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Altun BD, Bayramov N, Yalcinkaya SE. Radiological Associations between Posterior Edentulism and Condylar Bony Changes: A Retrospective Study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101650. [PMID: 37777182 DOI: 10.1016/j.jormas.2023.101650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023]
Abstract
This retrospective study aimed to investigate the relationship between posterior edentulism and condylar bone changes in patients aged 35-60 years. The CBCT images of 259 patients, including 131 posterior edentulous and 128 posterior dentulous patients, were analyzed to identify the types of condylar bone changes. The frequency of flattening, sclerosis, erosion, and reduced joint space was found to be higher in posterior edentulous patients. Regression analysis revealed that combined premolar and molar loss and being female were significant predictors of condylar erosion (p = 0.006; OR: 3.264; 95% CI: 1.401 - 7.603, p=0.031; OR: 2.652; %95 CI: 1.095 - 6.424). The study provides support for the domino effect phenomenon in temporomandibular joint pathology, indicating that posterior edentulism can have a significant impact on the occurrence of erosive condylar changes. The findings suggest that prosthetic and temporomandibular joint treatment approaches should consider the association between posterior edentulism and condylar bone changes, particularly in female patients with combined premolar and molar loss. Therefore, close attention should be paid to the management of these patients to minimize the risk of temporomandibular joint pathology.
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Affiliation(s)
- Busra Dilara Altun
- Marmara University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Istanbul, Turkey.
| | - Nuran Bayramov
- Istanbul Aydin University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Istanbul, Turkey
| | - Sebnem Ercalik Yalcinkaya
- Marmara University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Istanbul, Turkey
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Simonek M, Türp JC, Bornstein MM, Dagassan-Berndt D. Prevalence and correlation with sex, age, and dental status of bone apposition at the mandibular angle and radiographic alterations of the temporomandibular joints: a retrospective observational study in an adult Swiss population. BMC Oral Health 2024; 24:193. [PMID: 38321445 PMCID: PMC10845652 DOI: 10.1186/s12903-024-03855-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND The purpose of this study was to determine the prevalence of radiographic changes in the mandibular angle (bone apposition) and osseous alterations in the temporomandibular joints (TMJs) in the adult population of Switzerland. In addition, the study intended to investigate possible correlations between the two sites of contour bone changes (mandibular angle and TMJ) and to analyze various patient-related factors, including sex, age, dental status, and medical history. METHODS Panoramic radiographs of 600 patients distributed into six age groups (283 females, 317 males, aged 20 to 79 years) were included to evaluate radiographic changes. The bone in the mandibular angle region and the shape of the condylar heads were examined for contour changes (bone apposition at the jaw angles and osseous changes of the TMJs). General estimating equations, binormal tests, and chi-squared tests were used for statistical analysis. RESULTS Approximately half of the mandibular angles (47.8%) showed bone apposition, mostly bilateral. TMJ alterations were less common (27%), often unilateral, with flattening being the most frequent finding. No significant correlation was found between the two sites. Bone apposition at the mandibular angle showed a significant male predominance, whereas TMJ changes did not differ by sex. Alterations in both sites increased with age, and were not related to dental status or analgesic use. CONCLUSIONS Bone apposition at the mandibular angle should be interpreted as part of the natural functional adaptation of the bone associated with aging. Assuming that parafunctional habits may influence the development and progression of alterations in the mandibular angle or TMJs, the presence of radiographic changes in these areas should prompt dental clinicians to investigate further in this direction. TRIAL REGISTRATION The study was approved by the Swiss Association of Research Ethics Committees (swissethics), BASEC reference number: 2020-00963 (25.05.2020).
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Affiliation(s)
- Michelle Simonek
- Department of Oral Surgery, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland.
| | - Jens Christoph Türp
- Division of Temporomandibular Disorders and Orofacial Pain, Department of Oral Health & Medicine, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
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Zheng H, Shi L, Lu H, Liu Z, Yu M, Wang Y, Wang H. Influence of edentulism on the structure and function of temporomandibular joint. Heliyon 2023; 9:e20307. [PMID: 37829806 PMCID: PMC10565695 DOI: 10.1016/j.heliyon.2023.e20307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 09/11/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
Background With the acceleration of the aging process of the population, the number of edentulous patients continuously increased. Edentulism induces the loss of occlusal relationship and cause adverse effects on the stomatognathic system. Temporomandibular joint (TMJ), as a significant component of this system, may also be affected by edentulism in the process of supporting mandibular movement. Purpose Provide a comprehensive review of the structure and function of TMJ in the edentulous population, as well as the prevalence of temporomandibular joint disorder (TMD) in edentulous group. Study selection An electronic search was conducted on articles prior to December 2022 to filter all papers relevant to the structure and function of TMJ in edentulous population. The internet databases (PubMed, Cochrane Library, Embase) were searched using various combinations of keywords for "edentulism" or "edentulous" and "TMJ" or "TMD". Results Firstly, 522 articles were selected from the internet database, and finally, a total of 44 articles met the inclusion and exclusion criteria. The research content of these articles mainly focuses on the structure and function of TMJ in edentulous patients, as well as the clinical signs and symptoms of TMD. Conclusions Edentulous arch induces the loss of occlusal relationship, which may lead to degenerative changes of TMJ components consisting of changes in morphology and bone mass density of condyle, articular fossa, and articular eminence. In addition, the condyle could be shifted backward and upward, and displacement of the articular disc may occur after dentition loss. And the condyle and the articular disc may be guided back to the normal position after effective prosthodontic treatment. But the conclusions of the study on the function of TMJ and the prevalence of TMD in edentulous people are inconsistent. The condition of TMJ, especially the position of condyle-fossa and the symptoms and signs of TMD should not be ignored. If necessary, radiographic examinations should be performed.
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Affiliation(s)
- Huiyun Zheng
- Department of Oral Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Qiutao North Road 166, Hangzhou 310020, China
| | - Lei Shi
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Qiutao North Road 166, Hangzhou 310020, China
| | - Hongye Lu
- Department of Prosthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Qiutao North Road 166, Hangzhou 310020, China
| | - Zhichao Liu
- Department of Oral Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Qiutao North Road 166, Hangzhou 310020, China
| | - Mengfei Yu
- Department of Oral Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Qiutao North Road 166, Hangzhou 310020, China
| | - Yu Wang
- Department of Oral Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Qiutao North Road 166, Hangzhou 310020, China
| | - Huiming Wang
- Department of Oral Implantology, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Qiutao North Road 166, Hangzhou 310020, China
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Santana-Penín U, Santana-Mora U, López-Solache A, Mora MJ, Collier T, Pocock SJ, Lorenzo-Franco F, Varela-Centelles P, López-Cedrún JL. Remodeling dental anatomy vs sham therapy for chronic temporomandibular disorders. A placebo-controlled randomized clinical trial. Ann Anat 2023; 250:152117. [PMID: 37302432 DOI: 10.1016/j.aanat.2023.152117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/08/2023] [Accepted: 05/20/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence regarding the etiology or effective treatments for chronic orofacial pain, the majority diagnosed as temporomandibular disorder (TMD), is limited. PURPOSE To investigate whether occlusal equilibration therapy (ET) and decreasing the (higher) angle of the lateral guidance on the nonworking-side leads to a reduction in chronic TMDs intensity. METHODS It was conducted a randomized, explanatory, single blind with blinded assessment, placebo-controlled trial with strong protection against bias involving patients with chronic TMDs. Participants were randomly assigned to receive equilibration therapy or sham therapy. ET in this study consisted of minimal invasive occlusal remodeling to obtain balanced occlusion with reduction of the steeper angle of lateral mandibular movement with respect to the Frankfort plane. The primary outcome was a change in the pain intensity score (on a 0-10 point scale, with 0 indicating no pain and 10 the worst possible pain) at month 6. Secondary outcomes include maximum unassisted mouth opening and psychological distress. RESULTS A total of 77 participants underwent randomization, 39 of whom received ET and 38 sham therapy. The trial was stopped early for efficacy, according to preestablished rules when 67 participants (n = 34, n = 33, respectively) had completed the analysis. At month 6, the mean unadjusted pain intensity score was 2.1 in the ET and 3.6 in the sham therapy group (adjusted mean difference, -1.54; 95% confidence interval [CI] -0.5 to -2.6; P = 0.004; ANCOVA model). The mean increase in maximum unassisted mouth opening (main secondary outcome) was significantly higher in the real therapy group (adjusted mean difference 3.1 mm, 95% CI 0.5-5.7, p = 0.02). CONCLUSION ET significantly reduced the intensity of facial pain associated with chronic TMDs and increased maximum unassisted mouth opening, as compared with sham therapy, over the course of 6 months. There were no serious adverse events. Funded by the Instituto de Salud Carlos III from the Ministry of Science and Innovation of the Government of Spain and European Regional Development Fund, Grant nº PI11/02507; "una manera de hacer Europa".
