The presence of bacteria in the synovial fluid of the temporomandibular joint and clinical significance: preliminary study

J Oral Maxillofac Surg. 2003 Oct;61(10):1156-61. doi: 10.1016/s0278-2391(03)00674-8.

Abstract

Purpose: The objective of this study was to find any relation between the presence of specific bacterial species in the synovial fluid of the temporomandibular joint (TMJ) and clinical parameters.

Patients and methods: We studied 43 patients (male-to-female ratio, 1:1.69; average age, 34.37 +/- 14.55 years). Thirty-three patients had a displaced disc in the TMJ (DD group), and 10 patients did not have a displaced disc of the TMJ or any symptom related to TMJ disorders (NDD group). Clinical examinations were made to determine maximum mouth opening, joint sounds, previous trauma history, systemic disease, and TMJ pain. Six bacterial species that were reported in other studies were chosen to evaluate the presence of bacteria in the TMJ for this study.

Results: Mycoplasma genitalium was most frequently detected in synovial fluid (86.0%). Staphylococcus aureus, Mycoplasma fermentans/orale, Actinobacillus actinomycetemcomitans, and Streptococcus mitis were detected in 51.2%, 37.2%, 25.6%, and 7.0% of samples, respectively. beta-Hemolytic Streptococcus was not detected. The prevalence of S aureus was significantly higher in the DD group than in the NDD group (P <.05). The patients who had M. fermentans/orale were 5.40 times more likely to be younger than 30 years than were those without M. fermentans/orale (P <.05). Those with M. genitalium were 5.81 times more likely to be female than were those without M. genitalium (P <.05).

Conclusion: The presence of S. aureus in TMJ synovial fluid was related to TMJ disorder symptoms and clinical parameters seemed to be influenced by bacterial presence in TMJ synovial fluid.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aggregatibacter actinomycetemcomitans / isolation & purification
  • Aggregatibacter actinomycetemcomitans / pathogenicity
  • Analysis of Variance
  • DNA, Bacterial / analysis
  • Facial Pain / microbiology
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mycoplasma / isolation & purification
  • Mycoplasma / pathogenicity
  • Odds Ratio
  • Range of Motion, Articular
  • Staphylococcus aureus / isolation & purification
  • Staphylococcus aureus / pathogenicity*
  • Streptococcus mitis / isolation & purification
  • Streptococcus mitis / pathogenicity
  • Synovial Fluid / microbiology*
  • Temporomandibular Joint / microbiology*
  • Temporomandibular Joint Disorders / microbiology*

Substances

  • DNA, Bacterial