title: Reactive arthritis: preliminary microbiologic analysis of the human temporomandibular joint.
abstract: OBJECTIVE
  The presence of Chlamydia trachomatis has been previously shown in the temporomandibular joint (TMJ). This study investigated whether the presence of other bacteria associated with reactive arthritis (ReA) can be identified in the TMJ.
  
  
  METHODS
  Posterior bilaminar tissue removed during TMJ surgery from 26 patients (24 F, 2 M) was evaluated for the presence of C. trachomatis, Mycoplasma fermentans, Mycoplasma genitalium, Campylobacter jejuni, Yersinia enterocolitica, Salmonella spp, and Shigella spp by highly specific polymerase chain reaction (PCR) assays.
  
  
  RESULTS
  Bacterial DNA was identified in the TMJ as follows: C. trachomatis, 11 of 26 (42%); M. fermentans/orale, 6 of 26 (23%); M. genitalium, 9 of 26 (35%). Nine of 26 TMJs (35%) had the presence of a single bacterial species. Eight of 26 TMJs (31%) had more than 1 species, as follows: C. trachomatis with either M. genitalium or M. fermentans/orale in 5 of 26 (19%), M. fermentans/orale with M. genitalium 2 of 26 (8%), and C. trachomatis/M. fermentans/orale/M. genitalium, 1 of 26 (4%). A total of 17 of 26 (65%) of TMJs had the presence of bacteria identified in the TMJ. Campylobacter jejuni, Y. enterocolitica, Salmonella spp, and Shigella spp were not identified in any samples.
  
  
  CONCLUSIONS
  The presence of M. genitalium in the human TMJ has not been previously reported. The presence of bacteria in the TMJ, either singly or concurrently with other bacteria, may serve as the pathogenetic mechanism of TMJ inflammation. The presence of 2 bacteria from the urogenital tract in the TMJ suggests that internal derangement of the TMJ may occur as a result of a sexually acquired infection.
authors.affiliation: Boston University Goldman School of Dental Medicine, MA, USA. chenry@pol.net
authors.forename: C H
authors.initials: CH
authors.lastname: Henry
authors.forename: C V
authors.initials: CV
authors.lastname: Hughes
authors.forename: H C
authors.initials: HC
authors.lastname: Gérard
authors.forename: A P
authors.initials: AP
authors.lastname: Hudson
authors.forename: L M
authors.initials: LM
authors.lastname: Wolford
mesh_terms: D000293:Adolescent; D000328:Adult; D016918:Arthritis, Reactive / Q000382:microbiology*; D015373:Bacterial Typing Techniques; D016123:Campylobacter jejuni / Q000302:isolation & purification; D002692:Chlamydia trachomatis / Q000302:isolation & purification; D004269:DNA, Bacterial / Q000032:analysis; D004755:Enterobacteriaceae / Q000302:isolation & purification; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009161:Mycobacterium / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D000091402:Prohibitins; D013705:Temporomandibular Joint Disorders / Q000382:microbiology*
chemical_list: D004269:DNA, Bacterial; C000717331:PHB2 protein, human; D000091402:Prohibitins