Temporal-Mandibular Joint Anormaly and Idiopathic Condylar Resorption: Investigation of Pathomechanism and Related Risk Factors = 顳顎關節病變與不明原因下顎髁頭吸收:致病機轉與相關病變之探討
The temporomandibular (TM) joint, which connects the lower jaw and the cranium, plays important roles in mastication, speaking, respiration, and communication. Intercondylar disc has translation in relation to condylar articular eminence. The clinical symptoms of the TM joint disorders include noises, mouth opening limitation, jaw movement path deviation, mouth closing difficulty or locking, and pain during jaw movements, etc. This joint also plays an important component of oral-facial function/morphology and synchronizes with adjacent muscular structure such as masseter muscle. TM joint and masseter muscle are responsible for force transmission and elastic energy utilization in biting, chewing; and will reflect to body nutrition intake and general status. That would be no doubt influence the facial geometry. The most severe problems of TM joint usually came to idiopathic condylar resorption (ICR). Most of them do need orthodontic therapy. However, fail or recurrence after orthodontic therapy of ICR patients was extremely high. Alternative therapeutic approach by surgery or joint replacement are only recommended by limited population. According to our previous research, the TM joint with disc displacement /without reduction would be subsequently followed by condylar resorption. However, the causal relationship, disease duration or mechanism remained unclear. The patients with ICR would suffer from open-bite, malocclusion, mouth opening limitation, jaw movement path deviation, joint pain and facial asymmetry, etc. On the other hand, severity of joint contracture, altered microcirculation /inflammation of synovium or muscle, abnormal mechanical properties of the TM joint, stiffness or dysfunction of masseter muscle, and their correlation with body mass index (BMI) and bone mineral density (BMD) in the diseased groups are still unclear. This project intends to inspire fundamental mechanism research, which is very much needed in this area, to target the specific underlying patho-mechanism. By using technologies to investigate tissue microcirculation /inflammation and mechanical properties, as well as functional tests and newly developed MR and ultrasound approach, this research project could investigate and have more understanding about how different entities or roles that would affect the adaptation process and may be integrated into the current therapy and optimize precise treatments. These will have an emerging significant impact on biomechanics, tissue characteristics and oral- facial input of idiopathic condylar resorption (ICR) of TM joint problems.