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Hopkins D, Callary SA, Solomon LB, Woodford SC, Lee PVS, Ackland DC. Computational modeling of revision total hip arthroplasty involving acetabular defects: A systematic review. J Orthop Res 2024. [PMID: 38850264 DOI: 10.1002/jor.25902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/22/2024] [Accepted: 05/07/2024] [Indexed: 06/10/2024]
Abstract
Revision total hip arthroplasty (rTHA) involving acetabular defects is a complex procedure associated with lower rates of success than primary THA. Computational modeling has played a key role in surgical planning and prediction of postoperative outcomes following primary THA, but modeling applications in rTHA for acetabular defects remain poorly understood. This study aimed to systematically review the use of computational modeling in acetabular defect classification, implant selection and placement, implant design, and postoperative joint functional performance evaluation following rTHA involving acetabular defects. The databases of Web of Science, Scopus, Medline, Embase, Global Health and Central were searched. Fifty-three relevant articles met the inclusion criteria, and their quality were evaluated using a modified Downs and Black evaluation criteria framework. Manual image segmentation from computed tomography scans, which is time consuming, remains the primary method used to generate 3D models of hip bone; however, statistical shape models, once developed, can be used to estimate pre-defect anatomy rapidly. Finite element modeling, which has been used to estimate bone stresses and strains, and implant micromotion postoperatively, has played a key role in custom and off-the-shelf implant design, mitigation of stress shielding, and prediction of bone remodeling and implant stability. However, model validation is challenging and requires rigorous evaluation and comparison with respect to mid- to long-term clinical outcomes. Development of fast, accurate methods to model acetabular defects, including statistical shape models and artificial neural networks, may ultimately improve uptake of and expand applications in modeling and simulation of rTHA for the research setting and clinic.
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Affiliation(s)
- Daniel Hopkins
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia
| | - Stuart A Callary
- Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, South Australia, Australia
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - L B Solomon
- Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, South Australia, Australia
- Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Sarah C Woodford
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia
| | - Peter V S Lee
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia
| | - David C Ackland
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, Australia
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Grande F, Lepidi L, Tesini F, Acquadro A, Valenti C, Pagano S, Catapano S. Investigation of the precision of a novel jaw tracking system in recording mandibular movements: A preliminary clinical study. J Dent 2024; 146:105047. [PMID: 38719134 DOI: 10.1016/j.jdent.2024.105047] [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: 03/27/2024] [Revised: 05/03/2024] [Accepted: 05/05/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES This preliminary study aimed to clinically assess the precision of a novel optical jaw tracking system (JTS) in registering mandibular movements (MMs) of protrusion and mediotrusion. METHODS Twenty healthy participants underwent recordings using Cyclops JTS (Itaka Way Med) for functional MMs of protrusion and laterotrusion by two trained clinicians. Each subject performed five registrations at different times according to a standardized pattern within one-month period. The angulations of protrusive and mediotrusive functional paths within the first 2 mm from the maximal intercuspal position (MIP) were calculated for each trace, using a data software for angle measurements. Descriptive statistics were used to assess the repeatability of the recordings for each participant and MM. Additionally, inferential statistics were carried out on standard deviation values obtained (α=0.05). RESULTS The overall precision for all the patients was 7.07±3.37° for the protrusion angle, 5.24±2.24° for right laterotrusion and 5.14±3.06° for left laterotrusion angles. The protrusion angle ranged from 3.08° to 13.57°, while the right and left laterotrusion ranged from 1.82° to 9.42° and from 1.58° to 10.59°, respectively. No statistically significant differences were observed between different functional MM types and gender (p > 0.05). CONCLUSIONS Recordings functional MMs of mediotrusion and protrusion using Cyclops JTS showed consistent repeatability, regardless of gender and functional MM type. The results revealed non-negligible variations that may be due to the patients' abilities to precisely reproduce jaw movements or to the operator's ability to consistently connect the kinesiograph. CLINICAL SIGNIFICANCE Capturing functional MMs digitally and importing the data into dental CAD software is essential for virtual waxing in prosthetic rehabilitations to design a functionalized adapted occlusion. Establishing the repeatability of MM recordings by a JTS is a crucial step in better understanding this novel JTS in the market. This process could facilitate the interpretation of cusp angles, aid in CAD dynamic technical modeling, and enhance clinical data communication between clinicians and technicians in a modern workflow.
