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
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