Lateral cephalometric analysis of mandibular morphology: discrimination among subjects with and without temporomandibular joint disk displacement and osteoarthrosis

Transcriptomes in peripheral blood of young females with temporomandibular joint osteoarthritis

This study aimed to investigate immune-related pathophysiology of the temporomandibular joint (TMJ) osteoarthritis (OA) in young females by analyzing transcriptional profiles of peripheral blood mononuclear cells. The RNA-sequencing (RNA-seq) was conducted on 24 young females with TMJ OA (mean age 19.3 ± 3.1 years) (RNAOA) and 11 age and sex matched healthy controls (mean age 20.5 ± 3.7 years) (CON). RNA-seq datasets were analyzed to identify genes, pathways, and regulatory networks of those which were involved in the development of TMJ OA. RNA-seq data analysis revealed 41 differentially expressed genes (DEGs) between RNAOA and CON. A total of 16 gene ontology (GO) terms including three molecular and 13 biological terms were annotated via the GO function of molecular function and biological process. Through ingenuity pathway analysis (IPA), 21 annotated categories of diseases and functions were identified. There were six hub genes which showed significant results in both GO enrichment analysis and IPA, namely HLA-C, HLA-F, CXCL8, IL11RA, IL13RA1, and FCGR3B. The young females with TMJ OA showed alterations of the genes related to immune function in the blood and some of changes may reflect inflammation, autoimmunity, and abnormal T cell functions.

Associations Among Temporomandibular Joint Osteoarthritis, Airway Dimensions, and Head and Neck Posture

PURPOSE

This study sought to investigate associations among progressive temporomandibular joint osteoarthritis (TMJ OA), airway dimensions, and head and neck posture.

MATERIALS AND METHODS

In total, 114 temporomandibular disorders (TMDs) patients were enrolled. Among 114 patients, 28 had no pathologic bony changes in the TMJ condyles (TMDnoOA), 45 had progressive TMJ OA (TMJOApro), and 41 demonstrated TMJ OA which had not progressed for 12 months (TMJOAnopro). TMJ OA was diagnosed based on the Diagnostic Criteria for TMD axis I. Computed tomography (CT) images and lateral cephalograms were obtained at baseline (T0) and 12 months after treatment (T1). The head and neck posture and airway area in upright position were analyzed using lateral cephalograms whereas airway volume in supine position was determined by 3D reconstructed CT images.

RESULTS

The volume change of the oropharynx in supine position was more prominent in the TMJOApro than in the TMDnoOA but no significant differences in changes in the pharyngeal airway while in upright position were detected. The retrognathic facial profile became more remarkable at T1 in the TMJOApro and TMJOAnopro compared to those at T0. The forward head posture seemed to be progressed in the TMJOApro than in either the TMJOAnopro or TMDnoOA.

CONCLUSION

Progressive TMJ OA may have associations with retrognathia and decreased oropharyngeal airway volume in the supine position but not in the upright position. Progressive TMJ OA may be related with altered head posture in the upright position to compensate for reduced airway dimensions.

Characteristics of patients with temporomandibular joint osteoarthrosis on magnetic resonance imaging

INTRODUCTION

Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The aim of this study was to investigate the characteristics of the patients with TMJ osteoarthrosis on MR imaging.

METHODS

The MR images of 206 TMJs of 103 patients with temporomandibular disorders (TMD) were evaluated retrospectively in this study. The relationship between osteoarthrosis and age, gender, TMJ pain and MR imaging findings, such as disc displacement with or without reduction and TMJ effusion, was analysed.

RESULTS

The patients with TMJ osteoarthrosis (mean: 51.6 years) were significantly older than those without osteoarthrosis (mean: 44.8 years, P = 0.027). The incidence of the patients with TMJ osteoarthrosis was significantly different between with (10.0 %) and without reduction (57.0 %, P < 0.001). Logistic multivariate regression analysis demonstrated that disc displacement without reduction was significant in patients with TMJ osteoarthrosis (odds ratio = 12.285, P < 0.001).

CONCLUSIONS

This study suggests that characteristics of the patients with TMJ osteoarthrosis on MR imaging include older and disc displacement without reduction.