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Affiliation(s)
- Francesco Grande
- PhD student at Politecnico of Turin, Turin Italy; University of Ferrara, Ferrara Italy.
| | - Luca Lepidi
- Adjunct Professor Gnathology, University of Ferrara, Ferrara Italy
| | | | | | | | - Stefano Pagano
- Chief-Professor Dental Materials, Oral Prosthodontic, University of Perugia, Perugia, Italy
| | - Santo Catapano
- Chief-Professor Dental Materials, Oral Prosthodontic, University of Ferrara, Ferrara, Italy
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Jász B, Ambrus S, Garay T, Schmidt P, Hermann P, Körmendi S, Jász M. Different methods of determining centric relation - comparison with a digital mandibular motion analyser. BMC Oral Health 2024; 24:345. [PMID: 38500122 PMCID: PMC10946198 DOI: 10.1186/s12903-024-04131-x] [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: 09/19/2023] [Accepted: 03/11/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Finding and registering the maxillary-mandibular jaw relation is crucial in dental practice. Several comparative studies have been conducted to investigate the reproducibility and accuracy of techniques for determining the centric relation (CR) position of the mandible. The aim of our study was to determine which of seven different CR determination methods had the smallest deviation from the theoretical zero with the help of a digital mandibular motion analyser. The chosen theoretical zero position, the maximal intercuspal position (MIP), is the most reproducible and widely used position. METHODS Thirty-four volunteers (24 females and 10 males) with a mean (SD) age of 29.1 (± 7.3) years with a negative history of temporomandibular disorder (TMD) participated in the study. A digital mandibular motion analyser was used to register the condylar position after the use of each technique for the determination of CR. The calibration was performed to the maximal intercuspal position (MIP) for each volunteer. The investigated techniques were (A) the gothic arch tracer, (B) the adduction field method, (C) Dawson's bimanual manipulation, (D) the patient placing the tongue tip on the palatal rugae, (E) the patient placing the tongue tip to the border of the hard and soft palate, (F) the patient actively pulling the chin backwards, and (G) the examiner pushing the patient's chin back. RESULTS The position of the mandibular condyle was illustrated in a three-dimensional coordinate system, where the origin represented the MIP. Among the seven methods examined, five showed significant deviations compared to the MIP. Among these, two methods resulted in posterior deviation of the condyles. Methods C and E coincided with the MIP in all directions. CONCLUSIONS Within the limitations of our study, we found that the smallest deviations from our theoretical zero (MIP) among the investigated centric relation determining methods were obtained with the bimanual mandibular manipulation technique derived from Dawson and the placement of the tongue tip on the border of the hard and soft palate (linguomandibular homotrophy theory).
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Affiliation(s)
- Bálint Jász
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi u. 47, Budapest, 1088, Hungary.
| | - Szilvia Ambrus
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi u. 47, Budapest, 1088, Hungary
| | - Tamás Garay
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
- Division of Oncology, Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Schmidt
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi u. 47, Budapest, 1088, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi u. 47, Budapest, 1088, Hungary
| | - Szandra Körmendi
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi u. 47, Budapest, 1088, Hungary
| | - Máté Jász
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, Szentkirályi u. 47, Budapest, 1088, Hungary
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Wu Q, Zhang Y, Xiao H, Zheng J, Jiang T, Du Y, Cao M, Li F. Evaluation of mandibular motion in adolescents with skeletal class II division 1 malocclusion during mandibular advancement using clear functional aligners: a prospective study. BMC Oral Health 2024; 24:320. [PMID: 38461253 PMCID: PMC10924979 DOI: 10.1186/s12903-024-04082-3] [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: 09/24/2023] [Accepted: 02/27/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the characteristics of mandibular protrusive condylar trajectory in adolescents with skeletal Class II Division 1 malocclusion and the changes of condylar trajectory during mandibular advancement (MA) treatment using clear functional aligners. METHODS This prospective study consisted of a cross-sectional study and a longitudinal study. In cross-sectional study, sixty-one adolescents were divided into two groups: Class I (n = 30) and Class II Division 1 (n = 31). The condylar trajectory was measured and compared using the Mann-Whitney U test. The longitudinal study was the MA treatment group using clear functional aligner and consisted of 16 participants from Class II Division 1group. The condylar trajectory was collected at three-time points: pre-treatment (T1), during MA treatment at approximately 3 months (T2, 105.6 days average), and at the end of MA treatment (T3, 237.6 days average). The changes at T1, T2, and T3, as well as the symmetry between the left and right condyles across all groups, were examined using the Wilcoxon paired test. RESULTS A greater increase in the anteroposterior displacement and space displacement during protrusive movements was observed in the Class II Division 1 group compared with that in the Class I group, with a large difference being observed in the left and right condylar movements. The condylar anteroposterior displacement and space displacement decreased significantly at T2 and increased significantly at T3; however, no significant difference was observed between T1 and T3. A significant difference was observed between the condylar movement on the left and right sides at T1; however, no significant difference was observed at T2 and T3. CONCLUSIONS Adolescents with Class II Division 1 malocclusion had higher protrusive capacity than those with Class I. Moreover, their left and right condylar motion was more asymmetric. The range of condyle motion decreased first and then increased during MA therapy, and the left and right condyle movement became more symmetrical, which may be the adaptive response of neuromuscular function to the changes in jaw position.
