Mandibular condylar fractures and acute atlanto-axial subluxation Part 2 A physiopathological factor for the cervical spine sprain.

Science.gov (United States)

Cutilli, T; Corbacelli, A

2009-05-01

The aim of this study was to analyze the physiopathology of the acute cervical injure in the event of mandibular condylar fractures. As in the Part 1, 25 non-consecutive cases of condylar mandibular fractures (16 males and 9 females, mean age: 22.96/range 14-36 years) observed and treated in the Maxillofacial Surgery Department of the University of L'Aquila, have been studied. Types of fractures examined included: unilateral: 19 cases (solitary: 12; associated with other mandibular fractures: 7, homolateral: 2); bilateral: 6 cases (equivalent: 2, not equivalent: 4). A control group was constituted of 10 patients, 5 males and 5 females, aged from 19 to 24 years (mean range: 21.6) suffering from acute isolated cervical distorsion (whiplash). The study has been performed by means of the analysis of X-ray and computed tomography (CT)-CT/3D of the mandibular condylar regions, the occipital-atlanto-axial structures and the cervical region. In all the patients the following constant alterations that link up with these fractures have been observed: the rotation of atlas, the atlanto-axial subluxation and the derangement of the occipital-atlanto-epistropheal joint, homolateral to the side of the mandibular condylar fracture. The cervical spine shows the constant loss of physiological lordosis with hinge between C3 and C4. In the whiplash, as the authors have been able to assess in the control group, there are no alterations of occipital-atlanto-axial joint and the kinetic vector is placed on the longitudinal plane. In the mandibular condylar fractures the kinetic mechanism is completely different regarding the whiplash. The point of entry is the chin and the kinetic vector is oriented down-up, sometimes oblique in the opposite side. Subsequently the kinetic force is transmitted throughout the mandibular structure and causes the condylar or bicondylar fracture. The kinetic vector is placed before on the vertical plane, then on the horizontal plane and later on the vertical

Anterior mandibular displacement and condylar growth. An experimental study in the rat

International Nuclear Information System (INIS)

Tonge, E.A.; Heath, J.K.; Meikle, M.C.

1982-01-01

Anterior displacement of the mandible was produced in twenty-eight 1-month-old female rats by two methods: (1) cast-gold splints cemented to the maxillary incisor teeth and (2) a removable stainless steel mesh appliance worn 6 hours each day, during which time the animals were sedated. The controls were littermates without appliances and in the mesh group were also sedated. Animals in the splint group were killed after 24 hours, 1 week, and 1 month; those in the mesh group were killed after 24 hours and after 1 week. the condyles were removed and cultured for 24 hours in medium containing 3 H-thymidine. One condyle from each animal was processed for routine histologic and autoradiographic study. The other was digested in phosphate-buffered saline containing RNA-ase and pronase, and the specific activity of 3 H-thymidine incorporation expressed as dpm/microgramDNA. Anterior mandibular displacement produced by both methods failed to result in a significant increase in the incorporation of 3 H-thymidine into explant DNA. In the 7-day mesh experiment, however, there was a significant increase in the DNA content of the condylar explants from the displacement group, suggesting an increase in the cell population. This finding should be treated with caution because of the small numbers of animals involved, but it indicates an important area for further study. Changes in the distribution of labeled cells within the proliferative zone (PZ) were also observed autoradiographically in the mesh group, but there was little to suggest that mandibular displacement was accompanied by a significant increase in cell division within the PZ. Remodeling changes affecting both the articular tissue and the subchondral bone were a characteristic feature of the 1-month bit plane group

Internal fixation of severely displaced mandibular condylar neck fracture with the aid of ramus osteotomy. A revised technique

DEFF Research Database (Denmark)

Hillerup, S

1997-01-01

A technique is described whereby the mandibular condyle can be located, replaced and fixed in case of a severely displaced fracture with exarticulation of the condylar head.......A technique is described whereby the mandibular condyle can be located, replaced and fixed in case of a severely displaced fracture with exarticulation of the condylar head....

Digital diagnosis and treatment of mandibular condylar fractures based on Extensible Neuro imaging Archive Toolkit (XNAT.

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ZhongWei Zhou

Full Text Available The treatment of condylar fractures has long been controversial. In this paper, we established a database for accurate measurement, storage, management and analysis of patients' data, in order to help determine the best treatment plan.First of all, the diagnosis and treatment database was established based on XNAT, including 339 cases of condylar fractures and their related information. Then image segmentation, registration and three-dimensional (3D measurement were used to measure and analyze the condyle shapes. Statistical analysis was used to analyze the anatomical structure changes of condyle and the surrounding tissues at different stages before and after treatment. The processes of condylar fracture reestablishment at different stages were also dynamically monitored. Finally, based on all these information, the digital diagnosis and treatment plans for condylar fractures were developed.For the patients less than 18 years old with no significant dislocation, surgical treatment and conservative treatment were equally effective for intracapsular fracture, and had no significant difference for neck and basal fractures. For patients above 18 years old, there was no significant difference between the two treatment methods for intracapsular fractures; but for condylar neck and basal fractures, surgical treatment was better than conservative treatment. When condylar fracture shift angle was greater than 11 degrees, and mandibular ramus height reduction was greater than 4mm, the patients felt the strongest pain, and their mouths opening was severely restricted. There were 170 surgical cases with condylar fracture shift angel greater than 11 degrees, and 118 of them (69.4% had good prognosis, 52 of them (30.6% had complications such as limited mouth opening. There were 173 surgical cases with mandibular ramus height reduction more than 4mm, and 112 of them (64.7% had good prognosis, 61 of them (35.3% had complications such as limited mouth opening

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

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Kang-Young Choi

2012-07-01

Full Text Available The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture.

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

Science.gov (United States)

Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

2012-01-01

The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture. PMID:22872830

Cellular and Matrix Response of the Mandibular Condylar Cartilage to Botulinum Toxin.

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Eliane H Dutra

Full Text Available To evaluate the cellular and matrix effects of botulinum toxin type A (Botox on mandibular condylar cartilage (MCC and subchondral bone.Botox (0.3 unit was injected into the right masseter of 5-week-old transgenic mice (Col10a1-RFPcherry at day 1. Left side masseter was used as intra-animal control. The following bone labels were intraperitoneally injected: calcein at day 7, alizarin red at day 14 and calcein at day 21. In addition, EdU was injected 48 and 24 hours before sacrifice. Mice were sacrificed 30 days after Botox injection. Experimental and control side mandibles were dissected and examined by x-ray imaging and micro-CT. Subsequently, MCC along with the subchondral bone was sectioned and stained with tartrate resistant acid phosphatase (TRAP, EdU, TUNEL, alkaline phosphatase, toluidine blue and safranin O. In addition, we performed immunohistochemistry for pSMAD and VEGF.Bone volume fraction, tissue density and trabecular thickness were significantly decreased on the right side of the subchondral bone and mineralized cartilage (Botox was injected when compared to the left side. There was no significant difference in the mandibular length and condylar head length; however, the condylar width was significantly decreased after Botox injection. Our histology showed decreased numbers of Col10a1 expressing cells, decreased cell proliferation and increased cell apoptosis in the subchondral bone and mandibular condylar cartilage, decreased TRAP activity and mineralization of Botox injected side cartilage and subchondral bone. Furthermore, we observed reduced proteoglycan and glycosaminoglycan distribution and decreased expression of pSMAD 1/5/8 and VEGF in the MCC of the Botox injected side in comparison to control side.Injection of Botox in masseter muscle leads to decreased mineralization and matrix deposition, reduced chondrocyte proliferation and differentiation and increased cell apoptosis in the MCC and subchondral bone.

Hyaline cartilage cells outperform mandibular condylar cartilage cells in a TMJ fibrocartilage tissue engineering application.

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Wang, L; Lazebnik, M; Detamore, M S

2009-03-01

To compare temporomandibular joint (TMJ) condylar cartilage cells in vitro to hyaline cartilage cells cultured in a three-dimensional (3D) environment for tissue engineering of mandibular condylar cartilage. Mandibular condylar cartilage and hyaline cartilage cells were harvested from pigs and cultured for 6 weeks in polyglycolic acid (PGA) scaffolds. Both types of cells were treated with glucosamine sulfate (0.4 mM), insulin-like growth factor-I (IGF-I) (100 ng/ml) and their combination. At weeks 0 and 6, cell number, glycosaminoglycan (GAG) and collagen content were determined, types I and II collagen were visualized by immunohistochemistry and GAGs were visualized by histology. Hyaline cartilage cells produced from half an order to a full order of magnitude more GAGs and collagen than mandibular condylar cartilage cells in 3D culture. IGF-I was a highly effective signal for biosynthesis with hyaline cartilage cells, while glucosamine sulfate decreased cell proliferation and biosynthesis with both types of cells. In vitro culture of TMJ condylar cartilage cells produced a fibrous tissue with predominantly type I collagen, while hyaline cartilage cells formed a fibrocartilage-like tissue with types I and II collagen. The combination of IGF and glucosamine had a synergistic effect on maintaining the phenotype of TMJ condylar cells to generate both types I and II collagen. Given the superior biosynthetic activity by hyaline cartilage cells and the practical surgical limitations of harvesting cells from the TMJ of a patient requiring TMJ reconstruction, cartilage cells from elsewhere in the body may be a potentially better alternative to cells harvested from the TMJ for TMJ tissue engineering. This finding may also apply to other fibrocartilages such as the intervertebral disc and knee meniscus in applications where a mature cartilage cell source is desired.

Bone changes in the condylar head and mandibular fossa in patients with temporomandibular disorders. Helical CT observation

International Nuclear Information System (INIS)

Shimahara, Satoru; Ariyoshi, Yasunori; Kimura, Yoshihiro; Shimahara, Masashi

2011-01-01

In the present study, we investigated whether bone changes are present in sites impossible to observe by panoramic X-ray and Schuller's X-ray examination, namely the medial of the condylar head and mandibular fossa, in patients with type IV temporomandibular joint disorders. We observed the articular fossa using computed tomography, which is able to obtain detailed 3-dimensional information, in patients with type IV temporomandibular disorders. We examined 120 joints of 60 patiens who visited the Department of Oral Surgery, Osaka Medical College Hospital. Each condylar head was clearly visualized in panoramic X-ray and Schuller's X-ray examination findings, and shown to have possible changes unilaterally. Each joint was diagnosed as type IV, according to the diagnostic guidelines set by Japanese Society for Temporomandibular Joint, and further examined using helical CT. Changes in condylar head; We concluded that bone changes were present with considerable probability in the medial of condylar head in a manner similar to those found in the lateral and center of joints with type IV temporomandibular disorders. Changes in mandibular fossa; The bone changes occurred in various locations of the mandibular fossa, while they appeared significantly more frequently in the condylar head. We think that our finding will contribute to development of treatment strategies for temporomandibular disorders, as they clarify bone changes in sites previously unreported. (author)

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

OpenAIRE

Choi, Kang-Young; Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

2012-01-01

The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of ...

