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Omami G, Miller CS. Imaging Evaluation of the Temporomandibular Joint. Dent Clin North Am 2024; 68:357-373. [PMID: 38417995 DOI: 10.1016/j.cden.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This article describes the anatomy and function of the temporomandibular joint (TMJ), provides an overview of the various imaging modalities available for evaluating the TMJ, and discusses a variety of miscellaneous diseases that affect the TMJ.
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Affiliation(s)
- Galal Omami
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, Department of Oral Health Practice, University of Kentucky College of Dentistry, 770 Rose Street, D-140, Lexington, KY 40536, USA.
| | - Craig S Miller
- Division of Oral Diagnosis, Oral Medicine, and Oral Radiology, University of Kentucky College of Dentistry, 770 Rose Street, D-140, Lexington, KY 40536, USA
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Zhang Y, Yu F, Long X, Fang W. Imaging features of temporomandibular joint synovial chondromatosis with associated osseous degenerative changes. Int J Oral Maxillofac Surg 2024; 53:311-318. [PMID: 37840000 DOI: 10.1016/j.ijom.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023]
Abstract
Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign disease associated with the formation of multiple cartilaginous nodules in the synovial tissue of the TMJ. This can result in pain, swelling, clicking, limited mouth opening, and osseous degenerative joint changes. A retrospective cross-sectional study was performed to summarize the clinical features, radiographic findings, and surgical and histopathological findings of TMJ SC patients who underwent open surgery over a 24-year period. A radiographic scoring system was used to evaluate osseous changes and correlate condyle and joint fossa degeneration. The study included 38 patients and focused on 38 joints. All 38 of these joints showed degenerative changes in the condyle, while 37 showed osseous degenerative changes in the articular fossa. The degree of condylar degenerative changes was related to the duration of the chief complaints (r = 0.342, P = 0.036) and the histopathological stage of the TMJ SC (r = 0.440, P = 0.006), while the degree of joint fossa degenerative changes was associated with the radiographic extent of the SC (r = 0.504, P = 0.001), type of calcification (r = 0.365, P = 0.024), and the histopathological stage (r = 0.458, P = 0.004).
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Affiliation(s)
- Y Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China; Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Shandong Key Laboratory of Oral Tissue Regeneration, and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - F Yu
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - X Long
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China; Department of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - W Fang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China; Department of Oral and Maxillofacial Trauma and Temporomandibular Joint Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China.
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Dolwick MF, Widmer CG. Temporomandibular joint surgery: the past, present, and future. Int J Oral Maxillofac Surg 2024; 53:301-310. [PMID: 38135637 DOI: 10.1016/j.ijom.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
Temporomandibular joint surgery for various pathological conditions and diseases affecting the integrity, mobility, and function of the joint has a long history. However, the greatest explosion of knowledge regarding the diagnosis and management of temporomandibular joint pain, pathology, and rehabilitation has occurred in the last 50 years. This review focuses on the incremental expansion of knowledge over time that led to the development of concepts that support our current surgical decisions and techniques, with the aim of identifying gaps in knowledge that require well-designed studies to move the field forward. Using this approach will allow an enhancement of our understanding of temporomandibular joint form and function, and enable focus to be placed on the evaluation, diagnosis, and non-surgical and surgical management strategies that are the most efficacious for our patients.
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Affiliation(s)
- M F Dolwick
- Department of Oral and Maxillofacial Surgery, University of Florida, Gainesville, Florida, USA
| | - C G Widmer
- Division of Facial Pain, Department of Orthodontics, University of Florida, Gainesville, Florida, USA.
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Angst L, Koolstra JH, Wiedemeier D, Van Sluijs RM, Pulfer AM, Gallo LM, Colombo V. Masticatory Muscles Activation and TMJ Space During Asymmetrically Loaded Jaw Closing. Ann Biomed Eng 2024; 52:877-887. [PMID: 38214777 PMCID: PMC10940448 DOI: 10.1007/s10439-023-03424-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 12/09/2023] [Indexed: 01/13/2024]
Abstract
Masticatory muscle activation and temporomandibular joint (TMJ) load generated during asymmetrically loaded jaw closing are largely unknown. Two different strategies were developed to explain how the central nervous system (CNS) generates muscle activation patterns during motion: minimization of joint load (MJL) vs. minimization of muscle effort (MME). The aim of the present study was to investigate, experimentally, the neuromuscular strategy selected by the CNS to coordinate jaw closing in reaction to the application of an external asymmetric load. Masticatory muscle activation was measured with electromyography (EMG) and the minimum intra-articular distance (MID) was assessed by dynamic stereometry to infer joint loading. Ten healthy subjects performed jaw-closing movements against an asymmetric mandibular load set from 0.0 to 2.0 kg in 0.5-kg steps. Recordings were analyzed by exploratory and graphical statistical tools. Moreover, the observed differences in MID and EMG among the various mandibular loads were tested using non-parametric tests for repeated measures data. The ipsilateral-contralateral differences in MID and EMG of the anterior temporalis showed a significant increase (p < 0.001, p = 0.01) with increasing asymmetrical load with both joints being most heavily loaded at 1 kg. EMG signals of the masseter did not change significantly with increasing load. This study is the first to have analyzed the changes in the TMJ intra-articular space during asymmetrically loaded jaw-closing movements, not only three dimensionally and dynamically, but also combined with EMG. Asymmetrical load affected the TMJ space and masticatory muscle activation patterns, primarily resulting in an increased activation of the anterior temporalis muscle. This might suggest the involvement of a control mechanism to protect the joints from overloading. However, the results do not fully support the hypothesis of MJL nor the MME strategy.
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Affiliation(s)
- Lea Angst
- Clinic of Masticatory Disorders, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Jan Harm Koolstra
- Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute MOVE, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Daniel Wiedemeier
- Statistical Services, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Rachel M Van Sluijs
- Department of Functional Anatomy, Academic Centre for Dentistry Amsterdam (ACTA), Research Institute MOVE, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Anina M Pulfer
- Clinic of Masticatory Disorders, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Luigi M Gallo
- Clinic of Masticatory Disorders, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Vera Colombo
- Clinic of Masticatory Disorders, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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Taghizadeh Delkhoush C, Purzolfi M, Mirmohammadkhani M, Sadollahi H, Tavangar S. The linear intra-articular motions of the temporomandibular joint in individuals with severe forward head posture: A cross-sectional study. Musculoskelet Sci Pract 2024; 70:102908. [PMID: 38246011 DOI: 10.1016/j.msksp.2024.102908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND The cervical vertebrae and the temporomandibular joint (TMJ) may be linked through their common muscles. OBJECTIVES The aim of the present study was to compare the linear intra-articular motions of the TMJ between individuals with the normal craniocervical posture (CCP) and severe forward head posture (FHP). DESIGN Cross-sectional study. METHODS Volunteers (N = 38) were equally assigned to either the severe FHP group or the normal CCP group according to their craniovertebral angle (CVA). The CVA angles greater than 49° were considered as the normal CCP while angles between 44 and 40° were regarded as the severe FHP. The TMJ was imaged at the closed, median, and maximum open positions of the mouth using an ultrasound machine with a 7.5 MHz linear transducer in the sitting position. The best-fitting curve in the contour registration method was employed to measure displacement of the mandibular condyle on the transverse and vertical axes. RESULTS The forward displacement of the mandibular condyle in the severe FHP group was significantly (p-value = 0.037) reduced compared to the normal CCP group at maximum open position of the mouth, while no significant difference was revealed at closed (p-value = 0.937) or median open (p-value = 0.699) positions. The perpendicular displacement of the mandibular condyle exhibited no significant (p-value>0.107) difference between groups at any mouth position. DISCUSSION The current study demonstrated, for the first time, that severe FHP may impact the intra-articular motion of the TMJ. This study presumed that individuals with severe FHP may encounter a force imbalance in the anterior-posterior direction.
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Affiliation(s)
| | - Mahdis Purzolfi
- Department of Physiotherapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran.
| | - Majid Mirmohammadkhani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Hasti Sadollahi
- School of Dentistry, Semnan University of Medical Sciences, Semnan, Iran.
| | - Shiva Tavangar
- Department of Physiotherapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran.
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Ganem A, Rossouw PE, Michelogiannakis D, Javed F. Antinociceptive Efficacy of Shamanic Healing for the Management of Temporomandibular Disorders: An Evidence-Based Review. J Relig Health 2024; 63:942-953. [PMID: 37269379 DOI: 10.1007/s10943-023-01844-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
The aim of this evidence-based review was to assess the antinociceptive efficacy of shamanic healing (SH) for management of temporomandibular disorders (TMD). The addressed focused question was "Is SH effective for the management of TMD?" Indexed databases were searched without time and language restrictions up to and including January 2023 using the following keywords: "disc displacement disorders"; "healing"; "inflammation"; "pain"; "shamanic"; "therapy"; "temporomandibular joint"; "temporomandibular disorders" and "temporomandibular joint disorders". Clinical studies were considered eligible for inclusion. Editorials, case-reports, case-series and commentaries were excluded. Literature search was performed in accordance with the guidelines of the preferred reporting items for systematic review and meta-analysis. Pattern of this evidence-based review was customized to summarize the pertinent information. In the present review, three studies were included and processed for data extraction. All participants were females with a mean age of 38.3 ± 8.3 years (range 25-55 years). Self-rated pain was assessed before application of SH (baseline) and after 9 months of follow-up. In one study, SH significantly reduced self-rated TMD pain scores (P < 0.001) at 9-months' follow-up interview. In all studies patients reported that management of TMD via SH helped improve their quality of life. In one study patients perceived improvements in sleep, energy levels, digestion, and back pain at follow-up. In another study patients reported that they felt "calmer" and "at peace" at follow-up interview. The possible contribution of SH for managing pain among TMD patients warrants additional research. There is a dire need for well-designed and power-adjusted randomized clinical trials with adequate groups and long-term follow-up.
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Affiliation(s)
- Atheer Ganem
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA
| | - P Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA
| | - Fawad Javed
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Ave, Rochester, NY, 14620, USA.
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Sırlı Yılmazturk S, Bozdemir E, Orhan K, Orhan H. Evaluation of morphological and morphometric characteristics of the temporomandibular joint in children with different skeletal models in the sagittal and vertical direction. Oral Radiol 2024; 40:178-187. [PMID: 38010496 DOI: 10.1007/s11282-023-00718-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/27/2023] [Indexed: 11/29/2023]
Abstract
OBJECTIVE This study aims to evaluate differences in the morphological and morphometric features of hard tissue components of the temporomandibular joint (TMJ) in the cone beam computed tomography (CBCT) images of children with different skeletal models in the sagittal and vertical plane. METHODS Condyle dimensions, horizontal condylar angle, the distance of the condyle center to the midsagittal plane, condyle position, eminence height, eminence inclination, condyle, and fossa shape and symmetry were evaluated in CBCT images in 190 TMJs in 95 pediatric patients. Patients were classified as Class 1-2-3 in the sagittal direction, as hypodivergent, normodivergent, and hyperdivergent in the vertical direction. Children were divided into 10-13 and 14-17 age groups. RESULTS The left superior joint space in children with a different skeletal model in the sagittal plane was lower and found to be statistically significant in Class 3 children (p < 0.05). A statistically significant difference was found lower in the left articular eminence inclination and height in Class 3 children (p < 0.05). The most common oval fossa form was seen in Classes 2-3 children (p < 0.05). It was determined that the anterior joint space was lower in hyperdivergent children and the condyle was located more anteriorly. The mediolateral length of the condyle and the height of the articular eminence were positively correlated with age. CONCLUSIONS The results revealed that the difference in skeletal models seen in sagittal and vertical planes in children may cause morphological and morphometric changes in the hard tissue components of TMJ.
