Predictive Markers for Longitudinal TMJ Integrity

项目总结/摘要 颞下颌关节紊乱病（TMD）是一种普遍的疾病，估计占5%至10%， 女性的患病率高于男性（NASEM，2020），预计每年的成本为40亿美元（Stowell et al. 2007年）。TMD代表一组有和没有疼痛的情况，如颞下颌关节（TMJ） 椎间盘移位和退行性疾病。骨质变化是晚期退行性特征 （Farina等人，2009;吕德2002; Wiese等人，2008），倾向于在TMJ中比在其他关节中早发生>10年。 人体关节长期的目标是阐明变量负责过早颞下颌关节组织衰竭 和对女性的偏爱。颞下颌关节组织疲劳取决于应用力学和 行为;即输入到组织的能量的幅度和频率。公布的数据和初步数据显示， 通过机械行为评分（MBS， mJ/mm ~ 3），预测颞下颌关节结构的纵向变化。发现在≥5.3年的35例受试者中， 囊内诊断恶化的TMJ的平均MBS分别是TMJ的8倍和3倍 诊断分别改善和保持稳定。然而，有解剖学和 更容易测量和临床翻译的心理生理变量。解剖学- 心理生理学评分（APS），这些措施的算术产品，相关性以及MBS。 因此，总体目标是使用来自TMJ Impact Project（Schiffman）的现有地标数据集 等，2017），以评价这些标记物（APS）预测TMJ结构的纵向变化， 401例受试者（789例TMJ）8年内的囊内诊断。具体目标是： (1)确定是否容易测量的解剖学和心理生理学变量预测转换率， 与囊内诊断变化相关的TMJ结构变化方向，以及是否存在 性别差异 (2)下颌骨髁状突体积纵向变化的性别差异检验 诊断组。 这些具体目标的成果将有助于满足国家行动计划确定的当前需求。 科学、工程和医学院2020年关于“新工具、指标和 诊断TMD并预测其轨迹的生物标志物。”

Project Summary/Abstract Temporomandibular disorders (TMDs) are prevalent, with estimates of 5% to 10%, with two-fold higher prevalence for females than males (NASEM, 2020), and projected annual costs of $4 billion (Stowell et al. 2007). TMD represents a group of conditions with and without pain, such as temporomandibular joint (TMJ) disc displacement and degenerative disease. Osseous changes are late-stage, degenerative characteristics (Farina et al. 2009; Luder 2002; Wiese et al. 2008) that tend to occur >10 years earlier in the TMJ than in other human joints. The long-term goals are to elucidate the variables responsible for precocious TMJ tissue failure and the predilection for females compared to males. TMJ tissue fatigue depends on applied mechanics and behavior; that is, magnitudes and frequencies of energy input to tissues. Published and preliminary data show that magnitudes and frequencies of energy input to TMJ tissues, quantified by Mechanobehavior Score (MBS, mJ∙%/mm3), predict longitudinal changes in TMJ structures. It was found that in 35 subjects over ≥5.3 years, TMJs where intracapsular diagnoses worsened had average MBS 8-times and 3-times greater than TMJs where diagnoses improved and remained stable, respectively. However, there are anatomical and psychophysiological variables that are more easily measured and clinically translatable. The Anatomic- Psychophysiologic Score (APS), the arithmetic product of these measures, correlated well with MBS. Therefore, the overall objective is to use an existing landmark data set from the TMJ Impact Project (Schiffman et al. 2017) to evaluate these markers (APS) to predict longitudinal changes in TMJ structures and intracapsular diagnoses over 8 years in 401 subjects (789 TMJs). The specific aims are to: (1) Determine if easily measured anatomical and psychophysiological variables predict conversion rate and direction of changes to TMJ structures associated with changes in intracapsular diagnoses, and if there are sex differences. (2) Test for sex differences in longitudinal changes in mandibular condyle volume within and between diagnostic groups. The outcomes of these specific aims will help to address the current needs identified by the National Academies of Sciences, Engineering, and Medicine 2020 consensus report for "new tools, metrics, and biomarkers to diagnose TMD and forecast their trajectory.”