Evaluation of mandibular condylar changes in patients following orthognathic surgery: A retrospective study

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Vikas Aneja

2017-01-01

Full Text Available Background: Condylar resorption as a cause of relapse after orthognathic surgery is well known. Several authors have presented evidence of the relation between orthognathic surgery and condylar remodeling and resorption. This study was done to appraise the condylar changes along with the form and function following orthognathic surgery, as well as to assess what factors may have contributed to the problems. Methodology: A diagnosis of progressive condylar resorption (PCR was made by comparison of preoperative and postoperative radiographs (cephalometric radiograms, as well as clinical evaluations. The radiographs were taken for each patient preoperatively and postoperatively, which include immediately after osteotomy, at 6 months and 24 months. Additional radiographs were taken when required. Then, preoperative and postoperative tracings were compared at 24 months postoperatively. Results and Conclusion: It can be concluded from this study that females of relative low age (<18 years appeared to be a high-risk factor for the occurrence of condylar alteration including PCR. A steep mandibular plane angle, the low facial height ratio (post/ant, and magnitude of surgery were also significantly related to the occurrence of condylar alteration, but the multivariance regression showed that these parameters had only limited value.

[Topographological-anatomic changes in the structure of temporo-mandibular joint in case of fracture of the mandible condylar process at cervical level].

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Volkov, S I; Bazhenov, D V; Semkin, V A

2011-01-01

Pathological changes in soft tissues surrounding the fracture site as well as in the structural elements of temporo-mandibular joint always occured in condylar process fracture with shift at cervical mandibular jaw level. Other changes were also seen in the joint on the opposite normal side. Modelling of condylar process fracture at mandibular cervical level by means of three-dimensional computer model of temporo-mandibular joint contributed to proper understanding of this pathology emergence as well as to prediction and elimination of disorders arising in adjacent to the fracture site tissues.

Fetal jaw movement affects Ihh signaling in mandibular condylar cartilage development: the possible role of Ihh as mechanotransduction mediator.

Science.gov (United States)

Jahan, Esrat; Matsumoto, Akihiro; Rafiq, Ashiq Mahmood; Hashimoto, Ryuju; Inoue, Takayuki; Udagawa, Jun; Sekine, Joji; Otani, Hiroki

2014-10-01

Jaw movement is an important mechanical factor for prenatal development of the condylar cartilage of mandible. Fetal jaw movement restriction has been shown to cause deformity of the mandibular condyle. We hypothesized that this treatment affects the expression of mechanosensitive molecules, namely Indian hedgehog (Ihh) and Parathyroid hormone related protein (PTHrP) in the condyle. We restrained jaw movement by suturing the jaw of E15.5 mouse embryos and allowed them to develop until E18.5 using exo utero system, and analyzed them by immunohistochemistry and in situ hybridization methods. Morphological, histomorphometric and immunohistochemical study showed that the mandibular condylar cartilage was reduced and deformed, the volume and total cell numbers in the condylar cartilage were also reduced, and number and/or distribution of 5-bromo-2'-deoxyuridine-positive cells, Ihh-positive cells in the mesenchymal and pre-hypertrophic zones were significantly and correspondingly decreased in the sutured group. Using in situ hybridization, reduced expression of Ihh, PTHrP and their related receptors were observed in condylar cartilage of the sutured embryos. Our results revealed that the altered mechanical stress induced by prenatal jaw movement restriction decreased proliferating cells, the amount of cartilage, and altered expression of the Ihh and PTHrP, suggesting that Ihh act as mechanotransduction mediators in the development of mandibular condylar cartilage. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Inferior hemiarthroplasty of the temporo-mandibular joint with articulated condylar prosthesis type Stryker].

Science.gov (United States)

Bucur, A; Dincă, O; Totan, C; Ghită, V

2007-01-01

The optimal reconstruction of the mandible and of the temporo-mandibular joint after mandibular hemi-resection with disarticulation is still controversial in literature. This paperwork presents our experience on four cases in the reconstruction of the mandible together with the inferior arthroplasty of the temporo-mandibular joint, after the resection of extended benign tumors of the mandible, based on fibular free vascularized grafts having attached a Stryker titanium condylar prosthesis reconstructing the inferior segment of the temporo-mandibular joint. Our results for the this technique were excellent, with a functional rehabilitation very close to normal. After reviewing the various techniques and their arguments in literature, with accent on the TMJ reconstruction, we consider this method to be optimal for the reconstruction of mandibular defects in patients with neoplastic conditions.

[Extramedullary fixation combined with intramedullary fixation in the surgical reduction of sagittal mandibular condylar fractures].

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Chuanjun, Chen; Xiaoyang, Chen; Jing, Chen

2016-10-01

This study aimed to evaluate the clinical effect of extramedullary fixation combined with intramedullary fixation during the surgical reduction of sagittal mandibular condylar fractures. Twenty-four sagittal fractures of the mandibular condyle in18 patients were fixed by two appliances: intramedullary with one long-screw osteosynthesis or Kirschner wire and extramedullary with one micro-plate. The radiologically-recorded post-operative stability-associated com-plications included the screw/micro-plate loosening, micro-plate twisting, micro-plate fractures, and fragment rotation. The occluding relations, the maximalinter-incisal distances upon mouth opening, and the mandibular deflection upon mouth opening were evaluated based on follow-up clinical examination. Postoperative panoramic X-ray and CT scans showed good repositioning of the fragment, with no redislocation or rotation, no screw/plate loosening, and no plate-twisting or fracture. Clinical examination showed that all patients regained normal mandibular movements, ideal occlusion, and normal maximal inter-incisal distances upon mouth opening. Extramedullary fixation combined with intramedullary fixation is highly recommended for sagittal condylar fractures because of the anti-rotation effect of the fragment and the reasonable place-ment of the fixation appliances.

Masticatory motion after surgical or nonsurgical treatment for unilateral fractures of the mandibular condylar process.

Science.gov (United States)

Throckmorton, Gaylord S; Ellis, Edward; Hayasaki, Haruaki

2004-02-01

We sought to compare mandibular motion during mastication in patients treated in either an open or a closed fashion for unilateral fractures of the mandibular condylar process. Eighty-one male patients with unilateral condylar process fractures were treated either with (n = 37) or without (n = 44) surgical reduction and rigid fixation of their condylar process fractures. At 6 weeks, 6 months, 1 year, and 2 years after treatment, the subjects' chewing cycles were recorded using a magnetic sensor array (Sirognathograph; Siemens Corp, Bensheim, Germany) while chewing Gummi-Bears (HARIBO, Bonn, Germany) unilaterally on the same side as the fracture and on the opposite side. The chewing cycles were analyzed using a custom computer program, and the duration, excursive ranges, and 3-dimensional cycle shape were compared between the 2 treatment groups at each time interval using multilevel linear modeling statistics. The 2 treatment groups did not differ significantly for any measure of cycle duration or any excursive range (except lateral excursions at 1 year post-treatment) at any of the time intervals. However, the 3-dimensional cycle shapes of the 2 groups did differ significantly at all time intervals. Surgical correction of unilateral condylar process fractures has relatively little effect on the more standard measures (duration and excursive ranges) of masticatory function. However, surgical correction better normalizes opening incisor pathways during mastication on the side opposite the fracture.

Evaluation of skeletal and dental age using third molar calcification, condylar height and length of the mandibular body.

Science.gov (United States)

Kedarisetty, Sunil Gupta; Rao, Guttikonda Venkateswara; Rayapudi, Naveen; Korlepara, Rajani

2015-01-01

To identify the most reliable method for age estimation among three variables, that is, condylar height, length of mandibular body and third molar calcification by Demirjian's method. Orthopantomograms and lateral cephalograms of 60 patients with equal gender ratio were included in the study, among each gender 15 subjects were below 18 years and 15 subjects were above 18 years. Lateral cephalograms were traced, height of condyle and mandibular body are measured manually on the tracing paper, OPG's were observed on radiographic illuminator and maturity score of third molar calcification was noted according to Demirjian's method. All the measurements were subjected to statistical analysis. The results obtained are of no significant difference between estimated age and actual age with all three parameters (P > 0.9780 condylar height, P > 0.9515 length of mandibular body, P > 0.8611 third molar calcification). Among these three, length of mandibular body shows least standard error test (i.e. 0.188). Although all three parameters can be used for age estimation, length of mandibular body is more reliable followed by height of condyle and third molar calcification.

Treatment of Pediatric Condylar Fractures: A 20-Year Experience.

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Ghasemzadeh, Ali; Mundinger, Gerhard S; Swanson, Edward W; Utria, Alan F; Dorafshar, Amir H

2015-12-01

The purpose of this study was to define patterns of injury and treatment for condylar and subcondylar fractures and evaluate short-term outcomes in the pediatric population. A retrospective chart review was performed on pediatric patients with mandibular condylar fractures who presented between 1990 and 2010. Computed tomographic imaging was reviewed for all patients to assess fracture characteristics. Mandibular fractures were codified using the Strasbourg Osteosynthesis Research Group and Lindahl classification methods. Sixty-four patients with 92 condylar fractures were identified. Of these patients, 29 had isolated condylar fracture and 35 had a condylar fracture associated with an additional mandibular arch fracture. The most common fracture patterns were diacapitular fracture in the Strasbourg Osteosynthesis Research Group system (n = 46) and vertical condylar head fracture in the Lindahl system (n = 14). Condylar fracture with additional mandibular arch fractures were treated with maxillomandibular fixation more often than patients with condylar fracture [n = 40 (74.1 percent) versus n = 14 (25.9 percent); p = 0.004]. No condylar fracture was treated in an open fashion. Forty-three patients returned for follow-up. The median follow-up period was 81 days (interquartile range, 35 to 294 days). Ten patients had complications (23.3 percent). The most common complication was malocclusion (n = 5). Nine of 10 patients with complications had condylar fracture with an additional mandibular arch fracture. Closed treatment of condylar fractures yields satisfactory results in pediatric patients. Pediatric patients with condylar fractures combined with additional arch fractures experience a higher rate of unfavorable outcomes.

The effect of methotrexate on the bone healing of mandibular condylar process fracture: an experimental study in rats.

