Part I: Development and Physiology of the Temporomandibular Joint
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Purpose of Review
Investigate the developmental physiology of the temporomandibular joint (TMJ), a unique articulation between the cranium and the mandible.
Principal regulatory factors for TMJ and disc development are Indian hedgehog (IHH) and bone morphogenetic protein (BMP-2). The mechanism is closely associated with ear morphogenesis. Secondary condylar cartilage emerges as a subperiosteal blastema on the medial surface of the posterior mandible. The condylar articular surface is immunoreactive for tenascin-C, so it is a modified fibrous periosteum with an underlying proliferative zone (cambrium layer) that differentiates into fibrocartilage. The latter cushions high loads and subsequently produces endochondral bone. The TMJ is a heavily loaded joint with three cushioning layers of fibrocartilage in the disc, as well as in subarticular zones in the fossa and mandibular condyle.
The periosteal articular surface produces fibrocartilage to resist heavy loads, and has unique healing and adaptive properties for maintaining life support functions under adverse environmental conditions.
KeywordsTMJ Indian hedgehog BMP-2 Healing blastema Tenascin-C Fibrocartilage Periosteum Morphogenesis Pharyngeal arch
Compliance with Ethical Standards
Conflict of Interest
David Stocum and Eugene Roberts declare no conflict of interest. Dr. Roberts is the section editor for this section of the journal, but the paper was reviewed by an outside reviewer to avoid conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
- 1.Willard VP, Zhang L, Athanasiou KA. Tissue engineering of the temporomandibular joint. Elsevier 2011.Google Scholar
- 4.Reichert KB. Uber die Visceralbogen der Wirbelthiere im Allgemeinen und deren Metamorphosen bei den Vogeln und Saugethieren. Arch Anat Physiol Wissensch Med. 1837:120–220.Google Scholar
- 5.Gaupp E. De Reichertsche Theorie. Arch Anat Physiol Suppl. 1912:1–416.Google Scholar
- 6.Khojastepour L, Vojdani M, Forghani M. The association between condylar bone changes revealed in cone beam computed tomography and clinical dysfunction index in patients with or without temporomandibular joint disorders. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123(5):600–5.CrossRefPubMedGoogle Scholar
- 15••.. Utreja A, Dyment NA, Yadav S, Villa MM, Yingcui L, Xi J, et al. Cell and matrix response of temporomandibular cartilage to mechanical loading. Osteoarthr Cartil. 2016;24(2):335–44. Transgenic mice expressing fluorescent proteins to identify areas of gene expression in the mandibular condyle have documented the cell lineage progression in response to TMJ loading. CrossRefPubMedGoogle Scholar
- 19.Takahashi I. Mechano-reaction of chondrocytes in the mandibular condyle during orthopedic-orthodontic interaction. In: Ngan PW, Deguchi T, Roberts WE, editors. Orthodontic treatment of class III malocclusion. Mumbai: Bentham Books; 2014. p. 37–60.Google Scholar
- 23••.. Shibata S, Sakamoto Y, Yokohama-Tamaki T, Murakami G, Cho BH. Distribution of matrix proteins in perichondrium and periosteum during the incorporation of Meckel’s cartilage into ossifying mandible in midterm human fetuses: an immunochemical study. Anat Rec. 2014;297:1208–17. This reference documents that the articular surface of the mandibular condyle is covered with periosteum and not cartilage. CrossRefGoogle Scholar
- 26.Zhang H, Zhao X, Zhang Z, Chen W, Zhang X. An immunohistochemistry study of Soxp9, Runx2, and Osterix expression in the mandibular cartilages of newborn mouse. Biomed Res Int. 2013; https://doi.org/10.1155/2013/265380.
- 36.Minina E, Wenzel HM, Kreschel C, Karp S, Gaffield W, McMahon AP, and Vortkamp A. BMP and Ihh/PTHrP signaling interact to coordinate chondrocyte proliferation and differentiation. Development 2001:128:4523–4534.Google Scholar
- 37••.. Purcell P, Joo BW, Hu JK, Tran PV, Calicchio ML, O’Connell DJ, et al. Temporomandibular joint formation requires two distinct hedgehog-dependent steps. Proc Natl Acad Sci U S A. 2009;106:18297–302. An in-depth examination of Hedgehog signaling in TMJ development. CrossRefPubMedPubMedCentralGoogle Scholar