Investigation of the synovial fluid pro-inflammatory cytokines and clinical findings in disc displacements of TMJ
Abstract
Aims: Temporomandibular disorders (TMD) are common musculoskeletal disease that affects the soft tissues and bone structures of the temporomandibular joint (TMJ). Inflammatory mediators play a critical role in the etiology of TMD by affecting various molecular mechanisms. This study aims to investigate the effect of pro-inflammatory cytokines on TMJ internal derangements and evaluate the relationship between clinical features.
Methods: Patients who underwent arthrocentesis because of TMD were included in this study. Patients were divided into 2 groups according to anterior disc displacement with reduction (Group 1) and without reduction ( Group 2). Clinical findings before and after the arthrocentesis were evaluated retrospectively. Synovial fluid TNF-α, IL-1β, and IL-6 levels were analyzed with the ELISA method.
Results: A total of 28 patients were included, with 15 patients in Group 1 and 13 patients in Group 2. All patients were female with an average age of 30.75±14.9. The average pre-operative pain score was 6.6±1.95 in all patients. After the arthrocentesis, the average pain score was 2.0 ( 1.0 - 2.5) and the difference was significant (p<0.001). Group 1 have a higher maximum mouth opening (MMO) than Group 2 preoperatively and the difference was statistically significant (p=0.013). The difference in synovial fluid cytokine levels was not statistically significant between groups. There was no statistically significant correlation between cytokines and clinical findings.
Conclusion: Arthrocentesis is beneficial for reducing joint pain in patients with TMJ internal derangements. Pro-inflammatory cytokine levels are similar in TMJs with disc displacement with and without reduction.
Project Number
TDH-2019-9609
References
- Laskin DM. Arthrocentesis for the treatment of internal derangements of the temporomandibular joint. Alpha Omegan. 2009;102(2):46-50.
- Sato J, Segami N, Suzuki T, Kaneyama K, Yoshitake Y, Nishikawa K. The expression of vascular endothelial growth factor in synovial tissues in patients with internal derangement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(3):251-256.
- Matsumoto K, Honda K, Ohshima M, et al. Cytokine profile in synovial fluid from patients with internal derangement of the temporomandibular joint: a preliminary study. Dentomaxillofac Radiol. 2006;35(6):432-441.
- Brennan PA, Ilankovan V. Arthrocentesis for temporomandibular joint pain dysfunction syndrome. J Oral Maxillofac Surg. 2006;64(6):949-951.
- Laskin DM. Arthroscopy versus arthrocentesis for treating internal derangements of the temporomandibular joint. Oral Maxillofac Surg Clin North Am. 2018;30(3):325-328.
- Nitzan DW. Arthrocentesis--incentives for using this minimally invasive approach for temporomandibular disorders. Oral Maxillofac Surg Clin North Am. 2006;18(3):311-328.
- Quinn JH, Bazan NG. Identification of prostaglandin E2 and leukotriene B4 in the synovial fluid of painful, dysfunctional temporomandibular joints. J Oral Maxillofac Surg. 1990;48(9):968-971.
- Kaneyama K, Segami N, Nishimura M, Suzuki T, Sato J. Importance of proinflammatory cytokines in synovial fluid from 121 joints with temporomandibular disorders. Br J Oral Maxillofac Surg. 2002;40(5):418-423.
- Fu K, Ma X, Zhang Z, Chen W. Tumor necrosis factor in synovial fluid of patients with temporomandibular disorders. J Oral Maxillofac Surg. 1995;53(4):424-426.
- Fu K, Ma X, Zhang Z, Pang X, Chen W. Interleukin-6 in synovial fluid and HLA-DR expression in synovium from patients with temporomandibular disorders. J Orofac Pain. 1995;9(2):131-137.
- Nitzan DW, Dolwick MF, Martinez GA. Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg. 1991;49(11):1163-1167.
