ABSTRACT
BACKGROUND: Temporomandibular joint osteoarthritis (TMJOA) is a progressive degenerative disease caused by imbalance between anabolic and catabolic stimuli. OBJECTIVE: The aim of this study was to evaluate histopathological changes, collagen degeneration and the expression of eleven TMJOA biomarkers in articular discs. METHODS: Specimens were obtained from eight female patients submitted to discectomy. Discs were divided into anterior band (AB), intermediate zone (IZ) and posterior band (PB) for computerised histomorphometric analyses. Each was assigned a histopathological degeneration score (HDS). Collagen degeneration was assessed with Picrosirius-polarisation method. Biomarkers were evaluated through immunohistochemistry, including IGF-1, OPG, VEGF, TNF-α, FGF-23, IHH, MMP-3, MMP-9, TGF-ß1 , BMP-2 and WNT-3. Image processing software was used to calculate average immature collagen ratios and immunostained areas. Spearman rank tests were applied to verify correlations, with significance level of 0.05. RESULTS: The HDS showed negative correlation with expression of VEGF in IZ and PB (P < .05) and positive with TNF-α in AB (P < .01). Collagen degeneration correlated with TGF-ß1 (P < .05), BMP-2 (P < .01) and IHH (P < .05) immunostained areas in the IZ; TGF-ß1, BMP-2 and IHH expression correlated among each other in AB and IZ (P < .05). CONCLUSION: Angiogenesis and tissue fragmentation may result from aberrant physiologic responses mediated by VEGF and TNF-α, compromising TMJ discs during OA progression. The expression of TGF-ß1, BMP-2 and IHH could be related to collagen degeneration in displaced discs and may participate in TMJOA pathogenesis.
Subject(s)
Osteoarthritis , Temporomandibular Joint Disorders , Female , Fibroblast Growth Factor-23 , Humans , Immunohistochemistry , Temporomandibular JointABSTRACT
Surgical procedures involving the rehabilitation of the maxillofacial region frequently require use of bone grafts. Bone graft follow-up is generally done through clinical analysis and especially through image tests, although few studies specifically correlate both. The object of this research was to establish a relation between radiographic exams and the bone repair process stage in created defect with autogenous bone, blood clot and anorganic bovine bone matrix. Three 8 mm diameter defects were performed in the parietal bone of 6 male adult beagle dogs, choosing the selected graft for each defects; 3 and 6 week period were used for radiographic and histological analyses. The result show that autogenous bone and blood clot were similar between histological and radiograph analyses; for heterogeneous bone was present areas described how bone in radiograph that were residual particles in histological exam. We concluded that radiographic tests could be used as a parameter for reconstruction follow-up only when autogenous bone graft is used.
Los procedimientos que envuelven la rehabilitación de la región maxilofacial frecuentemente requieren el uso de injertos óseos. El seguimiento de la evolución del injerto óseo frecuentemente es realizado con análisis clínico y especialmente a través de estudios de imágenes, aunque pocos estudios han correlacionado ambos. El objetivo de esta investigación fue establecer la relación entre radiografías y las etapas de la reparación ósea en defectos creados con hueso autógeno, coagulo sanguíneo y matriz ósea de hueso bovino. Tres defectos de 8 mm de diámetro fueron realizados en el parietal de 6 perros adultos, escogiendo el injerto seleccionado para cada defecto; 3 y 6 semanas después fueron realizados los estudios histológicos y radiográficos. Los resultados mostraron que el hueso autógeno y el coágulo sanguíneo presentaron semejanzas en los análisis histológico y radiográfico; para el hueso bovino se observó áreas decritas como hueso en la radiografia mientras realmente fueron partículas de hueso heterogeno descritas en el análisis histológico. Concluimos que el test radiográfico puede ser usado como parámetro para la reconstrucción y seguimiento preferentemente cuando es usado el injerto autógeno.
Subject(s)
Animals , Dogs , Autografts , Biocompatible Materials , Bone Regeneration , Bone Transplantation/methods , Blood Coagulation , Cattle , Bone Matrix/transplantation , Transplantation, AutologousABSTRACT
We have reported a case series of five patients with jaw-opening oromandibular dystonia secondary to Wilson's disease (WD), in which the patients were treated with botulinum toxin type A (BTX-A). In all cases, dystonia score was partially reduced three weeks after injections. The most common side effect was transient mild dysphagia. This preliminary study showed that jaw-opening oromandibular dystonia in WD may be partially responsive to the use of BTX-A.
Subject(s)
Botulinum Toxins, Type A/therapeutic use , Dystonia/drug therapy , Hepatolenticular Degeneration/complications , Mandibular Diseases/drug therapy , Neuromuscular Agents/therapeutic use , Adult , Dystonia/etiology , Female , Humans , Injections, Intramuscular , Male , Mandibular Diseases/etiology , Treatment OutcomeABSTRACT
We have reported a case series of five patients with jaw-opening oromandibular dystonia secondary to Wilson's disease (WD), in which the patients were treated with botulinum toxin type A (BTX-A). In all cases, dystonia score was partially reduced three weeks after injections. The most common side effect was transient mild dysphagia. This preliminary study showed that jaw-opening oromandibular dystonia in WD may be partially responsive to the use of BTX-A.
Relata-se uma série de cinco casos de distonia oromandibular com abertura da boca, secundária à doença de Wilson, em que os pacientes foram tratados com toxina botulínica tipo A. Em todos os casos, a distonia oromandibular com abertura da boca foi parcialmente reduzida três semanas após as injeções. O efeito adverso mais comum foi a disfagia leve e transitória. Este estudo preliminar mostrou melhora parcial da distonia oromandibular com abertura da boca.