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Affiliation(s)
- Sinem Sırlı Yılmazturk
- Likyadent Oral and Dental Health Polyclinic, Taşyaka Mh.137.Sk. No:14 D.1-2 Fethiye, Muğla, Turkey.
| | - Esin Bozdemir
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Hikmet Orhan
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
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Woodford SC, Robinson DL, Abduo J, Lee PVS, Ackland DC. Muscle and joint mechanics during maximum force biting following total temporomandibular joint replacement surgery. Biomech Model Mechanobiol 2024:10.1007/s10237-023-01807-1. [PMID: 38502434 DOI: 10.1007/s10237-023-01807-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/20/2023] [Indexed: 03/21/2024]
Abstract
Total temporomandibular joint replacement (TMJR) surgery is the established treatment for severe temporomandibular joint disorders. While TMJR surgery is known to increase mouth-opening capacity, reduce pain and improve quality of life, little is known about post-surgical jaw function during activities of daily living such as biting and chewing. The aim of this study was to use subject-specific 3D bite force measurements to evaluate the magnitude and direction of joint loading in unilateral total TMJR patients and compare these data to those in healthy control subjects. An optoelectronic tracking system was used to measure jaw kinematics while biting a rubber sample for 5 unilateral total TMJR patients and 8 controls. Finite element simulations driven by the measured kinematics were employed to calculate the resultant bite force generated when compressing the rubber between teeth during biting tasks. Subject-specific musculoskeletal models were subsequently used to calculate muscle and TMJ loading. Unilateral total TMJR patients generated a bite force of 249.6 ± 24.4 N and 164.2 ± 62.3 N when biting on the contralateral and ipsilateral molars, respectively. In contrast, controls generated a bite force of 317.1 ± 206.6 N. Unilateral total TMJR patients biting on the contralateral molars had a significantly higher lateral TMJ force direction (median difference: 63.6°, p = 0.028) and a significantly lower ratio of working TMJ force to bite force (median difference: 0.17, p = 0.049) than controls. Results of this study may guide TMJ prosthesis design and evaluation of dental implants.
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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
| | - Jaafar Abduo
- Melbourne Dental School, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Peter V S 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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Naralan ME, Cakir B, Orhan K. The utilization of decision trees on orthopantomographic and lateral panoramic graphs for the diagnosis of unilateral anterior disc displacement of the temporomandibular joint. BMC Oral Health 2024; 24:340. [PMID: 38493117 PMCID: PMC10943886 DOI: 10.1186/s12903-024-04121-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 03/07/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Investigation is to utilize decision trees in conjunction with orthopantomography (OPT) and lateral panoramic graphy (LPG) to diagnose unilateral anterior disc displacement (ADD) of the temporomandibular joint. METHODS In this study, 161 patients with images obtained through all three imaging methods, MRI, OPT, and LPG, were selected from the archives. The participants were categorized into two groups: the study group, comprising 89 patients with unilateral anterior disc displacement, and the control group, consisting of 72 healthy individuals. Measurements, including 2 angles (antero-posterior angle and superior-inferior angle) and 3 distance parameters (anterior joint space distance, superior joint space distance, and posterior joint space distance), were conducted on each imaging modality dataset. To assess the obtained measurement data within each patient, the differences from each measurement were calculated. Statistical analysis of the measurement differences between the control and study groups was carried out with independent t test, and decision trees were generated using the SPSS 25 decision tree module 5.0. RESULTS In ADD patients, it was statistically significantly found that the APA increased while the SIA decreased for angle measurements. But for linear measurements, AS increased while the SS and PS decreased in MRI, OPT, and LPG. CONCLUSION ADD can be diagnosed in OPT and LPG. The identification of the specific type of ADD that occurs in the temporomandibular joint is not feasible.
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Affiliation(s)
- Muhammed Enes Naralan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, 53020, Turkey.
| | - Binali Cakir
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Resnick CM. Pediatric Temporomandibular Joint Pathology. Oral Maxillofac Surg Clin North Am 2024:S1042-3699(24)00008-6. [PMID: 38462395 DOI: 10.1016/j.coms.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Pediatric temporomandibular joint (TMJ) disorders represent a broad range of congenital and acquired diagnoses. Dentofacial deformities, including facial asymmetry, retrognathism, and malocclusion, commonly develop. Compared with adult TMJ conditions, pain and articular disc pathology are less common. Accurate diagnosis is paramount in planning and prognostication. Several specific considerations apply in preparation for skeletal correction, including timing in relation to disease progression and growth trajectory, expectation for postcorrection stability, reconstructive technique as it applies to expected durability and need for future revision, management of occlusion, and need for ancillary procedures to optimize correction. This article reviews common conditions and treatment considerations.
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Affiliation(s)
- Cory M Resnick
- Department of Oral and Maxillofacial Surgery, Harvard Medical School, Boston, MA, USA; Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA.
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Hirouchi H, Suzuki R, Hanada S, Takeuchi Y, Sugiyama Y, Takayama T, Hayashi K, Murakami G, Abe S. Exploratory Study of Growth of Circumference of Mandibular Fossa Adjacent to Petrous Portion of Temporal Bone Using Dried Skulls. Bull Tokyo Dent Coll 2024; 65:11-17. [PMID: 38355117 DOI: 10.2209/tdcpublication.2023-0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
The morphogenetic process of development of the circumference of the mandibular fossa during tooth eruption, which involves the replacement of deciduous teeth with permanent teeth, is strongly affected by occlusion. To the best of our knowledge, no studies have investigated the effect of occlusion on this process. This study investigated the morphogenetic process of development during tooth eruption using dried skulls harvested from Indian donors. The average distance between the ala-major-squamosa suture and the foramen ovale according to age group was as follows: 3.24 mm in the 8-month-old group and 8.92 mm in the adult group. The average distance between the ala-major-squamosa suture and the apex of the articular tubercle according to age groups was as follows: 10.38 mm in the 8-month-old group and 19.34 mm in the adult group. The average distance between the point of intersection of the petrosquamous fissure and petrotympanic fissure located on the perpendicular line drawn posteriorly from the shortest distance of the medio-lateral axis between the ala-major-squamosa suture and the apex of the articular tubercle according to age group was as follows: 9.68 mm in the 8-month-old group and 14.3 mm in the adult group. These results suggest that the mandibular fossa is strongly affected by load due to occlusion, unlike the growth of the neurocranium. This indicates that the effect of occlusion is a secondary element in the morphogenetic process of development of the circumference of the mandibular fossa.
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Affiliation(s)
| | - Ryu Suzuki
- Department of Anatomy, Tokyo Dental College
| | | | | | - Yuki Sugiyama
- Department of Anatomy, Tokyo Dental College
- Dentistry and Oral surgery, The Jikei University School of Medicine
| | - Takeshi Takayama
- Dentistry and Oral surgery, The Jikei University School of Medicine
| | | | - Gen Murakami
- Department of Anatomy, Tokyo Dental College
- Division of Internal Medicine, Cupid Clinic
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Zhu J, Gong Y, Zheng F, Yin D, Liu Y. Relationships between functional temporomandibular joint space and disc morphology, position, and condylar osseous condition in patients with temporomandibular disorder. Clin Oral Investig 2024; 28:193. [PMID: 38438806 DOI: 10.1007/s00784-024-05579-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/25/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To investigate the correlations between joint space and temporomandibular joint (TMJ) components and the compressive states of the disc and condyle subsequent to joint space changes. MATERIALS AND METHODS A total of 240 TMJs were categorized according to disc morphology, disc position, and condylar osseous condition. The two-dimensional (2D) and three-dimensional (3D) measurements were compared. The functional joint space (FJS) and disc areas on closed- and open-mouth images (DA-C and DA-O) were also calculated, and the joint space was measured in five directions. Different groups of TMJ components were compared. A spring model was used to simulate the effect of condylar displacement on the disc and condyle. RESULTS Disc morphology was strongly correlated with its position. The measurements were equivalent between 2D and 3D methods. DA-C and FJS differed significantly between groups. The DA-C to FJS ratio differed between the Class 2 and Class 3 groups and between disc displacement groups with and without reduction. Altered disc morphology and position were correlated with significant changes in joint space in the 60°, 90°, and 120° directions. Despite minor discrepancies among condylar osseous conditions, reduced joint space was correlated with bone destruction at the corresponding site. The spring model stimulation revealed that condylar displacement caused elevated stresses on the disc and condyle. CONCLUSIONS Condylar displacement causes joint space alterations while exerting compressive pressure on both the disc and condyle. CLINICAL RELEVANCE Proper condylar positioning within the fossa is recommended to ensure sufficient articular disc accommodation.
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Affiliation(s)
- Jinyi Zhu
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Yanji Gong
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Fangjie Zheng
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China
| | - Deqiang Yin
- College of Aerospace Engineering, Chongqing University, Chongqing, 400044, China.
| | - Yang Liu
- National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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Fiedler M, Meier JK, Gottsauner JM, Eichberger J, Reichert TE, Ettl T. Treatment of late-onset temporomandibular joint prosthesis infection by prosthesis revision: a case report. Oral Maxillofac Surg 2024; 28:451-454. [PMID: 36602552 DOI: 10.1007/s10006-022-01136-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023]
Abstract
Late-onset infection of an inserted temporomandibular joint prosthesis is a difficult complication to treat. Most treatment protocols for late prosthetic infections include device replacement. A 40-year-old female patient with an infected and exposed temporomandibular joint prosthesis presented 3 years after implant placement. The patient was treated with prosthesis revision including fistula coverage with a temporalis muscle flap and prolonged antibiotic therapy for 10 weeks. Since completion of treatment, the patient has been infection-free.
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Affiliation(s)
- Mathias Fiedler
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
| | - Johannes K Meier
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Josef Maximilian Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Jonas Eichberger
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Torsten E Reichert
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Tobias Ettl
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
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14
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Keith DA, Handa S, Mercuri LG. Peri-articular bone formation involving the temporomandibular joint: a narrative summary and Delphi consensus of a new classification system. Int J Oral Maxillofac Surg 2024; 53:212-218. [PMID: 37777385 DOI: 10.1016/j.ijom.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/30/2023] [Accepted: 09/04/2023] [Indexed: 10/02/2023]
Abstract
Heterotopic ossification (HO) is defined as 'bone where it does not belong'. Given the historical variety of nomenclature and eponyms, there is significant confusion about the etiology, pathogenesis, classification, and treatment of HO related to the temporomandibular joint (TMJ). The existing classifications for TMJ HO have shortcomings: they relate to specific populations, use differing imaging studies and demographic data, do not universally include alloplastic/autologous replacements, are based variously on radiological and/or clinical presentations that cannot always be combined, and were largely developed to assist oral and maxillofacial surgeons in surgical management. These deficiencies make it problematic to compare studies, draw valid conclusions, and pursue research. The aim of this study was to develop a new, more inclusive classification for TMJ HO. Currently available classifications were evaluated and a Delphi-type system used to build consensus from clinicians and researchers to develop a new system. Fourteen unique classifications for TMJ ankylosis/HO were identified. In light of the biological specifics related to heterotopic calcification of extracellular matrix versus heterotopic formation of actual bone, the group recommends a more unambiguous term - peri-articular bone formation - and proposes a new classification. This will help clinicians and researchers to study, describe, and manage various types of ectopic bone associated with the TMJ.
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Affiliation(s)
- D A Keith
- Oral and Maxillofacial Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, Massachusetts, USA.
| | - S Handa
- Orofacial Pain Division, Oral and Maxillofacial Surgery, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA; Orofacial Pain Division, Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, Massachusetts, USA
| | - L G Mercuri
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA
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15
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Ângelo DF, Nunes M, Monje F, Mota B, Salvado F. A role for total alloplastic temporomandibular joint replacement in Gardner syndrome. Int J Oral Maxillofac Surg 2024; 53:219-222. [PMID: 37985266 DOI: 10.1016/j.ijom.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023]
Abstract
Gardner syndrome (GS) is a rare autosomal dominant disorder that can present with craniomaxillofacial abnormalities. The identification of osteomas or craniomaxillofacial abnormalities can therefore serve as a marker of this condition, facilitating early referral and diagnosis. A 17-year-old female with GS was referred for the management of severe limited mouth opening, causing a major problem for routine endoscopy to monitor the gastrointestinal alterations of GS. Clinical and radiological evaluations showed multiple osteomas in the mandibular angle, condylar and coronoid regions bilaterally and maximum mouth opening of 8 mm. The patient underwent surgery for osteoma removal and bilateral customized alloplastic total temporomandibular joint replacement (TMJ-TJR). At the 2-year follow-up, the patient showed improvements in quality of life, with a maximum mouth opening of 34 mm, allowing routine upper endoscopy to be performed. This is the first report of GS, a rare and challenging craniomaxillofacial abnormality, treated with TMJ-TJR. A comprehensive overview of the patient's clinical presentation, diagnostic assessment, treatment planning, and outcomes is provided.
