been reported. Recently treatment with extracellular matrix injection becomes more and more popular to strengthen the joint itself. Since multifactorial in character, the best solution of the treatment modalities should be aimed to resolve possible etiology from different aspects. Team work may be indication to reach satisfied results.

Response of the temporomandibular joint tissue of rats to rheumatoid arthritis induction methods.

BACKGROUND/PURPOSE: The pathogenesis of rheumatoid arthritis (RA)-related temporomandibular joint (TMJ) disorder remains unclear. Studies have reported the change of the TMJ after complete Freund's adjuvant (CFA) injection, which is consistent with osteoarthritis. However, few studies have reported that the tissue response of the TMJ in collagen-induced arthritis (CIA) can mimic RA. The present study was aimed to investigate the TMJ response in rat models by CFA-induced arthritis and CIA to verify the proper RA-related TMJ arthritis rat model. MATERIALS AND METHODS: In total, 24 rats were randomly divided into four groups: (1) control group; (2) type I collagen injection group; (3) CFA-induced arthritis group; and (4) CIA group. Drugs were injected on Day 0, and the rats were sacrificed on Days 7 and 35. Next, TMJ tissue was collected for hematoxylin and eosin staining, and inflammatory gene (IL-1ß and MMP3) expression was investigated. RESULTS: Compared with the control group, the type I collagen injection group confirmed the negative inflammatory response through hematoxylin and eosin staining and IL-1ßand MMP3 expression. Although CFA-induced arthritis and CIA groups showed inflammatory response (P < 0.05) compared with the control group, histological changes were different. The 7-day CFA-induced arthritis group showed adaptive changes and partly recovered after 35 days of induction. In contrast, 7- and 35-day CIA groups underwent a degenerative process. CONCLUSION: Considering the study limitations, the CIA method is a proper method to study the mechanism of RA-related TMJ arthritis.

Comparison of Three Techniques for Swine Temporomandibular Joint Space Injection.

AIMS: To compare the feasibility and accuracy of three injection techniques for entering the superior joint space of the swine temporomandibular joint (TMJ). METHODS: Nine swine were used for this study, in which 500 µL of colored dye was injected into both TMJs of each swine. Three injection techniques were used: the posterior injection (PI), the anterosuperior injection (ASI), and the lateral injection (LI) techniques. Each injection technique was performed on six TMJs. Swine were sacrificed immediately after injection and the swine head was dissected in order to observe the dye distribution. Injection was considered successful if no dye could be observed outside the superior joint space. RESULTS: The PI technique was successful in all six TMJs (success rate: 100%), the LI technique in three out of six TMJs (success rate: 50%), and the ASI technique in two out of six TMJs (success rate: 33%); the differences were statistically significant (chi-square test, P < .05). CONCLUSION: The PI technique was more accurate than the LI or ASI techniques in accessing the swine superior TMJ space.