- Shibata T, Murakami KI, Kubota E, Maeda H. Glycosaminoglycan components in temporomandibular joint synovial fluid as markers of joint pathology. J Oral Maxillofac Surg. 1998;56(2):209-213.
- de Lange-Brokaar BJ, Ioan-Facsinay A, van Osch GJ, et al. Synovial inflammation, immune cells and their cytokines in osteoarthritis: a review. Osteoarthritis Cartilage. 2012;20(12):1484-1499.
- Ernberg M. The role of molecular pain biomarkers in temporomandibular joint internal derangement. J Oral Rehabil. 2017;44(6):481-491.
- Luo P, Feng C, Jiang C et al. IL-37b alleviates inflammation in the temporomandibular joint cartilage via IL-1R8 pathway. Cell Prolif. 2019;52(6):12692.
- Wake M, Hamada Y, Kumagai K, et al. Up-regulation of interleukin-6 and vascular endothelial growth factor-A in the synovial fluid of temporomandibular joints affected by synovial chondromatosis. Br J Oral Maxillofac Surg. 2013;51(2):164-169.
- Hamada Y, Kondoh T, Holmlund AB, Sakota K, Nomura Y, Seto K. Cytokine and clinical predictors for treatment outcome of visually guided temporomandibular joint irrigation in patients with chronic closed lock. J Oral Maxillofac Surg. 2008;66(1):29-34.
- Wang XD, Cui SJ, Liu Y, et al. Deterioration of mechanical properties of discs in chronically inflamed TMJ. J Dent Res. 2014;93(11):1170-1176.
- Segami N, Miyamaru M, Nishimura M, Suzuki T, Kaneyama K, Murakami K. Does joint effusion on T2 magnetic resonance images reflect synovitis? Part 2. Comparison of concentration levels of proinflammatory cytokines and total protein in synovial fluid of the temporomandibular joint with internal derangements and osteoarthrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):515-521.
- Matsumoto K, Honda K, Ohshima M et al. Cytokine profile in synovial fluid from patients with internal derangement of the temporomandibular joint: a preliminary study. Dentomaxillofac Radiol. 2006;35(6):432-441.
- Nishimura M, Segami N, Kaneyama K, Suzuki T, Miyamaru M. Proinflammatory cytokines and arthroscopic findings of patients with internal derangement and osteoarthritis of the temporomandibular joint. Br J Oral Maxillofac Surg. 2002;40(1):68-71.
- Ulmner M, Sugars R, Naimi-Akbar A et al. Synovial tissue cytokine profile in disc displacement of the temporomandibular joint. J Oral Rehabil. 2020;47(10):1202-1211.
- Gulen H, Ataoglu H, Haliloglu S, Isik K. Proinflammatory cytokines in temporomandibular joint synovial fluid before and after arthrocentesis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(5):1-4.
- Kellesarian SV, Al-Kheraif AA, Vohra F, et al. Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review. Cytokine. 2016;77:98-106.
- Kawashima M, Ogura N, Akutsu M, Ito K, Kondoh T. The anti-inflammatory effect of cyclooxygenase inhibitors in fibroblast-like synoviocytes from the human temporomandibular joint results from the suppression of PGE2 production. J Oral Pathol Med. 2013;42(6):499-506
TME disk deplasmanında synovial sıvı pro-inflamatuar sitokinlerin ve klinik bulguların değerlendirilmesi
Abstract
Amaç: Temporomandibular bozukluklar (TMB), temporomandibular eklemin (TME) yumuşak dokularını ve kemik yapılarını etkileyen yaygın bir kas-iskelet sistemi hastalığıdır. İnflamatuar mediatörler, çeşitli moleküler mekanizmaları etkileyerek TMB etiyolojisinde kritik bir rol oynamaktadır. Bu çalışmanın amacı, proinflamatuar sitokinlerin TME internal düzensizlikleri üzerindeki etkisini araştırmak ve klinik özellikler arasındaki ilişkiyi değerlendirmektir.