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Affiliation(s)
- D F Ângelo
- Instituto Português da Face, Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Clinica Universitária de Estomatologia, Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal.
| | - M Nunes
- Clinica Universitária de Estomatologia, Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal
| | - F Monje
- Department of Oral and Maxillofacial Surgery, Hospital Universitario de Badajoz, Badajoz, Spain
| | - B Mota
- Clinica Universitária de Estomatologia, Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal
| | - F Salvado
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Clinica Universitária de Estomatologia, Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal
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16
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Möhlhenrich SC, Kniha K, Peters F, Heitzer M, Szalma J, Prescher A, Danesh G, Hölzle F, Modabber A. Evaluation of bone contact area and intercondylar distance changes in orthognathic surgery - a comparison between BSSO and HSSO technique depending on mandibular displacement extent. Clin Oral Investig 2024; 28:182. [PMID: 38424318 PMCID: PMC10904418 DOI: 10.1007/s00784-024-05584-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/25/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES The present study aims to assess the impact of bilateral and high oblique sagittal split osteotomy (BSSO/HSSO), as well as displacement distances and directions on the expected and achievable bone contact area (BCA) and changes in the intercondylar distance (ICD). The primary question addressed is whether mandibular splitting through BSSO results in a greater BCA and/or ICD when compared to splitting through HSSO. MATERIALS AND METHODS Totally 80 mandibular displacements were performed on 20 fresh cadavers, for each subject, four splints were produces to facilitate mandibular advancement as well as setbacks of 4 and 8 mm. Pre- and postoperative CBCT scans were performed to plan the surgical procedures and to analyze the expected and achieved BCA and ICD. RESULTS Regarding the maximum mandibular displacement, the expected BCA for HSSO/BSSO were 352.58 ± 96.55mm2 and 1164.00 ± 295.50mm2, respectively, after advancement and 349.11 ± 98.42mm2 and 1344.70 ± 287.23mm2, respectively, after setback. The achieved BCA for HSSO/BSSO were 229.37 ± 75.90mm2 and 391.38 ± 189.01mm2, respectively, after advancement and 278.03 ± 97.65mm2 and 413.52 ± 169.52 mm2, respectively after setback. The expected ICD for HSSO/BSSO were 4.51 ± 0.73 mm and 3.25 ± 1.17 mm after advancement and - 5.76 ± 1.07 mm and - 4.28 ± 1.58 mm after setback. The achieved ICD for HSSO/BSSO were 2.07 ± 2.9 mm and 1.7 ± 0.60 mm after advancement and - 2.57 ± 2.78 mm and - 1.28 ± 0.84 mm after setback. Significant differences between the BCA after HSSO and BSSO were at each displacement (p < 0.001), except for the achieved BCA after 8-mm setback and advancement (p ≥ 0.266). No significant differences were observed regarding ICD, except for the expected ICD after 8-mm setback and advancement (p ≤ 0.037). CONCLUSIONS Compared to the virtual planning, the predictability regarding BCA and ICD was limited. ICD showed smaller clinical changes, BCA decreased significantly in the BSSO group. CLINICAL RELEVANCE BCA and ICD might have been less important in choosing the suitable split technique. in orthognathic surgery.
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Affiliation(s)
- Stephan Christian Möhlhenrich
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany.
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Kristian Kniha
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Florian Peters
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Marius Heitzer
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Josef Szalma
- Department Oral and Maxillofacial Surgery, Medical School, University of Pécs, 1. Tüzér St., Pécs, 7623, Hungary
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy, Medical Faculty of RWTH-Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Gholamreza Danesh
- Department of Orthodontics, University of Witten/Herdecke, Alfred-Herrhausen Str. 45, 58455, Witten, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
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Xie Q, Li P, Yang C, Chen M, Li H, Bai G, Ma Z, Shen P, Liu Z. Feasibility of simultaneous TMJ arthroscopy in ADDwoR patients undergoing orthognathic surgery for jaw deformity. J Craniomaxillofac Surg 2024; 52:347-354. [PMID: 38368209 DOI: 10.1016/j.jcms.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 02/19/2024] Open
Abstract
This study evaluated the feasibility of simultaneous temporomandibular joint (TMJ) arthroscopy and orthognathic surgery as a new treatment strategy for anterior disc displacement without reduction (ADDwoR) patients with severe jaw deformities. Twelve ADDwoR patients with facial deformities who underwent arthroscopy and orthognathic surgery between September 2015 and December 2019 were retrospectively evaluated. Pre- and postoperative maximum incisal opening (MIO) and joint pain were recorded. Computed tomography (CT) and three-dimensional cephalometric analysis were performed at 3 (T1) and ≥6 (T2) months postoperatively. Magnetic resonance imaging (MRI) of the TMJ was performed before, ≤7 days after and ≥6 months after surgery. The lateral profile radiological findings, the symmetry of the maxilla and mandible, and the MRI measurements were compared. Anterior disc displacement did not recur, and the maximum incisal opening (MIO) increased from 27.4 mm to 32.7 mm after surgery (p < 0.05). No significant differences were found in the lateral profile, symmetry indices or condylar height via MRI between T1 and T2. Joint morphology and the position of both the maxilla and mandible remained stable during postoperative follow-up, while joint symptoms were markedly relieved and facial appearance was noticeably improved. Combined arthroscopy and orthognathic surgery is effective and recommended for ADDwoR patients with jaw deformities.
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Affiliation(s)
- Qianyang Xie
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Peilun Li
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Chi Yang
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China.
| | - Minjie Chen
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China.
| | - Hui Li
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China.
| | - Guo Bai
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Zhigui Ma
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Pei Shen
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Zhiyang Liu
- Shanghai Xuhui District Dental Center, Shanghai, 200032, China
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18
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Sagl B, Schmid-Schwap M, Piehslinger E, Yao H, Rausch-Fan X, Stavness I. The effect of bolus properties on muscle activation patterns and TMJ loading during unilateral chewing. J Mech Behav Biomed Mater 2024; 151:106401. [PMID: 38237207 DOI: 10.1016/j.jmbbm.2024.106401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 02/03/2024]
Abstract
Mastication is a vital human function and uses an intricate coordination of muscle activation to break down food. Collection of detailed muscle activation patterns is complex and commonly only masseter and anterior temporalis muscle activation are recorded. Chewing is the orofacial task with the highest muscle forces, potentially leading to high temporomandibular joint (TMJ) loading. Increased TMJ loading is often associated with the onset and progression of temporomandibular disorders (TMD). Hence, studying TMJ mechanical stress during mastication is a central task. Current TMD self-management guidelines suggest eating small and soft pieces of food, but patient safety concerns inhibit in vivo investigations of TMJ biomechanics and currently no in silico model of muscle recruitment and TMJ biomechanics during chewing exists. For this purpose, we have developed a state-of-the-art in silico model, combining rigid body bones, finite element TMJ discs and line actuator muscles. To solve the problems regarding muscle activation measurement, we used a forward dynamics tracking approach, optimizing muscle activations driven by mandibular motion. We include a total of 256 different combinations of food bolus size, stiffness and position in our study and report kinematics, muscle activation patterns and TMJ disc von Mises stress. Computed mandibular kinematics agree well with previous measurements. The computed muscle activation pattern stayed stable over all simulations, with changes to the magnitude relative to stiffness and size of the bolus. Our biomedical simulation results agree with the clinical guidelines regarding bolus modifications as smaller and softer food boluses lead to less TMJ loading. The computed mechanical stress results help to strengthen the confidence in TMD self-management recommendations of eating soft and small pieces of food to reduce TMJ pain.
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Affiliation(s)
- Benedikt Sagl
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - Martina Schmid-Schwap
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria
| | - Eva Piehslinger
- Division of Prosthodontics, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria
| | - Hai Yao
- Department of Bioengineering, Clemson University, 29634, Clemson, SC, United States; Department of Oral Health Sciences, Medical University of South Carolina, 29425, Charleston, SC, United States
| | - Xiaohui Rausch-Fan
- Center for Clinical Research, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, SK S7N 5C9 Saskatoon, Saskatchewan, Canada
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Gaete C, Droguett C, Sáez F, Astorga P. Clinical and demographic factors associated with the effectiveness of temporomandibular joint arthroscopy. Oral Maxillofac Surg 2024; 28:405-411. [PMID: 37222837 DOI: 10.1007/s10006-023-01158-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/13/2023] [Indexed: 05/25/2023]
Abstract
PURPOSE High success rates and minimal complications have consolidated arthroscopy as the therapeutic alternative of choice for minimally invasive treatment of internal disorders (ID) of the temporomandibular joint (TMJ). However, there is no certainty regarding the demographic and clinical factors associated with the technique's success or failure. This study was performed to analyze the effectiveness of arthroscopy regarding pain and the mandibular dynamics and also to determine whether variables such as age, sex, and preoperative Wilkes stage influence the results. METHODS A retrospective study was conducted involving 92 patients with ID of the TMJ between September 2017 and February 2020. In all cases, a first stage of intra-articular lysis and lavage was executed. As needed, a phase of operative arthroscopy or arthroscopic discopexy was implemented. RESULTS A total of 152 arthroscopies were performed. Both the variation in pain and mouth opening in patients with ID of the TMJ treated were statistically significant for the follow-up periods studied. Better results were observed for patients with lower Wilkes stages. No association with age was found. CONCLUSION Based on the results, we recommend early intervention as soon as an ID in the TMJ is detected.
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Affiliation(s)
- Carlos Gaete
- Department of Maxillofacial Surgery, Hospital del Trabajador, ACHS, Santiago, Chile
- Private Practice, Oral and Maxillofacial Surgery at Clinica Santa Maria and Clinica Universidad de los Andes, Santiago, Chile
| | - Christian Droguett
- Department of Maxillofacial Surgery, Hospital del Trabajador, ACHS, Santiago, Chile
- Private Practice, Oral and Maxillofacial Surgery at Clinica Dávila and MEDS, Santiago, Chile
| | - Felipe Sáez
- Department of Maxillofacial Surgery, Hospital del Trabajador, ACHS, Santiago, Chile.
- Department of Oral and Maxillofacial Surgery, Universidad de los Andes, Santiago, Chile.
| | - Paula Astorga
- Department of Oral and Maxillofacial Surgery, Universidad de los Andes, Santiago, Chile
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Liu S, Wu C, Zhang Y. Transcriptomics analyses of IL-1β-stimulated rat chondrocytes in temporomandibular joint condyles and effect of platelet-rich plasma. Heliyon 2024; 10:e26739. [PMID: 38434027 PMCID: PMC10906425 DOI: 10.1016/j.heliyon.2024.e26739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024] Open
Abstract
The biological mechanism of action of platelet-rich plasma (PRP) in the treatment of temporomandibular joint (TMJ) osteoarthritis remains unclear. This study explored the mechanisms underlying interleukin (IL)-1β-induced inflammation and investigated the effect of PRP on TMJ condylar chondrocytes. Primary chondrocytes were isolated from the TMJ condyle of 4-week-old rats, and differentially expressed genes among three treatment groups (phosphate-buffered saline [control], IL-1β, and IL-1β + PRP) were identified using RNA-seq and characterized using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes path-enrichment analyses. IL-1β caused inflammatory injury to chondrocytes by upregulating the TNF, NF-κB, and IL-17 signaling pathways and downregulating the MAPK and PI3K/Akt signaling pathways. PRP activated the MAPK and PI3K/Akt signaling pathways, exerting a protective effect on IL-1β-induced chondrocytes. PRP also activated the TNF and IL-17 signaling pathways, producing an inflammatory effect. Additionally, PRP increased the mRNA expression of the matrix catabolism-related genes Mmp3, Mmp9, and Mmp13; the proliferative markers Mki67 and PCNA; and the anti-apoptotic genes of the Bcl-2 family (Bcl2a1 and Bok), while reducing the expression of the pro-apoptotic genes Casp4 and Casp12. The findings suggest that the protective effect of PRP on IL-1β-induced chondrocyte injury is mainly achieved via MAPK-PI3K/Akt signaling, increasing cell proliferation and inhibiting cell apoptosis.
