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Pediatric Rheumatology
Published in: Pediatric Rheumatology 1/2017

Open Access 01-12-2017 | Research article

Histologic effects of mandibular protrusion splints in antigen-induced TMJ arthritis in rabbits

Authors: Julia von Bremen, Kernt Köhler, Krystyna Siudak, Daniel Zahner, Sabine Ruf

Published in: Pediatric Rheumatology | Issue 1/2017

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Abstract

Background

Although it is common clinical practice to treat children with Juvenile Idiopathic Arthritis (JIA) with functional appliances, the scientific evidence for this is limited. The aim of this study was to study the histologic effects of mandibular protrusion splints in temporomandibular joint (TMJ) arthritis in rabbits.

Methods

Twenty-eight ten-week old New Zealand white rabbits were randomly divided into four groups: AO (TMJ arthritis, no splint), AS (TMJ arthritis, mandibular splint advancement), OS (no arthritis, mandibular splint advancement) and OO (no arthritis, no splint). TMJ arthritis was induced in the groups AO and AS; 1 week later mandibular protrusion splints were placed on the upper incisors of the AS and OS animals. After 60 days the animals were sacrificed and a semiquantitative histologic evaluation of each TMJ was carried out to analyze the amount of inflammation and bone modeling.

Results

AO and AS animals had a higher inflammation score (AO = 1.3; AS = 1.8) than the non-arthritis groups (OO = 0.6; OS = 0.4). Whereas in the untreated control (OO) the amount of apposition and resorption was almost in balance (+1), OS animals displayed significantly more apposition (+9) and AO animals significantly more resorption (−3) than the untreated control. Arthritis animals with protrusion appliances (AS), however, had remarkably more bone apposition (+3) than resorption, indicating a similar bony reaction as in healthy animals, although reduced in extent.