Yöntemler: Bu çalışmaya TMD nedeniyle artrosentez yapılan hastalar dahil edildi. Hastalar anterior disk deplasmanına göre redüksiyonlu (Grup 1) ve redüksiyonsuz (Grup 2) olarak 2 gruba ayrıldı. Artrosentez öncesi ve sonrası klinik bulgular retrospektif olarak değerlendirildi. Sinoviyal sıvı TNF-α, IL-1β ve IL-6 seviyeleri ELISA yöntemi ile analiz edildi.
Bulgular: Grup 1'de 15, Grup 2'de 13 olmak üzere toplam 28 hasta çalışmaya alındı. Hastaların tümü kadındı ve ortalama yaşları 30,75±14,9'du. Ameliyat öncesi ortalama ağrı skoru tüm hastalarda 6.6±1.95 idi. Artrosentez sonrası ortalama ağrı skoru 2,0 ( 1,0 - 2,5) olup aradaki fark anlamlıydı (p<0,001). Grup 1, Grup 2'den daha yüksek maksimum ağız açıklığına (MMO) sahipti ve fark istatistiksel olarak anlamlıydı (p=0,013). Sinoviyal sıvı sitokin seviyelerindeki fark, gruplar arasında istatistiksel olarak anlamlı değildi. Sitokinler ile klinik bulgular arasında istatistiksel olarak anlamlı bir ilişki yoktu.
Sonuç: Artrosentez, TME internal düzensizlikleri olan hastalarda eklem ağrısını azaltmada faydalıdır. Redüksiyonlu ve redüksiyonsuz disk deplasmanı olan hastalarda proinflamatuar sitokin seviyeleri benzerdir.
Supporting Institution
Bu çalışma Erciyes Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından desteklenmiştir.
Project Number
TDH-2019-9609
References
- Laskin DM. Arthrocentesis for the treatment of internal derangements of the temporomandibular joint. Alpha Omegan. 2009;102(2):46-50.
- Sato J, Segami N, Suzuki T, Kaneyama K, Yoshitake Y, Nishikawa K. The expression of vascular endothelial growth factor in synovial tissues in patients with internal derangement of the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93(3):251-256.
- Matsumoto K, Honda K, Ohshima M, et al. Cytokine profile in synovial fluid from patients with internal derangement of the temporomandibular joint: a preliminary study. Dentomaxillofac Radiol. 2006;35(6):432-441.
- Brennan PA, Ilankovan V. Arthrocentesis for temporomandibular joint pain dysfunction syndrome. J Oral Maxillofac Surg. 2006;64(6):949-951.
- Laskin DM. Arthroscopy versus arthrocentesis for treating internal derangements of the temporomandibular joint. Oral Maxillofac Surg Clin North Am. 2018;30(3):325-328.
- Nitzan DW. Arthrocentesis--incentives for using this minimally invasive approach for temporomandibular disorders. Oral Maxillofac Surg Clin North Am. 2006;18(3):311-328.
- Quinn JH, Bazan NG. Identification of prostaglandin E2 and leukotriene B4 in the synovial fluid of painful, dysfunctional temporomandibular joints. J Oral Maxillofac Surg. 1990;48(9):968-971.
- Kaneyama K, Segami N, Nishimura M, Suzuki T, Sato J. Importance of proinflammatory cytokines in synovial fluid from 121 joints with temporomandibular disorders. Br J Oral Maxillofac Surg. 2002;40(5):418-423.
- Fu K, Ma X, Zhang Z, Chen W. Tumor necrosis factor in synovial fluid of patients with temporomandibular disorders. J Oral Maxillofac Surg. 1995;53(4):424-426.
- Fu K, Ma X, Zhang Z, Pang X, Chen W. Interleukin-6 in synovial fluid and HLA-DR expression in synovium from patients with temporomandibular disorders. J Orofac Pain. 1995;9(2):131-137.