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Affiliation(s)
- Qiuyue Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Yueying Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Hua Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Jiajing Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Tianlu Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Yusen Du
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China
| | - Meng Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
| | - Feifei Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, National Clinical Research Center for Oral Diseases, The Third Affiliated Hospital of Air Force Medical University, Xi'an, Shaanxi, 710032, People's Republic of China.
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Banerjee A, Basu B, Saha S, Chowdhury AR. Design and development of a patient-specific temporomandibular joint implant: Probing the influence of bone condition on biomechanical response. J Biomed Mater Res B Appl Biomater 2023; 111:2089-2097. [PMID: 37624362 DOI: 10.1002/jbm.b.35311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/23/2023] [Accepted: 07/31/2023] [Indexed: 08/26/2023]
Abstract
Total temporomandibular joint (TMJ) replacement is widely recognized as an effective treatment for TMJ disorders. The long-term stability of TMJ implants depends on two important factors which are design concepts for fixation to anatomical locations in the mandible and bone conditions. Other factors include stress distribution, microstrain in the peri-implant, bone attributes like bone conditions leading to the clinical complications and failures. This study addresses these limitations by examining the influence of patient-specific design concepts and bone conditions on TMJ implant performance. Clinical evidences support the importance of implant design on healing ability. Previous studies have focused on achieving precise implant fit based on geometric considerations, however those published studies did not explore the impact of such. Against this perspective, the present study reports the extensive finite element analysis (FEA) results, while analyzing the impact of a newly designed patient-specific TMJ implant to address clinical complications associated with various bone conditions, particularly osteoporotic bone. In validating the FEA results, the performance of additively manufactured patient-specific TMJ implants was compared with designs resembling two commonly used clinically approved implant designs. By addressing the limitations of previous research and emphasizing the importance of bone conditions, the study provides valuable guidelines for the development of next-generation TMJ implants. These findings contribute to enhanced clinical outcomes and long-term success in the treatment of TMJ disorders.
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Affiliation(s)
- Anik Banerjee
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, India
| | - Bikramjit Basu
- Laboratory for Biomaterials, Materials Research Centre Indian Institute of Science, Bangalore, India
| | - Subrata Saha
- Department of Restorative Dentistry, University of Washington, Seattle, Washington, USA
| | - Amit Roy Chowdhury
- Department of Aerospace Engineering and Applied Mechanics, Indian Institute of Engineering Science and Technology, Shibpur, India
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Wang JL, Wang J, Chen KN, Guo JQ, Xu XL, Guo CB. Designing customized temporomandibular fossa prosthesis based on envelope surface of condyle movement: validation via in silico musculoskeletal simulation. Front Bioeng Biotechnol 2023; 11:1273263. [PMID: 38026896 PMCID: PMC10644477 DOI: 10.3389/fbioe.2023.1273263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Objective: This study presents an innovative articular fossa prosthesis generated by the envelope surface of condyle movement, and compares its mandible movements, muscle activities, and joint reaction forces with two temporomandibular joint (TMJ) prostheses using multibody musculoskeletal simulation. Methods: A healthy 23-year-old female was recruited for this study. Cone-beam computed tomographic (CBCT) was performed to reconstruct the mandibular bone geometry. A customized TMJ fossa prosthesis was designed based on the subject-specific envelope surface of condyle movement (ESCM). Mandibular kinematics and jaw-closing muscle electromyography (EMG) were simultaneously recorded during maximum jaw opening-closing movements. To validate our prosthesis design, a mandibular musculoskeletal model was established using flexible multibody dynamics and the obtained kinematics and EMG data. The Biomet fossa prosthesis and the ellipsoidal fossa prosthesis designed by imitating the lower limb prostheses were used for comparison. Simulations were performed to analyze the effects of different fossa prostheses on jaw opening-closing motions, mandibular muscle activation, and contact forces. Results: The maximum opening displacement for the envelope-based fossa prosthesis was greater than those for Biomet and ellipsoidal prostheses (36 mm, 35 mm, and 33 mm, respectively). The mandibular musculoskeletal model with ellipsoidal prosthesis led to dislocation near maximal jaw opening. Compared to Biomet, the envelope-based fossa reduced the digastric and lateral pterygoid activation at maximal jaw opening. It also reduced the maximal resistance to condylar sliding on the intact side by 63.2 N. Conclusion: A customized TMJ fossa prosthesis was successfully developed using the ESCM concept. Our study of musculoskeletal multibody modeling has highlighted its advantages and potential. The artificial fossa design successfully achieved a wider condylar range of motion. It also reduced the activation of jaw opening muscles on the affected side and resistance on the intact side. This study showed that an ESCM-based approach may be useful for optimizing TMJ fossa prostheses design.
