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Synovial apoptosis in temporomandibular joint disc displacement without reduction

Pervin Imirzalioğlu1, Sina Uçkan, Nurhan Güler

  • 1Department of Prosthodontics, Baskent University, Faculty of Dentistry, Ankara, Turkey.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
|September 1, 2009
PubMed
Abstract

Insights

Low levels of soluble Fas (sFas) in temporomandibular joint (TMJ) fluid suggest increased apoptosis, potentially contributing to TMJ degeneration in patients with disc displacement. This finding highlights a vulnerability to cell death in the joint synovium.

Area of Science:

  • Orthopedics
  • Cell Biology
  • Biochemistry

Background:

  • Temporomandibular joint (TMJ) degeneration is a significant clinical concern.
  • Apoptosis, or programmed cell death, in the joint synovium is a potential contributing factor to TMJ degeneration.
  • Soluble Fas (sFas) and nuclear matrix protein (NMP) are indicators of apoptosis.

Purpose of the Study:

  • To investigate the hypothesis that increased apoptosis in the synovium contributes to TMJ degeneration.
  • To measure sFas and NMP levels in TMJ synovial fluid from patients with disc displacement without reduction.

Main Methods:

  • Synovial fluid was collected from 17 patients (11 female, 6 male; mean age 31.5 years) with disc displacement without reduction.
  • Enzyme-linked immunosorbent assays were used to quantify APO-1/Fas (sFas) and cell death detection (NMP) in the synovial fluid.
  • Patients presented with limited mouth opening, joint sounds, or TMJ pain.

Main Results:

  • The study included 17 joints with disc displacement without reduction, with pain and limited mouth opening as primary complaints.
  • A significant increase in maximal mouth opening was observed immediately after arthrocentesis (P < .01).
  • Mean sFas levels were 484.9 +/- 466.7 pg/mL and mean NMP levels were 29.2 +/- 13.7 U/mL.

Conclusions:

  • Low levels of sFas in the synovial fluid of patients with internal derangement suggest vulnerability to apoptosis.
  • This vulnerability may indicate a mechanism contributing to TMJ degeneration.
  • Further research is warranted to explore the role of apoptosis in TMJ disorders.

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