for the control group are: MIO 47.8mm, protrusion6.0mm, R lat excursion 8.8mm, L lat excursion 8.4mm.The mean values for the unilateral group are: MIO13.7mm, protrusion 0mm, lateral excursion contralateralto prosthesis 1.0mm, lateral excursion to ipsilateral toprosthesis 5.4mm. The mean values for the bilateralgroup are: MIO 24.3mm, protrustion 0mm, R lat excur-sion 0.2mm, L lat excursion 1.25mm.

Conclusion: The results of patients studied to datehave confirmed many of the theoretical expectations ofunilateral and bilateral total joint reconstruction patients.This study provides objective data on the in vivo func-tioning of alloplastic TMJ reconstruction. The knowl-edge gained in this study will help establish post-surgicalfunctional expectations and allow TMJ reconstructivesurgeons to better counsel their patients.

References

Kuwahara T, Bessette RW, Maruyama T. Chewing pattern analysis inTMD patients with unilateral and bilateral internal derangement.Cranio. 1995; 13(3): 167-72

Kuwahara T, Bessette RW, Maruyama T. A retrospective study on theclinical results of temporomandibular joint surgery. Cranio. 1994;12(3): 179-83

Sinn DP, Evaldo A, Throckmorton GS. Mandibular excursions andmaximum bite force in patients with temporomandibular joint disor-ders. J Oral Maxillofac Surg. 1996; 54: 671-79

POSTER 248Involvement of TNF-� and IL-1� on JointDestruction via Synovial Cells FromHuman Temporomandibular JointYouichi Iwanami, DDS, Japan (Nagai H; Nakata A;Takano H; Fukuda M; Miyamoto Y)

Statement of the Problem: Inflammatory cytokines,such as tumor necrosis factor-alpha (TNF�), interleukin-beta (IL-1�) and interferon-gamma (IFN-�) were thoughtto play important roles in pathogenesis of the temporo-mandibular joint (TMJ) disorder(TMD),especially inter-nalderangement (ID) and osteoarthritis (OA) of theTMJ. In biochemical analyses, these inflammatory cyto-kines were detected in the synovial fluid of patients withTMD. Furthermore, these cytokines have been detectedin the synovial tissues by immunohistochemical analysisin TMD patients. These findings suggested that synovialcells actively participated in the pathogenetic process ofTMD. However, the role of synovial cells in TMD is notdefined distinctly. The aim of this study is to elucidatethe involvement of IL-1� andTNF� on joint destructionvia synovial cells from human TMJ.

Materials and Methods: We have established synoviallining cells strain (SGA2 cells) from human TMJ. SGA2cells were isolated by outgrowth from patient using anexplant culture method and clarified their characteristicsas described previously (Nagai et al.,J Oral Pathol

Med,2006). SGA2 cells were stimulated with variousconcentration of IL-1� and TNF� for 12hours

Method of Data Analysis: various inflammatory media-tors, matrixmetalloproteinases (MMPs), receptor activa-tor of NF-kappaB ligand (RANKL) and osteoprotegerin(OPG) mRNA expression were examined by reversetranscription-polymerase chain reaction (RT-PCR).

Results: SGA2 cells were positive for fibroblastic markersvimentin, prolyl 4-hydroxylase and also expressed lamininand heat shock protein 27, all of which are markers of typeB cells. These results suggested that SGA2 cells are predom-inantly synovial lining type B cells. The stimulation withIL-1� enhanced the expression of inflammatory mediators(IL-1�, IL-6, IL-8, IFN-�), MMPs (MMP-3, MMP-13), andRANKL in SGA2 cells. The stimulation with TNF-�en-hanced the expression of inflammatory mediators (IL-1�,IL-6, IL-8, COX-2), MMPs (MMP-3, MMP-13), and RANKL inSGA2 cells. These results indicated that human synovialcells from human TMJ produced various inflammatory me-diators and matrix metalloproteinases, and regulated oste-oclast differentiation.

Conclusion: In conclusion, we found that synoviallining cells from TMD play important roles in the patho-genesis of these disorders, which is characterized byprogressive articular destruction.

References

Nagai et al., J Oral Pathol Med, 2006E.Pantouli et al., Biochem biophys RES commun, 2003

POSTER 249Effect of NSAIDs on Pain in TMJ InternalDerangementYuki Hattori, DDS, 2-11 Suemori-dori Chikusa-ku,Nagoya, 464-8651, Japan (Kurita K; Nakashima K;Kondo N; Shimizu M; Tetsuya Y; Nabeshima H;Takaishi M; Kuroyanagi N; Ogi N)

Statement of the Problem: The effect of intraorallyadministrated NSAIDs (Amfenac Sodium) was evaluatedin patients with disc displacement with reduction(DDwR), disc displacement without reduction (DDw/oR), and osteoarthrosis (OA).

Materials and Methods: TMJ pain level was classified intonone, slight, moderate, and severe using visual analogscales. One hundred and eleven patients with moderate orsevere TMJ pain were classified into DDwR, DDw/oR, andOA using MRI. Amfenac Sodium, 200 mg, was given orally4 times a day for 2 weeks. Maximal mouth opening rangewas measured during the two weeks.