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Affiliation(s)
- Shasha Liu
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
- Department of Rehabilitation Medicine, Sijing Hospital of the Songjiang District of Shanghai, Shanghai, 201600 China
| | - Chaolun Wu
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Yuxin Zhang
- Department of Rehabilitation Medicine, The Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
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Saini RS, Ibrahim M, Khader MA, Kanji MA, Mosaddad SA, Heboyan A. The role of physiotherapy interventions in the management of temporomandibular joint ankylosis: a systematic review and meta-analysis : Running title: Physiotherapy in TMJ ankylosis. Head Face Med 2024; 20:15. [PMID: 38424599 PMCID: PMC10902984 DOI: 10.1186/s13005-024-00416-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The main aim of this systematic review and meta-analysis was to identify peer-reviewed scholarly journal articles reporting the significance of physiotherapy interventions in managing TMJ ankylosis. In addition, this study aimed to critically appraise the existing evidence on the prevalence and clinical presentation, physiotherapy intervention approaches, efficacy of physiotherapy interventions, adverse effects, and safety of physiotherapy interventions in TMJ ankylosis management. METHODS An all-inclusive literature search was conducted using the PubMed, Google Scholar, and Scopus electronic databases. The researchers screened the potential articles and assessed for eligibility based on the reported inclusion and exclusion criteria. The quality evaluation tool for observational cohort and cross-sectional studies developed by the National Institutes of Health (NIH) and the Cochrane Collaboration's Risk of Bias Tool were used to assess the quality of the included studies. Researchers also comprehensively analyzed the data, reported the results, and discussed them according to the predominant themes. RESULTS The primary electronic database search yielded 409 articles, of which 25 were included in this review. A secondary search was conducted from citations of the included studies, yielding 74 articles, of which six were included in the study. A significantly higher prevalence of bony ankylosis than fibrous ankylosis, with an overall effect size of p < 0.00001. In addition, there were significantly more unilateral than bilateral presentations with an overall effect size of p < 0.00001. Moreover, there were 78 reported complications out of 245 subjects according to five included studies demonstrating a significant effect size with p = 0.001 following the treatment protocols. CONCLUSION This study highlighted the prevalence of bony ankylosis in temporomandibular joint ankylosis, emphasizing its impact on patients' well-being. On the other hand, the results show that physiotherapy is essential to optimize postoperative outcomes and minimize adverse events such as re-ankylosis. Practitioners and healthcare professionals must monitor postoperative recovery and ensure strict adherence to physiotherapy protocols for optimal outcomes.
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Affiliation(s)
- Ravinder S Saini
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | - Mohammed Ibrahim
- Department of Oral Surgery, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohasin Abdul Khader
- Department of Periodontics and Community Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Masroor Ahmed Kanji
- Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia
| | - Seyed Ali Mosaddad
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Qasr-E-Dasht Street, Shiraz, Iran.
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, 0025, Yerevan, Armenia.
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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22
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Shen Z, Fan C, Ding C, Xu M, Wu X, Wang Y, Xing T. Loss of Slc39a12 in hippocampal neurons is responsible for anxiety-like behavior caused by temporomandibular joint osteoarthritis. Heliyon 2024; 10:e26271. [PMID: 38375280 PMCID: PMC10875581 DOI: 10.1016/j.heliyon.2024.e26271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 02/07/2024] [Accepted: 02/09/2024] [Indexed: 02/21/2024] Open
Abstract
Background An evident association between mood disorders and TMJ dysfunction has been demonstrated in previous studies. This study observed both the behavioral changes and the pathological changes in hippocampal tissue of rats in an animal model of TMJ-OA by injecting MIA into TMJ. Methods Eighteen SD rats were randomly assigned to the NC group and the MIA groups. A TMJ-OA model was established to assess the HWT in the TMJ region, and the rats were subjected to the OFT and EPM. HE, O-fast green staining, qRT-PCR and immunofluorescence were used to detect condylar damage. Serum and hippocampal oxidative stress levels were detected. Functions of genes obtained by RNA-Seq were investigated using H2O2, ZnCl2 and transfection of siRNA on HT22 cells. Results Injection of MIA resulted in disorganization of the chondrocyte layer on the condylar surface of rats, with reduced synthesis and increased degradation of the condylar cartilage matrix and reduced HWT. The results of the OFT and EPM showed that the rats in the MIA group developed anxiety-like behavior during the sixth week of MIA injection. Increased Nox4 expression, decreased SOD2 expression, elevated MDA level, and reduced GSH level were detected in serum and hippocampal neurons in the MIA group, with nuclear pyknosis and reduced Nissl bodies observed in neurons. The expression of Slc39a12 in hippocampal neurons of rats in the MIA group decreased. Slc39a12 knockdown in HT22 cells induced increased Nox4 expression, decreased SOD2 expression, increased MDA level, and reduced GSH and intracellular Zn2+. Oxidative stress in HT22 cells after transfection and H2O2 stimulation was reversed when ZnCl2 was added. Conclusion Loss of Slc39a12 in hippocampal neurons results in cellular oxidative stress, further leading to neuronal damage. This may potentially explain how TMJ-OA triggers anxiety-like behavior in rats.
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Affiliation(s)
- Zhenguo Shen
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Chenyu Fan
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Chunmeng Ding
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Mengyue Xu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Xian Wu
- Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University, Hefei, 230032, China
| | - Yuanyin Wang
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
| | - Tian Xing
- College & Hospital of Stomatology, Anhui Medical University, Key Lab. of Oral Diseases Research of Anhui Province, Hefei, 230032, China
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Zhang TM, Yang K, Jiao MN, Zhao Y, Xu ZY, Zhang GM, Wang HL, Liang SX, Yan YB. Temporal gene expression profiling during early-stage traumatic temporomandibular joint bony ankylosis in a sheep model. BMC Oral Health 2024; 24:284. [PMID: 38418977 PMCID: PMC10903020 DOI: 10.1186/s12903-024-03971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Investigating the molecular biology underpinning the early-stage of traumatic temporomandibular joint (TMJ) ankylosis is crucial for discovering new ways to prevent the disease. This study aimed to explore the dynamic changes of transcriptome from the intra-articular hematoma or the newly generated ankylosed callus during the onset and early progression of TMJ ankylosis. METHODS Based on a well-established sheep model of TMJ bony ankylosis, the genome-wide microarray data were obtained from samples at postoperative Days 1, 4, 7, 9, 11, 14 and 28, with intra-articular hematoma at Day 1 serving as controls. Fold changes in gene expression values were measured, and genes were identified via clustering based on time series analysis and further categorised into three major temporal classes: increased, variable and decreased expression groups. The genes in these three temporal groups were further analysed to reveal pathways and establish their biological significance. RESULTS Osteoblastic and angiogenetic genes were found to be significantly expressed in the increased expression group. Genes linked to inflammation and osteoclasts were found in the decreased expression group. The various biological processes and pathways related to each temporal expression group were identified, and the increased expression group comprised genes exclusively involved in the following pathways: Hippo signaling pathway, Wnt signaling pathway and Rap 1 signaling pathway. The decreased expression group comprised genes exclusively involved in immune-related pathways and osteoclast differentiation. The variable expression group consisted of genes associated with DNA replication, DNA repair and DNA recombination. Significant biological pathways and transcription factors expressed at each time point postoperatively were also identified. CONCLUSIONS These data, for the first time, presented the temporal gene expression profiling and reveal the important process of molecular biology in the early-stage of traumatic TMJ bony ankylosis. The findings might contributed to identifying potential targets for the treatment of TMJ ankylosis.
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Affiliation(s)
- Tong-Mei Zhang
- Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, West Huan-Hu Road, Ti Yuan Bei, Hexi District, Tianjin, 30060, PR China
- Tianjin's Clinical Research Center for Cancer, West Huan-Hu Road, Ti Yuan Bei, Hexi District, Tianjin, 30060, PR China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin, West Huan-Hu Road, Ti Yuan Bei, Hexi District, Tianjin, 30060, PR China
- Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin, 300070, PR China
| | - Kun Yang
- Department of Oromaxillofacial-Head and Neck Surgery, China Three Gorges University Affiliated Renhe Hospital, 410 Yiling Ave, Hubei, 443001, PR China
| | - Mai-Ning Jiao
- Department of Oral and Maxillofacial Surgery, Weifang people's Hospital, 151 GuangWen Street, KuiWen District, Weifang, ShanDong Province, 261000, PR China
| | - Yan Zhao
- Tianjin Medical University, 22 Qi-xiang-tai Road, Heping District, Tianjin, 300070, PR China
| | - Zhao-Yuan Xu
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, School of Medicine, Nankai University, 75 Dagu Road, Heping District, Tianjin, 300041, PR China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin, 300041, PR China
| | - Guan-Meng Zhang
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, School of Medicine, Nankai University, 75 Dagu Road, Heping District, Tianjin, 300041, PR China
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin, 300041, PR China
| | - Hua-Lun Wang
- Department of Oral and Maxillofacial Surgery, Jining Stomatological Hospital, 22 Communist Youth League Road, Rencheng District, Jining, ShanDong Province, 272000, PR China
| | - Su-Xia Liang
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin, 300041, PR China.
- Department of Operative Dentistry and Endodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, 75 Dagu Road, Heping District, Tianjin, 300041, PR China.
| | - Ying-Bin Yan
- Department of Oromaxillofacial-Head and Neck Surgery, Tianjin Stomatological Hospital, School of Medicine, Nankai University, 75 Dagu Road, Heping District, Tianjin, 300041, PR China.
- Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75 Dagu Road, Heping District, Tianjin, 300041, PR China.
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Xu L, Zhang Y, Yu J, Huo W, Xu J, Yang H, Zhang M, Yu S, Wu Y, Wang M. miR-708-5p deficiency involves the degeneration of mandibular condylar chondrocytes via the TLR4/NF-κB pathway. Osteoarthritis Cartilage 2024:S1063-4584(24)00049-9. [PMID: 38403153 DOI: 10.1016/j.joca.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE Ageing and aberrant biomechanical stimulation are two major risk factors for osteoarthritis (OA). One of the main characteristics of aged cartilage is cellular senescence. One of the main characteristics of osteoarthritic joints is cartilage degeneration. The cells in the temporomandibular joint (TMJ) cartilage are zonally arranged. The deep zone cells are differentiated from the superficial zone cells (SZCs). The purpose of the present study was to investigate whether degenerative shear stress (SS) stimulates the senescence programme in TMJ SZCs, and to determine which miRNA is involved in this process. METHOD SZCs were isolated from the TMJ condyles of 3-week-old rats and treated with continuous passaging or SS. RNA sequencing was conducted to identify miRNA(s) that overlap with those involved in the replication senescence process and the SS-induced degeneration programme. Unilateral anterior crossbite (UAC), which is TMJ-OA inducible, was applied to 2-month-old and 12-month-old mice for 3 weeks. The effect of TMJ local injection of agomiR-708-5p was evaluated histologically. RESULTS Both replication and SS treatment induced SZC senescence. miR-708-5p was identified. Knocking down miR-708-5p in SS-treated SZCs led to more severe senescence by alleviating the inhibitory impact of miR-708-5p on the TLR4/NF-κB pathway. miR-708-5p expression in mouse TMJ cartilage decreased with age. UAC induced more severe osteoarthritic cartilage lesions in 12-month-old mice than in 2-month-old mice. Injection of agomiR-708-5p suppressed UAC-induced osteoarthritic cartilage lesions. CONCLUSIONS Age-related miR-708-5p deficiency is involved in the mechanically stimulated OA process. Intra-articular administration of agomiR-708-5p is a promising new strategy for OA treatment.
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Affiliation(s)
- Lingfeng Xu
- Department of Oral Anatomy and Physiology and TMD, College of Stomatology, the Fourth Military Medical University. Xi'an, China
| | - Yuejiao Zhang
- Department of Oral Anatomy and Physiology and TMD, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China
| | - Jia Yu
- Department of Oral Anatomy and Physiology and TMD, College of Stomatology, the Fourth Military Medical University. Xi'an, China
| | - Wanqiu Huo
- Department of Oral Anatomy and Physiology and TMD, College of Stomatology, the Fourth Military Medical University. Xi'an, China
| | - Jiali Xu
- Department of Oral Anatomy and Physiology and TMD, College of Stomatology, the Fourth Military Medical University. Xi'an, China
| | - Hongxu Yang
- Department of Oral Anatomy and Physiology and TMD, College of Stomatology, the Fourth Military Medical University. Xi'an, China
| | - Mian Zhang
- Department of Oral Anatomy and Physiology and TMD, College of Stomatology, the Fourth Military Medical University. Xi'an, China
| | - Shibing Yu
- Department of Oral Anatomy and Physiology and TMD, College of Stomatology, the Fourth Military Medical University. Xi'an, China
| | - Yaoping Wu
- Department of Joint Surgery, Shenzhen Hospital of Southern Medical University, Shenzhen, China
| | - Meiqing Wang
- Department of Oral Anatomy and Physiology and TMD, College of Stomatology, the Fourth Military Medical University. Xi'an, China; Department of Oral Anatomy and Physiology and TMD, Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Shanghai Stomatological Hospital, Fudan University, Shanghai, China.