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Affiliation(s)
- Urbano Santana-Penín
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Urbano Santana-Mora
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Alicia López-Solache
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - María Jesús Mora
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Timothy Collier
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stuart J Pocock
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Pablo Varela-Centelles
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - José Luís López-Cedrún
- Oral and Maxillofacial Surgery Service, University Hospital of A Coruña, A Coruña, Spain
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Mercuri LG. Temporomandibular Joint Facts and Foibles. J Clin Med 2023; 12:jcm12093246. [PMID: 37176685 PMCID: PMC10179705 DOI: 10.3390/jcm12093246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The purpose of this article is to dispel some of the major foibles associated with the etiology and management of TMJ disorders, while presenting some of the facts based on the scientific literature to date. To appreciate this kind of update, the reader must be an "out of the box thinker" which requires openness to new ways of seeing the world and a willingness to accept new concepts based on evolving evidence.
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Affiliation(s)
- Louis Gerard Mercuri
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
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Matuck B, Ferraz da Silva LF, Warner BM, Byrd KM. The need for integrated research autopsies in the era of precision oral medicine. J Am Dent Assoc 2023; 154:194-205. [PMID: 36710158 PMCID: PMC9974796 DOI: 10.1016/j.adaj.2022.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/18/2022] [Accepted: 11/20/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Autopsy has benefited the practice of medicine for centuries; however, its use to advance the practice of oral health care is relatively limited. In the era of precision oral medicine, the research autopsy is poised to play an important role in understanding oral-systemic health, including infectious disease, autoimmunity, craniofacial genetics, and cancer. TYPES OF STUDIES REVIEWED The authors reviewed relevant articles that used medical and dental research autopsies to summarize the advantages of minimally invasive autopsies of dental, oral, and craniofacial tissues and to outline practices for supporting research autopsies of the oral and craniofacial complex. RESULTS The authors provide a historical summary of research autopsy in dentistry and provide a perspective on the value of autopsies for high-resolution multiomic studies to benefit precision oral medicine. As the promise of high-resolution multiomics is being realized, there is a need to integrate the oral and craniofacial complex into the practice of autopsy in medicine. Furthermore, the collaboration of autopsy centers with researchers will accelerate the understanding of dental, oral, and craniofacial tissues as part of the whole body. CONCLUSIONS Autopsies must integrate oral and craniofacial tissues as part of biobanking procedures. As new technologies allow for high-resolution, multimodal phenotyping of human samples, using optimized sampling procedures will allow for unprecedented understanding of common and rare dental, oral, and craniofacial diseases in the future. PRACTICAL IMPLICATIONS The COVID-19 pandemic highlighted the oral cavity as a site for viral infection and transmission potential; this was only discovered via clinical autopsies. The realization of the integrated autopsy's value in full body health initiatives will benefit patients across the globe.
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Affiliation(s)
- Bruno Matuck
- Department of Pathology, School of Medicine University of São Paulo, São Paulo, Brazil
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Blake M. Warner
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Kevin Matthew Byrd
- Salivary Disorders Unit, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
- Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lab of Oral & Craniofacial Innovation (LOCI), Department of Innovation and Technology Research, ADA Science & Research Institute, Gaithersburg, MD, USA
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Magnetic resonance imaging and fractal analysis findings in temporomandibular joints with disk perforation. Oral Surg Oral Med Oral Pathol Oral Radiol 2023:S2212-4403(23)00002-0. [PMID: 36890079 DOI: 10.1016/j.oooo.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/23/2022] [Accepted: 01/01/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study compared magnetic resonance imaging (MRI) findings and fractal dimension (FD) values in the temporomandibular joints (TMJs) of study patients with disk perforation vs control patients. STUDY DESIGN Of 75 TMJs examined with MRI for characteristics of the disk and condyle, 45 were included in the study group and 30 in the control group. MRI findings and FD values were compared for significance of differences between the groups. The frequency of subclassifications was analyzed for differences between the two forms of disk configuration and grades of effusion. Mean FD values were analyzed for differences among subclassifications of MRI findings and between groups. RESULTS Examination of MRI variables revealed that the study group had significantly greater frequencies of flattened disks, disk displacement, flattening and combined defects in condylar morphology, and grade 2 effusion (P = .001) Joints with perforated disks had a large percentage of normal disk-condyle relationships (73.3%). Significant differences were discovered between biconcave and flattened disk configuration in the frequencies of internal disk status and condylar morphology. FD values of all patients varied significantly among the subclassifications of disk configuration, internal disk status, and effusion. Mean FD values were significantly lower in the study group with perforated disks (1.07) compared with the control group (1.20, P = .001). CONCLUSIONS MRI variables and FD can be useful in investigating intra-articular TMJ status.
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Nussi AD, de Castro Lopes SLP, De Rosa CS, Gomes JPP, Ogawa CM, Braz-Silva PH, Costa ALF. In vivo study of cone beam computed tomography texture analysis of mandibular condyle and its correlation with gender and age. Oral Radiol 2023; 39:191-197. [PMID: 35585223 DOI: 10.1007/s11282-022-00620-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/24/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Texture analysis is an image processing method that aims to assess the distribution of gray-level intensity and spatial organization of the pixels in the image. The purpose of this study was to investigate whether the texture analysis applied to cone beam computed tomography (CBCT) images could detect variation in the condyle trabecular bone of individuals from different age groups and genders. METHODS The sample consisted of imaging exams from 63 individuals divided into three groups according to age groups of 03-13, 14-24 and 25-34. For texture analysis, the MaZda® software was used to extract the following parameters: second angular momentum, contrast, correlation, sum of squares, inverse difference moment, sum entropy and entropy. Statistical analysis was performed using Mann-Whitney test for gender and Kruskal-Wallis test for age (P = 5%). RESULTS No statistically significant differences were found between age groups for any of the parameters. Males had lower values for the parameter correlation than those of females (P < 0.05). CONCLUSION Texture analysis proved to be useful to discriminate mandibular condyle trabecular bone between genders.
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Affiliation(s)
- Amanda Drumstas Nussi
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade, São Paulo, SP, 01506-000, Brazil
| | - Sérgio Lucio Pereira de Castro Lopes
- Department of Diagnosis and Surgery, Science and Technology Institute, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Catharina Simioni De Rosa
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, SP, Brazil
| | - João Pedro Perez Gomes
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Celso Massahiro Ogawa
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade, São Paulo, SP, 01506-000, Brazil
| | - Paulo Henrique Braz-Silva
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, SP, Brazil
- Laboratory of Virology, Institute of Tropical Medicine of São Paulo, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Andre Luiz Ferreira Costa
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade, São Paulo, SP, 01506-000, Brazil.
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Dahal S, Atreya A, Gupta SP, Natarajan S. Oval Type of Human Mandibular Condyle in Panoramic Radiographs of a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:525-528. [PMID: 35690981 PMCID: PMC9275460 DOI: 10.31729/jnma.7416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/30/2022] [Indexed: 11/01/2022] Open
Abstract
Introduction Mandibular condyle is a prominent structure in the mandible, which forms the temporomandibular joint. An oval-shaped condyle is considered to be present with a normal temporomandibular joint and any morphological variation of the condyle is assumed to be pathologic in temporomandibular disorders. The aim of the study was to find out the prevalence of oval shaped mandibular condyle among orthopantomogram radiographs of patients visiting the tertiary care centre. Methods A descriptive cross-sectional study was performed among 752 condyles visiting a tertiary care center from November 29, 2021 to April 1, 2022. The ethical approval was taken from the Institutional Review Committee (Reference number: 184 (6-11) 078/079) before conducting the study. Convenience sampling was done. The radiographs were first examined and the observed morphological type of mandibular condyle was noted. Data analysis was done using Statistical Package for the Social Sciences version 22.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results The prevalence of oval shaped mandibular condyles out of 752 condyles was 416 (55.32%) (51.77-58.87 at 95% Confidence Interval). The oval-shaped condyle on the right side was 205 (54.52%) and on the left side was 211 (56.12%). Conclusions The prevalence of oval shaped condyles among patients in this study was similar to the studies done in similar settings. Keywords condyle; mandible; Nepal; X-ray.
