The occurrence of antibodies against Chlamydia species in patients with monoarthritis and chronic closed lock of the temporomandibular joint.

PURPOSE: The study goal was to investigate the occurrence of serum antibodies to Chlamydia trachomatis, Chlamydia pneumoniae, and Chlamydia psittaci in patients with temporomandibular joint (TMJ) monoarthritis or chronic closed lock and in control subjects. PATIENTS AND METHODS: An indirect microimmunofluorescence test for detecting antibodies against C trachomatis was used. Twenty-three patients (12 with monoarthritis and 11 with chronic closed lock) and 42 control subjects were evaluated. RESULTS: Six patients with monoarthritis, 5 patients with chronic closed lock of the TMJ, and 6 control individuals were considered to have had a past C trachomatis infection based on their immunoglobulin G titers. Corresponding groups for C pneumoniae investigation included 3 patients with monoarthritis, 4 patients with chronic closed lock, and 17 control subjects, and for C psittaci, 1 patient with monoarthritis, 2 patients with chronic closed lock, and 1 control subject. Statistically significant differences between patients and control subjects were found for C trachomatis only; monoarthritis versus control (P =.016), chronic closed lock versus control (P =.038), and all patients versus control (P =.007). Patients with monoarthritis did not differ from patients with chronic closed lock with regard to antibodies against C trachomatis. CONCLUSION: The occurrence of serum antibodies to C trachomatis was significantly higher in patients than in control subjects, but this occurrence did not correlate with severity of observed tissue changes. Nevertheless, an association may exist between the presence of C trachomatis and TMJ disease.

Characterization of tissue components in the temporomandibular joint disc and posterior disc attachment region: internal derangement and control autopsy specimens compared by morphometry.

PURPOSE: Our aim was to morphologically investigate the occurrence of fibroblasts, chondrocytes, and blood vessels in the tissue of the temporomandibular joint (TMJ) disc, the intermediate zone, and the posterior disc attachment region in control autopsy specimens and to compare the results with those observed in corresponding tissues from patients with TMJ internal derangement. PATIENTS AND METHODS: First, 20 bilateral TMJ disc specimens from selected autopsy cases were analyzed by conventional morphometry. Thus, the volume density of fibroblasts, chondrocytes, and blood vessels was determined. Second, the obtained results from the right joint of the autopsy disc specimens were compared with 12 TMJ disc specimens obtained at surgery from patients with internal derangement. RESULTS: The tissue compartments of interest (disc, intermediate zone, and posterior disc attachment region) were identified unequivocally in all specimens. None of the autopsy cases showed any significant difference between the right and left joints or related to gender. The only variable that differed between autopsy and patient specimens was volume density of blood vessels, which was higher in patient specimens. CONCLUSIONS: We found that the volume density of blood vessels was significantly higher in the posterior disc attachment region in patient specimens than in autopsy controls. Whether this reflects a role for vessels in the pathogenesis of TMJ internal derangement or merely is a reaction to another type of injury remains to be settled. In both the autopsy control and patient specimens, chondrocytes and fibroblasts were characteristic for disc respective posterior disc attachment region. Thus it appears that the occurrence of these cells can be used to distinguish TMJ disc from posterior disc attachment in small biopsy specimens.