Conclusions

Mandibular advancement in rabbits with TMJ arthritis is possible without detrimental histologic reactions and appears to partially compensate for the bone loss seen in rabbits with TMJ arthritis but without protrusion splints.
Literature
1.
Minden K. Juvenile idiopatische arthritis. In: Wagner N, Dannecker G, editors. Pädiatrische rheumatologie. 12th ed. Heidelberg: Springer Publishing Company; 2007. p. 177–81.
2.
Karhulahti T, Ylijoki H, Ronning O. Mandibular condyle lesions related to age at onset and subtypes of juvenile rheumatoid arthritis in 15-year-old children. Scand J Dent Res. 1993;101:332–8.PubMed
3.
Kreiborg S, Bakke M, Kirkeby S, Michler L, Vedtofte P, Seidler B, et al. Facial growth and oral function in a cases of juvenile rheumatoid arthritis during an 8-year period. Eur J Orthod. 1990;12:119–34.CrossRefPubMed
4.
Olson L, Eckerdal O, Hallonsten AL, Helkimo M, Koch G, Gäre BA. Craniomandibular function in juvenile chronic arthritis. A clinical and radiographic study. Swed Dent J. 1991;15:71–83.PubMed
5.
Pearson MH, Ronning O. Lesions of the mandibular condyle in juvenile chronic arthritis. Br J Orthod. 1996;23:49–56.CrossRefPubMed
6.
Schwarzer CL, Bumann A, Küster RM. Frühe Kiefergelenkbefunde bei Kindern mit Juveniler Chronischer Arthritis auf der Grundlage manueller Untersuchungstechniken. Inf Orthod Kieferorthop. 1995;27:549–63.
7.
Twilt M, Mobers SM, Arends LR, ten Cate R, van Suijlekom-Smit L. Temporomandibular involvement in juvenile idiopathic arthritis. J Rheumatol. 2004;31:1418–22.PubMed
8.
Wenneberg B, Kjellberg H, Kiliaridis S. Bite force and temporomandibular disorder in juvenile chronic arthritis. J Oral Rehabil. 1995;22:633–41.CrossRefPubMed
9.
Farronato G, Carletti V, Maspero C, Farronato D, Giannini L, Bellintani C. Craniofacial growth in children affected by JIA involving the TMJ: functional therapy. J Clin Pediatr Dent. 2009;33:351–7.CrossRefPubMed
10.
Grosfeld O. The orthodontist in the team-treatment for children with rheumatoid arthritis. Eur J Orthod. 1989;11:120–4.CrossRefPubMed
11.
Hanna VE, Rider SF, Moore TL, Wilson VK, Osborn TG, Rotskoff KS, Johnston Jr LE. Effects of systemic onset juvenile rheumatoid arthritis on facial morphology and temporomandibular joint form and function. J Rheumatol. 1996;23:155–8.PubMed
12.
Hu YS, Schneiderman ED. The temporomandibular joint in juvenile rheumatoid arthritis: I. Computed tomographic findings. Pediatr Dent. 1995;17:46–53.PubMed
13.
Hu YS, Schneiderman ED, Harper RP. The temporomandibular joint in juvenile rheumatoid arthritis: Part II. Relations between computed tomographic and clinical findings. Pediatr Dent. 1996;18:312–9.PubMed
14.
Jakobsson SO, Paulin G. The influence of activator treatment on skeletal growth in Angle Class II: 1 cases. A roentgenocephalometric study. Eur J Orthod. 1990;12(2):174–84.CrossRefPubMed
15.
Kitai N, Kreiborg S, Makke M, Paulsen HU, Møller E, Darvann TA, Pedersen H, Takada K. Three-dimensional magnetic resonance image of the mandible and masticatory muscles in a case of juvenile chronic arthritis treated with the herbst appliance. Angle Orthod. 2002;72:81–7.PubMed
16.
Kjellberg H, Fasth A, Kiliaridis S, Wenneberg B, Thilander B. Craniofacial structure in children with juvenile chronic arthritis (JCA) compared with healthy children with ideal or postnormal occlusion. Am J Orthod Dentofac Orthop. 1995;107:67–78.CrossRef
17.
Kjellberg H, Kiliaridis S, Thilander B. Dentofacial growth in orthodontically treated and untreated children with juvenile chronic arthritis (JCA). a comparison with angle class II division 1 subjects. Eur J Orthod. 1995;17:357–73.CrossRefPubMed
18.
19.
Peltomäki T, Kreiborg S, Pedersen TK, Ogaard B. Craniofacial growth and dento-alveoalr development in juvenile idiopathic arthritis patients. Semin Orthod. 2015;21:84–93.CrossRef
20.
von Bremen J, Ruf S. Orthodontic and dentofacial orthopedic management of juvenile idiopathic arthritis: a systematic review of the literature. Orthod Craniofac Res. 2011;14(3):107–15.CrossRef
21.
Stoustrup P, Küseler A, Kristensen KD, Herlin T, Pedersen TK. Orthopaedic appliance treatment can reduce mandibular asymmetry caused by unilateral temporomandibular involvement in juvenile idiopathic arthritis. Eur J Orthod. 2013;35(2):191–8.CrossRefPubMed
22.
Pedersen TK, Grønhøj J, Melsen B, Herlin T. Condylar condition and mandibular growth during early functional treatment of children with juvenile chronic arthritis. Eur J Orthod. 1995;17(5):385–94.CrossRefPubMed
23.
Pedersen TK, Norholt SE. Early orthopedic treatment and mandibular growth of children with temporomandibular joint abnormalities. Semin Orthod. 2011;17:235–45.CrossRef
24.
Pedersen TK, Verna C. Functional and orthopaedic treatment in developing dentofacial growth deviation in juvenile idiopathic arthritis. Semin Orthod. 2015;21:134–9.CrossRef
25.
Proffit WR, Turvey TA. Dentofacial asymmetry. In: Proffit WR, White RP, Sarver DM, editors. Contemporary treatment of dentofacial deformity. St. Louis: Elsevier; 2003. p. 600.
26.
