3047 Bone metabolism and MRI findings of the articular disk in TMJ disorders
M. TOYAMA, M. TSUCHIMOCHI, M. HARADA, T. KATADA, and Y. SASAKI, The Nippon Dental University School of Dentistry at Niigata, Japan

Objectives: The present study was carried out to clarify the correlation between the articular disk and bone metabolism by using bone markers, bone scintigraphy , and magnetic resonance Imaging (MRI). It is well known that images of bone scintigraphy represent bone metabolism status. The circulation pyridinoline cross-linked carboxyl-terminal telopeptide of type I collagen (ICTP) and corboxy-terminal propeptide of type I collagen (PICP) are also useful markers for bone metabolism . We compared the semi-quantifying ratio of radioactivities in bone scintigraphy, ICTP and PICP in synovial fluid, and MRI findings. Methods: The study cases consisted of 92 patients (18 males and 74 females, with average age of40.3 years) with TMJ disorders who underwent bone scintigraphy and synovial fluid study. We evaluated the articular disk position (normal position (NP), anterior disk displacement with reduction (ADWR), anterior disk displacement without reduction (ADWOR)), and articular disk configuration (biconcave (CAV), biplanar (PLA), enlargement (ENL), and biconvex (VEX)) by MRI. After establishing regions of Interest on scintigraphic images the Tc-99m-MDP radioactivity ratio was calculated using the following formula: TMJ region/soft tissue of neck region. The synovial fluid of superior TMJ space was collected at the procedure of arthrocentesis for analyzing ICTPand PICP concentration by radioimmunoassay. Results: 1) The accumulation ratio of ADWOR joints was significantly higher than that of NP and ADWR (P<0.001). The accumulation ratio of CAV was significantly lower than that of ENL (P<0.0001), and VEX (P<0.001). 2) There were no significant differences between the configurations and positions of the articular disk and bone metabolic markers (ICTP and PICP). 3) The accumulation ratio was correlated with ICTP(R=0.807, p<0.0001) and PICP(R=0.722, p<0.0001). Conclusions: The data suggests that TMJ disk deterioration may affect joint bone metabolism of TMJ disorders. This study was supported by a Grant-in-aid for Scientific Research (C) (No. 09672072) from the Ministry of Education, Science, Sports, and Culture of Japan.

Seq #275 - TMJ - Structure and Function II
3:45 PM-5:00 PM, Friday, 8 March 2002 San Diego Convention Center Exhibit Hall C

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