Immunohistochemical Expression TLR4 in Disks of Patients With TMJ Dysfunction

Objectives: Temporomandibular disorders (TMD) are a group of conditions affecting the temporomandibular joint (TMJ), leading to jaw dysfunction, joint and muscle pain, and a decrease in quality of life. When a disk is chronically overloaded, it may undergo structural changes with pathological consequences. Current research suggests that Toll-Like Receptor 4 (TLR4) precludes these pathologic changes, triggering the inflammatory process of the joint in patients with internal derangement and osteoarthritis. TLR4 acts as regulator of the pro-inflammatory cytokines which mediate the inflammatory response. In patients with internal derangements, fibroblasts may release TLR4 as a protective mechanism. There is a lack of study on human samples, however. The objective of this study is to determine the association of TLR4 expression in the disks of patients with TMJ dysfunctions using an immunohistochemical approach to evaluate the joint disk.
Methods: A total of 45 human TMJ samples were collected, 36 samples in the test group (patients with anterior disk displacement with reduction (n=29) and without reduction (7) and nine samples in the control group. The discs will be immunostained with monoclonal TLR4 antibodies and analyzed immunohistochemically and statistically compared to the control group.
Results: Expected results:
There will be a difference in the expression of TLR4 between the control group and the displacement groups. The experimental groups will express higher levels of TLR4 compared to the group without reduction. TLR4 will be expressed the most in the group with patients who had anterior disc displacement without reduction.
Conclusions: .Expected Conclusions:
The chronic mechanical stress generated during jaw movement in patients with disc displacement activates the inflammatory process in the disk. The higher expression of Toll-Like Receptor 4 found in disks of patients with disk displacement with and without reduction is due to a chronic inflammatory process.