Tetsuji Kawakami

Effect of Food Size on the Movement of the Mandibular First Molars and Condyles during Deliberate Unilateral Mastication in Humans

To date, the effect of food size on the movement of the mandibular first molars and condyles during chewing has not been fully examined due to methodological problems. The purpose of the present study was to examine the previously unknown effect of food size on masticatory jaw movement. Using a face bow, light-emitting diodes, and optical cameras, we recorded, in 16 young adults with good occlusion, mandibular movement for the first 10 strokes during the unilateral chewing of similarly shaped hard gummy jellies weighing 5 g and 10 g, respectively. The chewing cycle time for the 10-g jelly was significantly longer than that for the 5-g jelly. The jaw-closing and -opening maximum velocities, gapes at the maximum velocities, and maximum gape were significantly faster and larger when 10-g gummy jellies were chewed, compared with results with 5-g jellies, at the mandibular first molar on the chewing side and the condyle on the non-chewing side. With the exception of the velocity, similar tendencies were observed at the molar on the non-chewing side. However, such significant differences were not detected at the condyle on the chewing side. The mandibular first molar on the chewing side was that most affected by food size, and the mean value of the maximum gape coincided approximately with the height of each jelly. These results suggest that humans chew hard coherent food such that the mandibular teeth that come into contact with the food open to a height equivalent to that of the food bolus, and that the changes in movement of the other parts of the mandible are minimized, ensuring efficient mastication.

Motion of the Human Mandibular Condyle during Mastication

It has been reported that loading to the mandible during closing movement makes the condylar path move more in the superior direction than that during the free closing movement. In this study, the hypothesis was tested that the displacement of the condyle on the chewing side is greater in the direction of the mandibular fossa than that on the non-chewing side. Using a six-degrees-of-freedom jaw movement recording system, we recorded condylar motion in 12 healthy adults without TMD, during the chewing of a large hard gummy jelly. The maximum displacements at the condyle on the chewing side from the maximum intercuspation (CO) position were significantly larger in the superior and medial directions at the initial stage and in the posterior direction at all stages (0.5 mm, 0.5 mm, and 0.6 mm, respectively) than those on the non-chewing side (0.0 mm, 0.1 mm, and 0.1 mm, respectively). This suggests that, in healthy adults, the condyles at CO are located in a position such that excessive load is not applied to the temporomandibular joint when there are the aforementioned displacements.

MMP-3 activation is a hallmark indicating an early change in TMJ disorders, and is related to nitration

Recent studies on temporomandibular joint (TMJ) disorders have suggested that matrix metalloproteinases (MMPs) are closely involved in the pathophysiological progression of the internal derangement (ID) of TMJ. The aim of this study was to investigate MMPs in synovial fluid (SF) at different stages of ID. To examine the relationship between MMP activation and ID progression, 54 SF samples from ID patients were classified based on the criteria of Wilkes and were assayed for MMP activity. It was found that MMP-3 activity was transiently increased in the intermediate stage. This increase in the active form of MMP-3 was also confirmed by Western blotting. When the 54 samples were classified into two groups based on the presence or absence of inflammatory findings, the intensity of MMP-3 activity correlated with the inflammatory symptoms. These findings suggest that MMP-3 activation is a hallmark of early degenerative changes in ID. The tylosin nitration by the peroxynitrite can regulate the enzyme activity. To elucidate the activating pathway of MMPs in vivo, nitrated proteins in SF were analysed by immunoprecipitation. Some nitrated proteins in SF were identified as MMP-2 and -3, and the nitration of MMP-3 rendered them active in vitro.

Osteochondroma of the Mandibular Condyle

Abstract This report is of a 44-year-old man with osteochondroma of the mandibular condyle. Condylectomy and immediate reconstruction with autogenous costochondral graft resulted in a good long-term outcome.

Characteristics of Upper Quadrant Posture of Young Women with Temporomandibular Disorders

[Purpose] This study aimed to investigate the characteristics of upper quadrant posture of young women with temporomandibular disorders. [Subjects] The participants were 19 female patients with temporomandibular disorders (patient group: mean age, 30.1 years) and 14 controls (control group: mean age, 24.6 years). [Methods] Outcome measures were the neck inclination angle (formed by a line connecting C7 and the ear tragus with a horizontal line), the angle of the shoulder (formed by a line connecting C7 and the acromial angle with a horizontal line), the cranial rotation angle (formed by a line connecting the ear tragus and the corner of the eye with a horizontal line), and the neck-length/shoulder-width ratio [the ratio of the neck length (from C7 to the tragus) to the width of the shoulder between the acromial angle]. The maximum range of mouth opening was measured using a scale. [Results] The neck inclination angle and maximum range of mouth opening were significantly smaller in the patient group than in the control group. No significant differences were observed in the other outcome measures between the two groups. [Conclusion] Temporomandibular disorders with limited mouth opening in young females are associated with the head position relative to the trunk.