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Mouchoux J, Meyer-Marcotty P, Sojka F, Dechent P, Klenke D, Wiechens B, Quast A. Reliability of landmark identification for analysis of the temporomandibular joint in real-time MRI. Head Face Med 2024; 20:10. [PMID: 38365709 PMCID: PMC10874088 DOI: 10.1186/s13005-024-00411-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/22/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Real-time magnetic resonance imaging (rtMRI) is essential for diagnosing and comprehending temporomandibular joint (TMJ) movements. Current methods for tracking and analysis require manual landmark placement on each acquisition frame. Therefore, our study aimed to assess the inter- and intra-rater reliability of placing cephalometric landmarks in frames from a dynamic real-time TMJ MRI. MATERIAL AND METHODS Four real-time MRIs of the right TMJ were taken during mandibular movement at ten frames per second. Seven dentists identified ten landmarks on two frames (intercuspal position-ICP-and maximum mouth opening-MMO) twice at a two-week interval, yielding 112 tracings. Six typical cephalometric measurements (angles and distances) were derived from these landmarks. The reliabilities of landmarks and measurements were evaluated using distance-based (dbICC), linear mixed effect model intraclass correlation (lmeICC), and standard ICC. RESULTS The average inter-rater reliability for the landmarks stood at 0.92 (dbICC) and 0.93 (lmeICC). The intra-rater reliability scores were 0.97 and 0.98. Over 80% of the landmarks showed an ICC greater than 0.98 (inter-rater) and over 0.99 (intra-rater). The lowest landmark ICC was observed for the orbitale and the oblique ridge of the mandibular ramus. However, the cephalometric angle and distance measurements derived from these landmarks showed only moderate to good reliability, whereas the reliability in the frames with ICP was better than those with MMO. Measurements performed in the ICP frame were more reliable than measurements in the MMO frame. CONCLUSION While dentists reliably localize isolated landmarks in real-time MRIs, the cephalometric measurements derived from them remain inconsistent. The better results in ICP than MMO are probably due to a more familiar jaw position. The higher error rate of the TMJ measurements in MMO could be associated with a lack of training in real-time MRI analysis in dentistry.
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Affiliation(s)
- Jérémy Mouchoux
- Poliklinik Für Kieferorthopädie, Universitätmedizin Göttingen (UMG), Göttingen, Germany.
| | | | - Florian Sojka
- Poliklinik Für Kieferorthopädie, Universitätmedizin Göttingen (UMG), Göttingen, Germany
| | - Peter Dechent
- Institut Für Kognitive Neurologie, Universitätmedizin Göttingen (UMG), Göttingen, Germany
| | - Daniela Klenke
- Poliklinik Für Kieferorthopädie, Universitätmedizin Göttingen (UMG), Göttingen, Germany
| | - Bernhard Wiechens
- Poliklinik Für Kieferorthopädie, Universitätmedizin Göttingen (UMG), Göttingen, Germany
| | - Anja Quast
- Poliklinik Für Kieferorthopädie, Universitätmedizin Göttingen (UMG), Göttingen, Germany
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Bazsefidpay N, Ulmner M, Lund B. Did temporomandibular gap arthroplasty with temporalis interpositional flap improve function and pain in patients with end-stage joint disease? A 5-year retrospective follow-up. J Craniomaxillofac Surg 2024:S1010-5182(24)00060-X. [PMID: 38368213 DOI: 10.1016/j.jcms.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 11/07/2023] [Accepted: 02/02/2024] [Indexed: 02/19/2024] Open
Abstract
The primary aim of this study was to investigate whether patients with end-stage temporomandibular joint (TMJ) disease treated with gap arthroplasty with temporalis interpositional flap (GAT) had improved maximal interincisal opening (MIO) and TMJ pain in a long-term perspective. All patients with severe osteoarthritis, or fibrous or bony ankyloses, and subjected to GAT between 2008 and 2015 were included. The criteria of treatment success were TMJ pain VAS score ≤4 and MIO ≥30 mm. Reoperation was considered as a failure. Forty-four patients (mean age 47 years) were included in this retrospective descriptive case series and followed up for up to 7 years (mean 4.5). Comorbidities were frequent (n = 34) and most commonly rheumatic disease (n = 17). The indications for surgery were ankylosis (n = 32) or severe osteoarthritis (n = 12). Of the 44 included patients, 84% (n = 37) had a history of earlier TMJ surgery. The preoperative mean values for TMJ pain and MIO (VAS 7 and 23 mm, respectively) changed significantly (p < 0.001) to postoperative means of VAS 3 and 34 mm, respecitvely. The success rate was 59% (n = 26). When compared with a previous 2-year follow-up, the success rate was found to have decreased over time (p = 0.0097). The rate of successful treatment outcome in terms of MIO alone was 82% (n = 36). The most common reason for treatment failure was residual pain. In conclusion, the success-rate after GAT did not show long-term stability and continued to drop over time in this patient cohort. TMJ pain seems to be the main reason for failure.
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Affiliation(s)
- Nikoo Bazsefidpay
- Head-Neck and Plastic Surgery Clinic, Department of Oral and Maxillofacial Surgery, Örebro University Hospital, Örebro, Sweden; School of Medical Sciences, Örebro University, Sweden.
| | - Mattias Ulmner
- Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Bodil Lund
- Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
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Zhang D, Abdelrehem A, Luo Y, Shen P, Yang C. Effect of arthroscopic discopexy on condylar growth in adolescents with temporomandibular joint disc displacement without reduction: A retrospective self-controlled case series study. J Craniomaxillofac Surg 2024; 52:157-164. [PMID: 37925338 DOI: 10.1016/j.jcms.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 05/06/2023] [Accepted: 06/25/2023] [Indexed: 11/06/2023] Open
Abstract
This study was a retrospective self-controlled study that aimed to evaluate the effect of arthroscopic discopexy on condylar height and mandibular position in adolescents with temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDwoR). Patients between 10 and 20 years of age and diagnosed with bilateral TMJ ADDwoR by magnetic resonance image (MRI) were included in this study. All patients underwent a period of natural course before arthroscopic surgery and then a follow-up period postoperatively. Changes in condylar height and mandibular position were measured by MRI and X-ray radiographs. Data were analyzed by paired t-test, Pearson correlation analysis, and generalized estimating equations. This study comprised a total of 40 patients with a mean age of 14.80 years. Pearson correlation analysis showed correlations between condylar height and mandibular position changes. The condylar height change during the post-operative period was significantly higher than that during natural course period (3.57 mm, p < 0.001). The changes in mandibular position (including ANB angle, SNB angle, and Pog-Np) were significant different (all p < 0.05) between the two periods. This study found that arthroscopic discopexy can promote condylar growth and correct dentofacial deformity in adolescents with bilateral TMJ ADDwoR.
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Affiliation(s)
- Dahe Zhang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, No. 639, Zhi Zao Ju Road, Shanghai, 200011, Shanghai, China
| | - Ahmed Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Alexandria University, Alexandria, 21563, Egypt
| | - Yi Luo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, No. 639, Zhi Zao Ju Road, Shanghai, 200011, Shanghai, China
| | - Pei Shen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, No. 639, Zhi Zao Ju Road, Shanghai, 200011, Shanghai, China.
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, No. 639, Zhi Zao Ju Road, Shanghai, 200011, Shanghai, China.
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Liu R, Lai H, Davis C, Almeida FT. Association of anatomical features of the petrotympanic fissure and presence of foramen of Huschke with otalgia and tinnitus. Int J Oral Maxillofac Surg 2024; 53:165-169. [PMID: 37442688 DOI: 10.1016/j.ijom.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/15/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
The petrotympanic fissure (PTF) and foramen of Huschke (FH) are anatomical structures in the temporal bone that can connect the temporomandibular joint (TMJ) and the ear. The purpose of this retrospective study was to investigate the association between PTF morphology and otalgia and tinnitus, as well as the prevalence of the FH and otological symptoms, using cone beam computed tomography (CBCT). CBCT images from 114 patients presenting with symptoms of a temporomandibular disorder were examined retrospectively. The PTF was classified into three subtypes (open, semi-open, closed) and the presence of the FH was identified. Symptoms of otalgia and tinnitus were obtained from the patient files. The FH was observed in 12.3% of patients examined, and in 12.0% of those with otalgia and 18.9% of those with tinnitus. There was no significant association between the PTF subtypes or the presence of the FH and otalgia or tinnitus (all P > 0.05). The PTF subtype and presence of the FH alone do not appear to contribute to otalgia or tinnitus in patients with temporomandibular disorders.
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Affiliation(s)
- R Liu
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.
| | - H Lai
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.
| | - C Davis
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.
| | - F T Almeida
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Canada.
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Buch FO, Stokbro K. Accuracy and stability of the condyle position after orthognathic surgery: A retrospective study. J Craniomaxillofac Surg 2024; 52:240-245. [PMID: 38172014 DOI: 10.1016/j.jcms.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 06/21/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
The purpose of this study was to evaluate the accuracy and stability of condylar positioning in patients treated with bimaxillary procedures compared with patients treated with maxillary procedures alone. All patients had undergone treatment at Odense University Hospital and were treated with inferior maxillary procedures. The primary outcome was changes in condyle position and the primary predictor variable was time: pre-operative (T0) measurements to 1-week post-operative (T1) and 1-year post-operative (T2) measurements. Condyle movement was measured using dual voxel-based alignment. Sixteen patients were included. Seven patients underwent solitary maxillary procedure and 9 patients bimaxillary procedure. Bimaxillary procedures overall showed a condyle positional change in pitch from T0 to T1 and T1 to T2 compared to maxillary procedures alone. Condylar translation was stable despite large differences in positioning. Compared to solitary maxillary procedures, bimaxillary procedures showed a statistically significant anterocranial rotation at 1-week follow-up movement (3.95° vs. -0.95°; SD 3,74 vs 1,05; P value = 0.000) and an additional statistically significant anterocranial movement at 1 year after surgery (4.89° vs 0.60°; SD 3,82 vs 0,92; P value = 0.000). In conclusion a need for greater anterocranial stability of the sagittal split osteotomy than that provided by 3 bicortically fixated screws alone might be indicated.
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Affiliation(s)
- Frederik Ohm Buch
- Department of Oral and Maxillofacial Surgery, Odense University Hospital, Denmark
| | - Kasper Stokbro
- Consultant Surgeon & Head of Research, Department of Oral and Maxillofacial Surgery, Odense University Hospital, Oral and Maxillofacial Research Department, Clinical Institute, University of Southern Denmark, Denmark.
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Shi Y, Luo S, Wang H, Yao Q, Shi Y, Cheng J. Three-dimensional bone remodelling of glenoid fossa in patients with skeletal Class III malocclusion after bimaxillary orthognathic surgery. Int J Oral Maxillofac Surg 2024; 53:133-140. [PMID: 37442687 DOI: 10.1016/j.ijom.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
This study aimed to characterize three-dimensional quantitative morphological changes of glenoid fossa in patients with skeletal Class III malocclusion treated with bimaxillary orthognathic surgery. Ninety-five eligible patients (50 male, 45 female; mean age 22.09 years) were enrolled retrospectively. Cone beam computed tomography obtained at 1 week preoperatively (T0), immediately after surgery (T1), and at ≥ 12 months postoperatively (T2) were registered based on cranial base using voxel-based registration in 3D Slicer. Glenoid fossa surface was divided spatially into four regions, and bone modelling in these regions was visualized with color maps. Our data revealed that the mean surface variations of glenoid fossa were small, with modest bone formation as a whole. No significant associations between anteroposterior or vertical mandibular displacement and overall glenoid fossa remodeling were found (P > 0.05). Moreover, bone deposition was frequently observed in the anterior-lateral region of glenoid fossa in patients with a larger mandibular movement during T0-T1 (P < 0.001). Paired bone formation in the anterior-lateral region of glenoid fossa and bone resorption in the anterior-lateral region of condylar head was frequently observed. Collectively, our results revealed that glenoid fossa underwent complex but modest bone remodeling after bimaxillary surgery in skeletal Class III patients.
