Biomechanism of abnormal stress on promoting osteoarthritis of temporomandibular joint through Piezo1 ion channel.

OBJECTIVE: This study aimed to investigate whether flow fluid shear stress (FFSS)-mediated signal transduction affects the function of Piezo1 ion channel in chondrocyte and to further explore the role of mechanical overloading in development of temporomandibular joint osteoarthritis (TMJ OA). METHODS: Immunohistochemical staining was used to determine the expression of Piezo1 in TMJ OA tissue collected from rat unilateral anterior crossbite (UAC) models. Chondrocytes harvested from normal adult SD rats were treated with FFSS (0, 4, 8, 12 dyn/cm2) in vitro. Immunofluorescent staining, real-time polymerase chain reaction, western blotting, flow cytometry and phalloidin assay were performed to detect the changes of cellular morphology as well as the expression of Piezo1 and certain pro-inflammatory and degradative factors in chondrocyte. RESULTS: Immunohistochemical analysis revealed that significantly increased Piezo1 expression was associated with UAC stimulation (p < .05). As applied FFSS escalated (4, 8 and 12 dyn/cm2), the expression levels of Piezo1, ADAMTS-5, MMP-13 and Col-X gradually increased, compared with the non-FFSS group (p < .05). Administering Piezo1 ion channel inhibitor to chondrocytes beforehand, it was observed that expression of ADAMTS-5, MMP-13 and Col-X was substantially decreased following FFSS treatment (p < .05) and the effect of cytoskeletal thinning was counteracted. The activated Piezo1 ion channel enhanced intracellular Ca2+ excess in chondrocytes during abnormal mechanical stimulation and the increased intracellular Ca2+ thinned the cytoskeleton of F-actin. CONCLUSIONS: Mechanical overloading activates Piezo1 ion channel to promote pro-inflammation and degradation and to increase Ca2+ concentration in chondrocyte, which may eventually result in TMJ OA.

Chondromyxoid fibroma of the temporomandibular joint - a rare case.

BACKGROUND: Chondromyxoid fibroma (CMF) is a rare cartilaginous tumor, accounting for < 1% of benign bone tumors. We report a case of temporomandibular joint (TMJ)-CMF, involving the pterygopalatine space and skull base and discuss its epidemiology, clinical characteristics, and management. CASE PRESENTATION: A 56-year-old woman presented with facial asymmetry and progressive mouth opening restriction due to a mass expanding upwardly to the auriculotemporal region. Using digital techniques to determine the lesion's boundary and reconstruct the normal glenoid fossa, the temporalis myofascial flap was transplanted between the titanium mesh and condyle to reconstruct the disc after tumor resection. CONCLUSION: This case highlights the importance of identifying patients with TMJ-CMF.

A randomized controlled clinical trial of concentrated growth factor combined with sodium hyaluronate in the treatment of temporomandibular joint osteoarthritis.

OBJECTIVE: To investigate the effect of concentrated growth factor (CGF) combined with sodium hyaluronate (SH) on temporomandibular joint osteoarthritis (TMJOA). METHODS: Sixty patients with TMJOA who were diagnosed by cone-beam computed tomography (CBCT) between March 2020 and March 2023 at the Stomatological Hospital of Xi'an Jiaotong University were randomly divided into a control group (n = 30) and an experimental group (n = 30). The patients in the experimental group were treated with CGF + SH, and those in the control group were treated with SH only. The visual analogue scale (VAS) score indicating pain in the temporomandibular joint (TMJ) area; the Helkimo Clinical Dysfunction Index (Di); and changes in condylar CBCT at the first visit and 2 weeks, 3 months and 6 months after treatment were recorded. The CBCT data of the patients in the experimental and control groups were collected, and the three-dimensional CBCT image sequences were imported into Mimics Medical 19.0 software in DICOM format for condylar reconstruction. RESULTS: The VAS scores at 2 weeks, 3 months and 6 months after treatment were significantly lower in the experimental group than in the control group (P < 0.05), and the pain in the experimental group was significantly relieved. The Di was significantly lower in the experimental group than in the control group (P < 0.05), and the clinical function of the TMJ improved. After treatment, the CBCT score was significantly lower in the experimental group than in the control group (P < 0.05), and the condylar bone cortex was obviously repaired. Observation of the condylar bone cortex by three-dimensional reconstruction showed the same results as those obtained by CBCT. CONCLUSION: CGF combined with SH is effective in the treatment of TMJOA and can improve muscle pain, TMJ pain, Impaired TMJ function, Impaired range of movement, Pain on movement of the mandible and promote bone repair. THE REGISTRATION NUMBER (TRN): ChiCTR2400082712. THE DATE OF REGISTRATION: April 5, 2024.