Gassner R, Buckley MJ, Georgescu H, Studer R, Stefanovich-Racic M, Piesco NP, Evans CH, Agarwal S. Cyclic tensile stress exerts antiinflammatory actions on chondrocytes by inhibiting inducible nitric oxide synthase. J Immunol. 1999;163(4):2187–92.PubMedPubMedCentral
27.
Agarwal S, Long P, Gassner R, Piesco NP, Buckley MJ. Cyclic tensile strain suppresses catabolic effects of interleukin-1beta in fibrochondrocytes from the temporomandibular joint. Arthritis Rheum. 2001;44(3):608–17.CrossRefPubMedPubMedCentral
28.
Deschner J, Rath-Deschner B. Agarwal S Regulation of matrix metalloproteinase expression by dynamic tensile strain in rat fibrochondrocytes. Osteoarthr Cartil. 2006;14(3):264–72.CrossRefPubMed
29.
Ferretti M, Madhavan S, Deschner J, Rath-Deschner B, Wypasek E, Agarwal S. Dynamic biophysical strain modulates proinflammatory gene induction in meniscal fibrochondrocytes. Am J Physiol Cell Physiol. 2006;290(6):C1610–5.CrossRefPubMedPubMedCentral
30.
Spyropoulos MN, Tsolakis AI. Altered mandibular function and prevention of skeletal asymmetries after unilateral condylectomie in rats. Eur J Orthod. 1997;19:211–8.CrossRefPubMed
31.
Ruf S, Pancherz H. Temporomandibular joint growth adaptation in Herbst treatment: a prospective magnetic resonance imaging and cephalometric roentgenographic study. Eur J Orthod. 1998;20:385–8.CrossRef
32.
Ruf S, Pancherz H. Temporomandibular joint remodelling in adolescents and young adults during Herbst treatment: A prospective longitudinal magnetic resonance imaging and cephalometric investigation. Am J Orthod Dentofac Orthop. 1999;115:607–18.CrossRef
33.
Aidar LA, Abrahão M, Yamashita HK, Dominguez GC. Morphological changes of condyles and Helkimo clinical dysfunction index in patients treated with Herbst--orthodontic appliance. Braz Dent J. 2013;24(4):313–21.CrossRefPubMed
34.
Ruf S, Pancherz H. Does bite-jumping damage the TMJ? a prospective longitudinal clinical and MRI study of herbst patients. Angle Orthod. 2000;70:183–99.PubMed
35.
Kapila S, Lee C, Tavakkoli-Jou MR, Miller AJ, Richards DW. Development and histologic characterizations of an animal model of antigen-induced arthritis of the juvenile rabbit temporomandibular joint. J Dent Res. 1995;74(12):1870–9.CrossRefPubMed
36.
Rabie AB, Zhao Z, Shen G, Hägg EU, Robinson W. Osteogenesis in the glenoid fossa in response to mandibular advancement. Am J Orthod Dentofac Orthop. 2001;119:390–400.CrossRef
37.
Shen G, Rabie AB, Zhao ZH, Kaluarachchi K. Forward deviation of the mandibular condyle enhances endochondral ossification of condylar cartilage indicated by increased expression of type X collagen. Arch Oral Biol. 2006;51(4):315–24.CrossRefPubMed
38.
Wu MJ, Zhan J, Gu ZY. Time course of expression of bcl-2 and bax in rabbit condylar chondrocytes following forward mandibular positioning. Angle Orthod. 2008;78(3):453–9.CrossRefPubMed
39.
Ruf S, Wüsten B, Pancherz H. Temporomandibular joint effects of activator treatment: a prospective longitudinal magnetic resonance imaging and clinical study. Angle Orthod. 2002;72:527–40.PubMed
40.
Bayar N, Kara SA, Keles I, et al. Temporomandibular joint involvement in rheumatoid arthritis: a radiological and clinical study. Cranio. 2002;20:105–10.CrossRefPubMed
41.
Küseler A, Pedersen TK, Gelineck J, et al. A 2 year follow up study of enhanced magnetic resonance imaging and clinical examination of the temporomandibular joint in children with juvenile chronic arthritis. J Rheumatol. 2005;32:162–9.PubMed
42.
Assaf AT, Kahl-Nieke B, Feddersen J, Habermann CR. Is high-resolution ultrasonography suitable for the detection of temporomandibular joint involvement in children with juvenile idiopathic arthritis? Dentomaxillofac Radiol. 2013;42(3):20110379.CrossRefPubMedPubMedCentral
43.
Pedersen TK, Jensen JJ, Melsen B, Herlin T. Resorption of the temporomandibular condylar bone according to subtypes of juvenile chronic arthritis. J Rheumatol. 2001;28(9):2109–15.PubMed
44.
Björk A, Skieller V. Normal and abnormal growth of the mandible. A synthesis of longitudinal cephalometric implant studies over a period of 25 years. Eur J Orthod. 1983;5:1–46.CrossRefPubMed
45.
Björk A, Skieller V. Contrasting mandibular growth and facial development in long face syndrome, juvenile rheumatoid polyarthritis, and mandibulofacial dysostosis. J Craniofac Genet Dev Biol Suppl. 1985;1:127–38.PubMed
46.
Stoll ML, Cron RQ. Treatment of juvenile idiopathic arthritis in the biologic age. Rheum Dis Clin North Am. 2013;39(4):751–66.CrossRefPubMed
47.
Stoll ML, Cron RQ, Saureanmann RK. Systemic and intra-articular anti-inflammatory therapy of temporomandibular joint arthritis in children with juvenile idiopathic arthritis. Semin Orthod. 2015;21:125–33.CrossRef
Metadata
Title
Histologic effects of mandibular protrusion splints in antigen-induced TMJ arthritis in rabbits
Authors
Julia von Bremen
Kernt Köhler
Krystyna Siudak
Daniel Zahner
Sabine Ruf
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Pediatric Rheumatology / Issue 1/2017
Electronic ISSN: 1546-0096
DOI
https://doi.org/10.1186/s12969-017-0158-0

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