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Correlation of magnetic resonance imaging grades with cytokine levels of synovial fluid of patients with temporomandibular joint disorders: a cross-sectional study

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Abstract

Objectives

Magnetic resonance imaging (MRI) is a standardized method for assisting joint diagnosis. To validate the reliability of different imaging-based grading systems, this study examined (1) the associations between grading systems for osseous change, joint effusion, and the Wilkes classification of temporomandibular joint (TMJ) disorders and (2) the correlation between cytokines in synovial fluid and imaging-based joint scores.

Materials and methods

Twenty-seven patients, who routinely received numeric rating scale (NRS) and MRI assessment before TMJ arthrocentesis, were enrolled. Each joint was evaluated through the grading criteria for severity of osseous change and joint effusion by blinded observers using MRI. ImageJ was employed for classifying joint effusion. Joint synovial fluid, collected through arthrocentesis, was examined for cytokine expression by using a Luminex multiplex assay. All data were analyzed using the Pearson correlation analysis.

Results

The Wilkes classification was strongly correlated with osseous change scores, but not with joint effusion scores. Joint effusion scores significantly correlated with NRS scores, but not with the Wilkes classification and osseous change scores. Compared with osseous change scores, joint effusion scores had a higher correlation with the levels of inflammatory cytokines (interleukin (IL)-8 and soluble IL-6 receptor (sIL-6R)) and with anti-inflammatory cytokines (soluble tumor necrosis factor receptors I and II (sTNF-RI/II)).

Conclusions

In patients with TMJ disorders, MRI grades are strongly correlated with NRS scores and levels of cytokines (IL-8, sIL-6R, and sTNF-RI/II) in the synovial fluid.

Clinical relevance

Joint effusion scoring can be a reliable and valid indicator for pathological assessment of TMJ disorders.

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Funding

This research was supported by a grant from the Ministry of Science and Technology, Taiwan (MOST105-2314-B-010-031-MY2).

Author information

Authors and Affiliations

  1. Department of Dentistry, School of Dentistry, National Yang-Ming University, No. 155, Li-Nong Street, Section 2, Taipei, 11221, Taiwan

    Mu-Chen Yang, Ding-Han Wang, Wan-Chun Li, Tsai-Yu Chang, Wen-Liang Lo & Ming-Lun Hsu

  2. Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Road, Taipei, 11217, Taiwan

    Hung-Ta Wu

  3. Institute of Oral Biology, School of Dentistry, National Yang-Ming University, No. 155 Li-Nong Street, Section 2, Taipei, 11221, Taiwan

    Wan-Chun Li

  4. Cancer Progression Center, National Yang-Ming University, No. 155 Li-Nong Street, Section 2, Taipei, 11221, Taiwan

    Wan-Chun Li

  5. Division of Oral and Maxillofacial Surgery, Department of Stomatology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-pai Road, Taipei, 11217, Taiwan

    Wen-Liang Lo

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  1. Mu-Chen Yang
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Correspondence to Wen-Liang Lo or Ming-Lun Hsu.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Electronic supplementary material

Figure S1

No significant correlation between expression of cytokines and the Wilkes classification. TNF-α, IL-6, IFN-γ, MMP 3, MMP 12, MMP 13, IL-1β, IL-1ra, sIL-1RII, IL-4, IL-10, and IL-13 exhibited no significant correlations with the Wilkes classification. Tumor necrosis factor-α (TNF-α); Interleukin (IL); Interferon (IFN)-γ; Matrix metalloproteinase (MMP); IL-1 receptor antagonist (IL-1ra); Soluble IL-1 receptor II (sIL-1RII). (PDF 158 kb)

Figure S2

No significant correlation between expression of cytokines and the osseous change score. TNF-α, IL-6, IFN-γ, MMP 3, MMP 12, MMP 13, IL-1β, IL-1ra, sIL-1RII, IL-4, IL-10, and IL-13exhibited no significant correlations with the osseous change score. (PDF 157 kb)

Figure S3

No significant correlation between expression of cytokines and joint effusion score. TNF-α, IL-6, IFN-γ, MMP 3, MMP 12, MMP 13, IL-1β, IL-1ra, sIL-1RII, IL-4, IL-10, and IL-13 exhibited no significant correlations with the joint effusion score. (PDF 158 kb)

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Yang, MC., Wang, DH., Wu, HT. et al. Correlation of magnetic resonance imaging grades with cytokine levels of synovial fluid of patients with temporomandibular joint disorders: a cross-sectional study. Clin Oral Invest 23, 3871–3878 (2019). https://doi.org/10.1007/s00784-019-02817-z

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