Association of DOK3 and infiltrated tumor-associated macrophages with risk for the prognosis of Porphyromonas gingivalis-infected oral cancer: a 12-year data analysis of 200 patients from a tertiary teaching hospital, Urumqi, China.

BACKGROUND: While there is an understanding of the association between the expression of Porphyromonas gingivalis (P. gingivalis) and prognosis of oral squamous cell carcinoma (OSCC), significance specially to address the relevance between different immunohistochemical intensities of P. gingivalis and tumor-associated macrophages (TAMs) in OSCC tissue and related clinicopathologic characteristics has not been well investigated. The present study aimed to investigate the pathological features related to M2-TAM in P. gingivalis-infected OSCC and ascertain its clinical relevance with patients' prognosis. METHODS: A prospective cohort study was designed to comparatively analyze 200 patients from June 2008 to June 2020. Bioinformatics analyses were implemented to identify DOK3 as a key molecule and to appraise immunocyte infiltration using Gene Expression Omnibus and The Cancer Genome Atlas databases. Immunohistochemical evaluation was performed to analyze the association between the expression levels of P. gingivalis, DOK3, and M2-TAM and clinicopathological variables using Fisher's exact test or Pearson's chi-square test. Cox analysis was used to calculate hazard ratios (HR) with corresponding 95% confidence interval (CI) for various clinicopathological features. The Kaplan-Meier approach and log-rank test were used to plot the survival curves. RESULTS: The expression level of P. gingivalis was positively associated with DOK3 and M2-TAMs expression level (P < 0.001). Parameters, including body mass index, clinical stage, recurrence, tumor differentiation, and P. gingivalis, DOK3, and M2-TAM immunoexpression levels, affected the prognosis of patients with OSCC (all P < 0.05). In addition, P. gingivalis (HR = 1.674, 95%CI 1.216-4.142, P = 0.012), DOK3 (HR = 1.881, 95%CI 1.433-3.457, P = 0.042), and M2-TAM (HR = 1.649, 95%CI 0.824-3.082, P = 0.034) were significantly associated with the 10-year cumulative survival rate. CONCLUSIONS: Elevated expression of P. gingivalis and DOK3 indicates M2-TAM infiltration and unfavorable prognosis of OSCC, and could be considered as three novel independent risk factors for predicting the prognosis of OSCC.

Midterm outcomes of autogenous mature third molars transplantation into surgically created sockets: A retrospective cohort study.

BACKGROUND/AIMS: The purpose of this study was to observe the outcome of mature third molars transplantation into surgically created sockets with the assistance of computer designed three dimensional (3-D) printed replicas and compare its outcome with the conventional fresh socket autotransplantation. MATERIAL AND METHODS: This study included total of 96 mature third molars autotransplanted in 96 cases with the guidance of computer designed 3-D printed replicas. Forty-eight teeth autotransplanted into surgically created sockets were enrolled into the surgically created socket group and 48 teeth conventionally autotransplanted into fresh sockets were enrolled into the fresh socket group. In the surgically created socket group, mature third molars were autotransplanted into surgically prepared sockets at the site of previously missed or extracted molars in the alveolar bone and in the fresh socket group, autotransplantation of mature third molars were performed in fresh sockets of extracted diseased molars simultaneously. After transplantation, the visual analogue scale (VAS) score, Landry Wound Healing Index (LWHI), mobility and probing depth (PD) of the transplanted teeth were measured and the patient satisfaction questionnaire were held in both group. All patients underwent clinical and radiographic examinations during the follow-up. RESULTS: During the mean follow-up period of 47.63 ± 16.78 months (range 18-78 months), 92 out of 96 teeth remained in situ without clinical or radiographic complications with overall success rate of 95.83%. No statistically significant differences were found in success and survival rates between the two group. The average extra-oral time of the donor teeth were 60.76 ± 22.41 s and mean positioning trials of the donor teeth were 2.43 ± 1.19. The VAS score at Day 1 in the surgically created socket group was higher than the fresh socket group (p < .05). LWHI scores in the surgically created group were lower than the fresh socket group during the first 2 weeks (p < .05). The degree of mobility of the transplanted teeth in both group showed no statistically significant difference during the first 3 months. PD in the surgically created group were higher than the fresh socket group in the first month but there were no statistically significant difference after 1 month. Twenty-six out of 48 cases in the surgically created group needed crown restoration while only 10 cases went through crown restoration in the fresh socket group. Most patients in both group were satisfied with the treatment. CONCLUSIONS: Autogenous mature third molars transplantation into surgically created sockets is as effective as conventional fresh socket transplantation. This technique is worth recommending in carefully selected cases and optimistic results can be achieved.

