Modeling of the effect of friction in the temporomandibular joint on displacement of its disc during prolonged clenching.

PURPOSE: The effect of the frictional coefficient in the temporomandibular joint on the disc during prolonged clenching was examined. MATERIALS AND METHODS: For this purpose, a finite element model of the temporomandibular joint based on magnetic resonance images from a volunteer subject was used. Muscle forces applied for clenching were used as a loading condition for stress analysis during 10 minutes. With respect to the frictional coefficient between articular surfaces, 3 different values ranging from micro = 0.001 to micro = 0.1 were established. RESULTS: At the onset of clenching, large stresses were found in the central and lateral part of the intermediate zone in the disc, and its stress distribution was not markedly changed during 10 minutes of clenching. In the retrodiscal tissue, stress relaxation occurred during the first 2 minutes of clenching. When the frictional coefficient between articular surfaces increased, the anterior, lateral, and central points in the disc moved further forward. At the end of 10 minutes of clenching, the disc showed a more anterior position as the frictional coefficient increased. CONCLUSION: This result indicates that increase of the frictional coefficient between the articular surfaces may be a major cause for the onset of the disc displacement.

Influence of friction at articular surfaces of the temporomandibular joint on stresses in the articular disk: a theoretical approach with the finite element method.

The present study was designed to assess stress and displacement of the temporomandibular joint (TMJ) disk during jaw opening with different frictional coefficients (micro) from 0.0001 to 0.5 at the TMJ disk and bony component interfaces using three-dimensional finite element (FE) models of individual TMJs based on magnetic resonance (MR) images. An asymptomatic female volunteer and a female patient with anterior disk displacement without reduction were selected, and serial sagittal and frontal slices of their MR images were used for the TMJ reconstruction procedure. The condylar movement was recorded during jaw opening by a Gnatho-hexagraph and used as the loading condition for the subsequent stress analysis of the model. In the asymptomatic subject, relatively high von Mises stresses were observed in the anterior and lateral regions of the disk during jaw opening, and the superior boundary, contacting with the glenoid fossa, exhibited lower stresses than those on the inferior boundary facing the condyle. In the symptomatic subject, although the stress value in the disk was relatively low, the posterior connective tissue exhibited high stress throughout jaw opening. Additional increments in stress values and disk displacement were observed as the coefficient of friction increased, especially in the asymptomatic subject. It is concluded that an augmentation in the friction between the disk, glenoid fossa, and condyle produces an increment in stress and displacement of the disk.

Effect of hyperactivity of the lateral pterygoid muscle on the temporomandibular joint disk.

In this study, the effect of hyperactivity of the lateral pterygoid muscle (LPM) on the temporomandibular joint (TMJ) disk during prolonged clenching was examined with a mathematical model. Finite element models of the TMJ were constructed based on magnetic resonance images from two subjects with or without internal derangement of the TMJ. For each model, muscle forces were used as a loading condition for stress analysis for 10 min clenching. Furthermore, an intermittent increase of the LPM force with intervals of 1 min was applied. In the asymptomatic model, large stresses were found in the central and lateral part of the disk at the onset of clenching. In the retrodiscal tissue, stress relaxation occurred during the first 2 min of clenching. When the force of the LPM increased temporarily, the disk moved anteriorly and returned to its original position afterward. In the symptomatic model, large stresses were observed in both the posterior region of the disk and the retrodiscal tissue throughout clenching. Upon temporary increase of the LPM force, the disk was elongated anteriorly, which appeared to be irreversible. These results indicate that hyperactivity of the LPM may be involved in the progression of disk displacement.

Age-associated changes in viscoelastic properties of the bovine temporomandibular joint disc.

To test the hypothesis that compressive properties of the temporomandibular joint (TMJ) disc change with age, we investigated its viscoelastic properties and stress-relaxation behavior under compression. Compressive stress-relaxation tests were performed in different regions of bovine discs of various ages. For each disc, specimens were derived from three different regions (anterior, central, and posterior). For four strain levels (5, 10, 15, and 20%), a stress-relaxation test was conducted over a 5-min period. Values of the instantaneous modulus, E(0), appeared to be larger in the anterior than in the posterior region of the disc, irrespective of age. The E(0) value increased with age, especially in the central region. Values of the relaxed modulus, E(R), also increased significantly with age. There were no regional differences in values of the relaxed modulus. Under stress-relaxation, the relaxation time became longer with age, especially in the posterior region. The results suggest that the compressive properties, instantaneous and relaxed moduli, increase with age, while the relaxation time becomes longer. This implies that the TMJ disc becomes harder with age. Furthermore, the compressive properties of the TMJ disc are region-specific. As a result of the harder disc, it is likely that the TMJ becomes more vulnerable to secondary damage, such as fracture and tissue degradation.

Three-dimensional finite-element model of the human temporomandibular joint disc during prolonged clenching.

In the temporomandibular joint (TMJ), overloading induced by prolonged clenching appears to be important in the cascade of events leading to disc displacement. In this study, the effect of disc displacement on joint stresses during prolonged clenching was studied. For this purpose, finite-element models of the TMJ, with and without disc displacement, were used. Muscle forces were used as a loading condition for stress analysis during a time-period of 10 min. The TMJ disc and connective tissue were characterized as a linear viscoelastic material. In the asymptomatic model, large stresses were found in the central and lateral part of the disc through clenching. In the retrodiscal tissue, stress relaxation occurred during the first 2 min of clenching. In the symptomatic model, large stresses were observed in the posterior part of the disc and in the retrodiscal tissue, and the stress level was kept constant through clenching. This indicates that during prolonged clenching the disc functions well in the asymptomatic joint, meanwhile the retrodiscal tissue in the symptomatic joint is subject to excessive stress. As this structure is less suitable for bearing large stresses, tissue damage may occur. In addition, storage of excessive strain energy might lead to breakage of the tissue.