Temporomandibular joint (TMJ) disorders have complex and sometimes controversial etiologies. Also, under similar circumstances, one person’s TMJ may appear to deteriorate, while another’s does not. However, once degenerative changes start in the TMJ, this pathology can be crippling, leading to a variety of morphological and functional deformities. Primarily, TMJ disorders have a non-inflammatory origin. The pathological process is characterized by deterioration and abrasion of articular cartilage and local thickening. These changes are accompanied by the superimposition of secondary inflammatory changes. Therefore, appreciating the pathophysiology of the TMJ degenerative disorders is important to an understanding of the etiology, diagnosis, and treatment of internal derangement and osteoarthrosis of the TMJ. The degenerative changes in the TMJ are believed to result from dysfunctional remodeling, due to a decreased host-adaptive capacity of the articulating surfaces and/or functional overloading of the joint that exceeds the normal adaptive capacity. This paper reviews etiologies that involve biomechanical and biochemical factors associated with functional overloading of the joint and the clinical, radiographic, and biochemical findings important in the diagnosis of TMJ-osteoarthrosis. In addition, non-invasive and invasive modalities utilized in TMJ-osteoarthrosis management, and the possibility of tissue engineering, are discussed.

The temporomandibular joint (TMJ) disc consists mainly of collagen fibers and proteoglycans constrained in the interstices of the collagen fiber mesh. This construction results in a viscoelastic response of the disc to loading and enables the disc to play an important role as a stress absorber during function. The viscoelastic properties depend on the direction (tension, compression, and shear) and the type of the applied loading (static and dynamic). The compressive elastic modulus of the disc is smaller than its tensile one because the elasticity of the disc is more dependent on the collagen fibers than on the proteoglycans. When dynamic loading occurs, the disc is likely to behave less stiffly than under static loading because of the difference of fluid flow through and out of the disc during loading. In addition, the mechanical properties change as a result of various intrinsic and extrinsic factors in life such as aging, trauma, and pathology. Information about the viscoelastic behavior of the disc is required for its function to be understood and, for instance, for a suitable TMJ replacement device to be constructed. In this review, the biomechanical behavior of the disc in response to different loading conditions is discussed.

The present study was designated to determine the elastic properties of the periodontal ligament (PDL) in human subjects. A maxillary central incisor was experimentally translated so that stress or strain could be uniformly distributed in the PDL by applying a single force passing through the center of resistance. Displacements were measured under different magnitudes of load using a magnet-magnetic sensing system. From the load-displacement relations, Young's modulus of the PDL was calculated. The values determined were approximately 0.12 MPa under load ranging from 0 to 0.5 N, 0.25 MPa within the range of 0.5-1.0 N, 0.44 MPa under load 1.0-1.5 N, and between 0.69 and 0.96 MPa with 1.5-2.0 N. The values of Young's moduli increased almost exponentially with the increment of load due to a non-linear elasticity of the PDL.

The purpose of this study was to examine the antibacterial activity of composite resin with glass-ionomer filler particles versus that of contemporary commercial composite resins. Three composite resins were used: Beautifil II (containing S-PRG filler), Clearfil AP-X, and Filtek Z250. Resin blocks were bonded to maxillary first molars, and plaque accumulation on the resin block surface was examined after 8 hours. For the antibacterial test, the number of Streptococcus mutans in contact with the composite resin blocks after incubation for 12 hours was determined, and adherence of radiolabeled bacteria was evaluated. Less dental plaque was formed on Beautifil II resin block as compared to the other two materials. Antibacterial test revealed that there were no significant differences in the number of Streptococcus mutans among the three composite resins. However, the adherence of radiolabeled bacteria to the saliva-treated resin surface was significantly (p<0.01) lower in Beautifil II than in the other two materials. These results suggested that Beautifil II could reduce dental plaque formation and bacterial adherence, leading to prevention of secondary caries.

Monocytes give rise to macrophages, osteoclasts (OCs), and dendritic cells (DCs). Macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor-kappaB (RANK) ligand induce OC differentiation from monocytes, whereas granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-4 (IL-4) trigger monocytic differentiation into DCs. However, regulatory mechanisms for the polarization of monocytic differentiation are still unclear. The present study was undertaken to clarify the mechanism of triggering the deflection of OC and DC differentiation from monocytes. GM-CSF and IL-4 abolished monocytic differentiation into OCs while inducing DC differentiation even in the presence of M-CSF and RANK ligand. GM-CSF and IL-4 in combination potently up-regulate tumor necrosis factor-α (TNF-α) converting enzyme (TACE) and activity in monocytes, causing ectodomain shedding of M-CSF receptor, resulting in the disruption of its phosphorylation by M-CSF as well as the induction of osteoclastogenesis from monocytes by M-CSF and RANK ligand. Interestingly, TACE inhibition robustly causes the resumption of the surface expression of M-CSF receptor on monocytes, facilitating M-CSF–mediated phosphorylation of M-CSF receptor and macrophage/OC differentiation while impairing GM-CSF– and IL-4–mediated DC differentiation from monocytes. These results reveal a novel proteolytic regulation of M-CSF receptor expression in monocytes to control M-CSF signaling and monocytic differentiation into macrophage/OC-lineage cells or DCs.

The present study was designed to measure the elastic properties of temporomandibular joint (TMJ) discs from six adult dogs. Each disc was divided mediolaterally into medial, middle, and lateral parts. Under tension, the articular disc exhibited a non-linear stress-strain relationship, which could be represented as two lines (two moduli of elasticity) connected at a point of stress around 1.5 MPa. These two elastic moduli of the disc were approximately 44 MPa and 92 MPa in the lower- and higher-_stress regions, respectively. Elastic moduli of the articular disc in the middle area were significantly different from that in the lateral area of the disc. The reaction to external force appeared to be different in the medial, middle, and lateral regions of the disc.