A quantitative evaluation of inflammatory cells in human temporomandibular joint tissues from patients with and without implants.
OBJECTIVE
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.


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 microm) 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.
Alonso
Aurelio
A
School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA.
Kaimal
Shanti
S
Look
John
J
Swift
James
J
Fricton
James
J
Myers
Sandra
S
Kehl
Lois
L
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000737:chemistry*; D002102:Cadaver; D002452:Cell Count; D004396:Coloring Agents; D003238:Connective Tissue / Q000276:immunology / Q000473:pathology; D005260:Female; D005456:Fluorescent Dyes; D015726:Giant Cells / Q000473:pathology*; D006801:Humans; D007595:Joint Prosthesis; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000737:chemistry; D011428:Proplast / Q000737:chemistry; D011475:Prosthesis Failure; D013499:Surface Properties; D013704:Temporomandibular Joint / Q000276:immunology* / Q000473:pathology; D019224:Temporomandibular Joint Disc / Q000276:immunology / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000276:immunology / Q000601:surgery; D055815:Young Adult
D001672:Biocompatible Materials; D004396:Coloring Agents; D005456:Fluorescent Dyes; D011428:Proplast; D011138:Polytetrafluoroethylene