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Abstract

The objective of this study was to determine if gross signs of cadaveric osteoarthritis (OA) have

a tendency to present systemically and if this presentation includes pathology found at the

temporomandibular joint (TMJ). Signs of OA were then correlated to gross alterations of the aorta and common carotid arteries seen with atherosclerotic cardiovascular disease. Ipsilateral synovial joints including the TMJ, knee joint, radiocarpal joint and trapeziometacarpal (TMC) joint were all assessed for signs of OA in 4 cadaveric donors (3 males; 72, 82 and 92 years-old / 1 female; 89 years-old) using a validated scale of disease severity. A Grade 0-4 disease severity score was assigned to the condyle for each TMJ along with the femoral condyles, the distal radius, scaphoid, lunate, trapezium and base of the first metacarpal. Atherosclerosis was noted as absent, present or severe at each donor’s arch of the aorta, bifurcations of the aorta and common carotid arteries. The female donor was the only donor to demonstrate severe OA at all assessed joints. With each decade of life, male donors increased in average disease severity across their pool of assessed joints (Averaged Disease Severity Scores: Male 72- 2, Male 82 - 3.1, Male 92- 3.7). Scoring on TMJ condyles, regardless of sex or age, mirrored femoral condyle scoring. It may be hypothesized that females with Grade 4 OA at the knee, wrist and/or TMC joints may also experience Grade 4 TMJ OA based on the consistently severe scoring the female joints had for signs of OA. The presence of atherosclerosis was used as a marker for systemic metabolic or inflammatory conditions that can exacerbate OA progression. The female donor and the 82 years-old male donor were the only donors to present with severe atherosclerosis and both demonstrated these findings at two of the three assessed sites. In conclusion, systemic OA and holistic health deterioration may potentially present at a greater rate and severity of progression in females compared to males. Once males reach their 70s, they may begin to progress through the phases of OA degeneration that occur earlier in females, beginning at ‘Mild OA’ and progressing to ‘Moderate’ in their 80s and ‘Severe’ in their 90s. Female patients should be more carefully observed and managed for TMJ OA compared to men and their clinical history should be thoroughly evaluated and discussed in a holistic health fashion in the dental clinic. Presentation of OA in other joints or diagnosed vascular diseases may have strong correlation to a patient’s tendency to develop temporomandibular joint disorders (TMDs).

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