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Current Osteoporosis Reports
Published in: Current Osteoporosis Reports 4/2018

01-08-2018 | Craniofacial Skeleton (WE Roberts, Section Editor)

Part II: Temporomandibular Joint (TMJ)—Regeneration, Degeneration, and Adaptation

Authors: W. Eugene Roberts, David L. Stocum

Published in: Current Osteoporosis Reports | Issue 4/2018

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Abstract

Purpose of Review

Elucidate temporomandibular joint (TMJ) development and pathophysiology relative to regeneration, degeneration, and adaption.

Recent Findings

The pharyngeal arch produces a highly conserved stomatognathic system that supports airway and masticatory function. An induced subperiosteal layer of fibrocartilage cushions TMJ functional and parafunctional loads. If the fibrocartilage disc is present, a fractured mandibular condyle (MC) regenerates near the eminence of the fossa via a blastema emanating from the medial periosteal surface of the ramus. TMJ degenerative joint disease (DJD) is a relatively painless osteoarthrosis, resulting in extensive sclerosis, disc destruction, and lytic lesions. Facial form and symmetry may be affected, but the residual bone is vital because distraction continues to lengthen the MC with anabolic bone modeling. Extensive TMJ adaptive, healing, and regenerative potential maintains optimal, life support functions over a lifetime.

