. 2011 Mar;5(1):18–25. doi: 10.1177/204946371100500104

Table 2.

Potential actions of free radicals on TMJ articular system

1) Free radicals are proposed to damage the biomechanical properties of the articular tissues. The damaged articular tissues are then more susceptible to any further mechanical stresses placed upon them. This vicious circle is continued by the release of extracellular matrix degradation products from the damaged articular tissue. These degradation products attract inflammatory cells resulting in the release of cytokines that help further degrade the articular tissues¹⁵.

2) Alongside mechanical stress, free radicals present in the joint space can stimulate the release of neuropeptides and Nitric Oxide from peripheral sensory nerve endings^{23, 25, 26, 69}. The neuropeptides and Nitric oxide help increase the localised inflammatory response within the TMJ system and thereby contribute to further damaging the articular tissues through production of further free radicals and cytokines.

3) Free radicals can help produce adhesions within the joint space^24,27.

4) Free radicals play a role in changing the lubrication system within the TMJ through inhibiting hyaluronic acid synthesis and facilitating the degradation of the articular surfaces' phospholipids¹⁹.