Psychological stress induces alterations in temporomandibular joint ultrastructure in a rat model of temporomandibular disorder.

OBJECTIVE: The objective of this study was to investigate the effects of psychological stress on temporomandibular disorder (TMD). STUDY DESIGN: A communication box was used to induce psychological stress (PS) in rats. Then, the ultrastructure of temporomandibular was observed using scanning electron microscopy. Interleukin-1 (IL-1) and IL-6 were measured with reverse transcription polymerase chain reaction. RESULTS: The PS group showed evidence of ultrastructural changes in the condyle and articular disk after stimulation, i.e., incomplete gelatinlike material was observed on the condyle after 1 week of PS, wider waves on the articular disk and exposed condylar collagen were observed after 3 weeks of PS, and cracks were apparent on the surface of the condyle. The expression of IL-1 and IL-6 in the condyle cartilage significantly increased after exposure to psychological stress. CONCLUSIONS: These results indicate that psychological stress induces ultrastructure alterations in the temporomandibular joint and plays an important role in TMD.

Matrix metalloproteinase and its inhibitor in temporomandibular joint osteoarthrosis after indirect trauma in young goats.

Our aim was to examine the change in expression of matrix metalloproteinases (MMP-13), matrix metalloproteinases-3 (MMP-3), and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in the articular cartilage of goats with experimentally-induced osteoarthrosis of the temporomandibular joint (TMJ) at various times. Osteoarthrosis was induced in 20 goats in the bilateral TMJ and 5 goats acted as controls. There were 5 goats in each group, and a group was killed at 7 days, and 1, 3, and 6 months postoperatively. The samples were collected, and the joints evaluated histologically. Immunofluorescence was used to detect the presence of MMPs and TIMP-1 in the articular disc and condylar cartilage. The ultrastructure of the articular disc and condylar surface at 1 month was examined with scanning electron microscopy (SEM). Osteoarthrosis of the TMJ progressed gradually over time. MMP-13, MMP-3, and TIMP-1 were expressed strongly in the TMJ soon after injury; MMP-13 became gradually weakened, and MMP-3 strengthened later. None of these were expressed in the normal condyle. After a month the surface of the arthrotic condyle was uneven, and the underlying collagen fibrils were exposed in irregular fissures on the surface. The secretion of TIMP-1 was related closely to the changes of MMPs during osteoarthrosis of the TMJ. The unbalanced ratio between them caused degradation of the matrix of the cartilage and might be the cause of osteoarthrosis of the TMJ.

Ultrastructural study of the temporomandibular joint after unilateral meniscectomy in Wistar rats.

Meniscectomy of the temporomandibular joint (TMJ) was frequently performed until a few years ago but now is seldom employed. This procedure induces important articular modifications but the complete extent of ultrastructural changes is still unknown. Twenty-one Wistar rats were submitted to unilateral meniscectomy. Animals were randomly divided into three groups and followed for 15, 35 or 60 days. After killing both meniscectomized and contralateral TMJ specimens were sectioned sagittally and prepared for light and scanning electron microscopy studies. Normal TMJs are characterized by glenoid fossa and condylar process with distinct conjunctive layers in which regularly arranged type 1 collagen fibres predominate. Meniscectomized animals initially exhibit a different tissue covering the eroded articular surface of the condyle with the prevalence of type 3 collagen fibres but type 1 fibres predominate in the late postoperative period. Subchondral cysts are clearly visible. A complex remodelling process of the TMJ after meniscectomy is evident with important ultrastructural modifications that may correlate to unsatisfactory clinical results. The dynamic nature of this process is also observed when specimens from different postoperative periods are compared. Surgeons should always bear in mind these alterations when indicating this procedure.

Biomechanical responses of human temporomandibular joint disc under tension and compression.

The purpose of this study was to observe the microscopic changes in the temporomandibular joint (TMJ) disc in response to tension and compression, and to study the mechanism of disc failure when subjected to mechanical stresses. The scanning electron microscope was used to observe topographic characteristics of TMJ disc samples obtained from 13 cadavers before and during biomechanical experiments. The stress relaxation experiments were conducted at different strain levels (2, 3, 4 and 6%). The uniaxial tensile experiments were carried out at a constant strain rate (0.05 mm/s). The confined compression tests were performed with 3 different indenters (2, 3 and 4mm in diameter) for 150 s and 3 h. The maximal tensile strain of the disc was 5% (nearly equal to 0.22 MPa of tensile stress) in the mediolaterally tensile direction. Typical wavelike structure of the collagen fibrils of the disc was present at 2-4% strain ranges. Tensile and shear damage to local collagen fibrils was observed in specimens of the intermediate zone and the posterior band at 6% strain level. Changes in the collagen network from a wavelike structure to distortion observed on the surface of the testing samples were reversible in the 150-s indentation, but severe, irreversible breakdown and deformation of the collagen-proteoglycan network occurred in those specimens that had been compressed for 3h. Persistent and prolonged compression inevitably resulted in irrecoverable disc failure. Mechanical stress is a crucial factor in breakdown of the TMJ disc.

Cell type and distribution in the porcine temporomandibular joint disc.