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Cavalcanti, Samantha Cristine Santos X B; Corrêa, Luciana; Mello, Suzana Beatriz Veríssimo; Luz, João Gualberto C

2014-10-01

Methotrexate (MTX) is an anti-metabolite used in rheumatology and oncology. High doses are indicated for oncological treatment, whereas low doses are indicated for chronic inflammatory diseases. This study evaluated the effect of two MTX treatment schedules on the bone healing of the temporomandibular joint fracture in rats. Seventy-five adult male Wistar rats were used to generate an experimental unilateral medially rotated condylar fracture model that allows an evaluation of bone healing and the articular structures. The animals were subdivided into three groups that each received one of the following treatments intraperitoneally: saline (1 mL/week), low-dose MTX (3 mg/kg/week) and high-dose MTX (30 mg/kg). The histological study comprised fracture site and temporomandibular joint evaluations and bone neoformation was evaluated by histomorphometric analysis. A biochemical parameter of bone formation was also assessed. When compared with saline, high-dose MTX delayed bone fracture repairs. In this latter group, after 90 days, the histological analysis revealed atrophy of the fibrocartilage and the presence of fibrous tissue in the joint space. The histomorphometric analysis revealed diminished bone neoformation. The alkaline phosphatase levels also decreased after MTX treatment. It was concluded that high-dose MTX impaired mandibular condyle repair and induced degenerative articular changes. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

CHANGE IN CONDYLAR POSITION AND SKELETAL STABILITY ASSESSMENT FOLLOWING BSSO FOR MANDIBULAR SET BACK

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Manjunath

2015-09-01

Full Text Available Change in condylar position following mandibular bilateral sagittal split osteotomy (BSSO has been implicated as an important factor in the appearance of immediate postoperative relapse during rigid fixation. It has been suggested that the control of the condylar segment following BSSO is the most important aspect in preventing relapse. The study was done to evaluate changes in position of condyle taken with lateral and frontal cephalograms with 20 patients were assessed, 10 male and 10 female patients wer e divided as group 1 and group 2. Patients undergoing sagittal split ramus osteotomy for mandibular set back were selected; radiographs before operation/surgery, immediately after surgery, 3 months and 6 months post - surgery. Differences between groups were measured by PAIRED ‘T’ TEST a nd time dependent changes in cephalometric measurements were examined by FISCHERS TEST. The present study results conclude significant difference occurring in both proximal and distal segment including condyle. Occlusal stabil ity and skeletal stability also maintained post operatively

Relationship between fracture of mandibular condyle and absence of unerupted mandibular third molar-a retrospective study.

Science.gov (United States)

Rajan, Ritesh; Verma, Dinesh Kumar; Borle, R M; Yadav, Abhilasha

2016-06-01

The purpose of the present study was to find, if there exists, a co-relation between presence of unerupted mandibular third molar and fracture of mandibular condyle. A retrospective, multicenter study was done collecting the data of all mandibular condyle fractures treated from November 2006 till August 2015. Data was collected from the patient's records and radiographs for the following information: age, sex, etiology of fracture, presence and state of lower third molars, and associated fracture. The results were subjected to statistical analysis. Out of 180 patients of condylar fracture, unerupted third molars were present in 35 (19.44 %) cases compared to 145 (80.55 %) cases of condylar fracture where the unerupted third molars were not present. The difference was statistically significant (p fracture was seen in 4 (11.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 9 (25.7 %) cases, isolated unilateral condylar fracture in 0 (0.0 %) cases, and unilateral condylar fracture associated with other mandibular fractures in 17 (48.5 %) cases and condylar fracture associated with mid face fractures in 5 (14.2 %) cases. In the unerupted third molar absent group, isolated bilateral condylar fracture was seen in 5 (3.4 %) cases, bilateral condylar fracture associated with other mandibular fractures in 30 (20.6 %) cases, isolated unilateral condylar fracture in 24 (16.5 %) cases, unilateral condylar fracture associated with other mandibular fractures in 73 (50.34 %) cases, and condylar fracture associated with mid face fractures in 13(8.96 %) cases. The difference between the groups was statistically significant (p = 0.032). This study suggests that the fractures of mandibular condylar region have a significantly higher incidence in patients without an unerupted mandibular third molar.

[SCREW-BASED INTERMAXILLARY TRACTION COMBINED WITH OCCLUSAL SPLINT FOR TREATMENT OF PEDIATRIC MANDIBULAR CONDYLAR FRACTURE].

Science.gov (United States)

Wu, Yang; Long, Xing; Deng, Mohong; Cai, Hengxing; Meng, Qinggong; Li, Bo

2015-04-01

To evaluate the effectiveness of the screw-based intermaxillary traction combined with occlusal splint in the treatment of pediatric mandibular condylar fracture. Between June 2005 and December 2013, 35 pediatric patients with 49 mandibular condylar fractures were treated, and the clinical data were retrospectively reviewed. There were 25 boys and 10 girls, aged 3-13 years (mean, 7.3 years). The injury causes included falling (18 cases), traffic accident (14 cases), and violence (3 cases). The time between injury and treatment was 2-30 days (mean, 6.8 days). Restricted mouth opening was observed, and the maximal mouth opening was (22.74 +/- 7.22) mm except 3 patients who were too young to measure. Condylar fractures were located at the left (12 cases), at the right (9 cases), at bilateral (14 cases) based on the sites; and fractures were classified as intracapsular (35 fractures), neck (10 fractures), and subcondylar (4 fractures) based on the fracture line. Four self-drilling titanium screws were inserted into the alveolar bone of both maxilla and mandible. After screw inserting, an occlusal splint with a fulcrum was used on the affected side and elastic band was put to perform anterior intermaxillary traction. After 1 month, the screws and splint were removed. Follow-up examinations were carried out on schedule. All the patients were followed up from 6 months to 8 years and 10 months (median, 71 months). No screw-related complication occurred in the others except one case of screw loosening. The postoperative maximal mouth opening was (38.82 +/- 2.02) nim. Mild joint noise was found in 4 cases and opening deviation occurred in 6 cases. Radiographic results demonstrated complete condyle remodeling was achieved in 24 cases (32 fractures), and moderate remodeling in 11 cases (17 fractures) at last follow-up. The screw-based intermaxillary traction combined with occlusal splint might be an effective method for pediatric mandibular condylar fracture. The screw

[Three-dimensional evaluation of condylar morphology remodeling after orthognathic surgery in mandibular retrognathism by cone-beam computed tomography].

Science.gov (United States)

Chen, Shuo; Liu, Xiao-jing; Li, Zi-li; Liang, Cheng; Wang, Xiao-xia; Fu, Kai-yuan; Yi, Biao

2015-08-18

To evaluate the effect of orthognathic surgery on condylar morphology changes by comparing three-dimension surface reconstructions of condyles using cone-beam computed tomography (CBCT) data. In the study, 18 patients with mandible retrognathism deformities were included and CBCT data of 36 temporomandibular joints were collected before surgery and 12 months after surgery. Condyles were reconstructed and superimposed pre- and post-operatively to compare the changes of condylar surfaces. One-sample t test and χ2 test were performed for the analysis of three-dimension metric measurement and condylar head remodeling signs. P<0.05 was considered significant. The root-mean-square (RMS) of condylar surface changes before and after the surgery was (0.37±0.11) mm, which was significant statistically (P<0.05). The distribution of condylar remodeling signs showed significant difference (P<0.05). Bone resorption occurred predominantly in the posterior area of condylar head and bone formation occurred mainly in the anterior area. Three-dimension superimposition method based on CBCT data showed that condylar morphology had undergone remodeling after mandibular advancement.

Comparison of various approaches for the treatment of fractures of the mandibular condylar process.

Science.gov (United States)

Handschel, Jörg; Rüggeberg, Tim; Depprich, Rita; Schwarz, Frank; Meyer, Ulrich; Kübler, Norbert R; Naujoks, Christian

2012-12-01

Fractures of the mandibular condyle process are the most common fractures of the lower jaw. Unfortunately, the type of treatment is still a matter of debate. The aim of this investigation was to compare the outcome of different treatment approaches regarding function and surgical side-effects. 111 fractures of the mandibular condyle representing all types according to the classification of Spiessl and Schroll were included. Both closed reduction (CR) and open reduction with internal fixation (ORIF) including the retromandibular/transparotid, submandibular, preauricular and intraoral approach were performed. The clinical examination included functional and aesthetic aspects at least 1 year after the fracture. The majority of fractures (45%) were classified into Type II and IV according to Spiessl and Schroll followed by fractures without any displacement or dislocation (29.7%). The submandibular approach showed the worst outcome regarding permanent palsy of the facial nerve and hypertrophic scarring. No significant differences between the various approaches were detected in the functional status in any diagnosis group. Inferior condylar neck fractures benefit from ORIF by an intraoral approach whereas in high condylar neck fractures the retromandibular/transparotid approach shows the best results. Fractures of the condylar head were almost all treated by CR and our results cannot contribute to the debate of CR vs. ORIF in this type of fracture. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

A comparative study of the detectability of TMJ radiographic techniques for artificial mandibular condylar lesions

International Nuclear Information System (INIS)

Jeong, Hee Jeong; Jung, Yeon Hwa; Cho, Bong Hae

1997-01-01

The purpose of this study was to evaluate the detectability of various radiographic techniques for mandibular condylar lesions. Erosive lesion, osteophyte and flattening were formed on the artificial mandibular condyle, and panoramic, transcranial, transorbital radiography, lateral and frontal tomography were taken. The results were as follows; 1. The detectability for erosive lesions was superior in the order of frontal tomography (96%), lateral tomography (78%), transorbital (59%), transcranial (56%) and panoramic (48%) radiography. 2. The location of erosive lesion that showed the highest detectability was the medial third in panoramic, the lateral third in transcranial, the central portion of anteroposterior direction in transorbital, the central portion of mediolateral direction and the posterior third in lateral tomography. Frontal tomography disclosed all erosive lesions except one anterolateral lesion. 3. The detectability of osteophyte was 100% in lateral tomography, 78% in transcranial and 56% in panoramic radiography. 4. For flattening, lateral tomography showed the flattened condyle, but both panoramic and transcranial views showed only decreased bone density without the change of condylar shape.

Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

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Kang-Young Choi

2012-07-01

Full Text Available The incidence of condylar fractures is high,but the management of fractures of the mandibularcondyle continues to be controversial. Historically, maxillomandibular fixation, externalfixation, and surgical splints with internal fixation systems were the techniques commonlyused in the treatment of the fractured mandible. Condylar fractures can be extracapsularor intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on theage of the patient, the co-existence of other mandibular or maxillary fractures, whether thecondylar fracture is unilateral or bilateral, the level and displacement of the fracture, thestate of dentition and dental occlusion, and the surgeonnds on the age of the patient, theco-existence of othefrom which it is difficult to recover aesthetically and functionally;anappropriate treatment is required to reconstruct the shape and achieve the function oftheuninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, andcomplication prevention are required. In particular, as mandibular condyle fracture may causelong-term complications such as malocclusion, particularly open bite, reduced posterior facialheight, and facial asymmetry in addition to chronic pain and mobility limitation, great cautionshould be taken. Accordingly, the authors review a general overview of condyle fracture.

Chronic sleep restriction induces changes in the mandibular condylar cartilage of rats: roles of Akt, Bad and Caspase-3.