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Affiliation(s)
- Jun-Lin Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry, Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jing Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry, Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Ke-Nan Chen
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry, Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Jian-Qiao Guo
- MOE Key Laboratory of Dynamics and Control of Flight Vehicle, School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Xiang-Liang Xu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry, Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Chuan-Bin Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry, Ministry of Health, NMPA Key Laboratory for Dental Materials, Beijing, China
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Woodford SC, Robinson DL, Abduo J, Lee PVS, Ackland DC. Kinematics of the jaw following total temporomandibular joint replacement surgery. J Biomech 2023; 159:111741. [PMID: 37660523 DOI: 10.1016/j.jbiomech.2023.111741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 09/05/2023]
Abstract
Total temporomandibular joint (TMJ) replacement surgery aims to improve mandibular function, reduce pain and enhance quality of life in patients suffering from end-stage TMJ disorders. Traditional post-operative jaw evaluation is carried out using measurement of maximum interincisal opening distance; however, this can correlate poorly to joint function. The present study aimed to evaluate three-dimensional (3D) jaw motion during border movements and chewing in unilateral total TMJ replacement patients and healthy controls. Motion analysis experiments were performed on six unilateral total TMJ replacement patients and ten age-matched healthy controls. Subject-specific motion tracking plates worn by each participant were registered to CT scans of each participant's skull and mandible to enable anatomical mandibular kinematics measurement using an optoelectronic system. Participants performed 15 repetitions of maximal opening, protrusion, lateral excursions, and chewing cycles. Total TMJ replacement patients had significantly smaller incisal displacements at maximum mouth opening relative to the controls (median difference: 7.1 mm, p = 0.002) and decreased anterior translation of the prosthetic condyle (median difference: 10.5 mm, p = 0.002). When TMJ replacement subjects chewed using their contralateral molars, there was a significant increase in inferior condylar translation of the non-working condyle (median difference: 9.7 mm, p = 0.016). This study found that unilateral total TMJ replacement surgery was associated with mouth opening capacity within the range of healthy individuals, but reduced anterior movement of the prosthetic condyle and restricted protrusion and lateral excursions. The results provide future direction for prosthetic TMJ design to enhance postsurgical implant functionality and improve long-term clinical outcomes for prosthesis recipients.
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Affiliation(s)
- Sarah C Woodford
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Dale L Robinson
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Jaafar Abduo
- Melbourne Dental School, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Peter V S Lee
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia
| | - David C Ackland
- Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria 3010, Australia.
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Shu J, Li A, Ma H, Shao B, Chong DYR, Liu Z. The effects of the size and strength of food on jaw motion and temporomandibular joints. Med Eng Phys 2023; 116:103989. [PMID: 37230700 DOI: 10.1016/j.medengphy.2023.103989] [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: 11/20/2022] [Revised: 04/19/2023] [Accepted: 05/07/2023] [Indexed: 05/27/2023]
Abstract
Mastication displays much importance in people's lives. The masticatory mandibular motion associated with dental kinematics also impacts temporomandibular joint (TMJ) kinematics and even TMJ health status. How food properties impact kinematical parameters of TMJs is a meaningful question for the conservative treatment of temporomandibular disorders (TMD) and evidence for the diet recommendation of TMD patients. The aim of this study was to find the primary mechanical properties influencing the masticatory motion. The potato boluses with different boiling times and sizes were chosen. The optical motion tracking system was adopted to record the masticatory trials of chewing boluses with various mechanical properties. The mechanical experiments revealed that increasing boiling time could reduce compressive strength. Moreover, multiple regression models were built to find the primary property of food influencing the TMJ kinematics, including condylar displacement, velocity, acceleration, and crushing time. The results showed that the bolus size had a significant primary influence on condylar displacements. The chewing times had a significantly minor influence on condylar displacements, while bolus strength had only a small impact on condylar displacements. Furthermore, condylar displacements on the non-working side were more affected by bolus size and chewing times than on the working sides. The crushing time of the bolus was significantly influenced by the compressive strength. Meals with small sizes and soft properties were therefore advised to lessen condylar displacements and relax the crushing process, and further reduce the loadings in the TMJ.