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Affiliation(s)
- Samarika Dahal
- Department of Oral Pathology and Forensic Dentistry, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal,Correspondence: Dr Samarika Dahal, Department of Oral Pathology and Forensic Dentistry, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal. , Phone: +977-9841363051
| | - Alok Atreya
- Department of Forensic Medicine, Lumbini Medical College, Tansen, Palpa, Nepal
| | - Sanjay Prasad Gupta
- Department of Orthodontics and Dentofacial Orthopedics, Maharajgunj Medical Campus, Institute of Medicine, Maharajgunj, Kathmandu, Nepal
| | - Srikant Natarajan
- Department of Oral Pathology and Microbiology, Manipal College of Dental Sciences, Mangalore, Karnataka, India
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Patil D, Koshal N, Laller S, Malik M, Punia R, Sawhney H. Assessment of correlation between bone quality and degenerative bone changes in temporomandibular joint by computed tomography -A retrospective study. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2021. [DOI: 10.4103/jiaomr.jiaomr_230_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Altan Şallı G, Öztürkmen Z. Semi-automated three-dimensional volumetric evaluation of mandibular condyles. Oral Radiol 2020; 37:66-73. [PMID: 32020494 DOI: 10.1007/s11282-020-00426-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/24/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study is to research the mandibular condyle volumes of the Turkish subpopulation by sex, age, laterality, and posterior occlusal support, to provide volumetric data for young and old patient groups. METHODS The CBCT images of 690 condyles from 345 patients (165 females and 180 males) were assessed. Patients aged 18-25 years were chosen for the younger group, and 45-70 years for the older group. The dental statuses of the older patient group were divided into three categories, based on the Eichner index. All the CBCT images were transferred to the three-dimensional volumetric analysis software, ITK-Snap (Penn Image Computing and Science Laboratory (PICSL) at the University of Pennsylvania and Scientific Computing and Imaging Institute (SCI) at the University of Utah) and analyzed with sagittal, coronal, and axial sections. Mandibular condyles were defined using semi-automatic segmentation, then manual segmentation was performed to ensure accuracy. Analyses were performed using MedCalc statistical software. The p value < 0.05 was considered statistically significant. RESULTS The mean right condyle volume for the whole sample (n = 345) was 1678.8 mm3 and the left condyle volume was 1661.3 mm3. Males had a larger condyle volume than females in both the younger and older patient groups (p = 0.035, p < 0.01, respectively). The Eichner index did not correlate significantly with condylar volume in the older patient group (p = 0.134, p = 0.122). CONCLUSION There were significant differences between the volumes of mandibular condyles for different sex, while there were no significant differences in relation to age, laterality, and posterior occlusal support.
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Affiliation(s)
- Gülay Altan Şallı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Beykent University, Avalon Campus, F416, Beylikduzu, Istanbul, Turkey.
| | - Zeynep Öztürkmen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Biruni University, Istanbul, Turkey
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Gender and Age Differences of Temporomandibular Joint Disc Perforation: A Cross-Sectional Study in a Population of Patients With Temporomandibular Disorders. J Craniofac Surg 2019; 30:1497-1498. [PMID: 31299752 DOI: 10.1097/scs.0000000000005146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The presence or absence of disc perforation (DP) has great value for the treatment planning of temporomandibular disorders (TMDs). Epidemiologic features of DP are limited in the literature. The present study investigated the epidemiologic features of DP by retrospectively reviewing 13,556 temporomandibular joint arthrographic examinations. Pearson Chi-squared test demonstrated that the rate of male patients who received the examinations more than once was significantly lower than that of female patients and the rate of DP in males was significantly lower than that in females. The age of all patients showed a bimodal distribution, with a 1st peak around 21 years of age, and a 2nd peak around 53 years of age. Linear regression analysis showed that the rate of DP was positively correlated with ages. The DP rate was increased by 0.3% for every 1 year of age. This retrospective cross-sectional study validated some findings about the gender and age differences of temporomandibular joint DP in the literature, and more importantly uncovered the exact relationship between the DP rate and the age in a large TMD patient population.
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Tran Duy TD, Chen MC, Wen-Ching Ko E, Chen YR, Huang CS. Does Sleep Quality Affect Temporomandibular Joint With Degenerative Joint Changes? J Oral Maxillofac Surg 2019; 77:1594-1601. [DOI: 10.1016/j.joms.2019.02.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/12/2019] [Accepted: 02/15/2019] [Indexed: 12/16/2022]
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Correlation between pain and MRI findings in TMD patients. J Craniomaxillofac Surg 2018; 46:1167-1171. [PMID: 29884310 DOI: 10.1016/j.jcms.2017.12.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/17/2017] [Accepted: 12/27/2017] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Magnetic resonance imaging has been established as the gold standard for assessment of the temporomandibular joint. Apart from an excellent assessment of the soft tissues it has the advantage not to expose the patient to ionizing radiation. There is a lack of literature concerning the correlation between pain intensity and radiological findings of the temporomandibular joint. Moreover there is the question of whether a progressive degeneration of the cartilaginous components is accompanied by an increasing degeneration of the osseous parts of the mandibular joint and vice versa. Therefore, this study aims at analyzing correlations between pain and radiological findings. Furthermore, the link between osseous and cartilaginous degeneration is studied. MATERIALS AND METHODS 91 patients who attend our outpatient clinic for temporomandibular disorders are included in this prospective study. Apart from a detailed anamnesis and clinical examination - adapted to the Research Diagnostic Criteria for Temporomandibular Disorders -magnetic resonance imaging of both mandibular joints is performed. Pain intensity is measured using the visual analog scale. To assess and grade the radiological findings a classification system is established. The evaluation of the osseous components is based on the classification of osteoarthritis by Kellgren and Lawrence whereas the rating of the cartilaginous components is adapted to the Research Diagnostic Criteria for Temporomandibular Disorders. Correlations are verified by Spearman-Rho. RESULTS 83,5% of all patients are female. Most of the time, both sides are affected (47.25%). Women state an average pain of 5.7 (±2.4), men 3.5 (±2.5). 182 discs are examined and assessed with our classification system. Most discs (n = 71) show no pathological changes. The majority of patients show no dislocation (n = 104). The most common forms of dislocation are anterior dislocations (n = 51). The majority of patients show no changes in the osseous component (n = 115). Weak to moderate correlations are found between disc and bone degeneration. Moderate to strong correlations are found between left and right TMJ. CONCLUSIONS The classification system which is designed and applied during the study proves to be a reliable and practical Instrument. A standardized evaluation of pathologies concerning the temporomandibular joint is possible by using this system. Numerous patients attending our outpatient clinic do not show any signs of degenerative dysfunctions in the mandibular joints. Degenerations of the osseous components tend to be connected with degenerations of the cartilaginous components and vice versa. The question remains if in the future new procedures in imaging will be able to record pathologies not yet detected.
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Feng Y, Ke J, Cao P, Deng M, Li J, Cai H, Meng Q, Li Y, Long X. HMGB1-induced angiogenesis in perforated disc cells of human temporomandibular joint. J Cell Mol Med 2017; 22:1283-1291. [PMID: 29083089 PMCID: PMC5783830 DOI: 10.1111/jcmm.13410] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 08/29/2017] [Indexed: 11/29/2022] Open
Abstract
High mobility group 1 protein (HMGB1), a highly conserved nuclear DNA‐binding protein and inflammatory mediator, has been recently found to be involved in angiogenesis. Our previous study has demonstrated the elevation of HMGB1 in the tissue of perforated disc of temporomandibular joint (TMJ). Here, we investigated a novel mediator of HMGB1 in regulating hypoxia‐inducible factor‐1α (HIF‐1α) and vascular endothelial growth factor (VEGF) to mediate angiogenesis in perforated disc cells of TMJ. HMGB1 increased the expression of HIF‐1α and VEGF in a dose‐ and time‐dependent manner in these cells. Moreover, immunofluorescence assay exhibits that the HIF‐1α were activated by HMGB1. In addition, HMGB1 activated extracellular signal‐related kinase 1/2 (Erk1/2), Jun N‐terminal kinase (JNK), but not P38 in these cells. Furthermore, both U0126 (ErK inhibitor) and SP600125 (JNK inhibitor) significantly suppressed the enhanced production of HIF‐1α and VEGF induced by HMGB1. Tube formation of human umbilical vein endothelial cells (HUVECs) was significantly increased by exposure to conditioned medium derived from HMGB1‐stimulated perforated disc cells, while attenuated with pre‐treatment of inhibitors for VEGF, HIF‐1α, Erk and JNK, individually. Therefore, abundance of HMGB1 mediates activation of HIF‐1α in disc cells via Erk and JNK pathway and then, initiates VEGF secretion, thereby leading to disc angiogenesis and accelerating degenerative change of the perforated disc.