Possible difficult laryngoscopy caused by masticatory muscle tendon-aponeurosis hyperplasia: we anesthesiologists should be aware of this disease

Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a new disease entity characterized by limited mouth opening due to contracture of the masticatory muscles resulting from hyperplasia of tendons and aponeuroses. The other clinical feature is that the face of the patient with this disease displays a square mandible configuration. Muscle relaxants provide no relief for the limited mouth-opening ability. Anesthesiologists need to suspect difficult airway when patients have limited mouth opening with square mandible configuration. MMTAH can therefore be a possible cause of difficult intubation.

15-Deoxy-Δ12,14-prostaglandin J2 impairs the functions of histone acetyltransferases through their insolubilization in cells

The cyclopentenonic prostaglandin 15-deoxy-Delta(12,14)-PG J(2) (15d-PGJ(2)) is a metabolite derived from PGD(2). Although 15d-PGJ(2) has been demonstrated to be a potent ligand for peroxisome proliferator activated receptor gamma (PPARgamma), the functions are not fully understood. In order to examine the effect of 15d-PGJ(2) on histone acetyltransferases (HATs), several lines of cell including mouse embryonic fibroblast (MEF) cells were exposed to 15d-PGJ(2). Three types of HAT, p300, CREB-binding protein (CBP), and p300/CBP-associated factor (PCAF), selectively disappeared from the soluble fraction in time- and dose-dependent manners. Inversely, HATs in the insoluble fraction increased, suggesting their conformational changes. The decrease in the soluble form of HATs resulted in the attenuation of NF-kappaB-, p53-, and heat shock factor-dependent reporter gene expressions, implying that the insoluble HATs are inactive. The resultant insoluble PCAF and p300 seemed to be digested by proteasome, because proteasome inhibitors caused the accumulation of insoluble HATs. Taken together, these results indicate that 15d-PGJ(2) attenuates some gene expressions that require HATs. This inhibitory action of 15d-PGJ(2) on the function of HATs was independent of PPARgamma, because PPARgamma agonists could not mimick 15d-PGJ(2) and PPARgamma antagonists did not inhibit 15d-PGJ(2).

15-Deoxy-Δ12,14-prostaglandin J2 induces PPARγ- and p53-independent apoptosis in rabbit synovial cells

A ligand of peroxisome proliferator-activated receptor γ (PPARγ), 15-deoxy-Δ(12,14)-prostaglandin J2 (15d-PGJ2) induces apoptosis in various cells. However, the mechanism appears to be complex and cell-type specific. We investigated the mechanism of 15d-PGJ2-induced apoptosis of rabbit synovial cells. Exposure to 15d-PGJ2 resulted in DNA fragmentation accompanied by caspase-3 and -9 activations in the cells, suggesting occurrence of mitochondria-mediated apoptosis. Although the exposure also induced remarkable increase in p53 protein, its transcriptional activity was rather reduced, suggesting non-necessity of p53 in 15d-PGJ2-induced apoptosis. Covalent binding of 15d-PGJ2 to cellular proteins including p53 resulted in their insolubilization. N-acetylcysteine inhibited not only the 15d-PGJ2-induced apoptotic events but also the protein insolubilizations via its interaction with 15d-PGJ2. The studies using a PPARγ-agonist and -antagonist showed noninvolvement of PPARγ in 15d-PGJ2-induced apoptosis. The pre-exposure to pro-inflammatory cytokines did not affect the cytotoxicity of 15d-PGJ2 in synovial cells. Taken together, these results show that 15d-PGJ2 induces a mitochondria-mediated apoptotic pathway in p53- and PPARγ-independent manners.

Difference in Response to a Motor Imagery Task: A Comparison between Individuals with and without Painful Temporomandibular Disorders

The aim of the study was to investigate the difference in response to a motor imagery task between individuals with and without painful temporomandibular disorders (TMDs). The participants were 24 adults with and without TMD (TMD and control group, resp.). A set of photographic images of the profile view of a persons head and neck and a hand and a foot were presented in a random order. The set consisted of six different orientations with rotations of each image at 0, 60, 120, 180, 240, and 300 degrees and included left and right representations. The participants were required to view the image and make a decision as to whether it was a left or a right side presented, that is, mental rotation (MR) task. Data were collected on 48 tasks (including left and right) at each orientation for each body part. Reaction times (RTs) for correct answers and accuracy in making the left or right judgements were recorded. The RT was slower in the TMD group than in the control group. The RT for the profile image was slower than those for the hand and foot images. For images that were 180 degrees, the RT was slower and the accuracy was lower than those for five of the other image orientations. The judgements made about the 180-degree rotated image were more inaccurate compared to images of all other orientations among all types of stimuli.

Clinical study of the malar bone fracture. Part 2: Usefulness in diagnosis of the malar bone fracture and its classification using computed tomography.

In the malar bone fracture, conventional radiographic methods has the limitation to analyze the pattern of displacement in an anteroposterior direction of the face. Thirty-four patients with malar bone fractures were examined with the biplane computed tomography (CT), i. e. the axial CT combined with the coronal CT, to analyze the displacement of the fragments.Malar bone fractures were classified into five groups according to the location and direction of the fragments.It is possible to establish a more complete three-dimensional pattern of displacement in malar bone fractures using the biplane CT.