Application of deep learning radiomics in oral squamous cell carcinoma-Extracting more information from medical images using advanced feature analysis.

OBJECTIVE: To conduct a systematic review with meta-analyses to assess the recent scientific literature addressing the application of deep learning radiomics in oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS: Electronic and manual literature retrieval was performed using PubMed, Web of Science, EMbase, Ovid-MEDLINE, and IEEE databases from 2012 to 2023. The ROBINS-I tool was used for quality evaluation; random-effects model was used; and results were reported according to the PRISMA statement. RESULTS: A total of 26 studies involving 64,731 medical images were included in quantitative synthesis. The meta-analysis showed that, the pooled sensitivity and specificity were 0.88 (95 %CI: 0.87∼0.88) and 0.80 (95 %CI: 0.80∼0.81), respectively. Deeks' asymmetry test revealed there existed slight publication bias (P = 0.03). CONCLUSIONS: The advances in the application of radiomics combined with learning algorithm in OSCC were reviewed, including diagnosis and differential diagnosis of OSCC, efficacy assessment and prognosis prediction. The demerits of deep learning radiomics at the current stage and its future development direction aimed at medical imaging diagnosis were also summarized and analyzed at the end of the article.

Effect of Prophylactic Placement of Percutaneous Endoscopic Gastrostomy on the Surgical Prognosis in Patients With Oral Cancer: A Pilot Study.

This study assessed the application of prophylactic percutaneous endoscopic gastrostomy (pPEG) in patients with newly diagnosed oral cancer (OC) who underwent surgery and were ready for subsequential chemoradiation. In total, 113 patients who underwent OC surgical treatment were divided into pPEG (n = 26), nasogastric tube (n = 54), and oral feeding (n = 33) groups. Their baseline characteristics, surgery-related outcomes, and nutritional data were analyzed using the Wilcoxon rank-sum test and χ2 test. No statistical significance was shown among the 3 groups using different flaps for reconstructing OC-related defects (P > 0.05). Patients of the pPEG group had the lowest incidence of surgical site infection (SSI; 23.1%, P = 0.006), but the longest hospital stay (24.1 ± 7.9 d, P < 0.001). Prophylactic percutaneous endoscopic gastrostomy may decrease the frequency of SSI but increase the length of hospitalization in SSI OC. However, multicentric prospective clinical controlled trials with large sample sizes are needed to further validate our findings.

Descending necrotizing mediastinitis: a clinical analysis based on 10 years of published data in China / 口腔疾病防治

Objective@#To investigate the clinical characteristics, diagnosis, treatment, and prognosis of descending necrotizing mediastinitis (DNM) to provide a reference for the early diagnosis and timely treatment of DNM.@*Methods@#Data on DNM in China was electronically retrieved from the core databases and comprehensively reviewed from June 2012 to June 2023. The infection, pathogenic microorganisms, main symptoms, comorbidities and treatment methods of DNM were analyzed.@*Results@#The data of a total of 781 DNM patients, with an average age of (52.97 ± 5.64) years, were retrieved, including 554 males and 227 females. Odontogenic source, tonsillitis, pharyngeal abscess, sialoadenitis, upper respiratory tract infection, foreign body injury, or iatrogenic traumatic procedures are common causes. Among these, odontogenic infection is the most common source. Streptococcus sp. (n = 217) and Staphylococcus sp. (n = 82) were most isolated, followed by Klebsiella pneumoniae and Pseudomonas aeruginosa (equally n = 59). A total of 69.4% (542/781) of DNM patients recruited in this study were discovered to have various comorbidities, and more than one-third of these patients (n = 185) had diabetes. Of the broad antibiotics, carbapenem was most frequently used as treatment, and vancomycin was the most frequently coadministered. The mediastinal drainage approach varies widely, and the optimal regimen is still unknown. Seventy-two patients were treated with video-assisted thoracoscopic/mediastinoscopic surgical drainage, 22 patients were treated with percutaneous catheter drainage, 30 underwent the transcervical approach, and 40 underwent thoracotomy. A total of 617 patients who were selected underwent the appropriate combined operation for surgical drainage according to the specific location of the infected focus. The overall mortality rate of all 781 DNM patients included was 11.2%.@*Conclusion@#The most effective diagnosis and treatment of DNM is a high degree of clinical vigilance followed by prompt and adequate drainage with intensive care, including hemodynamic monitoring, nutritional support, computer tomographic scanning repeated as necessary, and combined use of systemic antibiotics.