Summary

Unique aspects of TMJ development, function, and pathophysiology may be useful for innovative management of other joints.
Literature
1.
Martek ML, Bronner ME. Regulatory logic underlying diversification of the neural crest. Trends Genet. 2017;33:715–27.CrossRef
2.
Lopez-Barneo J, Marcias D, Platero-Luengo A, Ortega-Saenz P, Pardal R. Carotid body oxygen sensing and adaptation to hypoxia. Pflugers Arch. 2016;468(1):59–70.CrossRefPubMed
3.
Hockman D, Burns AJ, Schlosser G, Gates KP, Jevans B, Mongera A, et al. Evolution of the hypoxia-sensitive cells involved in amniote respiratory reflexes. eLife. 2017;6:e21231.CrossRefPubMedPubMedCentral
4.
Selvi R, Mukunda PA. Role of SOX9 in the etiology of Pierre-Robin syndrome. Iran J Basic Sci. 2013;16(5):700–4.
5.
6.
Steinberg JP, Brady CM, Waters BR, Soldanska M, Burstein FD, Thomas JE, et al. Mid-term dental and nerve-related complications of infant distraction for Robin syndrome. Plast Reconstr Surg. 2016;138(1):82e–90e.CrossRefPubMed
7.
Bragagnolo S, Colovati MES, Souza MZ, Dantas AG, F de Soares MF, Melaragno MI, et al. Clinical and cytogenomic findings in OAV spectrum. Am J Med Genet A. 2018;176:638–48.CrossRefPubMed
8.
Khetani MA, Collett BR, Speltz ML, Werler MM. Health-related quality of life in children with hemifacial microsomia: parent and child perspectives. J Dev Behav Pediatr. 2013;34(9):661–8.CrossRefPubMedPubMedCentral
9.
10.
Zheng M, Wang X, Zhang L. Association between allergic and nonallergic rhinitis and obstructive sleep apnea. Curr Opin Allergy Clin Immunol. 2018;18(1):16–25.PubMed
11.
12.
13.
14.
Ngo R, Pullano E, Peacock ZS, Lahey ET, August M. Does the medical comorbidity profile of obstructive sleep apnea patients treated with maxillomandibular advancement differ from that of obstructive sleep apnea patients managed nonsurgically. J Oral Maxillofac Surg. 2018. https://​doi.​org/​10.​1016/​j.​joms.​2018.​01.​011.
15.
16.
17.
Certal VF, Zaghi S, Riaz M, Vieira AS, Pinheiro CT, Kushida C, et al. Hypoglossal nerve stimulation in the treatment of obstructive sleep apnea: a systematic review and meta-analysis. Laryngoscope. 2015;125(5):1254–64.CrossRefPubMed
18.
Sharples LD, Clutterbuck-James AL, Glover MJ, Bennett MS, Chadwick R, Pittman MA, et al. Meta-analysis of randomised controlled trials of oral mandibular advancement devices and continuous positive airway pressure for obstructive sleep apnoea-hypopnoea. Sleep Med Rev. 2016;27:108–24.CrossRefPubMed
19.
Näpänkangas R, Raunio A, Sipilä K, Raustia A. Effect of mandibular advancement device therapy on the signs and symptoms of temporomandibular disorders. J Oral Maxillofac Res. 2012;3(4):e5.CrossRef
20.
Stocum DL, Roberts WE. Part I: development and physiology of the temporormandibular joint. Curr Rep Osteoporos. 2018 (In Press).
21.
Lee SK, Kim YS, Lim CY, Chi JG. Prenatal growth pattern of the human maxilla. Acta Anat (Basel). 1992;145(1):1–10.CrossRef
22.
Smartt JM Jr, Low DW, Bartlett SP. The pediatric mandible: a primer on growth and development. Plast Reconstr Surg. 2005;116(1):14e–23e.CrossRefPubMed
23.
Hylander WL, Ravosa MJ, Ross CF, Wall CE, Johnson KR. Symphyseal fusion and jaw-adductor muscle force: an EMG study. Am J Phys Anthropol. 2000;112(4):469–92.CrossRefPubMed
24.
25.
Zhang S, Zhai G, Wang J, Shi W, Zhang R, Chen C. IGF-II expression and methylation in small for gestational age infants. J Pediatr Endocrinol Metab. 2015;28(5–6):613–8.PubMed
26.
Zhang Y, Blackwell EL, McKnight MT, Knutson GR, Vu WT, Ruest B. Specific inactivation of Twist1 in the mandibular arch neural crest cells affects the development of the ramus and reveals interactions with Hand2. Dev Dyn. 2012;241(5):924–40.CrossRefPubMedPubMedCentral
27.
Dhindsa A, Garg S, Damle SG, Opal S, Singh T. Fused primary first macromolar with a unique relation to its permanent successors: a rare tooth anomaly. Eur J Dent. 2013;7(2):289–42.CrossRef
28.
Nickel JC, McLachlan KR, Smith DM. Eminence development of the postnatal temporomandibular joint. J Dent Res. 1988;67(6):896–902.CrossRefPubMed
29.
Katsavrias EG. Changes in articular eminence inclination during the craniofacial growth period. Angle Orthod. 2002;72(3):258–64.PubMed
30.
Rakhshan V. Congenitally missing teeth (hypodontia): a review of the literature concerning the etiology, prevalence, risk factors, patterns and treatment. Dent Res J (Isfahan). 2015;12(1):1–13.CrossRef
31.
Shashikiran ND, Karthik V, Subbareddy VV. Multiple congenitally missing primary teeth: report of a case. Pediatr Dent. 2002;24(2):149–52.PubMed
