Biopolymer grafts often have limited biocompatibility, triggering excessive inflammatory responses similar to foreign bodies. Macrophage phenotype shifts are pivotal in the inflammatory response and graft success. The effects of the morphology and physical attributes of the material itself on macrophage polarization should be the focus. In this study, we prepared electrospun fibers with diverse diameters and formed a shish-kebab (SK) structure on the material surface by solution-induced crystallization, forming electrospun fiber scaffolds with diverse pore sizes and roughness. In vitro cell culture experiments demonstrated that SK structure fibers could regulate macrophage differentiation toward M2 phenotype, and the results of in vitro simulation of in vivo tissue reconstruction by the microenvironment demonstrated that the paracrine role of M2 phenotype macrophages could promote bone marrow mesenchymal stem cells (BMSCs) to differentiate into osteoblasts. In rats implanted with a subcutaneous SK-structured fiber scaffold, the large-pore size and low-stiffness SK fiber scaffolds demonstrated superior immune performance, less macrophage aggregation, and easier differentiation to the anti-inflammatory M2 phenotype. Large pore sizes and low-stiffness SK fiber scaffolds guide the morphological design of biological scaffolds implanted in vivo, which is expected to be an effective strategy for reducing inflammation when applied to graft materials in clinical settings.

Backgrounds: The primary controversy surrounding the treatment of anterior disc displacement (ADD) of temporomandibular joints (TMJ) stems from the unclear relationship between disc position and condylar adaptation. The long-term impact of varying disc position on condylar bone remodeling remains poorly understood. Methods: A randomized controlled clinical trial was conducted to evaluate the effects of different disc positions on condylar bone modeling/remodeling at baseline (T0) and after an 18-month follow-up (T1). Patients under 25 years of age diagnosed with TMJ ADD without reduction (ADDwoR) were enrolled and randomly allocated in a 1:1 ratio to either the disc displaced (DD) group or the disc reposited (DR) group. Participants in the DR group underwent arthroscopic disc repositioning surgery, whereas those in the DD group received no occlusal or surgical intervention. CT scans were obtained at T0 and T1, and three-dimensional condylar reconstructions were generated using Mimics 21.0 software. Seven anatomical points were defined on the condylar surface to represent distinct regions. The condylar volume and vertical height of 7 points were measured for the analysis. Results: This study included 60 patients with ADDwoR. At T1, the DR group demonstrated a significant increase in total condylar volume of 279.6 mm ³ per patient, compared to a slight 29.5 mm ³ increase in the DD group ( P < 0.0001). Differential height changes were observed between groups, particularly at the posterolateral and lateral condylar surfaces ( P < 0.05). Besides, anterolaterally displaced discs were associated with bone resorption at the posteromedial condyle, in contrast to anteromedially displaced discs at T0 ( P < 0.01). Conclusions: This study provides compelling evidence that ADDwoR restricts condylar bone growth in adolescents and young adults. Furthermore, disc position directly determines patterns of condylar bone modeling and remodeling in this population.

The aim of this study was to find out the most appropriate method of measuring condylar height on temporomandibular joint (TMJ) magnetic resonance imaging (MRI). Traditional three-circle method, modified three-circle method and ramal plane (RP) method were used by 2 separate observers for the measurement of condylar height and long axis of condyle on TMJ MRI. Pearson correlation coefficient (PCCs), intra-class correlation coefficient (ICC), paired t test and Bland–Altman analysis were applied for the comparison of CH and long axis of condyle between 2 observers. Thirty-two patients’ images were finally included in our study. Comparing the 3 methods, it was revealed that the RP method has the highest consistency among the observers, followed by the modified three-circle method, and the traditional three-circle method has the worst consistency. The RP method is preferred for measuring the condylar height on MRI. If mandible edge cannot be observed on MRI, the modified three-circle method is recommended.

According to the literature, there is no reliable and quantitative method available for the diagnosis and prognosis of early or potential temporomandibular joint (TMJ) condylar resorption (CR) thus far. The purpose of this study was to raise a new noninvasive method to quantitatively evaluate condylar quality using the signal intensity ratio (SIR) on magnetic resonance imaging (MRI) in order to assist in the diagnosis of TMJ CR. A retrospective exploratory study was performed to compare the condyle-to-cerebral cortex signal intensity ratios (SIR) on MRI among young female patients. We included 60 patients, and they were divided into three groups: the bilateral normal TMJ group (group 1), the bilateral TMJ anterior disc displacement (ADD) but without CR group (group 2), and the bilateral TMJ anterior disc displacement (ADD) with CR group (group 3). The SIR difference between the three groups was analyzed by the Kruskal–Wallis test (K-W test). The sensitivity, specificity, accuracy, and area under curve (AUC) were calculated by the receiver operating characteristic (ROC) curves. There was high consistency between the surgeon and the radiologist in the evaluation of the magnetic signal intensity with intraclass correlation coefficients of 0.939–0.999. The average SIR was 1.07 in the bilateral normal TMJ group (group 1), 1.03 in the ADD without CR group (group 2), and 0.78 in the ADD with CR group (group 3). It could be found by the K-W test that group 3 was significantly different from group 1 and group 2 (p < 0.05), while there was no significant difference between group 1 and group 2. The optimal critical SIR value was 0.96 for the diagnosis of CR according to the ROC curves and Youden index (p < 0.001, AUC = 0.9). The condyle-to-cerebral cortex SIR can be used as a noninvasive diagnostic tool for the quantitative evaluation of condylar quality and diagnosis and prognosis of CR. SIR ≥ 0.96 indicates a healthy condyle, while SIR < 0.96 is considered the optimal critical value for the diagnosis of CR. These findings are important for personalized and accurate treatment and prognosis prediction.