A PRISMA meta-analysis for diagnostic value of microRNA-21 in head and neck squamous cell carcinoma along with bioinformatics research.

OBJECTIVES: The use of miR-21 expression remains vague in diagnosis of head and neck squamous cell carcinoma (HNSCC). This study aimed to systematically evaluate the diagnostic potential of the miR-21 expression in patients with HNSCCs through investigating and summarizing the results reported in the literature. METHODS: Extant medical databases were examined for articles of clinical study assessing the miR-21 expression in HNSCC cases, published in the past 20 years. Bioinformatics research was also performed for finding miR-21 targets differentially expressed in HNSCC so as to present their biological behaviors. RESULTS: Our meta-analysis comprised 11 studies including 622/450 cases in HNSCC/control group. Forest plots displayed miR-21 which possessed significantly good specificity (0.76, p < 0.001) and sensitivity (0.80, p < 0.001). Diagnostic odds ratio was 2.46 (95% CI 1.87-3.24). Positive and negative likelihood ratio was 3.40 (95% CI 1.94-5.97) and 0.26 (95% CI 0.18-0.38), respectively. Area under the receiver operating characteristic curve was 0.85. CONCLUSION: This study is the highest level of evidence presently available in diagnosing HNSCC. This PRISMA meta-analysis indicated that the pooled results were robust, confirming the oncogenic potential of miR-21 that could be used successfully as a screening biomarker in HNSCC patients. Specifically, the overexpression of miR-21 in these patients presents a worse survival outcome.

Radioresistance or/and radiosensitivity of head and neck squamous cell carcinoma: biological angle.

OBJECTIVE: This narrative review aimed to compile and summarize clinically relevant literature in radiation therapy and to discuss the potential in radioresistant and radiosensitive head and neck squamous cell carcinoma (HNSCC). METHODS AND MATERIALS: Google Scholar, PubMed, and the Cochrane Library were retrieved using combined key words such as "radiotherapy" and "head and neck cancer." Search strings additionally queried were "radioresistant," "radiosensitive," "head and neck region," "squamous cell carcinoma," in combination with Boolean operators 'AND' and 'OR.' Subsequently, the resulting publications were included for review of the full text. RESULTS: Radiotherapeutic responses currently in clinical observation referred to HNSCC scoping were selected into this review. The compiled mechanisms were then detailed concerning on the clinical significance, biological characteristics, and molecular function. CONCLUSIONS: Brachytherapy or/and external-beam radiotherapy are crucial for treating HNSCC especially the early stage patients, but in some patients with locally advanced tumors, their outcome with radiation therapy is poor due to obvious radioresistance. The curative effects mainly depend on the response to radiation therapy so an updated review is needed to optimize further applications in HNSCC radiotherapy.

Effect of Prognostic Factors of Postoperative Radiotherapy in Oral Squamous Cell Carcinoma: A SEER-Based Study.

