Bone mineral density, bone microstructure, and bone turnover markers in females with temporomandibular joint osteoarthritis



The pathogenesis of the temporomandibular joint osteoarthritis (TMJ OA) has not been clearly revealed. This study aimed to investigate the pathogenesis of TMJ OA based on bone metabolism.


Fifty-nine young (mean age 23.4 ± 3.4 years) and 41 post-menopausal females (mean age 57.2 ± 4.6 years) were enrolled. Areal bone mineral density (aBMD) was measured via dual-energy X-ray absorptiometry of the lumbar spine, femoral neck, total hip, and ultradistal radius. Levels of four bone resorption markers, serum ionized calcium and C-telopeptide of type I collagen (CTx) and urinary N-telopeptide of type I collagen and deoxypyridinoline, two bone formation markers, serum bone alkaline phosphatase and osteocalcin, and serum 25-dihydroxyvitamin D were analyzed at baseline and after 12 months. Condylar bone quality was assessed by 3D reconstructed CT images.


Significant differences in condylar bone quality and aBMDs of the lumbar spine in accordance with TMJ OA stages were observed in young and post-menopausal females. The level of CTx was significantly associated with the development and progression of TMJ OA only in young females, whereas 25-dihydroxyvitamine D demonstrated significant associations in young and post-menopausal females. Progression of TMJ OA was accompanied by reduced condylar bone quality and concomitant with lower lumbar spine aBMDs in young and post-menopausal females.


Bone metabolism and condylar quality might be involved in the development and progression of TMJ OA.

Clinical relevance

CTx could be considered as a potential diagnostic and monitoring marker in young females, and vitamin D showed a therapeutic potential for TMJ OA.

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This research was supported by the two National Research Foundation of Korea (NRF) grant funded by the Korea government (No. 2018R1C1B6007671 and No. 2020R1I1A1A01071537).

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Correspondence to Jeong-Hyun Kang.

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The research protocol was approved by the Institutional Review Board of the University Hospital (AJIRB-MED-SMP-18-025). Informed consent was obtained from all participants.

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Hong, S.W., Kang, JH. Bone mineral density, bone microstructure, and bone turnover markers in females with temporomandibular joint osteoarthritis. Clin Oral Invest (2021).

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  • Bone mineral density
  • Temporomandibular joint
  • Osteoarthritis
  • Bone metabolism
  • Bone turnover marker