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Affiliation(s)
- Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, 644600, China
| | - Annan Li
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, 644600, China
| | - Hedi Ma
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, 644600, China
| | - Bingmei Shao
- Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, 644600, China; Basic Mechanics Lab, Sichuan University, Chengdu, 610065, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, 138683, Singapore
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology, Sichuan University Yibin Park, Yibin, 644600, China.
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Isaieva K, Leclère J, Felblinger J, Gillet R, Dubernard X, Vuissoz PA. Methodology for quantitative evaluation of mandibular condyles motion symmetricity from real-time MRI in the axial plane. Magn Reson Imaging 2023; 102:115-125. [PMID: 37187265 DOI: 10.1016/j.mri.2023.05.006] [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: 08/22/2022] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/17/2023]
Abstract
Diagnosis of temporomandibular disorders is currently based on clinical examination and static MRI. Real-time MRI enables tracking of condylar motion and, thus, evaluation of their motion symmetricity (which could be associated with temporomandibular joint disorders). The purpose of this work is to propose an acquisition protocol, an image processing approach, and a set of parameters enabling objective assessment of motion asymmetry; to check the reliability and find the limitations of the approach, and to verify if the automatically calculated parameters are associated with the motion symmetricity. A rapid radial FLASH sequence was used to acquire a dynamic set of axial images for 10 subjects. One more subject was involved to estimate the dependence of the motion parameters on the slice placement. The images were segmented with a semi-automatic approach based on U-Net convolutional neural network, and the condyles' mass centers were projected on the mid-sagittal axis. Resulting projection curves were used for the extraction of various motion parameters including latency, velocity peak delay, and maximal displacement between the right and the left condyle. These automatically calculated parameters were compared with the physicians' scores. The proposed segmentation approach allowed a reliable center of mass tracking. Latency and velocity peak delay were found to be invariant to the slice position, and maximal displacement difference considerably varied. The automatically calculated parameters demonstrated a significant correlation with the experts' scores. The proposed acquisition and data processing protocol enables the automatizable extraction of quantitative parameters that characterize the symmetricity of condylar motion.
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Affiliation(s)
- Karyna Isaieva
- IADI, University of Lorraine, INSERM U1254, Nancy, France.
| | - Justine Leclère
- IADI, University of Lorraine, INSERM U1254, Nancy, France; Oral Medicine Department, University Hospital of Reims, Reims, France
| | - Jacques Felblinger
- IADI, University of Lorraine, INSERM U1254, Nancy, France; CIC-IT 1433, INSERM, CHRU de Nancy, Nancy, France
| | - Romain Gillet
- IADI, University of Lorraine, INSERM U1254, Nancy, France; Guilloz Imaging Department, CHRU of Nancy, Nancy, France
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Dragus AC, Mihai A, Tanase G, Burlibasa M, Cristache CM. Intraindividual Left-Right Side Differences of Sagittal Condylar Inclination (SCI) in Different Skeletal Classes. Healthcare (Basel) 2023; 11:healthcare11091341. [PMID: 37174883 PMCID: PMC10178278 DOI: 10.3390/healthcare11091341] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/22/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
(1) Background: The temporomandibular joint (TMJ) is the most complex and one of the most important joints in the human body due to its essential roles in mastication, swallowing, breathing and speech. Several instruments have been used to track mandibular movements and register the characteristic parameters of the TMJ, among which condylography instruments are validated for the accurate clinical registration of the condylar path. Sagittal condylar inclination (SCI) is one of the most important parameters, together with the Bennett angle and the immediate side shift, used for articular settings in the process of oral rehabilitation. The aim of the present study was to evaluate the differences between the left and right SCI and to assess whether the differences were statistically significant for skeletal class, age, gender, dentate status, TMJ pathology or parafunctional habits. (2) Methods: One hundred and forty consecutive patients, fully dentate or partially edentulous, and with angle class I, II and II, were recruited. Their left and right SCIs were determined with an ultrasonic jaw tracking device. Each subject had to make three protrusive movements and three right and left laterotrusive movements. The software calculated the SCI from the mean of the protrusive movements. (3) Results: The mean values obtained for the right and left SCI were 34.68° (±12.44°) and 34.94° (±13.23°), respectively, with no statistically significant differences between the left and right values for gender, dentate status, TMJ disorders or parafunctional habits. Skeletal class III subjects registered lower SCI means, which were statistically significant for the left SCI. (4) Conclusions: For an optimal functionalization of prosthetic restorations and for an ideal treatment plan, the registration of both the left and right paths of the condyles and the articular disc should be taken into consideration.