Objective: The treatment of oral squamous cell carcinoma (OSCC) is dominated by surgery and radiochemotherapy, but its prognosis is still unsatisfactory, with around five tenths of 5-year survival. This study aimed to assess the prognosis of OSCC patients treated with surgery with and without postoperative radiotherapy. Study Design: Retrospective study. Methods: The clinicopathological information and follow-up datasets on patients with OSCC (T1-4 and/or N+) registered from 2010 to 2015 were downloaded from the Surveillance, Epidemiology, and End Results database. Totally 7231 enrolled subjects were divided into a case group (surgery alone, n = 4167) and a control group (surgery combined with postoperative radiotherapy, n = 3064). One-to-one matching was performed by propensity score matching to make the baseline data comparable between the 2 subgroups. Multivariate Cox regression analysis was used to calculate hazard ratios (HR) of various clinicopathological features. The Kaplan-Meier method and log-rank test were used to plot the survival curves. Results: The majority of patients in case group were tumor stage I (n = 2569, 61.7%), whereas most patients in control group were stages III to IV (n = 2360, 77.1%). In the case group, the 1-, 3-, and 5-year overall survival (OS; 76%, 59.5%, 53.7%) were significantly lower than those of the control group (85.1%, 64.1%, 55.8%; P < .0001). Similarly, the 1-, 3-, and 5-year cancer-specific survival (CSS) of the case group (80.2%, 66.6%, 63.3%) were significantly lower than those of the control group (87.2%, 69.3%, 63.9%, respectively; P < .0001). Cox multivariate analysis indicated that age, differentiation, clinical stage, and tumor-node-metastasis stage affected the prognosis of OSCC patients, while postoperative radiotherapy was a protective factor (OS: HR = 0.649, P < .001; CSS: HR = 0.702, P < .001). Conclusions: Postoperative radiation was an independent protective factor, hence, the combination of surgery plus radiotherapy is more beneficial for the survival of patients with OSCC, particularly for advanced cases.

RamanCMP: A Raman spectral classification acceleration method based on lightweight model and model compression techniques.

In recent years, Raman spectroscopy combined with deep learning techniques has been widely used in various fields such as medical, chemical, and geological. However, there is still room for optimization of deep learning techniques and model compression algorithms for processing Raman spectral data. To further optimize deep learning models applied to Raman spectroscopy, in this study time, accuracy, sensitivity, specificity and floating point operations numbers(FLOPs) are used as evaluation metrics to optimize the model, which is named RamanCompact(RamanCMP). The experimental data used in this research are selected from the RRUFF public dataset, which consists of 723 Raman spectroscopy data samples from 10 different mineral categories. In this paper, 1D-EfficientNet adapted to the spectral data as well as 1D-DRSN are proposed to improve the model classification accuracy. To achieve better classification accuracy while optimizing the time parameters, three model compression methods are designed: knowledge distillation using 1D-EfficientNet model as a teacher model to train convolutional neural networks(CNN), proposing a channel conversion method to optimize 1D-DRSN model, and using 1D-DRSN model as a feature extractor in combination with linear discriminant analysis(LDA) model for classification. Compared with the traditional LDA and CNN models, the accuracy of 1D-EfficientNet and 1D-DRSN is improved by more than 20%. The time of the distilled model is reduced by 9680.9s compared with the teacher model 1D-EfficientNet under the condition of losing 2.07% accuracy. The accuracy of the distilled model is improved by 20% compared to the CNN student model while keeping inference efficiency constant. The 1D-DRSN optimized with channel conversion method saves 60% inference time of the original 1D-DRSN model. Feature extraction reduces the inference time of 1D-DRSN model by 93% with 94.48% accuracy. This study innovatively combines lightweight models and model compression algorithms to improve the classification speed of deep learning models in the field of Raman spectroscopy, forming a complete set of analysis methods and laying the foundation for future research.

Risk assessment of venous thromboembolism in head and neck cancer patients and its establishment of a prediction model.

IMPORTANCE: Venous thromboembolism (VTE) is closely relevant to head and neck cancer (HNC) prognosis, but little data exist on the risk prediction of VTE in patients with HNC. OBJECTIVE: To study the risk factors regarding VTE in HNC patients and construct a nomogram model for its prediction. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional retrospective study was implemented to comparatively analyze 220 HNC patients from January 2018 to December 2021. The Lasso algorithm was used to optimize the selection of variables. A nomogram model for predicting HNC-associated VTE was established using multivariate logistic regression analysis. Internal validation of the model was performed by bootstrap resampling (1000 times). Calibration plot and decision curve analysis (DCA) were applied to evaluate the calibration capability of the prediction model. MAIN OUTCOME AND MEASURE: The demographics, medical history, blood biochemical indicators, and modalities of treatment were included for analysis. RESULTS: The incidence of HNC-associated VTE was 2.8% (55/1967) in authors' affiliation. Five variables of risk factors, including surgery, radiochemotherapy, D-dimer, aspartate transaminase, and globulin, were screened and selected as predictors by Lasso algorithm. A prediction model that incorporated these independent predictors was developed and presented as the nomogram. The model showed good discrimination with a C-index of 0.972 (95% CI: 0.934-0.997), and had an area under the receiver operating characteristic curve value of 0.981 (p < 0.001, 95% CI: 0.964-0.998). The calibration curve displayed good agreement of the predicted probability with the actual observed probability for HNC-associated VTE. The DCA plot showed that the application of this nomogram was associated with net benefit gains in clinical practice. CONCLUSIONS AND RELEVANCE: The high-performance nomogram model developed in this study may help early diagnose the risk of VTE in HNC patients and to guide individualized decision-making on thromboprophylaxis.