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Affiliation(s)
- Yaping Feng
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Jin Ke
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Pinyin Cao
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST), Key Laboratory of Oral Biomedicine Ministry of Education (KLOBM), School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Mohong Deng
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Jian Li
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Hengxing Cai
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Qinggong Meng
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Yingjie Li
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Xing Long
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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Lei J, Han J, Liu M, Zhang Y, Yap AUJ, Fu KY. Degenerative temporomandibular joint changes associated with recent-onset disc displacement without reduction in adolescents and young adults. J Craniomaxillofac Surg 2017; 45:408-413. [DOI: 10.1016/j.jcms.2016.12.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 11/06/2016] [Accepted: 12/13/2016] [Indexed: 11/16/2022] Open
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Disk displacement, eccentric condylar position, osteoarthrosis - misnomers for variations of normality? Results and interpretations from an MRI study in two age cohorts. BMC Oral Health 2016; 16:124. [PMID: 27855674 PMCID: PMC5114831 DOI: 10.1186/s12903-016-0319-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 11/09/2016] [Indexed: 01/25/2023] Open
Abstract
Background Clinical decision-making and prognostic statements in individuals with manifest or suspected temporomandibular disorders (TMDs) may involve assessment of (a) the position of articular disc relative to the mandibular condyle, (b) the location of the condyle relative to the temporal joint surfaces, and (c) the depth of the glenoid fossa of the temporomandibular joints (TMJs). The aim of this study was twofold: (1) Determination of the prevalence of these variables in two representative population-based birth cohorts. (2) Reinterpretation of the clinical significance of the findings. Methods From existing magnetic resonance imaging (MRI) scans of the TMJs that had been taken in 2005 and 2006 from 72 subjects born between 1930 and 1932 and between 1950 and 1952, respectively, the condylar position at closed jaw was calculated as percentage displacement of the condyle from absolute centricity. By using the criteria introduced by Orsini et al. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:489-97, 1998), a textbook-like disc position at closed jaw was distinguished from an anterior location. TMJ morphology of the temporal joint surfaces was assessed at open jaw by measuring the depth of the glenoid fossa, using the method proposed by Muto et al. (J Oral Maxillofac Surg 52:1269-72, 1994). Frequency distributions were recorded for the condylar and disc positions at closed jaw. Student’s t-test with independent samples was used as test of significance to detect differences of condylar positions between the age cohorts (1930 vs. 1950) and the sexes. The significance levels were set at 5%. First, the results from the measurement of the age cohorts were compared without differentiation of sexes, i.e., age cohort 1930–1932 versus age cohort 1950–1952. Subsequently, the age cohorts were compared by sex, i.e., men in cohort 1930–1932 versus men in cohort 1950–1952, and women in cohort 1930–1932 women men in cohort 1950–1952. Results In both cohorts, condylar position was characterized by great variability. About 50% of the condyles were located centrically, while the other half was either in an anterior or in a posterior position. In both female cohorts, a posterior position predominated, whereas a centric position prevailed among men. Around 75% of the discs were positioned textbook-like, while the remaining forth was located anteriorly. Age had no statistically significant influence on condylar or on disc position. Conversely, comparison between the age groups revealed a statistically significant decrease of the depth of the glenoid fossa in both older cohorts. This age-dependent changes may be interpreted as flattening of the temporal joint surfaces. Conclusions We call for a re-interpretation of imaging findings because they may insinuate pathology which usually is not present. Instead, anterior or posterior positions of the mandibular condyle as well as an anterior location of the articular disc should be construed as a variation of normalcy. Likewise, flattening of articular surfaces of the TMJs may be considered as normal adaptive responses to increased loading, rather than pathological degenerative changes. Trial registration Not applicable.
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Lazarin R, Previdelli I, Silva R, Iwaki L, Grossmann E, Filho L. Correlation of gender and age with magnetic resonance imaging findings in patients with arthrogenic temporomandibular disorders: a cross-sectional study. Int J Oral Maxillofac Surg 2016; 45:1222-8. [DOI: 10.1016/j.ijom.2016.04.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 02/29/2016] [Accepted: 04/25/2016] [Indexed: 11/27/2022]
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Kim K, Wojczyńska A, Lee JY. The incidence of osteoarthritic change on computed tomography of Korean temporomandibular disorder patients diagnosed by RDC/TMD; a retrospective study. Acta Odontol Scand 2016; 74:337-42. [PMID: 26881919 DOI: 10.3109/00016357.2015.1136678] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective Osteoarthritis (OA) of the temporomandibular joint (TMJ) is generally thought to be an age-related disease like those of other joints. This study aims to investigate the incidence of computed tomographic (CT) OA changes in Korean temporomandibular disorder (TMD) patients diagnosed by the Research Diagnostic Criteria for TMD (RDC/TMD). Materials and methods The clinical records and radiographs of 1038 TMD patients (297 men and 741 women with mean age 31.1 ± 17.4 and 34.0 ± 16.2, respectively) diagnosed based on RDC/TMD Axis I in 2010 were reviewed. Results The incidence rate of OA changes in TMD patients is estimated to 27.3%, and higher in women than in men (15.5% in men and 32.0% in women) by 2.3 odds (p < 0.001). It has no correlation with age, showing an almost flat incidence rate throughout the age from the 2nd decade and has no correlation as well with pain or disc displacement diagnosed according to RDC/TMD, while arthrosis/arthritis diagnosis based on RDC/TMD supplemented by plain radiographs shows high risk of OA changes on CT by 38.8 odds (p < 0.05). Conclusions These results imply that the OA changes in young Korean TMD patients are as common as in the old and have no correlation with clinical pain and noise. Considered with high prevalence of TMDs known in the young population, the overall/absolute OA changes in the TMJ can be even higher in the young than in the old population, not like in other joints.
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Affiliation(s)
- Kilyong Kim
- Department of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University, Daehak-Ro 101, Jongno-Gu, Seoul, 110-744, Korea (ROK)
| | - Aleksandra Wojczyńska
- Clinic of Masticatory Disorders, Removable Prosthodontics, Geriatric and Special Care Dentistry, Center of Dental Medicine, University of Zürich, Plattenstrasse 11, CH-8032, Switzerland
| | - Jeong-Yun Lee
- Department of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University, Daehak-Ro 101, Jongno-Gu, Seoul, 110-744, Korea (ROK)
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Headache or facial pain attributed to disorders of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cranial structures. HANDBOOK OF CLINICAL NEUROLOGY 2016. [PMID: 20816460 DOI: 10.1016/s0072-9752(10)97054-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register]
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No proven correlations between bone quality and degenerative bone changes in the mandibular condyle and articular eminence in temporomandibular joint dysfunction. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0206-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Pancherz H, Salé H, Bjerklin K. Signs and symptoms of TMJ disorders in adults after adolescent Herbst therapy: a 6-year and 32-year radiographic and clinical follow-up study. Angle Orthod 2015; 85:735-42. [PMID: 25551426 DOI: 10.2319/072914-530.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To analyze radiographic signs of temperomandibular joint (TMJ) osteoarthritis and clinical TMJ symptoms in patients 6 years and 32 years after treatment with a Herbst appliance. MATERIALS AND METHODS Fourteen patients were derived from a sample of 22 with Class II division 1 malocclusions consecutively treated with a banded Herbst appliance at the age of 12-14 years old (T1-T2). The subjects were reexamined after therapy at the ages of 20 years (T3) and 46 years (T4). The TMJs of the 14 patients were analyzed radiographically (conventional lateral tomography at T3 and cone-beam computed tomography at T4) and clinically/anamnestically at T3 and T4. RESULTS Six years after Herbst therapy, signs of osteoarthritis were seen in one patient. At the 32-year follow-up, two additional patients had developed signs of osteoarthritis. At the 6-year follow-up, TMJ clicking was present in two patients, though none of the patients reported TMJ pain. At the 32-year follow-up, six patients had TMJ clicking and one patient had TMJ pain. CONCLUSIONS This longitudinal very-long-term follow-up study after Herbst therapy revealed only minor problems from the TMJ. The TMJ findings 6 years and 32 years after Herbst treatment corresponded to those in the general population. Thus, in the very long term, the Herbst appliance does not appear to be harmful to the TMJ.