32.
Griffiths AJF, Miller JH, Suzuki DT. An introduction to genetic analysis. 7th ed. San Francisco: WH Freeman & Company; 2000.
33.
Nikopensius T, Annilo T, Jagomägi T, Gilissen C, Kals M, Krjutškov K, et al. Non-syndromic tooth agenesis associated with a nonsense mutation in ectodysplasin-A (EDA). J Dent Res. 2013;92(6):507–11.CrossRefPubMed
34.
Nikopensius T, Saag M, Jagomägi T, Annilo T, Kals M, Kivistik PA, et al. A missense mutation in DUSP6 is associated with Class III malocclusion. J Dent Res. 2013;92(10):893–8.CrossRefPubMed
35.
Goss RJ, Stagg MW. Regeneration of lower jaws in adult newts. J Morphol. 1958a;102:289–310.CrossRef
36.
Goss RJ, Stagg MW. Regeneration in lower jaws of newts after removal of the intermandibular regions. J Exp Zool. 1958b;137(1):12.CrossRef
37.
•• Ghosh S, Thorogood P, Ferretti P. Regenerative capacity of upper and lower jaws in urodele amphibians. Int J Dev Biol. 1994;38:479–90. This paper describes the spontaneous regeneration of maxilla and mandible in the urodele, Notophthalmus viridescens , which is of interest because it may give insights into how this might be accomplished in mammals. PubMed
38.
Kurosaka H, Takano-Yamamoth T, Yamashiro Y, Agata K. Comparison of molecular and cellular events during lower jaw regeneration of newt (Cynops pyrrhogaster) and West African clawed frog (Xenopus laevis). Dev Dyn. 2008;237:354–65.CrossRefPubMed
39.
Graver H. The polarity of the dental lamina in the regenerating salamander jaw. J Embryol Exp Morpholog. 1972;30:635–46.
40.
Robinson P. Articular cartilage of the temporomandibular joint: can it regenerate? Ann R Coll Surg Engl. 1993;75:231–6.PubMedPubMedCentral
41.
Kisner WH. Spontaneous posttraumatic mandibular regeneration. Plast Reconstr Surg. 1980;66:442–7.CrossRefPubMed
42.
Nwoku AL. Unusually rapid bone regeneration following mandibular resection. J Maxillofac Surg. 1980;8:309–15.CrossRefPubMed
43.
Boyne PJ. The restoration of resected mandible in children without use of bone graft. Head Neck. 1983;8:309–15.
44.
Nagase M, Ueda K, Suzuki I, Nakajima T. Spontaneous regeneration of the condyle following hemimandibulectomy by disarticulation. J Maxillofac Surg. 1985;43:218–20.CrossRef
45.
Devilla GH, Chen CT, Chen YR. Spontaneous bone regeneration of the mandible in elderly patient: a case report and review of the literature. Chang Gung Med J. 2003;26:369–90.
46.
Coen PD. Spontaneous bone regeneration after mandible resection in a case of ameloblastoma—a case report. Ann Scad Med Singapore. 2004;33(Suppl):59S–62S.
47.
Fujita T, Hayashi H, Shirakura M, Tsuka Y, Fujii E, Kawata T, et al. Regeneration of a condyle with a functional appliance. J Dent Res. 2013;92:322–8.CrossRefPubMed
48.
•• Hayashi H, Fujita T, Shirakura M, Tsuka Y, Fujii E, Terao A, et al. Role of articular disc in condylar regeneration of the mandible. Exp Anim. 2014;63:395–401. This study shows that the presence of the articular disc is necessary for regeneration of the condyle, suggesting that the disc produces a factor(s) that activates periosteal cells, leading to condylar regeneration. CrossRefPubMedPubMedCentral
49.
50.
Willard VP, Zhang L, Athanasiou KA. Tissue engineering of the temporomandibular joint. In Comprehensive Biomaterials. Vol. 5. Elsevier. 2011. p. 221–235.
51.
Kinoshita Y, Kobayashi M, Fukuoka S, Yoyoka S, Ikada Y. Functional reconstruction of jaw bones using poly(L-lactide) mesh and autogeneic particulate cancellous bone and marrow. Tissue Eng. 1996;2:327–41.CrossRefPubMed
52.
Warnke PH, Wiltfang J, Springer I, Acil Y, Bolte H, Kosmahl M, et al. Man as a living bioreactor: fate of an exogenously prepared customized tissue-engineered mandible. Biomaterials. 2006;27(17):3163–7.CrossRefPubMed
53.
•• Park JH, Tai K, Sato Y. Orthodontic treatment of a patient with severe crowding and unilateral fracture of the mandibular condyle. Am J Orthod Dentofac Orthop. 2016;149:899–911. This reference documents the healing blastema for a fractured mandibular condyle emanates from the periosteal surface on the medial aspect of the ascending ramus. Thus, regeneration of a fractured mandibular condyle is similar to the fetal origin of the condylar process for the mandible. CrossRef
54.
Choi YS, Choung PH, Moon HS, Kim SG. Temporomandibular disorders in 19-year-old Korean men. J Oral Maxillofac Surg. 2002;60(7):797–803.CrossRefPubMed
55.
56.
