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Hello my name is abigail velez today i’m going to talk about the effect of estrogen receptor beta on mandibular condylar growth first definition estrogen is an important modulator in the metabolism of bone tissue it has an effect on osteoblastic differentiation decreasing cell proliferation differentially the expression of the extracellular matrix which also
Explains the molecular mechanisms of growth and remodeling of bone by estrogens the estrogen increases inflammation and decreases bone resorption next a video the estrogen receptor molecular and cellular mechanisms like all steroid hormones estradiol circulates throughout the body via the vascular system and freely diffuses through membranes of cells in the body
In most cases estradiol molecules travel through the cellular cytoplasm and then migrate into the nucleus where the steroid exerts its major effects on cellular functioning steroid hormones including estradiol exert their effects by interacting with a special class of proteins called steroid receptors found in the cells of target tissues these receptor proteins have
Very specific binding properties and therefore associate with steroids and other chemicals in very particular ways estradiol and other estrogenic substances bind to the protein called the estrogen receptor although estradiol binds and activates estrogen receptors in both the cellular membrane and the cytoplasm most of its sustained effects on cellular functioning
Are the result of its interactions with estrogen receptors in the cell’s nucleus in the absence of estradiol estrogen receptors are distributed throughout the cell nucleus these receptor proteins are large complex structures that include a pocket called the ligand binding domain into which estradiol will eventually bind in the absence of estradiol receptors are
Associated with a large cluster of proteins called chaperones that serve to keep the receptor in the correct conformation to allow estradiol to approach and bind to the ligand-binding domain when estradiol enters the nucleus and begins to interact with the receptor the chaperone complex dissociates from the receptor and estradiol binds to the exposed ligand binding
Domain as a result of this interaction receptor complexes form clusters within the nucleus in the region of the chromatin second applications in dentistry estrogen receptor beta has a liberating effect on the osteoprogesterine opg being this protective of inflammatory mechanisms so the woman with a lack of this circulating hormone has an increase in inflammatory
Citizens innovating the formation of new bone consequently promoting reabsorption condylar and decreased bone dentistry next a video in our office we do zero surgery to treat tmj in our office we we we know that ninety percent of headaches come from muscle petite so a lot of the symptoms that people seek out treatment for their tmj are related to pain so what
We know about the muscles is that if we can get them calm then that means they’re in a good balance and if we can get a good balance with the with the teeth how the teeth meet together how the muscles meet together then we can get you in a better better position to where the tmj is not painful or anything like that that being said there may be indications where
Other doctors may need to be involved if you say if you were in a car accident or you know you had some kind of accident where your your bone to bone how they meet are causing issues or physical therapy so there are indications for other modalities in the treatment of this but what we’ve found is that 90 of the time headaches are called just simply by muscle
Fatigue without any accidents causing any tmj problems in our office if you were to come in this is how we would treat you we would take photos we’re going to take a look how the teeth come together if the teeth aren’t coming together properly we know that there’s also going to be a muscle imbalance there if there’s a muscle imbalance there’s going to be fatigue
And that can also relate to headaches so what we what we’ll do is our first course of treatment is to test to see if we can get your bite in a comfortable position and get the muscles relaxed we’ll make what’s called an orthotic that goes on your lower teeth without doing anything permanently to your teeth we’re going to be adjusting the bike we’re going to be
Running computerized scans to see how your bite is tracking and how the muscles are being relieved and there’s all these facets that we’re going to be doing over a six week period of time to see if we can get you comfortable if we can get you comfortable and you start feeling more comfortable then we can find out permanent options for you permanent options may
Be moving your teeth with orthodontics into that position of your of your comfort and other options may be doing porcelain crowns and veneers to get your teeth into that position where they have a home and sometimes it’s a combination of both of those moving your teeth and rebuilding some of the teeth a lot of times when we rebuild some of the teeth a lot of the
Teeth are already worn so much that we don’t have to do a lot of work to the teeth because we’re adding and building up to the teeth so in our office that’s kind of how we treat our tmj patients and surgery is not done in our office third pros and cons prose first the probability that it affects men is low second the severity of symptoms is related to the age
Of the patients third the prevalence is lower for post-menopausal women cons the first they usually occur after purity with a peak in a woman between the ages of 20 and 40. second the prevalence is higher for woman or reproductive age third as there is a low concentration of estrogens its protective role in bowel metabolism would be enhanced increasing inflammation
And reabsorption next a video about a testimony of a patient who suffered from temporomandibular disorder the sad part is all the professionals that you saw no one had a clue no no one had any idea that this i had never had an mri before um before you i mean well we did the first one we started the process and uh i’d never had an mri where are you from i’m from
Rock island tennessee and can you tell us how we met i actually was on the internet looking for any anyone who had tmj problems and i came across uh youtube videos of it was you and people who are see you know visiting you and talking about um how they how you help them and what was your problem why were you looking i just had severe pain in my jaws of wear oh
Yeah it was mostly on the left side but the right side hurt too it was very painful to to eat had you been to other doctors did anyone else yes i’d been to several dentists uh oral surgeon and everyone just always wanted me to wear a splint i was gonna fix it right didn’t fix it we screened you we actually looked with an mri and a ct and we looked at things no
One had ever done that for you beforehand and as i recall we wound up seeing things that we knew were beyond our scope in other words we couldn’t address this with simpler things in general dental world so i referred you on to a tmj surgeon dr piper can you tell us what happened there we um after my visit with you right after we got home like the next week i
Called and you know talked to him about it and said that we i had been to cu like the previous week and uh i just they went ahead and scheduled me an appointment so i went to see him in april of this year and he he had an mri done another one another mri they had done pictures and also a ct scan and he and evidently my problem was it was more severe than what i
Thought and i knew it was going to be bad from what you had told me but it was it was pretty bad the jawbone the avn avascular necrosis right basically the bone was dying and my discs were displaced and inwards and that’s what kinked the blood supply yes yes yep so everyone else was putting you in splints like that was going to fix yes a piece of dying fourth
Issue applied in ecuador in ecuador this issue is little known however there is some information about women with tmd who have a regular menstrual cycle facial pain increases in relation to the drop of estrogen produced in the late luteal phase and reaches its peak during menstruation when estrogen reaches its lowest level and finally the number five conclusion
The tmj degenerates with age between ages 73 to 75. some authors claim that women of child bearing age are less likely to suffer from tmj diseases on the other hand it is more likely to occur in women’s between 35 and 54 years of age because in the article high line cartilages estrogen ceases producing an alteration in the growth of the cartilage predisposing
Women to a greater probability of develop age-related accelerated degeneration of the tmj thanks
Transcribed from video
The Effects of Estrogens Receptor-Beta on Mandibylar Condylar Growth By Abigail Vélez