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Zhu, Yong; Wu, Gaoyi; Zhu, Guoxiong; Ma, Chuan; Zhao, Huaqiang

2014-01-01

The aim of the present study was to observe changes in the temporomandibular joint (TMJ) of rats that had been subjected to chronic sleep restriction and to investigate whether Akt, Bad and Caspase3 play a role in the mechanism underlying the changes. One hundred and eighty male Wistar rats were randomly divided into three groups (n = 60 in each): cage control group, large-platform control group, and sleep restriction group. Each group was divided into three subgroups (n = 20 in each) of three different time points (7, 14 and 21 days), respectively. The modified multiple platform method was used to induce chronic sleep restriction. The TMJ tissue histology was studied by staining with haematoxylin and eosin. The expression of Akt, p-Aktser473, Bad, p-Badser136 and Caspase3 proteins was detected by immunohistochemistry and western blotting. The expression of Akt, Bad and Caspase3 mRNAs was measured by real-time quantitative polymerase chain reaction (RT-qPCR). Compared with the large-platform and cage control groups, condylar cartilage pathological alterations were found in the sleep restriction group. There were significantly decreased expression levels of Akt, p-Aktser473 and p-Badser136 and significantly increased expression levels of Bad and Caspase3 after sleep restriction. These data suggest that sleep restriction may induce pathological alterations in the condylar cartilage of rats. Alterations in Akt, Bad and Caspase3 may be associated with the potential mechanism by which chronic sleep restriction influences the condylar cartilage.

Correction of rabbit model with mandibular ramus shortening by distraction osteogenesis at condylar neck.

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Meng, Qinggong; Yang, Xuewen; Long, Xing; Li, Jian; Cai, Hengxing

2012-04-01

The rabbit model has been established to mimic the effect of temporomandibular joint (TMJ) arthroplasty of ankylosis, and distraction at the level of the condylar neck is used to elongate the ascending ramus. The histomorphologic changes of TMJ and distraction gap were investigated. The unilateral condyles and articular discs were extirpated, and the experimental mandibular rami were shortened by 5 mm. An embedded distracter was used to restore the height of the mandibular ramus by unilateral condylar neck distraction (0.8 mm daily for 7 days). A total of 12 adult white rabbits were used, 8 in the experimental group and 4 in the control group. Of the 8 rabbits in the experimental group, 4 each were killed at 4 and 8 weeks after completion of distraction. The TMJ and distracted calluses were harvested and processed for radiographic and histologic examination. An open bite was seen in all rabbits postoperatively that had diminished at the end of distraction. The newly formed condyles radiologically showed remodeling, flattening, and sclerosis. The bony transport disc had gradually remodeled to a new condyle that was similar to the original condyle in appearance and structure. The surface of the transport disc was covered with a fibrous tissue. Moreover, the bony regeneration was perfect in the distraction gap. These results suggest that distraction osteogenesis at the condylar neck using the traditional preauricular approach of TMJ surgery, without the additional incision, can be performed concurrently with arthroplasty of TMJ ankylosis at the same region. Copyright © 2012 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluation of Mandibular Condylar Changes in Patients Following ...

African Journals Online (AJOL)

Background: Condylar resorption as a cause of relapse after orthognathic surgery is well known. Several authors have presented evidence of the relation between orthognathic surgery and condylar remodeling and resorption. This study was done to appraise the condylar changes along with the form and function following ...

[Differential expression of IGF-I and its mRNA in mandibular condylar cartilage of rat--direct evidence for servosystem theory of facial growth].

Science.gov (United States)

Zhou, Z; Luo, S

1998-05-01

It was studied the expression of IGF-I and its mRNA in the condylar cartilage of 10 7-week-old SD male rats by using in situ hybridization and immunohisto-chemistry technique. The results showed both IGF-I and its gene expressed in growing rat condyle. IGF-I peptide was abundant in germinal zone, and positive reaction of its mRNA was strongest in transitional and maturational zones. These indicate that condylar cartilage has the capability of local production and secretion of IGF-I, mediating the command effect of STH, and differential expression of IGF-I and its mRNA might establish the local feedback loop, which supply a direct evidence for servosystem theory of facial growth.

Histological and morphological evaluation of condylar cartilage of young rats in response to stimulation of mandibular protrusion

OpenAIRE

Milena Peixoto Nogueira de Sá; Adilson Luiz Ramos; Jacqueline Nelises Zanoni; Fabrício Dias de Souza; Daniele Esteves Pepelascov; Raquel Sano Suga Terada

2017-01-01

The aim of this study was to evaluate the histogical and morphological aspects of the condyle in response to mandibular protrusion induced by composite resin occlusal planes. Thirty five-week-old male Wistar rats were selected and randomly divided in two groups. One group received a composite resin type of oclusal plane that induced mandibular protrusion, and the other was the control group, without treatment. Animals were euthanized after experimental time intervals of 7, 21 and 30 days. For...

Psychological stress alters the ultrastructure and increases IL-1β and TNF-α in mandibular condylar cartilage

International Nuclear Information System (INIS)

Lv, Xin; Li, Qiang; Wu, Shun; Sun, Jing; Zhang, Min; Chen, Yong-Jin

2012-01-01

Psychological factors can be correlated with temporomandibular disorders (TMDs), but the mechanisms are unknown. In the present study, we examined the microstructural changes and expression of proinflammatory cytokines in mandibular condylar cartilage of the temporomandibular joint (TMJ) in a psychological stress animal model. Male Sprague-Dawley rats (8 weeks old, 210 ± 10 g) were randomly divided into 3 groups: psychological stress (PS, N = 48), foot shock (FS, N = 24), and control (N = 48). After inducing psychological stress using a communication box with the FS rats for 1, 3, or 5 weeks, PS rats were sacrificed and compared to their matched control littermates, which received no stress and were killed at the same times as the PS rats. Body and adrenal gland weight were measured and corticosterone and adrenocorticotropic hormone levels were determined by radioimmunoassay. After hematoxylin-eosin staining for histological observation, the ultrastructure of the TMJ was examined by scanning electron microscopy. Transcription and protein levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were evaluated by ELISA and semi-quantitative RT-PCR. The PS group showed a significantly higher adrenal gland weight after 3 weeks of stress and higher hormone levels at weeks 1, 3, and 5. Histopathological changes and thinning cartilage were apparent at weeks 3 and 5. In the PS group, TNF-α increased at 1, 3, and 5 weeks and IL-1β increased significantly after 1 and 3 weeks of stress, and then decreased to normal levels by 5 weeks. Psychological stress increased plasma hormone levels and RT-PCR indicated increased IL-1β and TNF-α expression in the TMJ in a time-dependent manner. These results suggest that cytokine up-regulation was accompanied by stress-induced cartilage degeneration in the mandibular condyle. The proinflammatory cytokines play a potential role in initiating the cartilage destruction that eventually leads to the TMDs

Psychological stress alters the ultrastructure and increases IL-1β and TNF-α in mandibular condylar cartilage

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Lv, Xin; Li, Qiang; Wu, Shun; Sun, Jing; Zhang, Min; Chen, Yong-Jin [Department of General Dentistry and Emergency, School of Stomatology, Fourth Military Medical University, Xi' an, Shaanxi (China)

2012-06-22

Psychological factors can be correlated with temporomandibular disorders (TMDs), but the mechanisms are unknown. In the present study, we examined the microstructural changes and expression of proinflammatory cytokines in mandibular condylar cartilage of the temporomandibular joint (TMJ) in a psychological stress animal model. Male Sprague-Dawley rats (8 weeks old, 210 ± 10 g) were randomly divided into 3 groups: psychological stress (PS, N = 48), foot shock (FS, N = 24), and control (N = 48). After inducing psychological stress using a communication box with the FS rats for 1, 3, or 5 weeks, PS rats were sacrificed and compared to their matched control littermates, which received no stress and were killed at the same times as the PS rats. Body and adrenal gland weight were measured and corticosterone and adrenocorticotropic hormone levels were determined by radioimmunoassay. After hematoxylin-eosin staining for histological observation, the ultrastructure of the TMJ was examined by scanning electron microscopy. Transcription and protein levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were evaluated by ELISA and semi-quantitative RT-PCR. The PS group showed a significantly higher adrenal gland weight after 3 weeks of stress and higher hormone levels at weeks 1, 3, and 5. Histopathological changes and thinning cartilage were apparent at weeks 3 and 5. In the PS group, TNF-α increased at 1, 3, and 5 weeks and IL-1β increased significantly after 1 and 3 weeks of stress, and then decreased to normal levels by 5 weeks. Psychological stress increased plasma hormone levels and RT-PCR indicated increased IL-1β and TNF-α expression in the TMJ in a time-dependent manner. These results suggest that cytokine up-regulation was accompanied by stress-induced cartilage degeneration in the mandibular condyle. The proinflammatory cytokines play a potential role in initiating the cartilage destruction that eventually leads to the TMDs.

Psychological stress alters the ultrastructure and increases IL-1β and TNF-α in mandibular condylar cartilage

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Xin Lv

2012-10-01

Full Text Available Psychological factors can be correlated with temporomandibular disorders (TMDs, but the mechanisms are unknown. In the present study, we examined the microstructural changes and expression of proinflammatory cytokines in mandibular condylar cartilage of the temporomandibular joint (TMJ in a psychological stress animal model. Male Sprague-Dawley rats (8 weeks old, 210 ± 10 g were randomly divided into 3 groups: psychological stress (PS, N = 48, foot shock (FS, N = 24, and control (N = 48. After inducing psychological stress using a communication box with the FS rats for 1, 3, or 5 weeks, PS rats were sacrificed and compared to their matched control littermates, which received no stress and were killed at the same times as the PS rats. Body and adrenal gland weight were measured and corticosterone and adrenocorticotropic hormone levels were determined by radioimmunoassay. After hematoxylin-eosin staining for histological observation, the ultrastructure of the TMJ was examined by scanning electron microscopy. Transcription and protein levels of interleukin-1β (IL-1β and tumor necrosis factor-α (TNF-α were evaluated by ELISA and semi-quantitative RT-PCR. The PS group showed a significantly higher adrenal gland weight after 3 weeks of stress and higher hormone levels at weeks 1, 3, and 5. Histopathological changes and thinning cartilage were apparent at weeks 3 and 5. In the PS group, TNF-α increased at 1, 3, and 5 weeks and IL-1β increased significantly after 1 and 3 weeks of stress, and then decreased to normal levels by 5 weeks. Psychological stress increased plasma hormone levels and RT-PCR indicated increased IL-1β and TNF-α expression in the TMJ in a time-dependent manner. These results suggest that cytokine up-regulation was accompanied by stress-induced cartilage degeneration in the mandibular condyle. The proinflammatory cytokines play a potential role in initiating the cartilage destruction that eventually leads to the TMDs.

