A Quantitative Evaluation of Inflammatory Cells in Human Temporomandibular Joint Tissues From Patients With and Without Implants

Alonso, Aurelio; Kaimal, Shanti; Look, John; Swift, James; Fricton, James; Myers, Sandra; Kehl, Lois

doi:10.1016/j.joms.2008.09.010

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 67, Issue 4 , Pages 788-796, April 2009

A Quantitative Evaluation of Inflammatory Cells in Human Temporomandibular Joint Tissues From Patients With and Without Implants

Aurelio Alonso, DDS, MS
- Graduate Assistant, Oral Biology PhD Program, School of Dentistry, University of Minnesota, Minneapolis, MN
Shanti Kaimal, BDS, MDS
- Research Fellow, Department of Diagnostic/Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN
John Look, DDS, PhD
- Senior Research Associate, Department of Diagnostic/Biological Sciences, Division of Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN
James Swift, DDS
- Professor, Department of Developmental/Surgical Sciences, Division of Oral Surgery, School of Dentistry, University of Minnesota, Minneapolis, MN
James Fricton, DDS, MS
- Professor, Department of Diagnostic/Biological Sciences, Division of Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, MN
Sandra Myers, DMD
- Associate Professor, Department of Diagnostic/Biological Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN
Lois Kehl, DDS, PhD
- Assistant Professor, Department of Anesthesiology, Medical School, University of Minnesota, Minneapolis, MN
- Address correspondence and reprint requests to Dr Kehl: Department of Anesthesiology, University of Minnesota, B524 Mayo, MMC 294, 420 Delaware St SE, Minneapolis, MN 55455

Purpose

Previous studies made only qualitative assessments of immune cell responses to temporomandibular joint (TMJ) implant wear debris. The aim of this study was to perform a quantitative comparison of inflammatory cell types in TMJ tissues with implant wear debris, TMJ tissues with a history of disc pathology without implant debris, and TMJ tissues from normal control subjects.

Materials and Methods

TMJ tissues were collected from the following 3 groups of subjects: 1) individuals with failed TMJ implants (implant group, n = 10), 2) patients with TMJ disc pathology but no history of implant placement (nonimplant surgery group, n = 10), and normal cadaveric tissues with no history of surgery (control group, n = 10). Tissue sections (5 μm) from all subjects were stained with hematoxylin-eosin, after which cell counts were done for 2 types of inflammatory cells: multinucleated giant cells and lymphocytes. Mean inflammatory cell counts from the 3 groups were compared by use of a 1-way analysis of variance procedure and Bonferroni adjustment to maintain an overall type I error rate of .05.

Results

Implant group tissues contained significantly more inflammatory cells than tissues from the nonimplant surgery and control groups (P < .0001). Multinucleated giant cells were only present in implant group tissues. Although the high number of multinucleated giant cells present in the implant group obscured a total count of lymphocytes for that group, lymphocyte cell counts were still significantly greater (P < .005) in implant group tissues than in tissues from the other 2 groups.

Conclusions

Our data provide quantitative confirmation that the presence of Proplast-Teflon implant (Vitek, Houston, TX) wear debris is associated with a significant increase in the number of local multinucleated giant cells and lymphocytes.