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Affiliation(s)
- Y Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China
| | - S Luo
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China; Jiangsu Key Laboratory of Oral Disease, Nanjing Medical University, Jiangsu, PR China
| | - H Wang
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - Q Yao
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - Y Shi
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China
| | - J Cheng
- Department of Oral and Maxillofacial Surgery, The Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing Medical University, Jiangsu, PR China.
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Luo H, Teng H, Shao B, Liu Z. The biomechanical effects of bilateral sagittal split ramus osteotomy and bimaxillary osteotomies to the patients with maxillofacial deformities under incisal clenching. J Stomatol Oral Maxillofac Surg 2024; 125:101642. [PMID: 37739222 DOI: 10.1016/j.jormas.2023.101642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE Bilateral sagittal split ramus osteotomy (BSSRO) and bimaxillary osteotomies (BSSRO plus Lefort1 osteotomy) are widely used to solve maxillofacial deformities. The effect of the surgeries on the temporomandibular joint (TMJ) is still not clear. The purpose of this study was to investigate the preoperative and postoperative stress environment of the patients and to compare the biomechanical differences of the two surgeries. METHODS Ten patients were performed BSSRO and fourteen underwent bimaxillary osteotomies. Eleven asymptomatic subjects were recruited to be the control group. The muscle forces of incisal clenching were applied on the finite element models. And contact was used to simulate the interactions within the TMJs. RESULTS two kinds of surgeries could not completely eliminate the negative biomechanical distribution within the TMJs. CONCLUSION Compared to BSSRO only, the bimaxillary osteotomies could better repair the biomechanical environment of the TMJs under incisal clenching. And the TMD symptoms were strongly related to the stress distributions of the TMJs.
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Affiliation(s)
- Haotian Luo
- 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
| | - Haidong Teng
- 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
- 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
| | - 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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Rustemeyer J, Busch A, Junker K. Dentinogenic Ghost Cell Tumour in Childhood Involving the Temporomandibular Joint: Considerations and Therapy. J Maxillofac Oral Surg 2024; 23:210-218. [PMID: 38312958 PMCID: PMC10830969 DOI: 10.1007/s12663-023-01874-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 02/15/2023] [Indexed: 02/26/2023] Open
Abstract
Background Although the uncommon dentinogenic ghost cell tumour (DGCT) is a benign entity, it possesses the ability to cause widespread destruction of the jaws and to recur after bone-preserving therapy. Hence, clear margins should be achieved upon surgery, and reconstruction techniques must often be used to restore osseous defects. However, this can be challenging in cases with involvement of the temporomandibular joint (TMJ), and especially in children. Case report We present a case of a DGCT in a 12-year-old boy with wide infiltration of the mandible and the TMJ. A two-staged reconstructive approach was performed. Upon primary surgery, tumour-free margins were obtained and mandibular anatomy was restored using an iliac crest graft and an alloplastic condyle implant for temporary TMJ reconstruction. In a second step 5 months later, having received a customized TMJ prosthesis consisting of a fossa and a condyle component, the TMJ was completely replaced for definitive reconstruction. Conclusion A customized TMJ prosthesis could be a solution for reconstruction of the TMJ in children. However, the further course with respect to growth disturbances must be evaluated upon short-term follow-ups and might require additional corrective interventions.
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Affiliation(s)
- Jan Rustemeyer
- Department of Oral and Maxillofacial Surgery and Plastic Operations, Klinikum Bremen–Mitte, School of Medicine of the University of Göttingen, Bremen, Germany
| | - Alexander Busch
- Department of Oral and Maxillofacial Surgery and Plastic Operations, Klinikum Bremen–Mitte, School of Medicine of the University of Göttingen, Bremen, Germany
| | - Klaus Junker
- Institute of Pathology, Klinikum Bremen–Mitte, School of Medicine of the University of Göttingen, Bremen, Germany
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Yang X, Li Q, Zhu S, Bi R. Comparison of Class II open bite correction by temporomandibular joint prostheses or bimaxillary orthognathic surgery. J Stomatol Oral Maxillofac Surg 2024; 125:101630. [PMID: 37689138 DOI: 10.1016/j.jormas.2023.101630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the outcome of skeletal Class II and anterior open bite patients who received simultaneous Le fort I osteotomies with temporomandibular joint (TMJ) prostheses or bimaxillary orthognathic surgery. MATERIALS AND METHODS Patients with condylar resorption (CR) were treated by TMJ prostheses and orthognathic surgery and divided into two groups. Cephalometric radiographs were obtained before and after operation to find out the surgical alteration by comparing measures at different time points. RESULTS 23 patients were included. Mean overbite of the patients was increased by 3.39 mm in TMJ prostheses group and 3.24 mm in orthognathic group. Occlusal plane angle was averagely rotated -6.06° and 1.31°; mandibular plane counterclockwise rotated 12.23° and 5.81°, respectively. The increase of ramus height in TMJ prostheses group were significantly greater than orthognathic surgery group (8.02 ± 1.96 mm vs. -0.09 ± 1.29 mm). The overall treatment effect was stable in both groups during the 1-year follow up. DISCUSSION Two surgical plans seem to be reliable treatments of anterior open bite and mandibular retrognathism caused by temporomandibular disease. TMJ prostheses with simultaneous Le fort I osteotomies close open bite by lengthening the height of ramus and rotating maxillo-mandibular complex counterclockwise, while bimaxillary orthognathic surgery by rotating maxilla clockwise and mandible counterclockwise without rebuilding ramus.
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Affiliation(s)
- Xianni Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qianli Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
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Pereira A, Gurgel M, Pereira R, Fabbro CD, de Barros Silva P, Costa F, Leite L, Moro A, Cevidanes L, Junior CM. Evaluation of condylar and mandibular movements on the upper airway during the use of mandibular advancement device for obstructive sleep apnea treatment. Clin Oral Investig 2024; 28:122. [PMID: 38286954 DOI: 10.1007/s00784-024-05513-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/16/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES To evaluate the temporomandibular joint (TMJ), condylar and mandibular movements in obstructive sleep apnea (OSA) patients treated with mandibular advancement device (MAD) and to identify the influence of these anatomic factors on upper airway (UA) volume and polysomnographic outcomes after treatment. MATERIALS AND METHODS Twenty OSA patients were prospectively treated with MAD. Clinical examinations, cone-beam computed tomography, and polysomnography were performed before MAD treatment and after achieving therapeutic protrusion. Polysomnographic variables and three-dimensional measurements of the TMJ, mandible, and upper airway were statistically analyzed. RESULTS Condylar rotation, anterior translation, and anterior mandibular displacement were directly correlated with total UA volume, while vertical mandibular translation was inversely correlated with the volume of the inferior oropharynx. MAD treatment resulted in an increase in the volume and area of the superior oropharynx. There was no statistically significant correlation between condylar rotation and translation and polysomnographic variables. With MAD, there was a significant increase in vertical dimension, changes in condylar position (rotation and translation), and mandibular displacement. The central and medial lengths of the articular eminence were inversely correlated with condylar rotation and translation, respectively. The lateral length of the eminence was directly correlated with condylar translation, and the lateral height was directly correlated with condylar rotation and translation. CONCLUSION Condylar and mandibular movements influenced UA volume. The articular eminence played a role in the amount of condylar rotation and translation. CLINICAL RELEVANCE Individualized anatomical evaluation of the TMJ proves to be important in the therapy of OSA with MAD.
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Affiliation(s)
| | | | | | | | | | - Fabio Costa
- Federal University of Ceará, Fortaleza, Brazil
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Takaoka R, Morioka S, Ueda Y, Tsunetou Y, Baba H, Ishigaki S. Changes in occlusal relationships observed using an intraoral scanner in patients with an acquired open bite: A case report. J Prosthodont Res 2024:JPR_D_23_00146. [PMID: 38281760 DOI: 10.2186/jpr.jpr_d_23_00146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
PATIENTS This case report describes a procedure for assessing changes in occlusal relationships in patients with acquired open bites due to temporomandibular joint disease using an intraoral scanner (IOS). A digital impression was made using the IOS at the initial visit. Subsequent impressions were made every 6 months using the IOS and magnetic resonance imaging (MRI) or computed tomography (CT). Standard triangulated language (STL) image files of two digital impressions at different points in time were superimposed, including the occlusal relationship with reference to the maxillary dentition. Finally, three-dimensional (3D) changes in the occlusal relationship over time were evaluated. DISCUSSION In Case 1, the superimposed STL image indicated almost no evident deviation of the mandible. Therefore, an orthodontic treatment was initiated. In contrast, in cases 2 and 3, where changes in the occlusal relationship continued, secondary treatment was postponed and patients continued to be monitored periodically. In case 3, even though left condyle resorption was progressive, the degree of open bite on the right side improved after 6 months. However, the open bite continued to progress for another 6 months despite the stability of the condyle. CONCLUSIONS Changes in the condylar shape observed using imaging may not always reflect changes in the occlusal relationship. In addition to changes in the condyles and eminences of the temporomandibular joint (TMJ), changes in the occlusal relationships of patients with acquired open bite should be evaluated using an intraoral scanner.
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Affiliation(s)
- Ryota Takaoka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Shion Morioka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - You Ueda
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Yohei Tsunetou
- Osaka University Dental Hospital Dental Laboratory, Suita, Japan
| | - Hirotaka Baba
- Osaka University Dental Hospital Dental Laboratory, Suita, Japan
| | - Shoichi Ishigaki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
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Ravikumar C, Sasikala B, Krishnakumar Raja VB, Elavenil P. Evaluation of the efficacy of autologous conditioned serum versus dextrose prolotherapy in internal derangement of the TMJ - A pilot study. J Craniomaxillofac Surg 2024:S1010-5182(24)00037-4. [PMID: 38368212 DOI: 10.1016/j.jcms.2024.01.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 11/19/2023] [Accepted: 01/16/2024] [Indexed: 02/19/2024] Open
Abstract
It was the aim of the study to compare the effectiveness of autologous conditioned serum (ACS) and dextrose prolotherapy (DP) solutions, in treating patients with TMJ internal derangement (ID). 24 participants with TMJ ID (Wilkes II-V) were recruited and randomized into study and control groups, with 12 patients each, treated with IA injection of ACS and DP, respectively. Pain, mouth opening, joint sounds, and jaw deviation were evaluated, with patients reviewed at 2 weeks, 1 month, and 2 months intervals. Based on the nature of the variables, appropriate descriptive statistics and statistical tests were applied. The pain score was zero in the study group after 2 months of treatment, which was statistically significant (p = 0.006). Deviation was also significantly reduced (p < 0.001) and mouth opening significantly improved (p = 0.004) in the ACS-treated patients. ACS demonstrated superiority over DP in the management of TMJ dysfunction. Therefore, ACS can be considered an ideal, minimally invasive treatment option for TMJ ID. Clinical trial registry number: (CTRI/2021/10/037043).
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Affiliation(s)
- C Ravikumar
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - B Sasikala
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India.
| | - V B Krishnakumar Raja
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - P Elavenil
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
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Gadd M, Attard A, Green J, Elledge ROC. Comorbid psychiatric conditions with temporomandibular disorders (TMD) in a tertiary referral clinic. Br J Oral Maxillofac Surg 2024:S0266-4356(24)00006-8. [PMID: 38355385 DOI: 10.1016/j.bjoms.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 12/26/2023] [Indexed: 02/16/2024]
Abstract
Patients with chronic pain have a higher prevalence of mood disorders with depression and anxiety contributing to higher pain intensity, emotional allodynia, and neuro-anatomical changes. We sought to quantify the prevalence of psychiatric comorbidities (PCs) in a tertiary referral clinic for temporomandibular disorders (TMDs). Medical records of all patients attending clinics run by three tertiary temporomandibular joint (TMJ) surgeons for the period January to April 2022 inclusive were audited for the prevalence of concomitant psychiatric conditions. A total of 166 patients were identified with a female to male ratio of 5:1 and mean (SD) age of 45.1 (15.2) years. A total of 124 (89.9%) of patients were tertiary referrals and 72 (43.4%) patients had concomitant psychiatric diagnoses, with 58 (34.9%) being on some form of psychotropic medication (PM) (patients on anticonvulsants for neuropathic pain were not included). A majority of 136 (81.9%) patients had some form of intervention (including Dysport® and minimally invasive surgery) which appeared more common in patients with co-existing psychiatric issues (p < 0.05). A higher proportion of mental health issues exist among TMD patients in a tertiary referral clinic than would be expected in the general population. We suggest a holistic approach to patients with multidisciplinary care taking into account this prevalence to ensure decision-making that contextualises the patient and not simply the pathology.