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Affiliation(s)
- Andi Ciprian Dragus
- Oral Implantology and Gnathology Department, Dr. Dragus Clinic, 110a Stirbei Voda Street, 010109 Bucharest, Romania
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Augustin Mihai
- Doctoral School, "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Street, 020021 Bucharest, Romania
| | - Gabriela Tanase
- Implant Prosthetic Therapy, "Carol Davila" University of Medicine and Pharmacy, 19 Plevnei Ave., 010221 Bucharest, Romania
| | - Mihai Burlibasa
- Department of Dental Techniques, "Carol Davila" University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd, 050474 Bucharest, Romania
| | - Corina Marilena Cristache
- Department of Dental Techniques, "Carol Davila" University of Medicine and Pharmacy, 8, Eroilor Sanitari Blvd, 050474 Bucharest, Romania
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11
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Morikawa K, Isogai R, Nonaka J, Yoshida Y, Haga S, Maki K. A New Intraoral Six-Degrees-of-Freedom Jaw Movement Tracking Method Using Magnetic Fingerprints. SENSORS (BASEL, SWITZERLAND) 2022; 22:8923. [PMID: 36433520 PMCID: PMC9693492 DOI: 10.3390/s22228923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/12/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
We proposed a novel jaw movement tracking method that can measure in six degrees of freedom. The magnetic field generated by a permanent magnet paired with a small, low-power-consumption Hall effect magnetic sensor is used to estimate the relative distance between two objects-in this instance, the lower and upper jaws. By installing a microelectromechanical system (MEMS) orientation sensor in the device, we developed a mouthpiece-type sensing device that can measure voluntary mandibular movements in three-dimensional orientation and position. An evaluation of individuals wearing this device demonstrated its ability to measure mandibular movement with an accuracy of approximately 3 mm. Using the movement recording feature with six degrees of freedom also enabled the evaluation of an individual's jaw movements over time in three dimensions. In this method, all sensors are built onto the mouthpiece and the sensing is completed in the oral cavity. It does not require the fixation of a large-scale device to the head or of a jig to the teeth, unlike existing mandibular movement tracking devices. These novel features are expected to increase the accessibility of routine measurements of natural jaw movement, unrestricted by an individual's physiological movement and posture.
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Affiliation(s)
- Kinta Morikawa
- Department of Orthodontics, School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo 145-8515, Japan
| | - Ryosuke Isogai
- Research and Development Department, Seiko Holdings Corporation, 563, Takatsukashinden, Chiba 270-2222, Japan
| | - Junya Nonaka
- Research and Development Department, Seiko Holdings Corporation, 563, Takatsukashinden, Chiba 270-2222, Japan
| | - Yoshifumi Yoshida
- Research and Development Department, Seiko Holdings Corporation, 563, Takatsukashinden, Chiba 270-2222, Japan
| | - Shugo Haga
- Department of Orthodontics, School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo 145-8515, Japan
| | - Koutaro Maki
- Department of Orthodontics, School of Dentistry, Showa University, 2-1-1 Kitasenzoku, Ota-ku, Tokyo 145-8515, Japan
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12
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Park HI, Lee JH, Lee SJ. The comprehensive on-demand 3D bio-printing for composite reconstruction of mandibular defects. Maxillofac Plast Reconstr Surg 2022; 44:31. [PMID: 36195777 PMCID: PMC9532487 DOI: 10.1186/s40902-022-00361-7] [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: 07/12/2022] [Accepted: 09/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background The mandible is a functional bio-organ that supports facial structures and helps mastication and speaking. Large mandible defects, generally greater than 6-cm segment loss, may require composite tissue reconstruction such as osteocutaneous-vascularized free flap which has a limitation of additional surgery and a functional morbidity at the donor site. A 3D bio-printing technology is recently developed to overcome the limitation in the composite reconstruction of the mandible using osteocutaneous-vascularized free flap. Review Scaffold, cells, and bioactive molecules are essential for a 3D bio-printing. For mandibular reconstruction, materials in a 3D bio-printing require mechanical strength, resilience, and biocompatibility. Recently, an integrated tissue and organ printing system with multiple cartridges are designed and it is capable of printing polymers to reinforce the printed structure, such as hydrogel. Conclusion For successful composite tissue reconstruction of the mandible, biologic considerations and components should be presented with a comprehensive on-demand online platform model of customized approaches.