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Affiliation(s)
- Hans Pancherz
- a Professor and Chair Emeritus, Department of Orthodontics, University of Giessen, Giessen, Germany
| | - Hanna Salé
- b Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Sweden
| | - Krister Bjerklin
- c Associate Professor, Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden
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Guarda-Nardini L, Piccotti F, Mogno G, Favero L, Manfredini D. Age-Related Differences in Temporomandibular Disorder Diagnoses. Cranio 2014; 30:103-9. [DOI: 10.1179/crn.2012.015] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Cho BH, Jung YH. Osteoarthritic changes and condylar positioning of the temporomandibular joint in Korean children and adolescents. Imaging Sci Dent 2012; 42:169-74. [PMID: 23071967 PMCID: PMC3465759 DOI: 10.5624/isd.2012.42.3.169] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 06/07/2012] [Accepted: 06/14/2012] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the prevalence of osteoarthritic changes and condylar positioning of the temporomandibular joint (TMJ) in Korean children and adolescents with or without temporomandibular disorders (TMDs). Materials and Methods A total of 101 asymptomatic and 181 symptomatic children and adolescents aged 10 to 18 years old were included in the study. Osteoarthritic changes such as flattening, sclerosis, osteophytes, or erosion, and the parasagittal positioning of the condyle were assessed using cone-beam computed tomography (CBCT) images. Results The overall prevalence of osteoarthritic changes was higher in symptomatic (26.8%) than in asymptomatic adolescents (9.9%) (p<0.05). In the symptomatic group, the frequency was higher in males (33.3%) than in females (23.0%) (p<0.05). Erosion was the most common change for the symptomatic group (15.6%), whereas sclerosis was the most common change for the asymptomatic group (5.4%). Posterior condylar position was more frequently observed in the symptomatic group (p<0.05). Erosion was more common in the samples with TMJ pain or mouth opening limitations as compared to those without them (p<0.05). Conclusion This study showed that osteoarthritic changes in TMJ were common in children and adolescents, with a much higher prevalence in symptomatic patients.
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Affiliation(s)
- Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
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Levartovsky S, Gavish A, Nagar Y, Sarphati L, Levartovsky D, Winocur E. The association between dental status and temporomandibular osseous changes: a morphological study on Roman-Byzantine skeletons. J Oral Rehabil 2012; 39:888-95. [DOI: 10.1111/joor.12001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2012] [Indexed: 11/30/2022]
Affiliation(s)
- S. Levartovsky
- Department of Oral Rehabilitation; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv
| | - A. Gavish
- Department of Oral and Maxillofacial Surgery; Beilinson Hospital; Rabin Medical Center; Sackler School of Medicine; Tel Aviv University; Tel Aviv
| | - Y. Nagar
- Department of Interdisciplinary Studies; Israel Antiquities Authority; Jerusalem
| | - L. Sarphati
- The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv
| | - D. Levartovsky
- Department of Rheumatology; Sourasky Medical Center; Sackler School of Medicine; Tel Aviv University; Tel Aviv Israel
| | - E. Winocur
- Department of Oral Rehabilitation; The Maurice and Gabriela Goldschleger School of Dental Medicine; Tel Aviv University; Tel Aviv
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Barghan S, Tetradis S, Mallya S. Application of cone beam computed tomography for assessment of the temporomandibular joints. Aust Dent J 2012; 57 Suppl 1:109-18. [PMID: 22376103 DOI: 10.1111/j.1834-7819.2011.01663.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Radiographic examination is essential for the diagnosis and management of temporomandibular joint (TMJ) disorders. The goals of TMJ radiography are to evaluate cortical and trabecular architecture of the bony structures and confirm their integrity, to assess the extent and monitor progression of osseous changes, and to evaluate the response to treatment. Accurate evaluation of the TMJ by conventional radiography is limited by structure superimposition. Cone beam computed tomography (CBCT) provides high-resolution multiplanar images and delivers substantially lower radiation dose, compared with multislice CT. CBCT allows examination of TMJ anatomy without superimposition and distortion to facilitate analysis of bone morphology, joint space and dynamic function in all three dimensions. This article will describe the role of CBCT imaging for the assessment of the TMJ osseous structures and present typical appearances of common pathological conditions of the TMJ.
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Affiliation(s)
- S Barghan
- Section of Oral and Maxillofacial Radiology, School of Dentistry, The University of California, Los Angeles, USA
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Magnusson C, Nilsson M, Magnusson T. Degenerative changes of the temporomandibular joint. Relationship to ethnicity, sex and occlusal supporting zones based on a skull material. Acta Odontol Scand 2012; 70:207-12. [PMID: 22050387 DOI: 10.3109/00016357.2011.629628] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The first aim of this study was to examine a contemporary human skull material for possible ethnic differences in respect of degenerative changes in the temporomandibular joints (TMJs). A second aim was to see if there was any correlation between such changes and occlusal support in any of the two groups and, if so, if this correlation was sex-related. MATERIALS AND METHODS The material consisted of 129 Caucasian skulls and 76 skulls from Afro-Americans. Ninety-four of the Caucasian skulls came from males (73%) and the corresponding figure for the Afro-Americans was 40 (53%). Their mean age at death was 46 years (range: 19-89 years) and 37 years (range: 18-70 years), respectively. RESULTS Dental status was in general poor and 13% of the Afro-Americans and 26% of the Caucasians were edentulous. Form and surface changes of the TMJs were more common in the present material compared to most previous studies. No differences could be found between the two ethnic groups in respect of degenerative joint changes in the TMJs. In men, no correlation of clinical relevance could be found between severity of joint changes and occlusal support. However, in both Caucasian and Afro-American women, such a correlation was obvious, especially in higher age. CONCLUSIONS The present findings give no evidence for any differences in the prevalence of degenerative changes in the TMJs in Caucasians and Afro-Americans. The strong correlation found between such changes and occlusal support in women but not in men might be explained by hormonal differences.
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Rando C, Waldron T. TMJ osteoarthritis: a new approach to diagnosis. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2012; 148:45-53. [PMID: 22371124 DOI: 10.1002/ajpa.22039] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2011] [Revised: 01/09/2012] [Accepted: 01/18/2012] [Indexed: 11/10/2022]
Abstract
Disorders of the temporomandibular joint (TMJ), including TMJ osteoarthritis (TMJ OA), are the topic of intensive clinical research; however, this is not the case in the archaeological literature, with the majority of work on the subject ceasing with the early 1990s. The methods employed in the diagnosis of TMJ OA within the archaeological work appear nonrepresentative of the disease and may have led to erroneous assumptions about the pattern and prevalence of OA. This current work presents a new method for evaluating OA specifically for the TMJ, considering both the biomechanics of the joint and the mechanisms of the disease. Totally, 496 specimens (including a group of modern documented specimens) were analyzed for the presence of TMJ OA using the following criteria: eburnation, osteophytes (marginal and new bone on joint surface), porosity, and alteration to joint contour. The results suggest that eburnation occurs rarely in the TMJ, so should not be used as an exclusive criterion. Rather a combination of at least two of the other criteria should be used, with osteophytes and porosity occurring the most frequently on both the mandibular condyle and articular eminence. Additionally, the prevalence of TMJ OA in the modern assemblage was similar to that observed in current clinical research, suggesting that the method employed here was able to produce a reasonable approximation of what is found in contemporary living populations.
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Affiliation(s)
- Carolyn Rando
- UCL Institute of Archaeology, University College London, UK.
