Department of Orthopedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29, Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, 164, Worldcup-ro, Yeongtong-gu, Suwon, Gyeonggi-do, 16499, Republic of Korea.
Clin Oral Investig. 2021 Nov;25(11):6435-6448. doi: 10.1007/s00784-021-03946-0. Epub 2021 Apr 16.
The pathogenesis of the temporomandibular joint osteoarthritis (TMJ OA) has not been clearly revealed. This study aimed to investigate the pathogenesis of TMJ OA based on bone metabolism.
Fifty-nine young (mean age 23.4 ± 3.4 years) and 41 post-menopausal females (mean age 57.2 ± 4.6 years) were enrolled. Areal bone mineral density (aBMD) was measured via dual-energy X-ray absorptiometry of the lumbar spine, femoral neck, total hip, and ultradistal radius. Levels of four bone resorption markers, serum ionized calcium and C-telopeptide of type I collagen (CTx) and urinary N-telopeptide of type I collagen and deoxypyridinoline, two bone formation markers, serum bone alkaline phosphatase and osteocalcin, and serum 25-dihydroxyvitamin D were analyzed at baseline and after 12 months. Condylar bone quality was assessed by 3D reconstructed CT images.
Significant differences in condylar bone quality and aBMDs of the lumbar spine in accordance with TMJ OA stages were observed in young and post-menopausal females. The level of CTx was significantly associated with the development and progression of TMJ OA only in young females, whereas 25-dihydroxyvitamine D demonstrated significant associations in young and post-menopausal females. Progression of TMJ OA was accompanied by reduced condylar bone quality and concomitant with lower lumbar spine aBMDs in young and post-menopausal females.
Bone metabolism and condylar quality might be involved in the development and progression of TMJ OA.
CTx could be considered as a potential diagnostic and monitoring marker in young females, and vitamin D showed a therapeutic potential for TMJ OA.
颞下颌关节骨关节炎（TMJ OA）的发病机制尚不清楚。本研究旨在基于骨代谢探讨 TMJ OA 的发病机制。
纳入 59 名年轻（平均年龄 23.4 ± 3.4 岁）和 41 名绝经后女性（平均年龄 57.2 ± 4.6 岁）。通过双能 X 射线吸收法对腰椎、股骨颈、全髋关节和桡骨远端进行骨矿物质密度（aBMD）测量。在基线和 12 个月时分析了 4 个骨吸收标志物（血清离子钙和 I 型胶原 C 端肽（CTX）、尿 I 型胶原 N 端肽和脱氧吡啶啉）、2 个骨形成标志物（血清骨碱性磷酸酶和骨钙素）和血清 25-羟维生素 D 的水平。通过 3D 重建 CT 图像评估髁突骨质量。
在年轻和绝经后女性中，TMJ OA 分期与髁突骨质量和腰椎 aBMD 存在显著差异。CTX 水平仅在年轻女性中与 TMJ OA 的发生和进展显著相关，而 25-羟维生素 D 在年轻和绝经后女性中均有显著相关性。TMJ OA 的进展伴随着髁突骨质量的降低，同时伴有年轻和绝经后女性腰椎 aBMD 的降低。
骨代谢和髁突质量可能参与了 TMJ OA 的发生和进展。
CTX 可作为年轻女性潜在的诊断和监测标志物，维生素 D 对 TMJ OA 具有治疗潜力。
