Iwasaki L R, Gonzalez Y M, Liu Y, Liu H, Markova M, Gallo L M, Nickel J C
University of Missouri-Kansas City, School of Dentistry, Department of Orthodontics & Dentofacial Orthopedics, USA; University of Missouri-Kansas City, School of Dentistry, Department of Oral & Craniofacial Sciences, USA.
University at Buffalo, School of Dental Medicine, Department of Oral Diagnostic Sciences, USA.
Osteoarthritis Cartilage. 2017 Jun;25(6):846-849. doi: 10.1016/j.joca.2016.12.027. Epub 2017 Jan 5.
Cartilage fatigue, due to mechanical work, may account for the early development of degenerative joint disease (DJD) in the temporomandibular joint (TMJ), and why women are three times more likely to be afflicted. This study tested for gender differences in mechanical energy densities in women and men with healthy TMJs.
Eighteen women and eighteen men gave informed consent. Research diagnostic criteria including imaging were used to ensure that subjects' TMJs were normal, without disc displacement or signs of DJD. Numerical modeling determined TMJ loads (F). Jaw tracking and three-dimensional dynamic stereometry characterized individual-specific data of stress-field dynamic mechanics during 10 symmetrical jaw closing cycles. These data were used to estimate tractional forces (F). Energy densities were then calculated, where: Energy Density = W/Q (W = work done or mechanical energy input = F*distance of stress-field translation, Q = volume of cartilage). Two-way analysis of variance (ANOVA) and follow-up two-group comparisons tested mean energy densities for ipsilateral and contralateral TMJs in women vs men.
Mean energy densities ± standard deviations in ipsilateral and contralateral TMJs in women were 9.0 ± 9.7 and 8.4 ± 5.5 mJ/mm, respectively, and were significantly larger (P = 0.004 and 0.001, respectively) compared to ipsilateral and contralateral TMJs in men, which were 5.6 ± 4.2 and 6.3 ± 4.2 mJ/mm, respectively.
Energy densities were significantly larger in healthy TMJs of women than men. Larger TMJ energy densities during normal jaw functions could predispose earlier mechanical fatigue of the TMJ disc.
由于机械功导致的软骨疲劳可能是颞下颌关节(TMJ)退行性关节病(DJD)早期发展的原因,也是女性患病几率是男性三倍的原因。本研究测试了健康颞下颌关节的男性和女性机械能密度的性别差异。
18名女性和18名男性签署了知情同意书。使用包括影像学在内的研究诊断标准,以确保受试者的颞下颌关节正常,无盘移位或DJD迹象。数值建模确定颞下颌关节负荷(F)。颌骨跟踪和三维动态立体测量法表征了10个对称闭口周期中应力场动态力学的个体特异性数据。这些数据用于估计牵引力(F)。然后计算能量密度,其中:能量密度 = W/Q(W = 所做的功或机械能输入 = F×应力场平移距离,Q = 软骨体积)。双向方差分析(ANOVA)和后续两组比较测试了女性与男性同侧和对侧颞下颌关节的平均能量密度。
女性同侧和对侧颞下颌关节的平均能量密度±标准差分别为9.0±9.7和8.4±5.5 mJ/mm,与男性同侧和对侧颞下颌关节相比显著更大(分别为P = 0.004和0.001),男性同侧和对侧颞下颌关节的平均能量密度分别为5.6±4.2和6.3±4.2 mJ/mm。
女性健康颞下颌关节的能量密度显著高于男性。正常颌骨功能期间较大的颞下颌关节能量密度可能使颞下颌关节盘更早出现机械疲劳。