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Ogura I, Kaneda T, Mori S, Sakayanagi M, Kato M. Magnetic resonance characteristics of temporomandibular joint disc displacement in elderly patients. Dentomaxillofac Radiol 2011; 41:122-5. [PMID: 22116131 DOI: 10.1259/dmfr/1286942] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the MR characteristics of temporomandibular joint (TMJ) disc displacement in elderly patients. METHODS Of the MR images of 1660 TMJs in 847 patients with disc displacement who underwent MRI for suspected temporomandibular disorders, 301 TMJs in 154 patients aged over 50 years were studied as an elderly group. These MR images of the elderly group were compared with those of a control group (1359 TMJs in 693 patients aged under 51 years) concerning disc displacement with or without reduction, joint effusion and osteoarthrosis. RESULTS The incidence of disc displacement with osteoarthrosis was significantly different between the elderly (41.9%) and the control (19.8%) groups (p = 0.000). Logistic multivariate regression analysis demonstrated that the osteoarthrosis was a significant variable (odds ratio = 2.94, p = 0.000). CONCLUSIONS This study suggests that MR characteristics of TMJ disc displacement in elderly patients includes osteoarthrosis.
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Affiliation(s)
- I Ogura
- Department of Radiology, Nihon University School of Dentistry at Matsudo, Chiba, Japan.
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Magnusson C, Nilsson M, Magnusson T. Degenerative changes in human temporomandibular joints in relation to occlusal support. Acta Odontol Scand 2010; 68:305-11. [PMID: 20586673 DOI: 10.3109/00016357.2010.494623] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Controversy exists concerning the etiological factors behind degenerative changes in the temporomandibular joints (TMJs). Tooth attrition, occlusal support, food consistency, ageing, gender and genetics are some possible causative factors that have been discussed in the literature. The aim of this study was to examine contemporary human skull material for possible relations between degenerative form and surface changes in the TMJs in relation to occlusal support. MATERIAL AND METHODS The material consisted of 259 human skulls from 170 males and 89 females, with an age range of 18-100 years. RESULTS Dental status was in general poor, and 22% of skulls were edentulous. Form and surface changes of both the condyles and the temporal components were more common in the present material compared to that in most previous studies. In males, irrespective of age, only weak and clinically insignificant correlations could be found between degenerative TMJ changes and occlusal support. In women, however, the correlations between these variables were in general much stronger, especially at higher ages. CONCLUSIONS The present findings do not lend support to the hypothesis that loss of occlusal support is a causative factor for degenerative changes in the TMJs in male subjects. In women, such a correlation was obvious in the present sample, at least at higher ages. It can be speculated that hormonal factors play a role in the sex difference found.
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Size, shape and age-related changes of the mandibular condyle during childhood. Eur Radiol 2010; 20:2512-7. [DOI: 10.1007/s00330-010-1828-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2010] [Revised: 03/25/2010] [Accepted: 05/07/2010] [Indexed: 10/19/2022]
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Liu XM, Zhang SY, Yang C, Chen MJ, Y Cai X, Haddad MS, Yun B, Chen ZZ. Correlation between disc displacements and locations of disc perforation in the temporomandibular joint. Dentomaxillofac Radiol 2010; 39:149-56. [PMID: 20203276 DOI: 10.1259/dmfr/72395946] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the correlation between disc displacement types and locations of disc perforation in the temporomandibular joint (TMJ). METHODS 157 patients (162 joints) with disc perforation observed through arthroscopy were included in this study. The types of disc displacement were analysed by TMJ MRI before operation. The locations of disc perforation under arthroscopy were recorded. The correlation between types of disc displacement and locations of disc perforation was analysed by Fisher's exact test. RESULTS Medial disc perforation was observed in 55.6% of patients with anterolateral displacement without reduction, but was observed in only 3.7% of patients with pure anterior displacement, and was not observed in patients with anteromedial displacement without reduction. There was a statistically significant difference between these groups in the incidence of medial disc perforation. CONCLUSIONS There is a correlation between different disc displacements and locations of disc perforation. The incidence of medial disc perforation in patients with anterolateral displacement was significantly higher. The types of disc displacement may have direct influence over the locations of disc perforation.
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Affiliation(s)
- X M Liu
- Department of Oral & Maxillofacial Surgery, Ninth People's Hospital, School of Stomatology, Shanghai JiaoTong University, No. 639, Zhi Zao Ju Rd, 200011, Shanghai, People's Republic of China
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Wang MQ, Xue F, He JJ, Chen JH, Chen CS, Raustia A. Missing posterior teeth and risk of temporomandibular disorders. J Dent Res 2009; 88:942-5. [PMID: 19783804 DOI: 10.1177/0022034509344387] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
There is disagreement about the association between missing posterior teeth and the presence of temporomandibular disorders (TMD). Here, the purpose was to investigate whether the number of missing posterior teeth, their distribution, age, and gender are associated with TMD. Seven hundred and forty-one individuals, aged 21-60 years, with missing posterior teeth, 386 with and 355 without TMD, were included. Four variables-gender, age, the number of missing posterior teeth, and the number of dental quadrants with missing posterior teeth-were analyzed with a logistic regression model. All four variables-gender (OR = 1.59, men = 1, women = 2), age (OR = 0.98), the number of missing posterior teeth (OR = 0.51), and the number of dental quadrants with missing posterior teeth (OR = 7.71)-were entered into the logistic model (P < 0.01). The results indicate that individuals who lose posterior teeth, with fewer missing posterior teeth but in more quadrants, have a higher prevalence of TMD, especially young women.
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Affiliation(s)
- M Q Wang
- Department of Oral Anatomy and Physiology, Xi'an, PR China 710032.
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Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol 2009; 38:141-7. [PMID: 19225084 DOI: 10.1259/dmfr/59263880] [Citation(s) in RCA: 164] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The aim of this study is to evaluate and correlate with age the severity of temporomandibular joint (TMJ) osteoarthritic changes using cone beam CT (CBCT). METHODS The images of 71 patients with findings of degenerative arthritis were retrieved from the computer data base. All patients had been examined with CBCT (NewTom 9000 QR-DVT). Left and right TMJs were evaluated independently for each patient. TMJ evaluation included: (a) bony changes of the condyle (flattening, erosion, sclerosis, osteophytes, resorption); (b) joint space (normal, increased, reduced, bony contact between the condyle and the mandibular fossa); and (c) bony changes of mandibular fossa (normal, sclerosis, erosion, resorption). The radiographic findings were statistically analysed. RESULTS Significant differences in the mean age were found: (a) between absent and moderate erosion (P = 0.019), as well as between absent and extensive erosion (P = 0.048); (b) between absent and extensive formation of osteophyte (P = 0.003), as well as between slight and extensive formation of osteophyte (P = 0.025); (c) between normal joint space and bony contact (P = 0.0002), as well as between reduced joint space and bony contact (P = 0.001). CONCLUSIONS Degenerative arthritis is an age-related disease. The progression and severity of osseous changes in the condylar head and mandibular fossa are increased with age. In older age groups, patients are expected to have more frequent and severe progressive degenerative bony changes due to the development of TMJ osteoarthritis than patients in younger age groups.
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Affiliation(s)
- Ke Alexiou
- Department of Oral Diagnosis and Radiology, School of Dentistry, University of Athens, Greece
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Halpern LR, Levine M, Dodson TB. Sexual dimorphism and temporomandibular disorders (TMD). Oral Maxillofac Surg Clin North Am 2008; 19:267-77, viii. [PMID: 18088884 DOI: 10.1016/j.coms.2007.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Numerous studies suggest a sexual predilection for temporomandibular disorders. The purpose of this article is to review and summarize patient-oriented and basic science studies that address the topic of a female predilection for temporomandibular disorders. The information presented provides oral and maxillofacial surgery practitioners with evidence-based data to suggest a female predilection for temporomandibular disorders based on biologic, genetic, and behavioral/psychosocial factors.
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Affiliation(s)
- Leslie R Halpern
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit Street, Warren 1201, Boston, MA 02114, USA.
