Establishment of the analytical system on a fine volume synovial fluid in the human temporomandibular joint

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1) Interleukin 1beta levels in synovial fluid of the TMJ have a positive correlation with OA change. The Stromelysin (MMP3) activity detected was greatly increased in patients with cartilage degradation. These changes may be important markers of early bone deterioration in TMJ_s that are undetectable by radiograph imaging.2) Concomitant increases in the level of cytokines (IL-1 and IL-6) and active forms of MMP_s could be potential catabolic markers for cartilage degradation in the TMJ.3) The PGE_2 level in the TMJ synovial fluid does not specifically reflect the intensity of pain or synovitis, but the detection of high concentrations of C4S and C6S,compared to the amount of HA,is a possible marker of proteoglycan degradation in the TMJ.4) The ratio of concentrations of C4S and C6S in the synovial fluid of the TMJ reflect the proteoglycan metabolism of the joint tissues, particularly of the articular cartilage and synovial tissue. This ratio could be used to diagnose joint diseases and to predict articular cartilage destruction or synovial proliferation due to these diseases.5) Aspiration should be repeated at least 5 times in order to remove high molecular weight substances from synovial fluid. However, when the intraarticular pathology is more complex, adequate removal of high molecular weight substances can not be achieved, even when aspiration is repeated 9 times.6) Our modified direct aspiration technique is both logical and will yield the highest success rate possible when attempting direct aspiration of TMJ synovial fluid.