THE MANAGEMENT OF LIMITED MANDIBULAR MOVEMENT CAUSED BY CONDYLAR FRACTURE WITH REPOSITIONING SPLINT

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Ira Tanti

2015-06-01

Full Text Available Fractures of the neck of condyle usually are the result of a blow to the mandible. A lateral blow to the body of the mandible commonly causes a contralateral condyle fracture. There are many signs and symptoms of a condylar fracture, for example crepitation, deviation of the mandible to the side of injury, and spasm of the associated group of muscles. These will result in a functional disability, which is usually seen as a limited mandibular movement. This paper reported a patient with a fracture of the condylar neck. Patient had been treated with closed reduction and immobilization for 2 months. After that, she felt that her bite was changed, she could not occlude her teeth well, and she had clicking sound in the right joint when she opened her mouth. Besides that, patient had difficulties to move the mandible to the left side, and she could not open her mouth widely. The patient was treated with a repositioning splint and she had to do some jaw exercises. The purposes were to regain the position of condyle, to reduce the muscle spasm and finally got the normal jaw movement.

How to improve retromandibular transmasseteric anteroparotid approach for mandibular condylar fractures: our clinical experience.

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Salgarelli, A C; Anesi, A; Bellini, P; Pollastri, G; Tanza, D; Barberini, S; Chiarini, L

2013-04-01

Fractures of the mandibular condyle are common and account for 25-35% of all mandibular fractures reported in the literature. Even with the development of a consensus on the preference for open reduction and internal fixation of these fractures, the clinician is still faced with a dilemma concerning the optimal approach to the ramus-condyle unit. Limited access and injury to the facial nerve are the most common problems. The most commonly used extraoral approaches are the submandibular, retromandibular and preauricular methods. In this study, we propose a modified cosmetic preauricular incision with a short end in the neck, to improve the transmasseteric anteroparotid (TMAP) approach previously described by Wilson et al. in 2005. We retrospectively analysed 13 patients treated in our department for mandibular condylar fractures. Post-operative complications, occlusal status, interincisal opening and joint tenderness were evaluated at 3 months after surgery. The wider skin incision described here provides a convenient approach for open reduction and rigid internal fixation, and good results were obtained. The follow-up ranged from 6 to 40 months. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Orthodontic-surgical management of a case of severe mandibular deficiency due to condylar ankylosis

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Sridevi Padmanabhan

2014-01-01

Full Text Available Dentofacial deformities involve deviations from the normal facial proportions and dental relationships and can range from mild to being severe enough to be severely handicapping.The term handicapping malocclusions though not a term commonly used, involves a fortunately small section (2-4% of patients who can suffer from esthetic,psychological and functional problems. Craniofacial Orthodontics is the area of orthodontics that treats patients with congenital and acquired deformities of the integument and it′s underlying musculoskeletal system within the craniofacial area and associated structures.This case report of a young woman with severe mandibular deficiency and facial asymmetry due to condylar ankylosis highlights the importance of team work in rehabilitation of such severe craniofacial deformities.

Three-dimensional morphological condylar and mandibular changes in a patient with juvenile idiopathic arthritis: interdisciplinary treatment

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G. Farronato

2014-11-01

Full Text Available Temporomandibular joint (TMJ involvement is common but usually delayed in patients with juvenile idiopathic arthritis (JIA. We describe the case of a JIA patient with bilateral TMJ involvement, mandibular retrognathia, bone erosion, and severely restricted mouth opening. The use of cone beam computed tomography and a 3D diagnostic protocol in young patients with JIA provides reliable, accurate and precise quantitative data and images of the condylar structures and their dimensional relationships. Analgesics and conventional disease modifying antirheumatic drugs were ineffective, but interdisciplinary treatment with etanercept and a Herbst functional appliance improved functional TMJ movement and bone resorption.

Open versus closed reduction: mandibular condylar fractures in children.

Science.gov (United States)

Chrcanovic, Bruno Ramos

2012-09-01

The purpose of the study was to review the literature regarding the evolution of current thoughts on management of mandibular condylar fractures (MCFs) in children. An electronic search in PubMed was undertaken in May 2012. The titles and abstracts from these results were read to identify studies within the selection criteria. Eligibility criteria included studies published in English or German from the last 20 years (from 1992 onwards) reporting clinical series of MCFs in children and adolescents until the age of 18. The search strategy initially identified 542 studies. The references from 1992 onwards totaled 339 articles. Twenty-seven studies were identified without repetition within the selection criteria. Additional hand-searching yielded two additional papers. Pediatric MCFs require thoughtful consideration in management to avoid significant growth disturbance. Early treatment is indicated in order to improve the chances for favorable development. Long-term follow-up is required, in order to properly treat late complications that may appear. Coronal computed tomography is helpful in substantiating the correct final diagnosis. Many studies show that conservative treatment (CTR) has satisfactory long-term outcome of jaw function, occlusion, and facial esthetics, despite a high frequency of radiological aberrations. Surgery before puberty should be reserved for exceptional cases such as missile injuries, in cases with extensive dislocation and lack of contact between the fragments, in cases with multiple midfacial fractures, in which the mandible has to serve as a guide to reposition the midfacial bones, and in cases which the dislocation of the fractured stump creates a functional impediment that cannot be resolved by CTR. As the craniofacial skeleton becomes more adult-like in its form at about 12 years of age, the decreased remodeling capacity in the adolescents may occasionally result in abnormally shaped condylar heads or shortened ramus heights that may

The application of the Risdon approach for mandibular condyle fractures.

Science.gov (United States)

Nam, Seung Min; Lee, Jang Hyun; Kim, Jun Hyuk

2013-07-06

Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 subcondylar fractures. All of the cases were reduced using the Risdon approach. For subcondylar fractures, reduction and fixation with plates was done under direct vision. For condylar neck fractures, reduction and fixation was done with the aid of a trochar in adults and a percutaneous threaded Kirschner wire in children. There were no malunions or nonunions revealed in follow-up care. Mild transient neuropraxia of the marginal mandibular nerve was seen in 4 patients, which was resolved within 1-2 months. The Risdon approach is a technique for reducing the condylar neck and subcondylar fractures that is easy to perform and easy to learn. Its value in the reduction of mandibular condyle fractures should be emphasized.

Effects of young-coconut juice on increasing mandibular cancellous bone in orchidectomized rats: Preliminary novel findings

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Pranee Suwanpal

2011-12-01

Full Text Available Androgens play a very important role in building the skeleton in young adults and help to prevent bone loss andosteoporosis in aging men. In addition, in hypogonadism or elderly men, bone mass has been related to estrogen levels ratherthan to testosterone. Estrogen replacement therapy has therefore been proposed to prevent bone loss in males as well as infemales. Estrogen, however, has been considered to be one of the hormonal risk factors for benign prostatic hyperplasia andprostate cancer and also has other side effects. Young coconut juice (YCJ presumably containing phytoestrogen was investigatedin the present study for its possible beneficial effects on delaying osteoporosis using a male rat model, and by this totest the possibility that it might be able to replace estrogen replacement therapy without side effects. In this study, mandibularcancellous bone was used as the osteoporotic model. Using the same model, we have previously found that total cartilagethickness particularly the hypertrophic zone of mandibular condylar cartilage was thicker in the sham-operated rats receivingYCJ orally fed for a 14 day period, compared with sham, orchidectomized animal, orchidectomized rats receiving estradiolbenzoate, and orchidectomized rats receiving YCJ. The present study confirmed our former study that mandibular cancellousbone in the sham-operated rats and in the orchidectomized rats receiving YCJ orally fed for a 14–day period were thicker thanthose of the sham and orchidectomized rat groups. This study results are novel and they indicate that YCJ may have beneficialeffects in the treatment of osteoporosis in andropause men.

Association between condylar morphology and inflammation in experimental temporomandibular joint TMJ arthritis

DEFF Research Database (Denmark)

Kristensen, Kasper Dahl; Stoustrup, Peter bangsgaard; Küseler, Annelise

not previously been investigated. Aim: We studied the effects of antigen-induced arthritis on the bony structures in rabbit mandibular condylar development, in particular the morphological changes and the bone micro-architecture. Materials and Methods: Included were juvenile rabbits with ovalbumin-induced TMJ...... arthritis treated with intraarticular saline, intra-articular etanercept (an anti-TNF-α drug) or subcutaneous etanercept. One TMJ from each animal was scanned using micro-computed tomography and structural parameters were calculated. Three-dimensional reconstructions of the mandibular condyle were scored...... blindly by two independent observers as normal or abnormal. TMJs were stratified for condylar morphology and evaluated against data on inflammation, trabecular structural parameters, and overall mandibular growth. Mineral apposition rate was measured using fluorochrome labelling. Results and discussion...

Ankylosis of the temporomandibular joint and mandibular growth disturbance caused by neglected condylar fracture in childhood

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Endrajana Endrajana

2010-06-01

Full Text Available Background: Fractures of the mandibular condyle may lead to complications such as disturbance of occlusal function, internal derangement of the joint, ankylosis and mandibular growth disturbance. When treating young patients with the history of mandible trauma, ankylosis of the temporomandibular joint and mandibular growth disturbance are two most important complications of condyle fracture that should be considered. Purpose: This case report attempts to emphasize the long term complication of neglected condylar fracture in children i.e. ankylosis of the temporomandibular joint and subsequently lead to mandibular growth disturbance. Case: A case of right temporo-mandibular joint ankylosis and mandibular growth disturbance in a 28 years old male patient is presented. He had a history of trauma to the mandible after a traffic accident when he was 8 years old. Since then, he experienced difficulty in mouth opening which eventually developed into severe trismus. Case management: The case was treated surgically with gap and interpositional arthroplasty using Mersilen mesh™. Conclusion: Mandibular fractures involving temporomandibular joint in young children should be examined thoroughly and treated adequately in order to prevent ankylosis of the TMJ and the subsequent mandibular growth disturbance.Latar belakang: Fraktur pada kondilus mandibula dapat menyebabkan beberapa komplikasi berupa: gangguan oklusi, internal derangement sendi, ankilosis serta gangguan pertumbuhan mandibula. Pada perawatan penderita usia muda dengan riwayat trauma pada mandibula, perlu diwaspadai dua macam komplikasi akibat fraktur pada kondilus, yaitu ankilosis sendi temporo mandibula dan adanya gangguan pertumbuhan mandibula. Tujuan: Laporan kasus ini bertujuan untuk menekankan bahwa fraktur kondilus pada anak-anak yang tidak mendapatkan perawatan yang semestinya akan mengakibatkan komplikasi jangka panjang berupa ankilosis sendi temporomandibula yang diikuti dengan

Osteochondroma of the mandibular condyle

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Ashish Kumar

2011-01-01

Full Text Available Osteochondroma (OC of the mandibular condyle is a relatively rare condition that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporomandibular joint (TMJ dysfunction, and malocclusion. Radiographically, there is a unilaterally enlarged condyle usually with an exophytic outgrowth of the tumor from the condylar head. We present a case of a left mandibular condylar OC that created a major facial asymmetry, malocclusion, and TMJ dysfunction. Discussion includes the rationale for treatment and the method used in this case. In actively growing OCs, surgical intervention is indicated to remove the tumor stopping the benign growth process and improve facial symmetry, occlusion, and jaw function.