Wysocki J, Reymond J, Krasucki K. Vascularization of the mandibular condylar head with respect to intracapsular fractures of the mandible. J Craniomaxillofac Surg. 2012;40(2):112–5.CrossRefPubMed
57.
Li H, Zhang G, Cui J, Liu W, Dilxat D, Liu L. A modified preauricular approach for treating intracapsular condylar fractures to prevent nerve injury: the supratemporalis approach. J Oral Maxillofac Surg. 2016;74(5):1013–22.CrossRefPubMed
58.
59.
He D, Cai Y, Yang C. Analysis of temporomandibular joint ankylosis caused by condylar fracture. J Oral Maxillofac Surg. 2014;72(4):763e1–9.CrossRef
60.
Cervelli V, Bottini DJ, Arpino A, Trimarco A, Cervelli G, Mugnaini F. Hypercondylia: problems in diagnosis abd therapeutic indictions. J Cranitofac Surg. 2008;19(2):406–10.CrossRef
61.
Lu S-W, Chang C, Roberts WE. Asymmetric crowded Class II with missing first molars: space closure or implants? Int J Orthod Implantol. 2015;40:18–41.
62.
63.
64.
Greene CS, Laskin DM. Temporomandibular disorders: moving from a dentally based to a medically based model. J Dent Res. 2000;79(10):1736–9.CrossRefPubMed
65.
Tournavitis A, Tortopidis D, Fountoulakis K, Menexes G, Koidis P. Psychopathologic profiles of TMD patients with different pain locations. Int J Prosthodont. 2017;30(3):251–7.CrossRefPubMed
66.
Boughner JC. Implications of vertebrate craniodental evo-devo for human oral health. J Exp Zool B Mol Dev Evol. 2017;328(4):321–33.CrossRefPubMed
67.
Ikeda Y, Yonemitsu I, Takei M, Shibata S, Ono T. Mechanical loading leads to osteoarthritis-like changes in the hypofunctional temporomandibular joint in rats. Arch Oral Biol. 2014;59(12):1368–76.CrossRefPubMed
68.
Lee A, Chang C, Roberts WE. MIH-related loss of mandibular first molars resulted in an acquired class II skeletal malocclusion: conservatively treated with space closure on one side and implant-supported prosthesis on the other. Int J Orthod Implantol. 2017;47:26–48.
69.
Vasconcelos BC, Barbosa LM, Barbalho JC, Araújo GM, Melo AR, Santos LA. Ear pruritus: a new otologic finding related to temporomandibular disorder. Gen Dent. 2016;64(5):39–43.PubMed
70.
71.
Huang GJ, Rue TC. Third molar extraction as a risk factor for temporomandibular disorder. J Am Dent Assoc. 2006;137(11):1547–54.CrossRefPubMed
72.
Kuritia H, Kurashina K, Ohtsuka A. Efficacy of a mandibular molar technique in reducing the permanently displaced temporomandibular joint disc. J Oral Maxillofac Surg. 1999;57(7):784–7.CrossRef
73.
Hosgor H, Bas B, Celenk C. A comparison of the outcomes of four minimally invasive treatment methods for anterior disc displacement of the temporomandibular joint. Int J Oral Maxillofac Surg. 2017;46(11):1403–10.CrossRefPubMed
74.
Gössi DB, Gallo LM, Bahr E, Palla S. Dynamic intra-articular space variation in clicking TMJs. J Dent Res. 2004;83(6):480–4.CrossRefPubMed
75.
Michelotti A, Iodice G, Piergentili M, Farella M, Martina R. Incidence of temporomandibular joint clicking in adolescents with and without unilateral posterior cross-bite: a 10-year follow-up study. J Oral Rehabil. 2016;43(1):16–22.CrossRefPubMed
76.
Al-Baghdadi M, Durham J, Araujo-Soares V, Robalino S, Errington L, Steele J. TMJ disc displacement without reduction management: a systematic review. J Dent Res. 2014;93(7 Suppl):37S–51S.CrossRefPubMedPubMedCentral
77.
Jeon DM, Jung WS, Mah SJ, Kim TW, Ahn SJ. The effects of TMJ symptoms on skeletal morphology in orthodontic patients with TMJ disc displacement. Acta Odontol Scand. 2014;72(8):776–82.CrossRefPubMed
78.
79.
Zhu Y, Zheng C, Deng Y, Wang Y. Arthroscopic surgery for treatment of anterior displacement of the disc without reduction of the temporomandibular joint. Br J Oral Maxillofac Surg. 2012;50(2):144–8.CrossRefPubMed
80.
Liu XM, Cai XY, Yang C, Zhang SY, Chen MJ, Yun B, et al. Can puncture increase the risk of intra-articular adhesion in the temporomandibular joint? J Craniofac Surg. 2014;25(1):e26–9.CrossRefPubMed
81.
Wang BL, Yang C, Cai XY, Chen MJ, Zhang SY, Fang B, et al. Malocclusion as a common occurrence in temporomandibular joint arthroplastic disc repositioning: outcomes at 49 days after surgery. J Oral Maxillofac Surg. 2011;69(6):1587–93.CrossRefPubMed
82.
Kanatas AN, Jenkins GW, Smith AB, Worrall SF. Changes in pain and mouth opening at 1 year following temporomandibular joint replacement—a prospective study. Br J Oral Maxillofac Surg. 2011;49(6):455–8.CrossRefPubMed
83.