- Nitzan DW, Dolwick MF, Martinez GA. Temporomandibular joint arthrocentesis: a simplified treatment for severe, limited mouth opening. J Oral Maxillofac Surg. 1991;49(11):1163-1167.
- Shibata T, Murakami KI, Kubota E, Maeda H. Glycosaminoglycan components in temporomandibular joint synovial fluid as markers of joint pathology. J Oral Maxillofac Surg. 1998;56(2):209-213.
- de Lange-Brokaar BJ, Ioan-Facsinay A, van Osch GJ, et al. Synovial inflammation, immune cells and their cytokines in osteoarthritis: a review. Osteoarthritis Cartilage. 2012;20(12):1484-1499.
- Ernberg M. The role of molecular pain biomarkers in temporomandibular joint internal derangement. J Oral Rehabil. 2017;44(6):481-491.
- Luo P, Feng C, Jiang C et al. IL-37b alleviates inflammation in the temporomandibular joint cartilage via IL-1R8 pathway. Cell Prolif. 2019;52(6):12692.
- Wake M, Hamada Y, Kumagai K, et al. Up-regulation of interleukin-6 and vascular endothelial growth factor-A in the synovial fluid of temporomandibular joints affected by synovial chondromatosis. Br J Oral Maxillofac Surg. 2013;51(2):164-169.
- Hamada Y, Kondoh T, Holmlund AB, Sakota K, Nomura Y, Seto K. Cytokine and clinical predictors for treatment outcome of visually guided temporomandibular joint irrigation in patients with chronic closed lock. J Oral Maxillofac Surg. 2008;66(1):29-34.
- Wang XD, Cui SJ, Liu Y, et al. Deterioration of mechanical properties of discs in chronically inflamed TMJ. J Dent Res. 2014;93(11):1170-1176.
- Segami N, Miyamaru M, Nishimura M, Suzuki T, Kaneyama K, Murakami K. Does joint effusion on T2 magnetic resonance images reflect synovitis? Part 2. Comparison of concentration levels of proinflammatory cytokines and total protein in synovial fluid of the temporomandibular joint with internal derangements and osteoarthrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(4):515-521.
- Matsumoto K, Honda K, Ohshima M et al. Cytokine profile in synovial fluid from patients with internal derangement of the temporomandibular joint: a preliminary study. Dentomaxillofac Radiol. 2006;35(6):432-441.
- Nishimura M, Segami N, Kaneyama K, Suzuki T, Miyamaru M. Proinflammatory cytokines and arthroscopic findings of patients with internal derangement and osteoarthritis of the temporomandibular joint. Br J Oral Maxillofac Surg. 2002;40(1):68-71.
- Ulmner M, Sugars R, Naimi-Akbar A et al. Synovial tissue cytokine profile in disc displacement of the temporomandibular joint. J Oral Rehabil. 2020;47(10):1202-1211.
- Gulen H, Ataoglu H, Haliloglu S, Isik K. Proinflammatory cytokines in temporomandibular joint synovial fluid before and after arthrocentesis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(5):1-4.
- Kellesarian SV, Al-Kheraif AA, Vohra F, et al. Cytokine profile in the synovial fluid of patients with temporomandibular joint disorders: A systematic review. Cytokine. 2016;77:98-106.
- Kawashima M, Ogura N, Akutsu M, Ito K, Kondoh T. The anti-inflammatory effect of cyclooxygenase inhibitors in fibroblast-like synoviocytes from the human temporomandibular joint results from the suppression of PGE2 production. J Oral Pathol Med. 2013;42(6):499-506
Details
| Primary Language | English |
|---|---|
| Subjects | Oral and Maxillofacial Surgery |
| Journal Section | Research Articles [en] Araştırma Makaleleri [tr] |
| Authors | |
| Project Number | TDH-2019-9609 |
| Publication Date | August 30, 2023 |
| Published in Issue | Year 2023 Volume: 4 Issue: 4 |
TR DİZİN ULAKBİM and International Indexes (1d)
Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]
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