Skeletal maturation and predicted adult height in adolescents with temporomandibular joint osteoarthritis

BACKGROUND

The occurrence of osteoarthritis (OA) of the temporomandibular joint (TMJ) in juveniles could be associated with fluctuating levels of oestrogen and growth hormone (GH) during adolescence.

OBJECTIVE

To investigate extent of skeletal maturation and predicted adult height in adolescents with TMJ OA.

METHOD

In total, 155 adolescents (54 males, 101 females; mean age, 14.1 ± 2.0 years) were enrolled. Among them, 19 adolescents (CON) showed no sign of TMD, 50 adolescents exhibited signs of disc displacement but did not have TMJ OA (TMDnoOA), 23 adolescents exhibited the initial stage of TMJ OA (TMJOAini) and 63 adolescents exhibited the severe stage of TMJ OA (TMJOApro). TMJ OA was diagnosed based on the Research Diagnostic Criteria axis I and bone age was estimated using the Greulich-Pyle method. The height, weight and body mass index of participated adolescents were measured and statistically converted to z-scores. The predicted adult height and age of peak height velocity (APHV) were calculated using the BoneXpert® software.

RESULTS

In female adolescents, the differences between the chronological and bone ages were significantly higher and the z-score for height was significantly lower in the TMJOApro. Female adolescents with TMJOA exhibited a significantly shorter predicted adult height and earlier APHV than those in the CON and TMDnoOA.

CONCLUSION

The adolescents with TMJ OA exhibited premature skeletal maturations and short predicted adult stature, particularly the female adolescents.

Condylar long axis and articular eminence in MRI in patients with temporomandibular disorders

OBJECTIVE

To compare morphologic findings in MRI and skeletal divergence of a group of patients with temporomandibular joint disorders (TMD) subdivided into condylar symmetric and asymmetric.

METHODS

Fifty-nine adults (26.7 years old) with TMD were retrospectively recruited. Condylar height symmetry was evaluated by orthopantomography (Habets's method) and used to divide patients into Symmetric and Asymmetric groups; skeletal divergence was assessed on lateral cephalograms. MRI was used to evaluate the condylar long axis' angle, the glenoid fossa morphology, and the degree of disc displacement.

RESULTS

Asymmetric subjects showed a hyperdivergent skeletal pattern (p = 0.036), asymmetric condylar long axis (p = 0.018), and deeper (p = 0.025) and asymmetric (p = 0.001) glenoid fossa compared to symmetric subjects.

CONCLUSION

Patients with TMD and condylar asymmetry diagnosed with orthopantomography are more likely to show hyperdivergent skull in cephalometry, condylar asymmetry of both height and major axis, and a steeper glenoid fossa in MRI.

Incidence of anterior disc displacement without reduction of the temporomandibular joint in patients with dentofacial deformity

The aim of this study was to investigate the incidence of anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) in patients with dentofacial deformity. Eighty-eight female patients (176 joints) with skeletal class III malocclusion and 33 female patients (66 joints) with skeletal class II malocclusion, with or without anterior open bite and asymmetry, were evaluated. Magnetic resonance imaging (MRI) of the TMJ was used to diagnose ADDwoR. A statistical analysis was performed to examine the relationship between ADDwoR and skeletal structure. ADDwoR was present in 37 of the 66 joints (56.1%) in class II compared to 34 of the 176 joints (19.3%) in class III (P<0.05). In class III, ADDwoR was significantly more common in joints with mandibular asymmetry (24/74; 32.4%) than in joints with open bite (9/62; 14.5%) and joints with open bite and without mandibular asymmetry (1/38; 2.6%). In class II, ADDwoR was significantly less common in joints with mandibular asymmetry and without open bite (1/8; 12.5%). ADDwoR was only observed on the deviated side in both class III and class II with mandibular asymmetry. The prevalence of ADDwoR differed according to the dentofacial morphology.

Vertical Craniofacial Morphology and its Relation to Temporomandibular Disorders

Objectives

This study investigated the association between craniofacial morphology and temporomandibular disorders in adults. The influence of different craniofacial morphologies on painful temporomandibular disorders was also evaluated.