Condylar volume and surface in Caucasian young adult subjects

International Nuclear Information System (INIS)

Tecco, Simona; Saccucci, Matteo; Nucera, Riccardo; Polimeni, Antonella; Pagnoni, Mario; Cordasco, Giancarlo; Festa, Felice; Iannetti, Giorgio

2010-01-01

There have been no quantitative standards for volumetric and surface measurements of the mandibular condyle in Caucasian population. However, the recently developed cone-beam computed tomography (CBCT) system allows measurement of these parameters with high accuracy. CBCT was used to measure the condylar volume, surface and the volume to surface ratio, called the Morphometric Index (MI), of 300 temporo-mandibular joints (TMJ) in 150 Caucasian young adult subjects, with varied malocclusions, without pain or dysfunction of TMJs. The condylar volume was 691.26 ± 54.52 mm 3 in males and 669.65 ± 58.80 mm 3 in, and was significantly higher (p< 0.001) in the males. The same was observed for the condylar surface, although without statistical significance (406.02 ± 55.22 mm 2 in males and 394.77 ± 60.73 mm 2 in females). Furthermore, the condylar volume (693.61 ± 62.82 mm 3 ) in the right TMJ was significantly higher than in the left (666.99 ± 48.67 mm 3 , p < 0.001) as was the condylar surface (411.24 ± 57.99 mm 2 in the right TMJ and 389.41 ± 56.63 mm 2 in the left TMJ; t = 3.29; p < 0.01). The MI is 1.72 ± 0.17 for the whole sample, with no significant difference between males and females or the right and left sides. These data from temporomandibular joints of patients without pain or clinical dysfunction might serve as examples of normal TMJ's in the general population not seeking orthodontic care

Evaluation of protein undernourishment on the condylar process of the Wistar rat mandible correlation with insulin receptor expression

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Marcelo Arthur CAVALLI

2015-04-01

Full Text Available The mandible condylar process cartilage (CP of Wistar rats is a secondary cartilage and acts as a mandibular growth site. This phenomenon depends on adequate proteins intake and hormone actions, including insulin. Objectives The present study evaluated the morphological aspects and the expression of the insulin receptor (IR in the cartilage of the condylar process (CP of rats subjected to protein undernourishment. Material and Methods The nourished group received a 20% casein diet, while the undernourished group (U received a 5% casein diet. The re-nourished groups, R and RR, were used to assess the effects of re-nutrition during puberty and adulthood, respectively. CPs were processed and stained with picro-sirius red, safranin-O and azocarmine. Scanning electron microscopy and immunohistochemistry were also performed. Results The area of the CP cartilage and the number of cells in the chondroblastic layer decreased in the U group, as did the thickness of the CP layer in the joint and hypertrophic layer. Renourishment during the pubertal stage, but not during the adult phase, restored these parameters. The cell number was restored when re-nutrition occurred in the pubertal stage, but not in the adult phase. The extracellular matrix also decreased in the U group, but was restored by re-nutrition during the pubertal stage and further increased in the adult phase. IR expression was observed in all CPs, being higher in the chondroblastic and hypertrophic cartilage layers. The lowest expression was found in the U and RR groups. Conclusions Protein malnutrition altered the cellularity, the area, and the fibrous cartilage complex, as well as the expression of the IRs.

[Maxillo-facial surgery in skeletal Class II: repercussions on the temporo-mandibular joints].

Science.gov (United States)

Manière-Ezvan, Armelle; Savoldelli, Charles; Busson, Floriant; Oueiss, Arlette; Orthlieb, Jean-Daniel

2016-03-01

These interventions usually aimed at the correction of the skeletal discrepancy by mandibular retrognatism with an advancement of the distal portion of the mandible after mandibular osteotomy. The position of the condyle is determined during the osteosynthesis with miniplates. Condyles are set back in relation with the supine position of the patient and the weakness of his (her) curarized muscle. All studies show that surgery of mandibular advancement causes a lateral, torque and backward movement of the condyles, all harmful to the condyles. Factors that predispose to condylar resorption are "the patient": a woman, young (between 15 and 40), high mandibular angle, with a history of temporo-mandibular disorders and surgical overload applied to the condyles. What are the possible solutions to avoid failures? Patient preparation before surgery and surgery simulation with an articulator, condylar position control during surgery, working with surgeons to achieve a condylar portion stabilization system (with the CAD), quickly set up a mobilization of the mandible by physiotherapy. © EDP Sciences, SFODF, 2016.

Spatio-temporal expression patterns of Wnt signaling pathway during the development of temporomandibular condylar cartilage.

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Chen, Kan; Quan, Huixin; Chen, Gang; Xiao, Di

2017-11-01

There is a growing body of evidence supporting the involvement of the Wnt signaling pathway in various aspects of skeletal and joint development; however, it is unclear whether it is involved in the process of temporomandibular joint development. In order to clarify this issue, we examined the spatio-temporal distribution of mRNAs and proteins of the Wnt family during the formation of the mandibular condylar cartilage at the prenatal and postnatal stages. An in situ hybridization test revealed no mRNAs of β-catenin and Axin2 during early mesenchymal condensation; the ligands surveyed in this study (including Wnt-4, 5a, and 9a) were clearly detected at various ranges of expression, mainly in the condylar blastema and later distinct cartilaginous layers. Apart from β-catenin and Axin2, the Wnt family members surveyed in this study, including Lef-1, were found to be immunopositive during early chondrogenesis in the condylar cartilage at E14.5. After distinct chondrocyte layers were identified within the cartilage at E16.5, the expression of the Wnt signaling members was different and mainly restricted to proliferating cells and mineralized hypertrophic chondrocytes. In the adult mandibular condylar cartilage, the Wnt-4 mRNA, as well as the Wnt-4 and Wnt-9a proteins, was not observed. Our findings demonstrated that the Wnt signaling pathway was associated with the development of mandibular condylar cartilage. Copyright © 2017 Elsevier B.V. All rights reserved.

Condylar growth after non-surgical advancement in adult subject: a case report

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Caradonna Carola

2009-07-01

Full Text Available Abstract Background A defect of condylar morphology can be caused by several sources. Case report A case of altered condylar morphology in adult male with temporomandibular disorders was reported in 30-year-old male patient. Erosion and flattening of the left mandibular condyle were observed by panoramic x-ray. The patient was treated with splint therapy that determined mandibular advancement. Eight months after the therapy, reduction in joint pain and a greater opening of the mouth was observed, although crepitation sounds during mastication were still noticeable. Conclusion During the following months of gnatologic treatment, new bone growth in the left condyle was observed by radiograph, with further improvement of the symptoms.

Mandibular kinematics after orthognathic surgical treatment a pilot study.

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Sforza, Chiarella; Ugolini, Alessandro; Rocchetta, Davide; Galante, Domenico; Mapelli, Andrea; Giannì, Aldo Bruno

2010-03-01

We recorded three-dimensional mandibular movements, while the mouth was being opened and closed, using an optoelectronic motion analyser in 14 patients (5 skeletal Class II, 9 skeletal Class III) who were being assessed 7-49 months after orthognathic operations, and in 44 healthy subjects. All 14 patients had satisfactory healing on clinical examination, and function had been restored. Mandibular movement was divided into its rotational and translational components. On maximum mouth opening, the patients had significantly less total displacement of the mandibular interincisor point (p=0.05), and more mandibular movement that was explained by pure condylar rotation (p=0.006), than control subjects. There was no significant relation between maximum mouth opening and percentage rotation. While mandibular motion was well restored clinically by orthognathic surgery, the kinematics of the joint were modified. Larger studies and longitudinal investigations are necessary to appreciate the clinical relevance of the variations in condylar rotational and translational components.

Evaluation of Mandibular Condylar Changes in Patients Following ...

African Journals Online (AJOL)

orthognathic surgery, as well as to assess what factors may have contributed to ... study that females of relative low age (<18 years) appeared to be a high‑risk ... Maharaja Ganga Singh Dental College and Research Centre, ... cause alteration of the position of the condyle in the ... of condylar shape and decrease in mass.

Positional change of the condylar heads after wearing complete denture on dental cone beam CT

International Nuclear Information System (INIS)

Lee, Bong Ho; Kim, Jae Duk; Chung, Chae Heon

2008-01-01

The aim of this study was to evaluate the change in the position of the mandibular condyle within articular fossa by a CBCT after wearing complete denture (CD). CBCT of 34 temporomandibular joints were taken from 9 male and 8 female patients with CB Mercuray TM (Hitachi, Japan) before and after wearing a CD for rehabilitation. Position of mandibular condyle within articular fossa at centric occlusion was evaluated with Vimplant2.0 TM (CyberMed, Korea) on the central parasagittal view and curved panoramic coronal view of the condylar head. A statistical evaluation was done with SPSS. The range of anteroposterior positional rate (AP) of condylar head within articular fossa was -16-5 and -10-12 respectively on the right and left sides. Before wearing CD, the AP rate showed discrepancy between right and left sides (p<0.05). After wearing CD, both condyles showed a tendency to decrease in posterior condylar position (right side; p<0.05). The average discrepancy between right and left side in mediolateral positional rate (MD) was 15.5 and 4.5 respectively before and after wearing CD. The improvement was observed in mediolateral relationship of both condylar heads after wearing CD (p<0.01). Before wearing CD, the average horizontal angle of long axis of condylar head was 79.6 ± 2.7 .deg. C and 80.1 ± 5.7 .deg. C respectively on the right and left sides. After wearing CD, both condyles were rotated in the same direction in average on axial plane. We observed with CBCT the significant clinical evidence in case of positional change of mandibular condyle after wearing complete denture.

Effects of the condylar process fracture on facial symmetry in rats submitted to protein undernutrition Efeitos da fratura do processo condilar na simetria facial em ratos submetidos à desnutrição protéica

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Lucimar Rodrigues

2011-04-01

Full Text Available PURPOSE: To investigate the facial symmetry of rats submitted to experimental mandibular condyle fracture and with protein undernutrition (8% of protein by means of cephalometric measurements. METHODS: Forty-five adult Wistar rats were distributed in three groups: fracture group, submitted to condylar fracture with no changes in diet; undernourished fracture group, submitted to hypoproteic diet and condylar fracture; undernourished group, kept until the end of experiment, without condylar fracture. Displaced fractures of the right condyle were induced under general anesthesia. The specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. The values obtained were subjected to statistical analyses among the groups and between the sides in each group. RESULTS: There was significative decrease of the values of serum proteins and albumin in the undernourished fracture group. There was deviation of the median line of the mandible relative to the median line of the maxilla, significative to undernutrition fracture group, as well as asymmetry of the maxilla and mandible, in special in the final period of experiment. CONCLUSION: The mandibular condyle fracture in rats with proteic undernutrition induced an asymmetry of the mandible, also leading to consequences in the maxilla.OBJETIVO: Investigar a simetria facial de ratos submetidos à fratura experimental de côndilo mandibular e com desnutrição protéica (8% de proteína por meio de mensurações cefalométricas. MÉTODOS: 45 ratos Wistar adultos foram distribuídos em três grupos: grupo fraturado, submetido a fratura condilar sem alteração na dieta; grupo fraturado desnutrido, submetido a dieta hipoprotéica e fratura condilar; grupo desnutrido, mantido até o final do experimento, sem fratura condilar. Fraturas com desvio foram feitas no côndilo direito com anestesia geral. Os espécimes foram submetidos à incidência radiogr

Open Reduction in Pediatric Condylar Fracture.