PURPOSE: Surprisingly little is known about the cellular composition of the temporomandibular joint (TMJ) disc, which is a crucial piece of the puzzle in tissue engineering efforts. Toward this end, cell types were identified and quantified regionally in the TMJ disc. MATERIALS AND METHODS: Porcine TMJ discs were examined by histology, electron microscopy, and immunohistochemistry. Histology consisted of hematoxylin and eosin staining to identify regional variation of cell type and cell numbers. Transmission electron microscopy was used to elucidate differences in organelle content and pericellular matrix between TMJ disc cells and chondrocytes from hyaline cartilage. Immunohistochemistry was used to assess the presence of smooth and skeletal muscle character in the TMJ disc. RESULTS: The overall ratio of fibroblasts to chondrocyte-like cells in the TMJ disc was approximately 2.35 to 1, with the highest relative number of chondrocyte-like cells in the intermediate zone. Electron microscopy revealed distinct differences between TMJ disc chondrocyte-like cells and chondrocytes from hyaline cartilage with respect to organelles and the pericellular region. Immunostaining identified smooth muscle in the form of vessels, which were most prominent in the anterior band. Skeletal muscle was not observed. CONCLUSION: The cells of the TMJ disc are distinctly different from cells of hyaline cartilage, and consequently should not be referred to as chondrocytes. TMJ disc cells are comprised of heterogeneously distributed subpopulations, with fibroblasts predominating over fibrochondrocytes.

Ultrastructure of the human intra-articular disc of the temporomandibular joint.

The ultrastructural appearance of the human intra-articular disc (IAD) was investigated in three discs that had been surgically removed due to disease from three female patients aged 47, 50, and 54 years of age. Regions of the IAD were selected from central areas that appeared to be least affected by disease. Sections were fixed in 2.5 per cent glutaraldehyde in 0.1 M phosphate buffer, pH 7.3 immediately after surgery. The regions examined showed no obvious signs of inflammation. The cells showed moderate amounts of the intracellular organelles associated with protein synthesis and secretion, and possessed considerable amounts of microfilamentous material, thus resembling those described in other mammals. Despite the large number of cells examined, only one cell showed evidence of a chondrocyte-like morphology in that it possessed an incomplete pericellular zone of microfilamentous material separating the cell membrane from the adjacent collagen bundles of the extracellular matrix (ECM). Thus, on morphological grounds, fibrocartilage was virtually non-existent in the specimens examined. The mean collagen fibril diameter was 43.9 nm and the fibril diameter distribution was not unimodal. Although the majority of fibrils had a relatively small diameter, two of the three specimens possessed many fibrils with diameters of over 100 nm, this being consistent with tissue subjected to tension. The mean area of a fibre bundle occupied by collagen (as opposed to the ground substance) was approximately 56 per cent.

The microanatomy of the rhesus monkey temporomandibular joint.

PURPOSE: The objective of this study was to describe and compare the histology of the rhesus monkey temporomandibular joint (TMJ) with that of the human joint. MATERIALS AND METHODS: Seventeen rhesus monkeys (Macaca mulatta) with an age range from 4 to 11 years were used. Both TMJs of the first animal and the left TMJs of the remaining 16 animals were used for this study. The joint specimens were sectioned sagittally and processed for light and electron microscopic studies. RESULTS: The rhesus monkey TMJ consists of the condylar, glenoid fossa, and articular disc components. The histology of these components is described at the light and electron microscopic level. CONCLUSIONS: The monkey TMJ was found to be anatomically similar to the human joint. It was concluded that the rhesus monkey is one of the most suitable animal models for studies involving the TMJ.

Ultrastructural study on adhesions in internal derangement of the temporomandibular joint.

PURPOSE: This study examined the ultrastructural characteristics of adhesions in the upper joint compartment of temporomandibular joint (TMJ). MATERIALS AND METHODS: Tissue biopsy specimens of adhesions were obtained during arthroscopic operation on 36 joints in 22 patients with internal derangement (ID). The biopsy specimens were examined by light and transmission electron microscopy. RESULTS: Adhesions were grossly divided into two types based on arthroscopic observation: 1) a band-like type, which connected the articular fossa and TMJ disc, and 2) a pseudowall-like type, which faced the synovial fluid and was lined by articular tissue. Two types of collagen arrangement were observed at the electron microscopic level: orderly arranged collagen bundles and randomly arranged collagen bundles. Orderly arranged collagen bundles were prominent in the band-like adhesions. In pseudowall-like adhesions, mainly the randomly arranged collagen bundles were seen. However, in some dense fiber parts, orderly arranged collagen bundles also were observed. In other pseudowall-like adhesions, only orderly arranged collagen bundles were seen. Elastic fibers were abundant in some pseudowall-like adhesions with randomly arranged collagen bundles. There were no elastic fibers in the band-like adhesions, some dense fiber parts of the pseudowall-like adhesion, pseudowall-like adhesions consisting of only orderly arranged collagen bundles, and in the synovial membrane. CONCLUSION: The different arrangement of collagen fibers and presence or absence of elastic fibers were observed in the two types of adhesions. These findings served to show that extracellular components correspond to a dysfunction involving an ID of TMJ.