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Affiliation(s)
- Han Ick Park
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Jee-Ho Lee
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea.
| | - Sang Jin Lee
- Wake Forest Institute for Regenerative Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157, USA.
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13
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Zhao W, Yu Y, Zhang Z, He D, Zhang H. Bioinspired Nanospheres as Anti-inflammation and Antisenescence Interfacial Biolubricant for Treating Temporomandibular Joint Osteoarthritis. ACS APPLIED MATERIALS & INTERFACES 2022; 14:35409-35422. [PMID: 35894784 DOI: 10.1021/acsami.2c09120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The development of temporomandibular joint (TMJ) osteoarthritis is highly associated with mechanical overloading, which can result in accelerated cartilage degradation and damage due to increased interfacial friction and the release of inflammatory factors and catabolic enzymes. In the present study, we for the first time developed self-assembled drug-free nanospheres with pharmaceutical-active functions, which could be used as an intra-articularly injected biolubricant for the treatment of TMJ osteoarthritis based on a synergistic therapy of enhanced lubrication, anti-inflammation, and antisenescence. The nanospheres possessed the hydrophobic core of dopamine methacrylamide and the hydrophilic shell of sulfobetaine methacrylate, which formed into spherical aggregates in aqueous solution by specific interactions following reversible addition-fragmentation chain transfer polymerization. The biodegradation test, tribological test, and free radical scavenging test showed that the nanospheres were endowed with physiological stability, lubrication enhancement, and free radical scavenging capability. In addition, the in vitro cell test revealed that the nanospheres alleviated inflammatory and senescent phenotype for inflammation and oxidative stress stimulated chondrocytes. Furthermore, the in vivo animal test indicated that the nanospheres, after intra-articular injection into TMJ with an osteoarthritis environment, effectively protected condylar cartilage and subchondral bone from structural damage and attenuated cartilage matrix degradation and aging. In summary, the self-assembled nanospheres might be used as a promising biolubricant for achieving anti-inflammatory and antisenescent treatment of TMJ osteoarthritis.
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Affiliation(s)
- Weiwei Zhao
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
- Department of Biomaterials, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Provincial Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan 250012, China
| | - Yeke Yu
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai 200011, China
| | - Zhiyuan Zhang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai 200011, China
| | - Dongmei He
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology, Shanghai 200011, China
| | - Hongyu Zhang
- State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Beijing 100084, China
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14
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Scolaro A, Khijmatgar S, Rai PM, Falsarone F, Alicchio F, Mosca A, Greco C, Del Fabbro M, Tartaglia GM. Efficacy of Kinematic Parameters for Assessment of Temporomandibular Joint Function and Disfunction: A Systematic Review and Meta-Analysis. Bioengineering (Basel) 2022; 9:bioengineering9070269. [PMID: 35877320 PMCID: PMC9311583 DOI: 10.3390/bioengineering9070269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/18/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this review was to answer the following PICO question: “Do TMJ kinematic parameters (intervention and comparison) show efficacy for assessment of mandibular function (Outcome) both in asymptomatic and TMD subjects? (Population)”. PubMed, Scopus, Web of Science, Embase, Central databases were searched. The inclusion criteria were (1) performed on human, (2) English only, (3) on healthy, symptomatic or surgically altered TMJ, (4) measured dynamic kinematics of mandible or TMJ (5) with six degrees of freedom. To assess the Risk of Bias, the Joanna Briggs Institute tool for non-randomised clinical studies was employed. A pairwise meta-analysis was carried out using STATA v.17.0 (Stata). The heterogeneity was estimated using the Q value and the inconsistency index. Ninety-two articles were included in qualitative synthesis, nine studies in quantitative synthesis. The condylar inclination was significantly increased in female (effect size 0.03°, 95% CI: −0.06, 0.12, p = 0.00). Maximum mouth opening (MMO) was increased significantly in female population in comparison with males (effect size 0.65 millimetres (0.36, 1.66). Incisor displacement at MMO showed higher values for control groups compared with TMD subjects (overall effect size 0.16 millimetres (−0.37, 0.69). Evidence is still needed, considering the great variety of devices and parameters used for arthrokinematics. The present study suggests standardising outcomes, design, and population of the future studies in order to obtain more reliable and repeatable values.