Material and Methods

A total of 200 subjects were selected, including 100 with temporomandibular disorders (TMD) and 100 without TMD (control), diagnosed by research diagnostic criteria for temporomandibular disorders. All subjects were submitted to lateral cephalometric radiographs, and classified as brachyfacial, mesofacial, or dolichofacial by Ricketts’ analysis. Data were analysed by Tukey-Kramer and Chi-square tests.

Results

No association between craniofacial morphology and TMD was found (P = 0.6622). However, brachyfacial morphology influences the presence of painful TMD (P = 0.0077).

Conclusions

Craniofacial morphology is not related to temporomandibular disorders in general.

Temporomandibular joint condylar changes following maxillomandibular advancement and articular disc repositioning

PURPOSE

To evaluate condylar changes 1 year after bimaxillary surgical advancement with or without articular disc repositioning using longitudinal quantitative measurements in 3-dimensional (3D) temporomandibular joint (TMJ) models.

METHODS

Twenty-seven patients treated with maxillomandibular advancement (MMA) underwent cone-beam computed tomography before surgery, immediately after surgery, and at 1-year follow-up. All patients underwent magnetic resonance imaging before surgery to assess disc displacements. Ten patients without disc displacement received MMA only. Seventeen patients with articular disc displacement received MMA with simultaneous TMJ disc repositioning (MMA-Drep). Pre- and postsurgical 3D models were superimposed using a voxel-based registration on the cranial base.

RESULTS

The location, direction, and magnitude of condylar changes were displayed and quantified by graphic semitransparent overlays and 3D color-coded surface distance maps. Rotational condylar displacements were similar in the 2 groups. Immediately after surgery, condylar translational displacements of at least 1.5 mm occurred in a posterior, superior, or mediolateral direction in patients treated with MMA, whereas patients treated with MMA-Drep presented more marked anterior, inferior, and mediolateral condylar displacements. One year after surgery, more than half the patients in the 2 groups presented condylar resorptive changes of at least 1.5 mm. Patients treated with MMA-Drep presented condylar bone apposition of at least 1.5 mm at the superior surface in 26.4%, the anterior surface in 23.4%, the posterior surface in 29.4%, the medial surface in 5.9%, or the lateral surface in 38.2%, whereas bone apposition was not observed in patients treated with MMA.

CONCLUSIONS

One year after surgery, condylar resorptive changes greater than 1.5 mm were observed in the 2 groups. Articular disc repositioning facilitated bone apposition in localized condylar regions in patients treated with MMA-Drep.

Magnetic resonance imaging-verified temporomandibular joint disk displacement in relation to sagittal and vertical jaw deformities

This retrospective study was designed to analyze the relationships between temporomandibular joint (TMJ) disk displacement and skeletal deformities in orthodontic patients. Subjects consisted of 460 adult patients. Before treatment, lateral cephalograms and TMJ magnetic resonance imaging (MRI) were recorded. Subjects were divided into six groups based on TMJ MRI according to increasing severity of TMJ disk displacement, in the following order: bilateral normal TMJs, unilateral disk displacement with reduction (DDR) and contralateral normal, bilateral DDR, unilateral disk displacement without reduction (DDNR) and contralateral normal, unilateral DDR and contralateral DDNR, and bilateral DDNR. Subjects were subdivided sagittally into skeletal Class I, II, and III deformities based on the ANB (point A, nasion, point B) angle and subdivided vertically into hypodivergent, normodivergent, and hyperdivergent deformities based on the facial height ratio. Linear trends between severity of TMJ disk displacement and sagittal or vertical deformities were analyzed by Cochran-Mantel-Haenszel test. The severity of TMJ disk displacement increased as the sagittal skeletal classification changed from skeletal Class III to skeletal Class II and the vertical skeletal classification changed from hypodivergent to hyperdivergent. There were no significant differences in the linear trend of TMJ disk displacement severity between the sexes according to the skeletal deformities. This study suggests that subjects with skeletal Class II and/or hyperdivergent deformities have a high possibility of severe TMJ disk displacement, regardless of sex.