Abstract
Expression of proteolytic enzymes in synovial fluid of the temporomandibular joint (TMJ) is caused by excessive mechanical stress on articulating surfaces. This phenomenon indicates the severity of arthritis in affected TMJs. The purpose of the present study was to elucidate the relationship between expression of proteinases and arthroscopic findings, especially synovitis and fibrous adhesion, of 36 TMJs in 27 patients. Prior to arthroscopy, synovial fluid was aspirated from the upper joint compartment, then the expression of MMP-2, -9 and ADAMTS-4 was examined. Preoperative MRI showed 18 cases of deformed mandibular condyles. Arthroscopic findings showed synovitis and fibrous adhesion in all cases and those 7 cases with disc perforation. Bio-chemical analysis of the fluid showed expression of MMP-2 in 24 cases, MMP-9 in 25 cases, and ADAMTS-4 in 26 cases. These results revealed the incidence of high expression of proteolytic enzymes in particular in the affected TMJs, and progression with arthritic changes.