A pilot investigation of condylar position and asymmetry in patients with unilateral posterior scissors-bite malocclusion based on three-dimensional reconstructive imaging technique.

OBJECTIVE: Unilateral posterior scissors-bite (uPSB) malocclusion is common clinically. This study aimed to investigate the condylar morphological alterations and condyle-fossa relationship in patients with uPSB, through cone beam computed tomography (CBCT) and three-dimensional reconstructive imaging technique. METHODS: A retrospective study was designed to comparatively analyze 95 patients with uPSB between July 2016 and December 2021. They were divided into three subgroups: 12 to 20, 21 to 30, and ≥ 31 years, according the age distribution. The morphological parameters regarding condyle, fossa, and joint space after three-dimensional reconstruction were measured and analyzed by a series of digital software. SPSS 26.0 software package was performed for statistical analysis on data sets, using paired t-test, one-way analysis of variance, Wilcoxon signed-rank sun test, Kruskal-Wallis H test, and Bonferroni correction. RESULTS: The condylar volume (CV) of scissors-bite side was greater than that of the non-scissors-bite side (CV A = 1740.68 ± 559.80 mm3 > CV N = 1662.25 ± 524.88 mm3, P = 0.027). So was the condylar superficial area (CSA) (CSA A = 818.71 ± 186.82 mm2 > CSA N = 792.63 ± 173.44 mm2, P = 0.030), and the superior joint space (SJS) [SJS A = 2.46 (1.61, 3.68) mm) > SJS N = 2.01 (1.55, 2.87) mm), P = 0.018], and the anterior joint space (AJS) (AJS A = 3.94 ± 1.46 mm > AJS N = 3.57 ± 1.30 mm, P = 0.017). The constituent ratios of the different parts of the bilateral condyles were 23% on the posterior slope, 21% on the top, 20% on the anterior slope, 19% on the lateral slope and 17% on the medial slope, respectively. CONCLUSION: Due to long-term abnormal occlusion of uPSB, the pathological bite force in temporomandibular joint would cause changes in the shape of the condyle. Among them, CV, CSA, SJS and AJS had significant changes in the scissors-bite status, which has the greatest damage to the posterior slope of the condyloid process.

Effects of osseous structure based on three-dimensional reconstructive imaging evaluation in the assessment of temporomandibular joint disc position.

OBJECTIVES: This pilot morphological study aimed to investigate the association between anterior disc displacement (ADD) and the status of the mandibular condyle and articular fossa. MATERIALS AND METHODS: Thirty-four patients were divided into a normal articular disc position group and an ADD with and without reduction group. Images reconstructed were used to determine multiple group comparisons of these three different types of disc position, and the diagnostic efficacy for the morphological parameters with significant group difference was analyzed to assess. RESULTS: The condylar volume (CV), condylar superficial area (CSA), superior joint space (SJS), and medial joint space (MJS) all exhibited obvious changes (P < 0.05). Additionally, they all had a reliable diagnostic accuracy in differentiating between normal disc position and ADD with an AUC value from 0.723 to 0.858. Among them, the CV, SJS, and MJS (P < 0.05) had a significantly positive impact on the groups by analysis of multivariate logistic ordinal regression model. CONCLUSIONS: The CV, CSA, SJS, and MJS are significantly associated with different disc displacement types. The condyle in ADD exhibited altered dimensions. These could be promising biometric markers for assessing ADD. CLINICAL RELEVANCE: The morphological changes of mandibular condyle and glenoid fossa were significantly influenced by the status of disc displacement, and condyles with disc displacement had three-dimensionally altered condylar dimensions, irrespective of age and sex.

Association of HMGB1 levels in synovial fluid with the severity of temporomandibular joint osteoarthritis.