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Barbosa, Alexandre Agostini; Mariano, Ronaldo Célio

2017-05-01

Facial fractures in children are rare. Lack of pneumatization, fat pockets, mixed dentition, contribute to the elasticity and bone stability. When mandibular fractures occur in children, most often involve the condyle by indirect trauma. Such fractures are the center of discussion on the form of treatment if this should be performed conservatively, or held the reduction and fixation of the fracture with surgical exposure of the fragments. In condylar fractures in children, in most patients, the proposed treatment is closed reduction. Treatment with open reduction and fixation has its specific indications. In this case, the authors report a patient cycling accident victim, with cut-contusion injury in ment with limited mouth opening and left condylar fracture with medial rotation. The treatment was the reduction and fixation of fragments by open process.

Surgical treatment of adolescent internal condylar resorption (AICR) with articular disc repositioning and orthognathic surgery in the growing patient--a pilot study.

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Bodine, Trevor P; Wolford, Larry M; Araujo, Eustaquio; Oliver, Donald R; Buschang, Peter H

2016-01-01

The aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the Mitek mini-anchor technique affects condylar growth in growing patients with adolescent internal condylar resorption (AICR). Twenty-two adolescent patients diagnosed with AICR and anterior temporomandibular disc displacement were compared to untreated control subjects without AICR matched for age, sex, and Angle classification. Pre-surgical (T1 and T2) and post-surgical (T3 and T4) mandibular tracings were superimposed on natural stable structures to evaluate the horizontal, vertical, and total changes in the position of condylion. The treated group showed an overall decrease in condylar height pre-surgically and statistically significant changes in condylar growth direction between the pre- and post-surgical observation periods. Pre-surgically, the treated group showed significantly more posterior condylar growth than the control group; they also showed inferior condylar growth, while the controls showed superior growth. Controls and patients in the treated group showed no significant differences in condylar growth post-surgically. Adolescent patients diagnosed with AICR and anterior disc displacement treated with mandibular ramus and maxillary osteotomies, along with Mitek anchors to reposition internally deranged discs, showed post-surgical normalization of condylar growth.

Surgical treatment of adolescent internal condylar resorption (AICR with articular disc repositioning and orthognathic surgery in the growing patient—a pilot study

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Trevor P. Bodine

2016-01-01

Full Text Available Abstract Background The aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the Mitek mini-anchor technique affects condylar growth in growing patients with adolescent internal condylar resorption (AICR. Methods Twenty-two adolescent patients diagnosed with AICR and anterior temporomandibular disc displacement were compared to untreated control subjects without AICR matched for age, sex, and Angle classification. Pre-surgical (T1 and T2 and post-surgical (T3 and T4 mandibular tracings were superimposed on natural stable structures to evaluate the horizontal, vertical, and total changes in the position of condylion. Results The treated group showed an overall decrease in condylar height pre-surgically and statistically significant changes in condylar growth direction between the pre- and post-surgical observation periods. Pre-surgically, the treated group showed significantly more posterior condylar growth than the control group; they also showed inferior condylar growth, while the controls showed superior growth. Controls and patients in the treated group showed no significant differences in condylar growth post-surgically. Conclusions Adolescent patients diagnosed with AICR and anterior disc displacement treated with mandibular ramus and maxillary osteotomies, along with Mitek anchors to reposition internally deranged discs, showed post-surgical normalization of condylar growth.

Modified endaural approach for the treatment of condylar fractures: A review of 75 cases

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S M Balaji

2016-01-01

Conclusion: Surgery for mandibular condyle fractures with modified approach allows direct vision of the fracture and reduces surgical trauma to the site while avoiding permanent facial nerve injury. Hence, the author's modified Al-Kayat Bramley incision via endaural approach could be considered as the best approach for open reduction and internal fixation of condylar neck and subcondylar mandibular fractures.

Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

OpenAIRE

Choi, Kang-Young; Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

2012-01-01

In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and de...

Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

Science.gov (United States)

Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

2012-01-01

In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle. PMID:22872831

Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

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Kang-Young Choi

2012-07-01

Full Text Available In the treatment of mandibular condyle fracture, conservative treatment using closed reduction or surgical treatment using open reduction can be used. Management of mandibular condylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma. For each type of condylar fracture,the treatment method must be chosen taking into consideration the presence of teeth, fracture height, patient'sadaptation, patient's masticatory system, disturbance of occlusal function, and deviation of the mandible. In the past, closed reduction with concomitant active physical therapy conducted after intermaxillary fixation during the recovery period had been mainly used, but in recent years, open treatment of condylar fractures with rigid internal fixation has become more common. The objective of this review was to evaluate the main variables that determine the choice of an open or closed method for treatment of condylar fractures, identifying their indications, advantages, and disadvantages, and to appraise the current evidence regarding the effectiveness of interventions that are used in the management of fractures of the mandibular condyle.

The Relationship of the Facial Nerve to the Condylar Process: A Cadaveric Study with Implications for Open Reduction Internal Fixation

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H. P. Barham

2015-01-01

Full Text Available Introduction. The mandibular condyle is the most common site of mandibular fracture. Surgical treatment of condylar fractures by open reduction and internal fixation (ORIF demands direct visualization of the fracture. This project aimed to investigate the anatomic relationship of the tragus to the facial nerve and condylar process. Materials and Methods. Twelve fresh hemicadavers heads were used. An extended retromandibular/preauricular approach was utilized, with the incision being based parallel to the posterior edge of the ramus. Measurements were obtained from the tragus to the facial nerve and condylar process. Results. The temporozygomatic division of the facial nerve was encountered during each approach, crossing the mandible at the condylar neck. The mean tissue depth separating the facial nerve from the condylar neck was 5.5 mm (range: 3.5 mm–7 mm, SD 1.2 mm. The upper division of the facial nerve crossed the posterior border of the condylar process on average 2.31 cm (SD 0.10 cm anterior to the tragus. Conclusions. This study suggests that the temporozygomatic division of the facial nerve will be encountered in most approaches to the condylar process. As visualization of the relationship of the facial nerve to condyle is often limited, recognition that, on average, 5.5 mm of tissue separates condylar process from nerve should help reduce the incidence of facial nerve injury during this procedure.

Impacted mandibular third molars and their influence on mandibular angle and condyle fractures--a retrospective study.

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Gaddipati, Rajasekhar; Ramisetty, Sudhir; Vura, Nandagopal; Kanduri, Rajeev Reddy; Gunda, Vinay Kumar

2014-10-01

Previous retrospective analyses prove that impacted mandibular third molars (M3s) increase the risk of angle fractures and decrease the risk of concomitant fractures to the condyle. A retrospective cohort was designed for patients reported to the Department of Oral and Maxillofacial Surgery from January 2011 till June 2013. The study variables are presence or absence of third molar, if it is present, their position, classified using the Pell and Gregory system; angulation, classified using Shiller's method. The outcome variables were angle and condyle fractures. Hospital records and panoramic radiographs were used to determine and classify these variables. The study sample comprised of 118 mandibular angle and condyle fractures in 110 patients. Database was constructed and analysed using SPSS version 10.0. This present retrospective study concluded that the presence of impacted third molar predisposes the angle to fracture and reduces the risk of a concomitant condylar fracture. However absence of impacted third molar increases the risk of condylar fracture. The highest incidence of angle fracture was observed in position A impacted mandibular third molars. And there is no significant relationship, concerning ramus position and angulation of impacted mandibular third molars with the angle fracture. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Mandibular growth changes and cervical vertebral maturation. a cephalometric implant study.

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Gu, Yan; McNamara, James A

2007-11-01

To evaluate mandibular dimensional changes and regional remodeling occurring during five intervals of circumpubertal growth. This investigation evaluated a unique sample of subjects in whom tantalum implants were placed into the craniofacial complex during childhood. The sample was obtained from the Mathews and Ware implant study originally conducted at the University of California San Francisco in the 1970s, with longitudinal cephalometric records of 20 subjects (13 female, 7 male) available for evaluation. Cephalograms at six consecutive stages of cervical vertebral maturation (CS1 through CS6) were analyzed. Peak mandibular growth was noted during the interval from CS3 to CS4. Forward rotation of the mandible was due to greater mandibular growth posteriorly than anteriorly. Progressive closure of the condylar-ramus-occlusal (CRO) angle resulted in a forward and upward orientation of the ramus relative to the corpus of the mandible due to increased vertical growth of the condyle. A peak in mandibular growth at puberty was substantiated. Mandibular remodeling and condylar rotation continue to occur after the growth spurt.

[Temporo-mandibular joint. Morpho-functional considerations].

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Scutariu, M D; Indrei, Anca

2004-01-01

The temporo-mandibular joint is distinguished from most other synovial joints of the body by two features: 1. the two jointed components carry teeth whose position and occlusion introduce a very strong influence on the movements of the temporo-mandibular joint and 2. its articular surfaces are not covered by hyaline cartilage, but by a dense, fibrous tissue. This paper describes the parts of the temporo-mandibular joint: the articular surfaces (the condylar process of the mandible and the glenoid part of the temporal bone), the fibrocartilaginous disc which is interposed between the mandibular and the temporal surface, the fibrous capsule of the temporo-mandibular joint and the ligaments of this joint. All these parts present a very strong adaptation at the important functions of the temporo-mandibular joint.

The panoramic radiographic study of the vertical mandibular asymmetry of in the TMJ disorder patients

International Nuclear Information System (INIS)

Yoon, Gui Hyeon; Choi, Soon Chul

1993-01-01

To evaluate of the relationship between the TMJ disorder and the vertical mandibular asymmetry, the author analyzed the differences between condylar heights, ramus heights and mandibular heights of both sides. All measurements were performed with a digital micrometer on the panoramic radiographs of 36 TMJ disorder patients and 30 normal control group. The differences were expressed in millimeters and percentage using the following formula; [(R-L)/(R+L)] X 100%. The results were as follows: 1. The condylar height difference was greater of in patient group (1.86±1.66 mm) than that of in control group (1.22±0.85 mm) (p<0.05). 2. The ramus height difference and ramus height ratio difference of patient group (4.52±3.70 mm, 4.39±3.49%) were greater than those of control group (2.64±2.13 mm, 2.46±2.02 %) (p<0.05, p<0.01). 3. The mandibular height difference and mandibular height ratio difference of patient group (4.32±3.52 mm, 3.59±2.81 %) were greater than those of contro group(2.57±2.46 mm, 2.01 (1.95%) (p<0.05). 4. The ratio difference in condylar height to ramus height and condylar height to mandibular height of patient group (5.01±4.13%, 3.36±2.88%) were greater than those of control group (2.33±1.78%, 1.90±1.40%) (p<0.01).

