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Aims: To test for orthotropy in the stress-strain behavior of the
temporomandibular joint (TMJ) disc under repeated physiologic
loading before and after an impact event. Methods: Two groups,
each consisting of 10 discs, were subjected to repeated tensile
cycling in the dorsoventral (group 1) and mediolateral (group 3)
direction. Two additional groups, each consisting of 10 discs, had
preconditioning in the form of a 1.18 N¡¤s impulsive load before
tensile cycling in either the dorsoventral (group 2) or mediolateral
(group 4) direction. Physiologic loads of 1 to 3 N were cycled at
0.1 Hz, and stress-strain responses were recorded every cycle
between 1 to 10 cycles, and then periodically at 50, 100, 500, 750,
and 1,000 cycles. The properties of elastic modulus, residual strain
upon unloading, and area contained within the hysteresis loop
were measured. Results: Dorsoventral loading produced 5-fold
higher elastic modulus, 5-fold lower residual strain, and 5-fold
lower hysteresis compared to mediolateral tensile loading (P ¡Ü
.001). Repeated loading effectively reduced the viscous response
for all discs, as the elastic modulus increased while residual strain
and hysteresis decreased. Impulsive loading caused elastic modulus
to increase for dorsoventrally cycled discs, whereas hysteresis
decreased for mediolaterally cycled discs (P ¡Ü .05). Conclusion:
The findings suggest that damage from the impact load may have
increased the porosity of the extracellular matrix, which ultimately
resulted in additional stress transfer to the collagen fibers during
loading. Impulsive loads may be an important preconditioning
factor in the fatigue failure of the TMJ disc in vivo.
J OROFAC PAIN 2003;17:160¨C166.
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