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Kuribayashi A, Okochi K, Kobayashi K, Kurabayashi T. MRI findings of temporomandibular joints with disk perforation. ACTA ACUST UNITED AC 2008; 106:419-25. [PMID: 18504154 DOI: 10.1016/j.tripleo.2007.11.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Revised: 11/15/2007] [Accepted: 11/15/2007] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate magnetic resonance imaging (MRI) findings of temporomandibular joints (TMJs) with disk perforation. STUDY DESIGN Thirty-one TMJs (31 patients) with disk perforation, 37 TMJs (34 patients) with anterior disk displacement and no disk perforation, and 22 asymptomatic TMJs of 11 volunteers were examined by MRI. The presence or absence of disk perforation was confirmed by TMJ arthrography. The MR images were evaluated for the presence or absence of disk deformity, disk displacement, condylar bone changes and joint effusion and for visualization of the temporal posterior attachment (TPA) of the posterior disk attachment. Those findings were compared among the 3 groups. RESULTS The incidences of anterior disk displacement and condylar bone changes in the patients group with disk perforation were significantly higher than in asymptomatic volunteers. Disk deformity and obscurity of TPA were significantly more frequent in the patient group with disk perforation than in the other 2 groups. CONCLUSION In addition to disk deformity, TPA obscurity was considered to be one of the characteristic MRI findings of TMJs with disk perforation.
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Affiliation(s)
- Ami Kuribayashi
- Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
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Okochi K, Ida M, Honda E, Kobayashi K, Kurabayashi T. MRI and clinical findings of posterior disk displacement in the temporomandibular joint. ACTA ACUST UNITED AC 2008; 105:644-8. [DOI: 10.1016/j.tripleo.2007.07.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 07/06/2007] [Accepted: 07/21/2007] [Indexed: 10/22/2022]
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Takayama Y, Miura E, Yuasa M, Kobayashi K, Hosoi T. Comparison of occlusal condition and prevalence of bone change in the condyle of patients with and without temporomandibular disorders. ACTA ACUST UNITED AC 2008; 105:104-12. [PMID: 17449297 DOI: 10.1016/j.tripleo.2006.12.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Revised: 12/18/2006] [Accepted: 12/31/2006] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the differences in dental and occlusal conditions, and prevalence of bone change in the condyle, between a group of patients with temporomandibular disorders (TMD) and a group of dental patients without such complaints. STUDY DESIGN A group of 504 patients with temporomandibular disorders (TMD patients) and a group of 970 patients without such complaints (dental patients), all 25 years of age or older, were compared using the criteria of age, sex, dental and occlusal condition, and prevalence of bone change in the condyle based on panoramic radiographs and imaging request forms. RESULTS In both groups, the rate of complete dental arch was high for both jaws. According to Eichner's index, the rate for group A among the dental patients was 59.6%, whereas it was 84.7% in the TMD patients (P < .01). The prevalence of bone change in the condyle was 17.7% for the TMD patients and 11.6% for the dental patients (P < .01). Eichner's group C was somewhat high for the dental patients, and group A was high for the TMD patients. However, there were no significant differences in the occlusal conditions based on the prevalence of bone change. Deformity was the most common abnormality of bone change for both the dental and the TMD patients. In the TMD patients, the rate of osteophytes was the second most common abnormal finding. Osteophytes were the highest among the average age for all abnormal bone changes in the condyle. With the TMD patients, all the changes were more commonly found in Eichner's group A. CONCLUSIONS It was demonstrated that the symptoms of TMD correlated with age, sex, and dental and occlusal conditions. However, the prevalence of bone change in the condyle correlated poorly with age, sex, and dental and occlusal condition with and without TMD.
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Affiliation(s)
- Yasuko Takayama
- The First Department of Prosthetic Dentistry, Tsurumi University School of Dental Medicine, Yokohama, Japan.
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Wang MQ, Cao HT, Liu FR, Chen C, Li G. Association of tightly locked occlusion with temporomandibular disorders. J Oral Rehabil 2007; 34:169-73. [PMID: 17302944 DOI: 10.1111/j.1365-2842.2006.01657.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The association between teeth loss and temporomandibular disorders (TMD) is still inconclusive. A kind of secondary changes of the occlusion after teeth lose called the tightly locked occlusion (TLO), defined as the occluding contact that delivers angled occlusal force on the drifted neighbour and/or the tipped antagonists of the lost posterior teeth, was hypothesized to be association with TMD. The study aimed at investigating the association between the TLO and TMD. A total of 113 posterior-teeth losing patients, 64 with TMD symptoms (group of TMD) and 49 without (group of TMD-Free) were included. Study casts and joint radiographs were made to diagnose the TLO and joint morphological changes. The simultaneous contribution of the potential variables of gender, age, tooth losing number, the TLO, joint symmetry and signs of osteoarthrosis shown on radiographs were tested through binary logistic regression analysis. In women, the TLO entered into logistic model, and had an effect on the incidence of TMD (P = 0.008). The odds ratio of with-TLO versus without-TLO is 2.6 (95% CI: 1.2, 5.8) after controlling for the effect of gender. Age, tooth lose number, joint asymmetry or osseous changes had no effect on the incidence of TMD. The tightly locked occlusion is associated with some signs and symptoms of TMD. Randomized controlled trials will be needed in further studies to test the hypothesis that treatment of a TLO, as defined in the present study, will have a beneficial effect on the signs and symptoms of TMD.
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Affiliation(s)
- M-Q Wang
- Department of Oral Anatomy and Physiology, Stomatological College, Fourth Military Medical University, Xi'an City, Shaanxi Province, China.
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Tomas X, Pomes J, Berenguer J, Quinto L, Nicolau C, Mercader JM, Castro V. MR imaging of temporomandibular joint dysfunction: a pictorial review. Radiographics 2006; 26:765-81. [PMID: 16702453 DOI: 10.1148/rg.263055091] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The first step in MR imaging of the TMJ is to evaluate the articular disk, or meniscus, in terms of its morphologic features and its location relative to the condyle in both closed- and open-mouth positions. Disk location is of prime importance because the presence of a displaced disk is a critical sign of TMJ dysfunction. However, disk displacement is also frequently seen in asymptomatic volunteers, so that other findings may be required to help make the diagnosis. These findings include thickening of an attachment of the lateral pterygoid muscle, rupture of retrodiskal layers, and joint effusion and can serve as indirect early signs of TMJ dysfunction. It is important for the radiologist to detect early MR imaging signs of dysfunction, thereby avoiding the evolution of this condition to its final stage, an advanced and irreversible phase that is characterized by osteoarthritic changes such as condylar flattening or osteophytes. Further studies conducted with the latest MR imaging techniques will allow a better understanding of the sources of TMJ pain and of any discrepancy between imaging findings and patient symptoms.
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Affiliation(s)
- Xavier Tomas
- Department of Radiology, Hospital Clínic, Facultat de Medicina, Universitat de Barcelona, Villarroel 170, Barcelona 08036, Spain
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Matsumoto K, Honda K, Sawada K, Tomita T, Araki M, Kakehashi Y. The thickness of the roof of the glenoid fossa in the temporomandibular joint: relationship to the MRI findings. Dentomaxillofac Radiol 2006; 35:357-64. [PMID: 16940484 DOI: 10.1259/dmfr/30011413] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to clarify the relationship between the thickness of the roof of the glenoid fossa (RGF) and magnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) disorders (TMDs). METHODS Eighty-seven patients with symptoms and indications of TMD in one or both TMJs were referred for MRI. Cone-beam CT (3DX) was used to measure the thickness of the RGF at its thinnest point. Linear measurements were made three times on the monitor by three separate investigators and the mean values obtained were used for the statistical analyses. RESULTS The joints were categorised as normal (70 joints), anterior disc displacement with reduction (ADWR; 53 joints) or anterior disc displacement without reduction (ADWOR; 51 joints). The joint disorders were also categorised into the following subgroups: with osteoarthritis (OA) (21 joints), without OA (153 joints), with disc deformation (33 joints), without disc deformation (141 joints), with joint effusion (JE) (61 joints) and without JE (113 joints). The average minimum thickness of the RGF was 0.85 mm for normal joints, 0.90 mm with ADWR, 0.93 mm with ADWOR, 0.99 mm with OA, 0.87 mm without OA, 0.87 mm with disc deformation and 0.89 mm without disc deformation. There was no significant difference between these figures. There was a significant difference in the thickness of the RGF with (0.97 mm) and without (0.84 mm) JE. CONCLUSIONS These results suggest that RGF thickness is influenced by JE, but is unaffected by disc position and configuration.
