Expression of proteoglycan mRNA in patients with painful clicking and chronic closed lock of the temporomandibular joint.

RT-PCR was used to analyze the expression of a series of mRNAs coding for proteoglycans aggrecan, versican, biglycan, decorin, fibromodulin and also hyaluronan synthase 1 in specimens obtained during discectomy of the temporomandibular joint in patients with unilateral signs and symptoms of chronic closed lock (eight patients) and painful clicking (seven patients). Regarding the disc, aggrecan expression was higher in patients with chronic closed lock. As for the posterior disc attachment specimens, patients with chronic closed lock showed a tendency for higher expression of biglycan and hyaluronan synthase 1. The degradation of matrix in patients with chronic closed lock of the temporomandibular joint seems not to be caused by a reduced synthesis and the degenerative process seen in these patients is one with low turnover similar to the situation in primary osteoarthrosis of hyaline cartilage. The results indicate that any treatment should intervene early in the disease process of chronic closed lock in order to prevent the development of a degenerative process.