Method of Data Analysis: TMJ pain was consideredimproved when pain decreased to none or slight. TotalTMJ dysfunction was considered improved when themaximal mouth opening increased by more than 35 mmand pain decreased to none or slight.

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Results:1. Pain improvements were: DDwR:69.7%, DDw/

oR:48.3%, and OA:60%.2. Maximal mouth openings before and after treat-

ment were 33mm and 40mm in DDwR, 29mmand 33mm in DDw/oR, and 30mm and 33mm,respectively, in OA.

3. The improvement rates of Total TMJ dysfunctionwere: DDwR:54.5%, DDw/oR:20.7%, andOA:25.0%.

Conclusion: TMD pain was relieved by Amfenac So-dium. However, there was just a low level of improve-ment of maximal mouth opening. The study suggeststhat physical therapy such as mouth opening exercisesbe added to increase jaw mobility for DDw/oR and OA.

References

Randomized effectiveness study of four therapeutic strategies forTMJ closed lock

Utilization of pharmaceuticals among patients with temporomandib-ular disorders: a controlled study

POSTER 250Relative MRI Signal Intensity ofRetrodiscal Tissue in theTemporomandibular Joint DisorderSe-Heon Jeong, Korea (Jeong SH; Lee SH; Yoon HJ)

Statement of the Problem: The temporomandibularjoint disorder (TMD) not only affects disc and bonetissue, but also can induce inflammation and/or fibroticadhesion in retrodiscal tissue, which may affect the clin-ical symptoms of this disorder. Although MRI is com-monly used for the diagnosis of TMD, there is littleinformation on the relationship between the MRI char-acteristics of retrodiscal tissue and clinical symptoms.The aims of this study were to determine the utility ofT2-weighted MRI relative signal intensities of retrodiscaltissue in TMD patients as diagnostic markers, and todetermine the relationship between signal intensity,pain and limitation of opening of the mouth.

Materials and Methods: We studied 132 joints from 66TMD patients who presented at the Department of Oraland Maxillofacial Surgery of St. Mary’s Hospital, TheCatholic University of Korea from May 2003 to Decem-ber 2006. All patients exhibited more than one of thefollowing TMD symptoms: joint pain, sounds associatedwith jaw movement, or limitation in opening of themouth. MRI was conducted before the patients under-went surgery. The signal intensity of the region of inter-est immediately posterior to the disc of the temporoman-dibular joint was measured using a T2-weighted MRIimage taken with the mouth in the closed position. Therelative signal intensity of the retrodiscal tissue was ref-erenced to the region of interest in the gray matter of the

brain. The relationships between relative signal intensityand condylar degenerative change (t-test), joint effusion(t-test), disc position (ANOVA), pain (t-test), and limitedopening of the mouth (t-test) were determined.

Method of Data Analysis: n/aResults: The relative signal intensity of retrodiscal tis-

sue was significantly elevated when the disc was dis-placed without reduction and when joint effusion, con-dylar degenerative changes or pain was present. Limitedopening of the mouth was not significantly correlatedwith the relative signal intensity of the retrodiscal tissue.

Conclusion: Relative T2-weighted MRI for determina-tion of the signal intensity of retrodiscal tissue is a valu-able noninvasive tool for monitoring the progression ofTMD. Additional clinical studies are warranted.

References

Sang-Hwa Lee, Mok-Kyun Choie. Relative signal intensity of retrodis-cal tissue in MRI, and synovial fluid concentration of interleukin-6,MMP-2, and MMP-9 in temporomandibular joint disorder. J. Kor. Oralmaxillofac. Surg. 2005;31:399-408

Sakuma K, Sano T, Yamamoto M, Tachikawa T, Okano T.Doesdecreased T1 signal intensity in the retrodiscal tissue of the temporo-mandibular joint reflect increased density of collagen fibers? DentogfacRadiol 2003;32:222-228

POSTER 251Analysis of X-Ray Photograph onTemporomandibular Joint Disorders(TMD)Tomohiro Ninomiya, DDS, PhD, Department of Oraland Maxillofacial Surgery, Graduate School of DentalScience, Kyushu University, 3-1-1, Maidashi, Higashi-ku,Fukuoka, 812-8582, Japan (Takenoshita Y; Kubota Y;Horinouchi Y; Kurahara S; Sasaki M; Higuchi S;Tsunomachi S; Ashizuka M; Nitta S; Maeda Y;Shirasuna K)

Statement of the Problem: The aim of this study is toanalyze of X-ray photograph on temporomandibularjoint disorders (TMD).

Materials and Methods: Four groups of TMD patients(Group T1; 30 twenties males, T2; 30 twenties females,T3; 30 thirties males, T4; 30 thirties females) and twogroups of progenie patients who had no TMJ symptomsand facial asymmetry (Group P1; 30 twenties males, P2;30 twenties females) were analyzed by using their X-rayphotographs (panoramic tomography and axial projec-tion). The length of ramus mandibulae, processus con-dylaris, long and short axis of caput mandibulae, thewidth of caput mandibulae, the angle of angulus man-dibulae and long axis of caput mandibulae, the area ofcaput mandibulae were measured by using CIS-Image/Viewer for Windows.

Method of Data Analysis: Statistical analysis were per-

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