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Affiliation(s)
- Madeleine Gadd
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
| | - Alan Attard
- Consultant Oral and Maxillofacial Surgeon, University Hospitals Birmingham NHS Foundation Trust, UK.
| | - Jason Green
- Consultant Oral and Maxillofacial Surgeon, University Hospitals Birmingham NHS Foundation Trust, UK.
| | - Ross O C Elledge
- Consultant Oral and Maxillofacial Surgeon, University Hospitals Birmingham NHS Foundation Trust, UK; Consultant Oral and Maxillofacial Surgeon / Honorary Senior Clinical Lecturer, University Hospitals Birmingham NHS Foundation Trust, UK.
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Zhang Y, Zheng J, Wu Q, Jiang T, Xiao H, Du Y, Qi Y, Jin Z, Li F. Three-dimensional spatial analysis of temporomandibular joint in adolescent Class II division 1 malocclusion patients: comparison of Twin-Block and clear functional aligner. Head Face Med 2024; 20:4. [PMID: 38184631 PMCID: PMC10770962 DOI: 10.1186/s13005-023-00404-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Our study aimed to use three-dimensional (3D) spatial morphological measurement methods to compare the influence of Twin-Block and clear functional aligners on the temporomandibular joint (TMJ) of adolescent Class II division 1 malocclusion mandibular retraction patients. We also aimed to explore the similarities and differences in the effects on the TMJ upon using Twin-Block and clear functional aligner. METHODS Cone-beam computed tomography (CBCT) data of 49 patients with Class II division 1 malocclusion (Twin-Block group: 24; clear functional aligner group: 25) were collected before and after functional orthodontic treatment, and a 3D model of the TMJ was reconstructed using MIMICS 21.0 software. Eighteen measurement parameters, including the anterior, superior, and posterior joint spaces, were measured and compared using the 3D model. RESULTS After the two groups underwent functional appliance treatment, the height, volume, and surface area of the condyle, length of the mandibular ramus and mandibular length increased; The retro-displaced condyle moved to the middle position of the articular fossa, while the rest of the condylar position did not change significantly. Remodeling of the articular fossa after treatment was not evident. The superior joint space of the clear functional aligner group increased, but there was no significant change after Twin-Block appliances treatment. CONCLUSIONS Both appliances promote condylar growth and sagittal and vertical development of the mandible in adolescent Class II division 1 malocclusion mandibular retraction patients. The length of the mandibular ramus showed a more significant increase following treatment with the Twin-Block appliances than with clear function aligners.
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Affiliation(s)
- Yueying Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Jiajing Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Qiuyue Wu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Tianlu Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Hua Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yusen Du
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Yizhe Qi
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China
| | - Zuolin Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
| | - Feifei Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, The Third Affiliated Hospital of Air Force Medical University, Xian, 710032, Shaanxi, People's Republic of China.
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Costa ALF, Castilho Fardim KA, de Almeida BM, Gomes JPP, Braz-Silva PH, Dieguez FL, Cardoso CDAB, Araki AT, de Castro Lopes SLP. Eccentric movements of temporomandibular joint and upper airway volume: Three-dimensional segmentation using cone beam computed tomography. Cranio 2024; 42:10-17. [PMID: 33719936 DOI: 10.1080/08869634.2021.1894860] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of the present investigation was to assess whether possible changes in the dynamic movements of the TMJ might cause a greater variation between the volumes of the upper airways in open- and closed-mouth positions. METHODS CBCT scans of 92 subjects were used to assess the TMJ bilaterally. All scans were acquired in closed (CM) and maximum mouth opening (MMO) positions. The difference in the volume of the oropharyngeal cavity obtained by subtracting the CM volume from the MMO volume (delta volume or volume variation) was calculated. The resulting volume was analyzed by Mann-Whitney test for variation in rotation. RESULTS A significant difference was found (p-value = 0.0188) on the right side regarding changes in the rotational movement of the condyle (Mann-Whitney test). CONCLUSION This study showed a relationship between degree of abnormal or limited rotation and variation in the upper airway volume on one side.
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Affiliation(s)
| | - Karolina Aparecida Castilho Fardim
- Department of Diagnosis and Surgery, São José dos Campos Dental School, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - Bruna Maciel de Almeida
- Department of Diagnosis and Surgery, São José dos Campos Dental School, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - João Pedro Perez Gomes
- Department of Stomatology, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | | | - Flávia Limberg Dieguez
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), São Paulo, SP, Brazil
| | | | - Angela Toshie Araki
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), São Paulo, SP, Brazil
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Navallas M, Tolend M, Otobo TM, Panwar J, Clemente EJI, Hemke R, van Rossum MA, Doria AS. Developing standards for MRI evaluation of joints in children with juvenile idiopathic arthritis utilizing the temporomandibular joint as a model. Jpn J Radiol 2024; 42:56-68. [PMID: 37626169 DOI: 10.1007/s11604-023-01479-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023]
Abstract
The treatment of a patient with juvenile idiopathic arthritis (JIA) is best monitored with standardized and validated tools to measure joint changes over time. Treatment approaches are best indicated if the clinicians are aware of the structural status of the joint at a given time, especially in anatomically deep joints for which clinical assessment is limited. Magnetic resonance imaging (MRI) is of utmost importance for assessment of deep joints and extra-articular soft tissue of the entire body for which ultrasound may be suboptimal. Because the distinction between pathologic and physiologic joint changes on MRI is key for proper diagnosis and treatment of patients with arthropathies, a comprehensive standardized approach is needed to effectively measure outcomes of growing joints of children with JIA. Such an approach is essential for both clinical assessment and to conduct clinical trials in patients with JIA treated in different centers around the world. To meet this need, several international imaging collaborative research groups have been developing MRI scales over the past years, including the MRI in JIA (JAMRI) special interest group within the Outcome Measures in Rheumatology (OMERACT) research network. This manuscript reviews the efforts of the OMERACT JAMRI working group to generate and validate pediatric MRI scoring systems for different joints in children with JIA that can have ubiquitous utilization anywhere in the world. In particular, it describes the different steps of development and validation of an MRI scale using the TMJ as a model.
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Affiliation(s)
- Maria Navallas
- Department of Diagnostic Imaging. Hospital 12 de Octubre, Madrid, Spain
| | - Mirkamal Tolend
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, and Department of Medical Imaging, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Tarimobo M Otobo
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, and Department of Medical Imaging, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | - Jyoti Panwar
- Department of Medical Imaging, The Tweed Hospital, Lumus Imaging, Tweed Heads, NSW, Australia
| | - Emilio J Inarejos Clemente
- Department of Diagnostic Imaging. Sant Joan de Deu Barcelona Children Hospital, University of Barcelona, Barcelona, Spain
| | - Robert Hemke
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Amsterdam Movement Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Marion A van Rossum
- Department of Pediatrics, Emma Children's Hospital Amsterdam University Medical Centers and Amsterdam Rheumatology and Immunology Center | Reade, Amsterdam, The Netherlands
| | - Andrea S Doria
- Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, and Department of Medical Imaging, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
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Mercuri LG. Alloplastic temporomandibular joint replacement - past, present, and future: "Learn from the past, prepare for the future, live in the present." Thomas S. Monson. Br J Oral Maxillofac Surg 2024; 62:91-96. [PMID: 38000963 DOI: 10.1016/j.bjoms.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/09/2023] [Accepted: 10/17/2023] [Indexed: 11/26/2023]
Abstract
Based on evidence from the orthopaedic, biomedical engineering, and oral and maxillofacial surgical literature, this paper discusses reported successes and failures of past alloplastic temporomandibular joint (TMJ) devices that have led to the development of present total temporomandibular joint replacement (TMJR) devices. The paper concludes with discussion of the ongoing research that will lead to future embodiment (materials, designs, and manufacture) advances in TMJR management of severe and debilitating end-stage TMJ disease, further improving patients' mandibular function, form, and overall quality of life.
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Affiliation(s)
- Louis G Mercuri
- Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Chicago, IL 60612, United States; Department of Biomedical Engineering, University of Illinois Chicago, 851 S Morgan St, Chicago, IL 60607, United States.
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Fernández-Rubio EM, Radlanski RJ. Development of the human primary and secondary jaw joints. Ann Anat 2024; 251:152169. [PMID: 37875166 DOI: 10.1016/j.aanat.2023.152169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
This study investigates the development of the primary and secondary jaw joints in humans, focusing on their concomitance and subsequent disconnection. Development begins with the primary temporomandibular joint as a connection between Meckel's cartilage and the incus, while the secondary temporomandibular joint develops anteriorly as an articulation between the mandibular condyle and the mandibular fossa. Previous research in mice has provided insights into the morphogenesis of these joints, but their specific development of the 3D morphogenesis in humans remains unclear. To address this gap, histological serial sections of embryos and fetuses ranging from 19 to 230 mm crown-rump length were analyzed. The 3D morphogenesis of the middle ear and the temporomandibular joint was examined, paying attention to the morphological characteristics, timing, and potential mechanisms of movement and disconnection. The primary jaw joint is initially formed at 25 mm (8th week), followed by the appearance of the secondary jaw joint arising at 87 mm (12th week). Both joints persist present simultaneously, until a separation occurs between 150 and 230 mm (18th-24th week). It is remarkable that both joints remain concomitant and function somehow for a period exceeding 6 weeks, with the mechanism of their separation still unclear. Understanding the precise timing and functional movements involved with these temporarily connected joints is crucial for comprehending the overall development of the temporomandibular joint. Further research is needed to explore the molecular and cellular processes underlying these developmental changes.
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Affiliation(s)
- E M Fernández-Rubio
- Charité - Campus Benjamin Franklin at Freie Universität Berlin Center for Dental and Craniofacial Sciences Dept. of Craniofacial Developmental Biology, Assmannshauser Str. 4-6, Berlin 14197, Germany
| | - R J Radlanski
- Charité - Campus Benjamin Franklin at Freie Universität Berlin Center for Dental and Craniofacial Sciences Dept. of Craniofacial Developmental Biology, Assmannshauser Str. 4-6, Berlin 14197, Germany.
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Meral SE, Koç O, Tosun E, Tüz HH. Effects of sagittal split Ramus osteotomy on condylar position and Ramal orientation in patients with mandibular asymmetry. Clin Oral Investig 2023; 28:65. [PMID: 38158456 DOI: 10.1007/s00784-023-05400-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The purpose of this study is to assess the impact of Sagittal Split Ramus Osteotomy (SSRO) on the alignment of the condyle and orientation of the Ramal segment following surgery in patients operated for the correction of mandibular asymmetry. METHODS A total of 27 patients who underwent SSRO were enrolled in this study, and study groups were defined as asymmetric (study group) and symmetric (control group) using linear measurements from the dental midline based on a three-dimensional coordinate system. Differences on preoperative and postoperative values of anterior (AJS), posterior (PJS) and superior joint spaces (SJS), condylar axial angle (CAA), Sagittal Ramal Angle (SRA), and Coronal Ramal Angles (CRA) of study and control groups were measured and compared. The data was analyzed using the "Wilcoxon signed-ranks test" to identify differences between groups. RESULTS Differences between preoperative and postoperative values of CRA and SRA of the contralateral group showed statistically significant results with p-values of 0.007 and 0.005, respectively. A statistically significant change in CAA angle was found in the control and deviation groups (p = 0.018 and p = 0.010, respectively). CONCLUSIONS SSRO has inevitable effects on the condylar and ramal orientation. Individuals with asymmetry require particular attention throughout the planning process and beyond. Conjunctive modalities and modifications should be considered and utilized when necessary. Future studies with larger sample sizes, homogenous follow-up periods, and more comprehensive clinical data are needed to substantiate understanding of the response of the condylar segment. CLINICAL RELEVANCE Orthognathic surgeries inevitably alter the alignment and harmony of temporomandibular structures and may result in change of AJS, PJS, SJS, CAA, SRA, and LRA, which may change the biomechanics of joint and lead to several complications like temporomandibular disorders. Especially in cases with midline asymmetry needs special consideration from planning till the end of the treatment to achieve best results. In severe cases, conjunctive modalities and modifications and other alternatives such as inverted-L osteotomies should be considered.