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Affiliation(s)
- Alessandra Scolaro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Shahnawaz Khijmatgar
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Pooja Mali Rai
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Francesca Falsarone
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Francesca Alicchio
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Arianna Mosca
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
| | - Christian Greco
- Azienda Sanitaria dell’Alto Adige, Merano Hospital, 39100 Bolzano, Italy;
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- IRCC Orthopaedic Institute Galeazzi, 20161 Milan, Italy
| | - Gianluca Martino Tartaglia
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy; (A.S.); (S.K.); (P.M.R.); (M.D.F.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy; (F.F.); (F.A.); (A.M.)
- Correspondence:
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15
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Chęciński M, Chęcińska K, Nowak Z, Sikora M, Chlubek D. Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used. J Clin Med 2022; 11:2305. [PMID: 35566431 PMCID: PMC9102811 DOI: 10.3390/jcm11092305] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION Hyaluronic acid, steroids and blood products are popularly injected into the temporomandibular joint (TMJs) to relieve pain and increase the extent of mandibular abduction. The purpose of this review is to identify other injectable substances and to evaluate them in the above-mentioned domains. MATERIAL AND METHODS The review included articles describing clinical trials of patients treated with intra-articular injections with or without arthrocentesis. RESULTS The following emerging substances were initially evaluated to be effective in treating TMJ pain and increasing the amplitude of mandibular abduction: analgesics, dextrose with lidocaine, adipose tissue, nucleated bone marrow cells and ozone gas. DISCUSSION Better effects of intra-articular administration are achieved by preceding the injection with arthrocentesis. CONCLUSIONS The most promising substances appear to be bone marrow and adipose tissue.
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Affiliation(s)
- Maciej Chęciński
- Department of Oral Surgery, Preventive Medicine Center, Komorowskiego 12, 30-106 Cracow, Poland;
| | - Kamila Chęcińska
- Department of Glass Technology and Amorphous Coatings, Faculty of Materials Science and Ceramics, AGH University of Science and Technology, Mickiewicza 30, 30-059 Cracow, Poland;
| | - Zuzanna Nowak
- Department of Temporomandibular Disorders, Medical University of Silesia in Katowice, Traugutta 2, 41-800 Zabrze, Poland;
| | - Maciej Sikora
- Department of Maxillofacial Surgery, Hospital of the Ministry of Interior, Wojska Polskiego 51, 25-375 Kielce, Poland;
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Dariusz Chlubek
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
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16
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Woodford SC, Robinson DL, Edelmann C, Mehl A, Röhrle O, Vee Sin Lee P, Ackland DC. Low-Profile Electromagnetic Field Sensors in the Measurement and Modelling of Three-Dimensional Jaw Kinematics and Occlusal Loading. Ann Biomed Eng 2021; 49:1561-1571. [PMID: 33409850 DOI: 10.1007/s10439-020-02688-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 11/04/2020] [Indexed: 11/30/2022]
Abstract
Dynamic occlusal loading during mastication is clinically relevant in the design and functional assessment of dental restorations and removable dentures, and in evaluating temporomandibular joint dysfunction. The aim of this study was to develop a modelling framework to evaluate subject-specific dynamic occlusal loading during chewing and biting over the entire dental arch. Measurements of jaw motion were performed on one healthy male adult using low-profile electromagnetic field sensors attached to the teeth, and occlusal anatomy quantified using an intra-oral scanner. During testing, the subject chewed and maximally compressed a piece of rubber between both second molars, first molars, premolars and their central incisors. The occlusal anatomy, rubber geometry and experimentally measured rubber material properties were combined in a finite element model. The measured mandibular motion was used to kinematically drive model simulations of chewing and biting of the rubber sample. Three-dimensional dynamic bite forces and contact pressures across the occlusal surfaces were then calculated. Both chewing and biting on the first molars produced the highest bite forces across the dental arch, and a large amount of anterior shear force was produced at the incisors and the second molars. During chewing, the initial tooth-rubber contact evolved from the buccal sides of the molars to the lingual sides at full mouth closure. Low-profile electromagnetic field sensors were shown to provide a clinically relevant measure of jaw kinematics with sufficient accuracy to drive finite element models of occlusal loading during chewing and biting. The modelling framework presented provides a basis for calculation of physiological, dynamic occlusal loading across the dental arch.
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Affiliation(s)
- Sarah C Woodford
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Dale L Robinson
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Cornelia Edelmann
- Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Albert Mehl
- Centre of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Oliver Röhrle
- Institute for Modelling and Simulation of Biomechanical Systems, University of Stuttgart, Stuttgart, Germany
| | - Peter Vee Sin Lee
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia
| | - David C Ackland
- Department of Biomedical Engineering, University of Melbourne, Parkville, VIC, 3010, Australia.
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