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Affiliation(s)
- K Matsumoto
- Department of Radiology, Nihon University School of Dentistry, Tokyo, Japan
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Wadhwa S, Embree M, Ameye L, Young MF. Mice deficient in biglycan and fibromodulin as a model for temporomandibular joint osteoarthritis. Cells Tissues Organs 2006; 181:136-43. [PMID: 16612079 DOI: 10.1159/000091375] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The temporomandibular joint (TMJ) within the craniofacial complex is unique. In humans, the TMJ can become diseased resulting in severe and disabling pain. There are no cures for TMJ disease at this time. Animal models of TMJ disease are scarce, but some exist, and they are described in this paper. We present in greater detail one animal model that is deficient in two extracellular matrix (ECM) proteoglycans, biglycan (BGN) and fibromodulin (FMOD). Doubly deficient BGN/FMOD mice develop premature TMJ osteoarthritis (OA). In order to explore the mechanistic basis of TMJ-OA, tissues from the condyle of mutant mice were examined for their relative capacity to differentiate and undergo apoptosis. Our data show that there is a redistribution of the critical ECM protein, type II collagen, in mutant mice compared with controls. Mutant mice also have increased apoptosis of the chondrocytes embedded in the articular cartilage. We speculate that the overall imbalance in apoptosis may be the cellular basis for the abnormal production of structural ECM proteins. The abnormal production of the ECM could, in turn, lead to premature erosion and degradation of the articular surface resulting in TMJ-OA. These data underscore the importance of the ECM in controlling the structural integrity of the TMJ.
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Affiliation(s)
- Sunil Wadhwa
- Craniofacial and Skeletal Diseases Branch, National Institutes of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.
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Rudisch A, Emshoff R, Maurer H, Kovacs P, Bodner G. Pathologic-sonographic correlation in temporomandibular joint pathology. Eur Radiol 2006; 16:1750-6. [PMID: 16508767 DOI: 10.1007/s00330-006-0162-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2005] [Revised: 10/23/2005] [Accepted: 01/13/2006] [Indexed: 11/24/2022]
Abstract
The accuracy of high-resolution ultrasonography (HR-US) in detecting disk displacement and condylar erosion of the temporomandibular joint (TMJ) was evaluated, using corresponding cryosections as a "gold standard". HR-US of the TMJ was performed with a high frequency 12 MHz transducer on 30 preserved autopsy specimens. Succeeding sonography, the autopsy specimens were deep-frozen and cut in paracoronal planes corresponding to the sonographic images. HR-US diagnoses were compared with cryosectional findings in a blinded fashion. HR-US detected 19 (95%) of 20 instances of condylar erosion and 16 (73%) of 22 instances of disk displacement. There were one false-positive finding for condylar erosion and two false-positive findings for disk displacement. The accuracy of HR-US evaluating condylar erosion and disk displacement rated 93% and 73%, respectively. In conclusion, condylar erosion was reliably assessed by HR-US, but the evaluation of disk position was less accurate.
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Affiliation(s)
- Ansgar Rudisch
- Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
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Schmitter M, Rammelsberg P, Hassel A. The prevalence of signs and symptoms of temporomandibular disorders in very old subjects. J Oral Rehabil 2005; 32:467-73. [PMID: 15975125 DOI: 10.1111/j.1365-2842.2005.01449.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Previous studies on the prevalence of signs of temporomandibular disorders (TMD) in elderly people have used non-standardized and invalidated examination protocols. The prevalence of the different signs of TMD in this group is therefore still unclear. The aim of this study was to evaluate the prevalence of signs of TMD in subjects of advanced aged, using a standardized and validated examination protocol. Additionally, young subjects were examined as a control group. Fifty-eight old peoples' home inhabitants and 44 young subjects were examined using a standardized and validated examination protocol. Differences between the groups were assessed using Mann-Whitney U-test or t-test. Geriatric subjects more often exhibited objective symptoms of TMD (38% exhibited joint sounds on opening), but rarely suffered from pain (pain at rest: 0%, joint pain: 0%, muscle pain: 12%). In contrast, young subjects rarely exhibited objective symptoms (joint sounds: 7%), but suffered more frequently from pain (facial: 7%, joint pain: 16%, muscle pain: 25%). The mandibular range of motion was higher in young subjects. Differences between the groups with respect to joint sounds, muscular palpation pain and mandibular range of motion were significant. Although older subjects more frequently exhibited objective signs (joint sounds) of TMD, they rarely suffered from pain. In contrast, younger subjects rarely exhibited objective TMD signs but more frequently suffered from subjective signs (muscular pain on palpation) and facial pain.
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Affiliation(s)
- M Schmitter
- Poliklinik für Zahnärztliche Prothetik, Im Neuenheimer Feld, Heidelberg, Germany.
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Broussard JS. Derangement, osteoarthritis, and rheumatoid arthritis of the temporomandibular joint: implications, diagnosis, and management. Dent Clin North Am 2005; 49:327-42. [PMID: 15755408 DOI: 10.1016/j.cden.2004.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Temporomandibular joint (TMJ) dysfunction is often believed to bea young person's malady. However, geriatric patients also present with clinical findings of TMJ clicking, locking, crepitation, limited opening, and pain. With our aging population and the high prevalence of rheumatic and musculoskeletal diseases in the elderly, it is important to understand the etiopathogenesis, clinical presentation, and management of derangement, rheumatoid arthritis, and osteoarthritis of the TMJ. Although arthritis of the TMJ usually causes only mild-to-moderate dysfunction in older patients, they present challenges related to medication use and comorbidity. This article presents the most recent understanding and therapeutic protocols for patient diagnosis and management.
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Affiliation(s)
- Jack S Broussard
- University of Southern California, School of Dentistry, Oral Health Center, 3151 South Hoover Street, Los Angeles, CA 90089-7792, USA.
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Crow HC, Parks E, Campbell JH, Stucki DS, Daggy J. The utility of panoramic radiography in temporomandibular joint assessment. Dentomaxillofac Radiol 2005; 34:91-5. [PMID: 15829691 DOI: 10.1259/dmfr/24863557] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Panoramic radiography was used to determine (1) intrarater and inter-rater reliability in assessing temporomandibular joint (TMJ) condylar morphology; (2) alteration in condylar shape in patients with temporomandibular disorders (TMD) and controls when matched by age, gender, and state of dentition; and (3) prevalence of condylar abnormalities in individuals with and without TMD. METHODS One hundred panoramic radiographs were randomly selected from a hospital clinic (45 TMD and 55 non-TMD patients). The images were cropped to include only the temporomandibular apparatus and were independently evaluated by three examiners without knowledge of the patient's clinical status. Multiple statistical tests were performed to evaluate the accumulated data. RESULTS Intrarater reliability demonstrated substantial agreement, while inter-rater reliability was fair. There was no difference in condylar morphology between patient groups, but mild condylar change was prevalent in all age groups, regardless of TMD status. CONCLUSIONS Morphological condylar abnormalities are present on panoramic images in all adult age ranges, regardless of status of the dentition or presence of TMD. Condylar shape alone is not an indicator of TMD, and minor condylar discrepancies may have no significance in TMD.
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Affiliation(s)
- H C Crow
- Department of Oral Diagnostic Sciences, TMD and Orofacial Pain Program, University at Buffalo, Buffalo, NY 14214, USA.
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50
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Touré G, Duboucher C, Vacher C. Anatomical modifications of the temporomandibular joint during ageing. Surg Radiol Anat 2004; 27:51-5. [PMID: 15565328 DOI: 10.1007/s00276-004-0289-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2003] [Accepted: 05/21/2004] [Indexed: 11/28/2022]
Abstract
It is essential to know the normal and pathological changes of ageing in the temporomandibular joint (TMJ) because of the frequency of pathology in this joint and the increased duration of life in current populations. A study was done on 70 TMJs harvested from 35 subjects older than 75 years. These joints were studied macroscopically, radiologically and histologically. Degenerative pathology of the TMJ affected more than 50% of the subjects studied and the disc was perforated in 7%. Ageing of the TMJ without any degenerative pathology is marked by radiographic signs which are not specific to the TMJ (cortical thinning, demineralisation). Histologically, amyloid degeneration was present in nearly 50% of TMJs studied.
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Affiliation(s)
- G Touré
- Faculté Bio-médicale des Saints-Pères, Institut d'Anatomie de Paris, 45 rue des Saints Pères, 75005, Paris, France
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