Reactive arthritis: Preliminary microbiologic analysis of the human temporomandibular joint

Purpose: The presence of Chlamydia trachomatis has been previously shown in the temporomandibular joint (TMJ). This study investigated whether the pre sence of other bacteria associated with reactive arthritis (ReA) can be ide ntified in the TMJ. Materials and Methods: Posterior bilaminar tissue removed during TMJ surger y from 26 patients (24 F, 2 M) was evaluated for the presence of C trachoma tis, Mycoplasma fermentans, Mycoplasma genitalium, Campylobacter jejuni, Ye rsinia enterocolitica, Salmonella spp, and Shigella spp by highly specific polymerase chain reaction (PCR) assays. Results: Bacterial DNA was identified in the TMJ as follows: C trachomatis, 11 of 26 (42%); M fermentans/orale, 6 of 26 (23%); M genitalium, 9 of 26 ( 35%). Nine of 26 TMJs (35%) had the presence of a single bacterial species. Eight of 26 TMJs (31%) had more than 1 species, as follows: C trachomatis with either M genitalium or M fermentans/orale in 5 of 26; (19%), M ferment ans/orale with M genitalium 2 of 26 (8%), and C trachomatis/M fermentans/or ale/M genitalium, 1 of 26 (4%). A total of 17 of 26 (65%) of TMJs had the p resence of bacteria identified in the TMJ. Campylobacter jejuni, Y enteroco litica, Salmonella spp, and Shigella spp were not identified in any samples . Conclusions: The presence of M genitalium in the human TMJ has not been pre viously reported. The presence of bacteria in the TMJ, either singly or con currently with other bacteria, may serve as the pathogenetic mechanism of T MJ inflammation. The presence of 2 bacteria from the urogenital tract in th e TMJ suggests that internal derangement of the TMJ may occur as a result o f a sexually acquired infection. (C) 2000 American Association of Oral and Maxillofacial Surgeons.