Tarsitano A, Battaglia S, Ramieri V, Cascone P, Ciocca L, Scotti R, et al. Short-term outcomes of mandibular reconstruction in oncological patients using a CAD/CAM prosthesis including a condyle supporting a fibular free flap. J Craniomaxillofac Surg. 2017;45(2):330–7.CrossRefPubMed
84.
Vilimek M, Horak Z, Baca V. Force ratio in masticatory muscles after total replacement of the temporomandibular joint. Acta Bioeng Biomech. 2016;18(3):131–6.PubMed
85.
McKenzie WS, Louis PJ. Temporomandibular total joint prosthesis infections: a ten-year retrospective analysis. Int J Oral Maxillofac Surg. 2017;46(5):596–602.CrossRefPubMed
86.
87.
Murphy MK, MacBarb RF, Wong ME, Athanasiou KA. Temporomandibular joint disorders: a review of etiology, clinical management, and tissue engineering strategies. Int J Oral Maxillofac Implants. 2013;28(6):e393–414.CrossRefPubMedPubMedCentral
88.
Li X, Liu H, Gu S, Liu C, Sun C, Zheng Y, et al. Replacing Shox2 with human SHOX leads to congenital disc degeneration of the temporomandibular joint in mice. Cell Tissue Res. 2014;355(2):345–54.CrossRefPubMed
89.
Ge C, Mohamed F, Binrayes A, Kapila S, Franceschi RT. Selective role of discoidin domain receptor 2 in murine temporomandibular joint development and aging. J Dent Res. 2018;97(3):321–8.CrossRefPubMed
90.
Lin YY, Tanaka N, Ohkuma S, Iwabuchi Y, Tanne Y, Kamiya T, et al. Applying an excessive mechanical stress alters the effect of subchondral osteoblasts on chondrocytes in a co-culture system. Eur J Oral Sci. 2010;118(2):151–8.CrossRefPubMed
91.
Ravosa MJ, Kane RJ. Dietary variation and mechanical properties of articular cartilage in the temporomandibular joint: implications for the role of plasticity in mechanobiology and pathobiology. Zoology. 2017;124:42–50.CrossRefPubMed
92.
Liu F, Steinkeler A. Epidemiology, diagnosis, and treatment of temporomandibular disorders. Dent Clin N Am. 2013;57(3):465–79.CrossRefPubMed
93.
Blanco Aguilera A, Gonzalez Lopez L, Blanco Aguilera E, De la Hoz Aizpurua JL, Rodriguez Torronteras A, Segura Saint-Gerons R, et al. Relationship between self-reported sleep bruxism and pain in patients with temporomandibular disorders. J Oral Rehabil. 2014;41(8):564–72.CrossRefPubMed
94.
95.
96.
Arsan B, Köse TE, Çene E, Özcan I. Assessment of the trabecular structure of mandibular condyles in patients with temporomandibular disorders using fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123(3):382–91.CrossRefPubMed
97.
Roh H-S, Kim W, Kim Y-K, Lee J-Y. Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings. J Cranio-Maxillofac Surg. 2012;40(3):283–6.CrossRef
98.
99.
Dimitroulis G. The prevalence of osteoarthrosis in cases of advanced internal derangement of the temporomandibular joint: a clinical, surgical and histological study. Int J Oral Maxillofac Surg. 2005;34(4):345–9.CrossRefPubMed
100.
101.
102.
103.
104.
Roberts WE. Bone physiology, metabolism and biomechanics in orthodontic practice. Orthodontics: current principles and techniques, Chapter 10, 5th ed., Graber LW, Vanarsdall RL Jr, Vig KWL Elsevier Mosby, St. Louis, 2012, pp 287–343.
105.
Roberts WE, Hartsfield JK Jr. Bone development and function: genetic and environmental mechanisms. Semin Orthod. 2004;10:100–22.CrossRef
106.
Barghan S, Merrill R, Tetradis S. Cone beam computed tomography imaging in the evaluation of the temporomandibular joint. J Calif Dent Assoc. 2010;38(1):33–9.PubMed
107.
Roberts WE, Roberts JA, Epker BN, Burr DB, Hartsfield JK Jr. Remodeling of mineralized tissues, part I: the Frost legacy. Semin Orthod. 2006;12(4):216–23.CrossRef
108.
Chen KN, Wen CY, Shieh JY, Tseng TM. The somatotopy of the masticatory neurons in the rat trigeminal motor nucleus as revealed by HRP study. Proc Natl Sci Counc Repub China B. 1988;12(3):146–55.PubMed
109.
Fay RA, Norgren R. Identification of rat brainstem multisynaptic connections to the oral motor nuclei using pseudorabies virus. I Masticatory muscle motor systems. Brain Res Brain Res Rev. 1997;25(3):255–75.CrossRefPubMed
110.
Toro-Ibacache V, O’Higgins P. The effect of varying jaw-elevator muscle forces on a finite element model of the human cranium. Anat Rec (Hoboken). 2016;299(7):828–39.CrossRef
Metadata
Title
Part II: Temporomandibular Joint (TMJ)—Regeneration, Degeneration, and Adaptation
Authors
W. Eugene Roberts
David L. Stocum
Publication date
01-08-2018
Publisher
Springer US
Published in
Current Osteoporosis Reports / Issue 4/2018
Print ISSN: 1544-1873
Electronic ISSN: 1544-2241
DOI
https://doi.org/10.1007/s11914-018-0462-8

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