Abstract
BackgroundThe temporomandibular joint (TMJ) is well innervated by braches of the trigeminal nerve. The temporomandibular joint disorders (TMD) can cause neural-inflammation in the peripheral nervous system (PNS) at the site of injury, or compression, and may have systemic effects on the central nervous system (CNS). Neural-inflammation causes elevations in cytokine expression and microglia activation. When the site of injury, or compression is treated, or relieved, neural inflammation is reduced. These changes can be seen and measured with fMRI brain activities.MethodsFor this study, patients with comorbid TMD and systemic/neurologic conditions were compared using clinical diagnostic markers, inflammatory, pain, tissue destruction enzymatic biomarkers, and functional magnetic resonance imaging (fMRI) activity of the brain, with and without a custom-made dental orthotic.ResultsOur results showed a correlation between the clinical diagnosis of the pathological TMJ, biomarkers and the fMRI study. There was a marked elevation of biomarkers in samples taken from TMJ of patients who were clinically diagnosed with TMD. The fMRI study of TMD patients showed an abnormal hyper-connected salience network and a diminished blood flow to the anterior frontal lobes when they did not wear their customized dental orthotics.ConclusionsOur findings highlight the importance of TMJ-CNS connections and use of fMRI as an investigative tool for understanding TMD and its related neurological pathologies.
Highlights
The temporomandibular joint (TMJ) is well innervated by braches of the trigeminal nerve
The temporomandibular joint (TMJ) is a complex joint, which comprises the relationship of the mandibular condyle, articular disc and glenoid fossa of the temporal bone
Pathologies affecting the TMJ are termed as temporomandibular joint disorders (TMD), a common condition involved in orofacial pain
Summary
The temporomandibular joint (TMJ) is well innervated by braches of the trigeminal nerve. The temporomandibular joint disorders (TMD) can cause neural-inflammation in the peripheral nervous system (PNS) at the site of injury, or compression, and may have systemic effects on the central nervous system (CNS). When the site of injury, or compression is treated, or relieved, neural inflammation is reduced. These changes can be seen and measured with fMRI brain activities. The temporomandibular joint (TMJ) is a complex joint, which comprises the relationship of the mandibular condyle, articular disc and glenoid fossa of the temporal bone. During the opening motion of the mouth, the mechanism of action between the articular disc is to traverse in the anterior direction across the surface of the glenoid fossa, while the mandibular condyle is rotating under the concave surface of the disc [1]. Investigators indicated 1–75% of the populations had at least one objective sign of TMD, while 5–33% reported subjective symptoms with a higher prevalence
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