Xiao Miao, Ni Shilei
The First Department of Oral and Maxillofacial Surgery & Oral Plastic and Aesthetic Surgery, Hospital of Stomatology, Jilin University, Changchun, China.
Front Physiol. 2025 Apr 3;16:1539342. doi: 10.3389/fphys.2025.1539342. eCollection 2025.
Temporomandibular joint disorder (TMJD) is a group of diseases occurring in the temporomandibular joint (TMJ) with clinical manifestations of pain in the joint area, mastication disorders, and restriction of mouth opening, which is one of the most common diseases of the oral and maxillofacial region, and its specific etiology has not yet been fully elucidated. As a biomechanical orchestrator, the TMJ mediates dynamic transduction of masticatory forces during the functional loading cycle. Notably, as a secondary cartilage type, the condylar cartilage exhibits postnatal remodeling that is critically dependent on functional mechanical stimulation. Abnormal mechanical stimulation can result in structural dysfunction of the TMJ.
The purpose of this review was to outline the remodeling responses of TMJ cartilage, subchondral bone, and disc to abnormal mechanical stimulation of different types and intensities, especially the subchondral bone and articular disc.
Abnormal mechanical stress induces degeneration of the condylar cartilage, characterized by dysregulated chondrocyte proliferation and differentiation, elevated cell apoptosis, and ECM injury. The ability of TMJ condylar cartilage to adapt to changes in the mechanical load environment for remodeling is influenced by age, as well as the type, intensity, and duration of the applied mechanical load. Bone loss is often the first response of subchondral bone to abnormal mechanical forces. Abnormal mechanical stimuli affect nutrient supply and matrix metabolism of TMJ discs.
颞下颌关节紊乱病（TMJD）是一组发生于颞下颌关节（TMJ）的疾病，临床表现为关节区疼痛、咀嚼障碍及张口受限，是口腔颌面部最常见的疾病之一，其具体病因尚未完全阐明。作为生物力学协调器，颞下颌关节在功能负荷周期中介导咀嚼力的动态传导。值得注意的是，作为一种继发性软骨类型，髁突软骨表现出出生后重塑，这严重依赖于功能性机械刺激。异常的机械刺激可导致颞下颌关节结构功能障碍。
本综述旨在概述颞下颌关节软骨、软骨下骨和盘对不同类型和强度异常机械刺激，尤其是软骨下骨和关节盘的重塑反应。
异常机械应力诱导髁突软骨退变，其特征为软骨细胞增殖和分化失调、细胞凋亡增加及细胞外基质损伤。颞下颌关节髁突软骨适应机械负荷环境变化进行重塑的能力受年龄以及所施加机械负荷的类型、强度和持续时间影响。骨质流失往往是软骨下骨对异常机械力的首要反应。异常机械刺激影响颞下颌关节盘的营养供应和基质代谢。