BACKGROUND: HMGB1 usually serves as a damage-associated molecular pattern (DAMP) molecule (also known as alarmin) that regulates the inflammatory and immune responses via different receptors or direct uptake. Numerous studies have reported the association between HMGB1 and inflammatory diseases; however, its role in temporomandibular joint (TMJ) osteoarthritis (OA) has not been elucidated. In this retrospective study, we aimed to investigate HMGB1 levels in the synovial fluid (SF) in patients with TMJOA and TMID, their correlation with TMJOA and TMID severity, and the therapeutic effect of sodium hyaluronate (hyaluronic acid, HA) on TMJOA. METHODS: SF samples were analyzed for 30 patients with TMJ internal derangement (TMJID) and TMJOA, along with visual analog scale (VAS) scores, radiographic stages, and mandibular functional limitations. The SF levels of HMGB1, IL-1ß, IL-18, PGE2, RAGE, TLR4, and iNOS were determined via an enzyme-linked immunosorbent assay. To evaluate the therapeutic effects of HA, pre-treatment and post-treatment clinical symptoms were also compared in patients of the TMJOA group who had received an intra-articular injection of HA. RESULTS: VAS and Jaw Functional Limitation Scale (JFLS) scores were significantly higher in the TMJOA group than in the TMNID group, as were SF levels of HMGB1, TLR4, IL-1ß, IL-18, PGE2, and iNOS. The synovial HMGB1 level was positively correlated with the VAS score (r = 0.5512, p = 0.0016) and mandibular functional limitations (r = 0.4684, p = 0.0054). The cut-off value for the HMGB1 level as a diagnostic biomarker was 986.8 pg/ml. The SF level of HMGB1 yielded an area under the curve value (AUC) of 0.8344 for predicting TMJOA. HA alleviated TMJ disorders by significantly reducing the VAS score and improving the maximum extent of mouth opening in both the TMJID and TMJOA groups (p < 0.05). Moreover, patients in both the TMJID and TMJOA groups exhibited significant improvement in the JFLS score following HA treatment. CONCLUSIONS: Our results indicate that HMGB1 is a potential marker for predicting the severity of TMJOA. Intra-articular HA injection exerts a positive therapeutic effect on TMJOA; however, further investigations are warranted to validate its therapeutic effect in the late phase of visco-supplementation treatment.

Investigation of Morphologic Changes in Temporomandibular Joint With Anterior Disk Displacement Based on 3-Dimensional Reconstructive Imaging.

The objective of this study was to measure the association between the disk position and condylar alteration in patients diagnosed with anterior disk displacement (ADD) of temporomandibular joint (TMJ). A retrospective cross-sectional study was designed, dividing into 4 groups: normal articular disk position (NADP) of unilateral ADD patients (n=10), ADD with reduction (ADDwR, n=16), ADD without reduction (ADDwoR, n=24), and healthy volunteers (HV, n=30) based on magnetic resonance imaging and cone-beam computed tomography. After morphologic parameters were calculated from 3-dimensional reconstructive images, differences in parameters with respect to ADD status were tested with analysis of variance and Fisher least significant difference multiple comparisons were performed. Condylar volume of ADDwR, ADDwoR, NADP, and HVs were 1768.29±404.19, 1467.13±438.20, 1814.48±753.60, and 1914.66±476.48 mm, respectively, showing a significant downward trend from healthy disk to a displaced one ( P <0.05). Same trend also found in condylar superficial area, with the condylar superficial area of the ADDwR, ADDwoR, NADP, and HVs were 842.56±138.78 mm, 748.52±157.42 mm, 842.87±263.00 mm, and 892.73±164.19 mm, respectively. From NADP to ADDwR to ADDwoR, superior joint space (SJS) was declined, [SJS (NADP) (2.10±0.91 mm) > SJS (ADDwR) (1.85±0.61 mm) > SJS (ADDwoR) (1.50±0.50 mm), P =0.034]; medial joint space was significantly associated with the different disk displacement types ( P(HV-ADDwR) =0.001; P(HV-ADDwoR) =0.021; P(NADP-ADDwR) =0.022; P(ADDwR-ADDwoR) =0.001). Our findings suggest that condylar volume and superficial area, and superior and medial joint space, albeit with a small sample size, are significantly associated with different disk displacement types, detection of which might therefore be worth exploring for assessing ADD.