The influence of unilateral disc displacement on stress in the contralateral joint with a normally positioned disc in a human temporomandibular joint: An analytic approach using the finite element method

Abstract Objectives To investigate the influence of unilateral disc displacement (DD) in the temporomandibular joint (TMJ) on the stress in the contralateral joint, with a normally-positioned disc, during clenching. Study design A finite element model of the TMJ was constructed based on MRI and 3D-C...

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Bibliographic Details
Published in:Journal of cranio-maxillo-facial surgery 2014-12, Vol.42 (8), p.2018-2024
Main Authors: Hattori-Hara, Erica, Mitsui, Silvia N, Mori, Hiroyo, Arafurue, Keiji, Kawaoka, Takuji, Ueda, Kanji, Yasue, Akihiro, Kuroda, Shingo, Koolstra, Jan Harm, Tanaka, Eiji
Format: Article
Language:English
Subjects:
Adult
Algorithms
Biomechanical Phenomena
Cartilage, Articular - physiopathology
Clenching
Connective Tissue - physiopathology
Dentistry
Female
Finite Element Analysis
Finite element method
Humans
Image Processing, Computer-Assisted - methods
Imaging, Three-Dimensional - methods
Joint Dislocations - physiopathology
Magnetic Resonance Imaging - methods
Mandibular Condyle - physiopathology
Muscle Contraction - physiology
Stress analysis
Stress, Mechanical
Surgery
Temporal Bone - physiopathology
Temporomandibular joint
Temporomandibular Joint - physiopathology
Temporomandibular Joint Disc - pathology
Temporomandibular Joint Disorders - physiopathology
Tomography, X-Ray Computed - methods
Unilateral disc displacement
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Summary:Abstract Objectives To investigate the influence of unilateral disc displacement (DD) in the temporomandibular joint (TMJ) on the stress in the contralateral joint, with a normally-positioned disc, during clenching. Study design A finite element model of the TMJ was constructed based on MRI and 3D-CT of a single patient with a unilateral DD. A second model with bilateral normally-positioned discs served as a reference. The differences in stress distribution in various TMJ components during clenching were predicted with these models. Results In the unaffected joint of the unilateral DD model, the largest von Mises stress at the start of clenching was predicted in the inferior surface of the disc and increased by 30% during clenching. In the connective tissue the largest stress (1.16 MPa) did not reduce during clenching, in contrast to the (unaffected) joints of the reference model. In the affected joint, the largest stress was predicted in the temporal cartilage throughout clenching. In the surrounding connective tissue, the largest stress (1.42 MPa) hardly changed during clenching indicating no, or negligible, stress relaxation. Conclusions This suggested that a unilateral DD could affect the stresses in the unaffected (contralateral) joint during clenching, where it may lead to weakening of the tissues that keep the disc on the top of the condyle. The results may be helpful in counseling worried patients, since they give insight into possible future developments of the disorder.
ISSN:1010-5182
1878-4119
DOI:10.1016/j.jcms.2014.09.008