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Affiliation(s)
- Salih Eren Meral
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey.
| | - Onur Koç
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey
| | - Emre Tosun
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey
| | - Hakan H Tüz
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey
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Bhargava D. Hybrid total alloplastic temporomandibular joint replacement prosthesis: a pilot study to evaluate feasibility, functional performance and impact on post-operative quality of life. Oral Maxillofac Surg 2023:10.1007/s10006-023-01203-0. [PMID: 38153609 DOI: 10.1007/s10006-023-01203-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/10/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE The aim of the present study was to investigate the clinical efficiency of hybrid alloplastic temporomandibular joint (TMJ) prosthesis in patients undergoing TMJ total alloplastic joint replacement (TMJR). The prosthesis utilized for this study for TMJR is a hybrid variant with combination of stock prototype design and a partial customization of components. MATERIALS AND METHODS A prospective clinical study was conducted involving five patients with unilateral TMJ ankylosis or end-stage joint disease (ESJD) indicated for and requiring TMJR. The patients underwent resection of the joint or gap arthroplasty followed by TMJR using the hybrid alloplastic TMJ prosthesis. The subjective and objective variables that included the jaw function (JF), inter-incisal opening (IO), diet intake (DI) and quality of life (QoL) were assessed using the psychometric modified Likert scale. The nutritional status of the patients was evaluated using the mid-upper arm circumference (MUAC) as reference. RESULTS The assessed study variables demonstrated functional and observational improvement in the post-operative follow-up when compared to the pre-operative period. The patients showed an improvement in overall QoL and nutritional status post-operatively. The follow-up period showed subjective and objective improvement in the parameters assessed among the study population. CONCLUSION There is a technical and clinical feasibility to utilize the hybrid alloplastic TMJ prosthesis as a reliable alloplastic option for treating patients requiring TMJR, with prudent indications.
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Affiliation(s)
- Darpan Bhargava
- Oral and Maxillofacial Surgery, TMJ Consultancy Services, Bhopal, Madhya Pradesh, India.
- DAMER, Bhopal, India.
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Ângelo DF, Mota B, Sanz D, Pimentel J. Septic arthritis of the temporomandibular joint managed with arthroscopy: a case report. Int J Oral Maxillofac Surg 2023; 52:1278-1281. [PMID: 37479607 DOI: 10.1016/j.ijom.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/06/2023] [Accepted: 06/29/2023] [Indexed: 07/23/2023]
Abstract
Septic arthritis of the temporomandibular joint (SATMJ) is an uncommon bacterial or fungal infection of the joint space. A 68-year-old man with underlying diabetes mellitus and a history of liver transplant, who was on immunosuppressants, presented to the oral and maxillofacial surgery department of the authors´ institution in Portugal. His main symptoms were arthralgia in the right temporomandibular joint, malocclusion, pre-auricular swelling and erythema. After clinical, laboratory, and imaging evaluations, diagnoses of chronic suppurative otitis media and SATMJ were made. The patient was managed with arthroscopy of the right temporomandibular joint, which allowed joint fluid collection for microbiological examination, lavage, and biopsy. The biopsy sample was positive for Pseudomonas aeruginosa. After surgery, targeted intravenous antibiotic treatment (amikacin) was given for 30 days. No recurrence of any complaints was reported after 12 months of follow-up.
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Affiliation(s)
- D F Ângelo
- Instituto Português da Face, Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
| | - B Mota
- Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal
| | - D Sanz
- Instituto Português da Face, Lisbon, Portugal
| | - J Pimentel
- Instituto Português da Face, Lisbon, Portugal
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Tang L, Bai X, Wang Y, Chen Y, Chen ME, Xia C, Li Z. Effect of TMJ disc position on condylar bone remodeling after arthroscopic disc repositioning surgery. Eur J Radiol 2023; 169:111189. [PMID: 37939605 DOI: 10.1016/j.ejrad.2023.111189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/17/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE The objective of this study was to analyze the effect of TMJ disc position on condylar bone remodeling after arthroscopic disc repositioning surgery. METHODS Nine patients with anterior disc displacement without reduction (ADDWoR, 15 sides) who underwent arthroscopic disc repositioning surgery were included. Three-dimensional (3D) reconstruction of the articular disc and the condyle in the closed-mouth position was performed using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) data. Then, the CBCT and MRI images were fused and displayed together by multimodal image registration techniques. Morphological changes in the articular disc and condyle, as well as changes in their spatial relationship, were studied by comparing preoperative and 3-month postoperative CBCT-MRI fused images. RESULTS The volume and superficial area of the articular disc, as well as the area of the articular disc surface in the subarticular cavity, were significantly increased compared to that before the surgical treatment(P < 0.01). There was also a significant increase in the volume of the condyle (P < 0.001). All condyles showed bone remodeling after surgery that could be categorized as one of two types depending on the position of the articular disc, suggesting that the location of the articular disc was related to the new bone formation. CONCLUSIONS The morphology of the articular disc and condyle were significantly changed after arthroscopic disc repositioning surgery. The 3D changes in the position of the articular disc after surgery tended to have an effect on condylar bone remodeling and the location of new bone formation.
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Affiliation(s)
- Liangchen Tang
- 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, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xiaofeng Bai
- 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, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yujie Wang
- 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, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yifan Chen
- 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, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Min-Er Chen
- 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, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Chenlong Xia
- 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, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zhiyong Li
- 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, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China.
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de Souza-Pinto GN, Herreira-Ferreira M, Grossmann E, Brasil DDM, Hara GF, Groppo FC, Iwaki LCV. Assessment of temporomandibular joint bone changes associated with anterior disc displacement: An MRI cross-sectional study. J Stomatol Oral Maxillofac Surg 2023; 124:101657. [PMID: 37866505 DOI: 10.1016/j.jormas.2023.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE This cross-sectional study aimed to evaluate the presence of bone changes on magnetic resonance imaging (MRI) scans of patients with temporomandibular joint (TMJ) anterior disc displacement (ADD) with reduction (ADDWR) and without reduction (ADDWoR). METHODS TMJ-MRI scans were screened for the presence of ADD. 285 scans presented ADD, being further divided into ADDWR (n = 188) and ADDWoR (n = 97). Bone changes on the mandibular condyle and articular eminence were also assessed and computed. The chi-square test compared the association of these bone changes with the presence of ADDWR and ADDWoR, with a significance level of 5 %. Also, the prevalence ratio (PR) was calculated. RESULTS In the mandibular condyle, subchondral cyst (p = 0.035, PR = 1.08) and bone edema (p = 0.044, PR = 2.40), more prevalent on ADDWR, and generalized sclerosis (p = 0.015, PR = 1.04), more prevalent on ADDWoR, presented significant association with ADD. On the articular eminence, generalized sclerosis (p = 0.015, PR = 1.04) and articular surface flattening (p = 0.003, PR = 1.19) presented significant association with ADD, both more prevalent on ADDWoR. CONCLUSION Bone changes are usual findings in TMJ with ADD diagnosis. The real influence of ADD is not fully clear, although clinicians should be aware of patients with this condition, to provide an early diagnosis and improve patient´s prognosis.
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Affiliation(s)
| | - Matheus Herreira-Ferreira
- Department of Dentistry, State University of Maringá, Avenida Mandacaru, 1550 - 87080-000, Maringá, Brazil.
| | - Eduardo Grossmann
- Dentistry Faculty, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492- 90035-004, Porto Alegre, Brazil.
| | - Danieli de Moura Brasil
- Piracicaba Dental School, State University of Campinas, Avenida Limeira, 901 - 13414-903, Piracicaba, Brazil.
| | - Giovana Felipe Hara
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil, Avenida Mandacaru, 1550 - 87080-000, Maringá, Brazil.
| | - Francisco Carlos Groppo
- Piracicaba Dental School, State University of Campinas, Avenida Limeira, 901 - 13414-903, Piracicaba, Brazil.
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Handa S, Guastaldi FPS, Violette L, Abou-Ezzi J, Rosén A, Keith DA. Which comorbid conditions and risk factors affect the outcome of and progression to total temporomandibular joint replacement? Int J Oral Maxillofac Surg 2023; 52:1265-1271. [PMID: 37277244 DOI: 10.1016/j.ijom.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 05/16/2023] [Accepted: 05/24/2023] [Indexed: 06/07/2023]
Abstract
Surgery is an effective modality to reduce pain and increase range of motion (ROM) in TMJ disorders. The aim of this study was to determine which comorbidities and risk factors affect outcomes and progression to total joint replacement (TJR). A retrospective cohort study of patients who underwent TJR between 2000- 2018 at MGH was conducted. Primary outcome was successful vs unsuccessful surgery. Success was defined as pain score ≤ 4 and ROM ≥ 30 mm; failure was defined as lack of either or both. Secondary outcome was differences between patients undergoing TJR only (group A) and those undergoing multiple surgeries progressing to TJR (group B). 99 patients (82 females, 17 males) were included. Mean follow-up was 4.1 years; mean age at first surgery was 34.2 (range 14-71) years. Unsuccessful outcomes were associated with high preoperative pain, low preoperative ROM, and higher number of surgeries. Male sex favored successful outcome. 75.0% group A and 47.6% group B had successful outcome. Group B had more females, higher postoperative pain, lower postoperative ROM, and used more opioids compared to group A. High preoperative pain, low preoperative ROM, and more surgeries were associated with poorer outcomes and frequent opioid use.
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Affiliation(s)
- S Handa
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA
| | - F P S Guastaldi
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA
| | - L Violette
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA
| | - J Abou-Ezzi
- College of Human Ecology, Cornell University, New York City, NY, USA
| | - A Rosén
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway; Department of Oral and Maxillofacial Surgery, Haukeland University Hospital, Bergen, Norway
| | - D A Keith
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA, USA.
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Ulmner M, Sugars R, Naimi-Akbar A, Reseland JE, Lund B. General joint hypermobility in temporomandibular joint disease; clinical characteristics, biomarkers, and surgical aspects. Heliyon 2023; 9:e23051. [PMID: 38149208 PMCID: PMC10750043 DOI: 10.1016/j.heliyon.2023.e23051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/23/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
Objectives This study aimed at identifying biomarkers in the temporomandibular joint (TMJ) synovial tissue analysing 28 extra cellular matrix proteins in TMJ diseased patients, classified with either general joint hypermobility (GJH) or normal joint mobility (NJM), and to compile clinical and protein characterisation to reveal potential surgical predictive factors. Study design A prospective observational cohort study including 97 consecutive patients scheduled for TMJ surgery was performed. Joint mobility and several other predefined clinical variables were recorded. Synovial tissue was harvested during surgery followed by examination using multi-analytic profiling. A multivariate quantile regression model was used for analysis purposes. Results The GJH/NJM ratio was 2:5. The GJH cohort were younger (P = 0.001) and more likely to be women (P = 0.026) compared to the NJM cohort. None of the protein concentrations could be correlated to joint mobility in the multivariate regression model, but often to the variable TMJ diagnosis. The surgical outcome after the six-month follow-up were equal between GJH and NJM patients. Conclusions GJH was more common in the study cohort compared to general population frequencies, but GJH was not a negative factor for surgical outcome. Young age and female gender correlated to GJH. No TMJ biomarkers were GJH specific, and the results suggested that TMJ diagnosis more strongly correlated to the protein profile compared to GJH and the other investigated variables.
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Affiliation(s)
- Mattias Ulmner
- Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Karolinska University Hospital, 171 76, Stockholm, Sweden
- Department of Dental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Rachael Sugars
- Department of Dental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Aron Naimi-Akbar
- Health Technology Assessment-Odontology, Malmö University, 205 06, Malmö, Sweden
| | - Janne Elin Reseland
- Department of Biomaterials, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, 0317, Oslo, Norway
| | - Bodil Lund
- Medical Unit of Plastic Surgery and Oral and Maxillofacial Surgery, Karolinska University Hospital, 171 76, Stockholm, Sweden
- Department of Dental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden
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