A novel technique for preventing skin pressure sores using a rubber tube during surgical treatment of mandibular condyle fractures.

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Kawase-Koga, Yoko; Mori, Yoshiyuki; Hoshi, Kazuhito; Takato, Tsuyoshi

2013-11-01

Craniofacial surgery occasionally results in sores and necrosis of the facial skin because of pressure from surgical instruments. During surgical treatment of mandibular condylar process fractures, the main mandibular fragment is routinely retracted downward using a wire to achieve a satisfactory anatomic reduction. This procedure may injure the facial skin. This potential complication is easily overlooked by medical staff, but it is easily preventable. We herein describe a method of using a rubber tube to avoid causing pressure sores of the facial skin during surgical treatment of mandibular condylar process fractures.

Eosinophilic granuloma of the mandibular condyle

International Nuclear Information System (INIS)

Huh, Kyung Hoe; Yi, Won Jin; Oh, Sung Won; Lee, Sam Sun; Choi, Mun Kyung

2008-01-01

The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

Eosinophilic granuloma of the mandibular condyle

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Huh, Kyung Hoe; Yi, Won Jin; Oh, Sung Won; Lee, Sam Sun [Department of Oral and Maxillofacial Radiology, and Dental Research Institute, School of Dentistry, Seoul National University, Seoul (Korea, Republic of); Choi, Mun Kyung [Department of Oral and Maxillofacial Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of)

2008-03-15

The present study reports a case of eosinophilic granuloma of the mandibular condyle. Eosinophilic granulomas on the mandibular condyle are very rare, but there are several common clinical and radiographic presentations. The clinical presentations involve swelling on preauricular area, limitation of opening, TMJ pain, etc. The radiographic presentations involve radiolucent lytic condylar lesion with or without pathologic fracture. Sometimes new bone formations are observed. The purpose of the article is to add new cases to the literatures.

Condylectomy and "surgery first" approach: An expedited treatment for condylar hyperplasia in a patient with facial asymmetry.

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López, Diego Fernando; Aristizábal, Juan Fernando; Martínez-Smit, Rosana

2017-01-01

Condylar Hyperplasia (CH) is a self-limiting pathology condition that produces severe facial deformity at the expense of mandibular asymmetry. In this case report a 15-year-old female patient was diagnosed with Unilateral Condylar Hiperplasia (UCH) by mean of single-photon emission computed tomography (SPECT) and histological study. A high condylectomy in the right condyle was performed to stop the active status of the hyperplasia. A month after condylectomy, orthognathic jaw impaction and asymmetric mandibular setback surgery was performed with the Surgery First Approach (SFA). After 10 days, orthodontic appointments were made every two weeks during 4 months. The active phase of treatment lasted 14 months. Excellent facial and occlusal outcomes were obtained and after 24 months in retention the results remained stable.

Condylar cartilaginous changes after mandibular distraction osteogenesis in rabbits.

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Ahn, Sin-Young; Kim, Su-Gwan

2011-10-01

The purpose of this study was to evaluate histologic and immunohistochemical changes in the condylar articular surface in response to distraction osteogenesis (DO) of the mandibular body in rabbits. A unilateral osteotomy of the mandible at the premolar area was performed in 16 rabbits. The animals were divided into 4 groups based on different distraction parameters (rate and rhythm). After a 5-day latency, the mandible was lengthened by 0.5 mm daily for 6 days (group 1); 0.5 mm twice daily for 3 days (group 2); 0.5 mm once daily for 10 days (group 3); or 0.5 mm twice daily for 5 days (group 4). All 4 groups underwent a 14-day consolidation period. Four rabbits were included in the control group. The specimens were stained with hematoxylin-eosin for histologic examination. Immunohistochemical analysis was performed to evaluate the expression of growth factors. None of the groups demonstrated any degenerative changes in the temporomandibular joint (TMJ). On the distraction side in all groups, the histopathological examination revealed a hypertrophic thickening of the cartilage zone. Prominent endochondral ossification and high active osteoblasts were observed in groups 3 and 4. On the nondistraction side, no major changes were observed excluding the appearance of osteoclasts in groups 3 and 4. The immunohistochemical analysis revealed tenascin immunoreactivity in bone marrow mesenchymal cells on the distraction side in group 4. Connexin immunoreactivity did not display a marked change in any of the groups. Osteocalcin was observed on the distraction side in group 2, which suggested that bone formation is increased. Nitric oxide synthase 2 immunoreactivity was observed on the distraction side in group 2, which is associated with stress and inflammation. The results indicated that the hypertrophy of the cartilage zone and endochondral ossification became more pronounced as the extent and rate of distraction increased. Copyright © 2011 Mosby, Inc. All rights reserved.

Aquaporin-1 and aquaporin-3 expressions in the temporo-mandibular joint condylar cartilage after an experimentally induced osteoarthritis.

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Meng, Juan-hong; Ma, Xu-chen; Li, Zhi-min; Wu, Deng-cheng

2007-12-20

Over 70% of the total tissue weight in the cartilage matrix consists of water, and the early-stage osteoarthritic cartilage is characterized by swelling. Water transport in the cartilage matrix and across the membranes of chondrocytes may be important in normal and pathological conditions of cartilage. The purpose of this study was to identify aquaporin-1 (AQP1) and aquaporin-3 (AQP3) expressions in the mandibular condylar cartilage after experimentally induced osteoarthritis (OA) in rats. An experimental temporomandibular joint OA was induced by partial discectomy in rats. The pathological characteristics of the normal, early-stage, and late-stage osteoarthritic TMJ cartilages were verified by histological techniques. The AQP1 and AQP3 gene expressions in the normal and osteoarthritic cartilages were measured using quantitative real-time reverse-transcription PCR analysis. The cartilage sections were incubated in primary polyclonal antibodies to AQP3; immunofluorescent microscopy was used to examine the AQP3 expression shown by its protein level. The mRNA expression levels of AQP1 and AQP3, analyzed using quantitative PCR, revealed that AQP3 mRNA was highly up-regulated in the OA cartilage, which was considered significant. There was no notable difference in the expression of AQP1 mRNA between OA and normal controls. With the progressing of the OA, the localization of the AQP3 protein was quite different from that of the normal cartilage. Compared to the normal cartilage, the expressions of AQP3 protein were observed mainly in the proliferative zone and the upper mid-zone chondrocytes at the early-stage of OA, and were observed to appear frequently throughout the mid- and deep zone during the late-stage of OA. The high expression of AQP3 mRNA in the OA cartilage and the different localization of the AQP3 protein suggest that it may play a particular role in OA pathogenesis. Further study of AQP3 function may provide new insight into the understanding of the

Surgical treatment of sagittal fracture of mandibular condyle using long-screw osteosynthesis.

Science.gov (United States)

Luo, Shufang; Li, Bo; Long, Xing; Deng, Mohong; Cai, Hengxing; Cheng, Yong

2011-07-01

The retrospective study evaluated long-screw (bicortical screw) osteosynthesis used in the surgical treatment of sagittal fracture of the mandibular condyle and compared it with titanium plates and removal of the condylar fragment. Ninety-five patients with sagittal fracture of the mandibular condyle received open surgical treatment from 1997 to 2008. Among these patients, the condylar fragments were fixed with long screws in 56 cases (group A), were fixed with titanium plates in 12 cases (group B), and were completely removed in 24 cases (group C). Follow-up was carried out clinically and radiologically. The clinical features included limitation of mandibular mobility, occlusion disturbance, lateral deviation on mouth opening, joint pain, clicking, facial asymmetry, and patient's subjective evaluation. The radiologic parameters consisted of degree of bony resorption, bony change, change of osteosynthesis material, and shortening of mandibular ramus height. Anatomic reduction and functional restoration were obtained and no severe complication was detected in group A. However, 3 of 14 patients had severe osteoarthrosis and 2 of 14 patients had ankylosis in group B. In group C 3 of 24 patients had mandibular retrusion, 4 of 24 patients had front teeth open bite, 4 of 24 patients had severe osteoarthrosis, and 1 of 24 patients had ankylosis. The long-screw fixation group had a more favorable prognosis than the titanium plate group and the group in which removal of the condylar fragment was performed. The long-screw fixation technique might be suitable for use in the surgical treatment of sagittal fractures of the mandibular condyle. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[Clinical application of artificial condylar process for reconstructing temporomandibular joint].

Science.gov (United States)

Huang, Xiangdao; Shao, Zhanying; Wang, Fasheng; Duan, Yi

2012-01-01

To assess the feasibility and clinical outcomes of artificial condylar process in reconstruction of the temporomandibular joint. Between January 2005 and January 2010, the reconstructions of the temporomandibular joints with artificial condylar process were performed in 10 cases (11 sides, including 7 left sides and 4 right sides). There were 7 males and 3 females with an average age of 50 years (range, 40-68 years). Mandibular condyle defects were caused by mandible tumor in 7 patients with a mean disease duration of 15 months (range, 9-24 months) and by bilateral condylar fractures in 3 patients with the disease duration of 2, 3, and 2 days respectively. According to Neff classification, there were type M and A in 1 case, type M and B in 1 case, and type M in one side and subcondylar fracture in the other side in 1 case. Incisions in all patients healed by first intention, and no complication occurred. All cases were followed up 1 to 4 years, showed facial symmetry and good occluding relation, and the mouth opening was 22-38 mm (mean, 30 mm). No temporomandibular joint clicking or pain and no recurrence of tumor were observed. Most of the artificial condylar process were in good position except 1 deviated from the correct angle slightly. All the patients could have diet normally. The results of temporomandibular joint reconstruction after tumor resection with artificial condylar process are good, but the clinical outcome for intracapsular condylar fracture is expected to be further verified.

Condylectomy and “surgery first” approach: An expedited treatment for condylar hyperplasia in a patient with facial asymmetry

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López, Diego Fernando; Aristizábal, Juan Fernando; Martínez-Smit, Rosana

2017-01-01

ABSTRACT Condylar Hyperplasia (CH) is a self-limiting pathology condition that produces severe facial deformity at the expense of mandibular asymmetry. In this case report a 15-year-old female patient was diagnosed with Unilateral Condylar Hiperplasia (UCH) by mean of single-photon emission computed tomography (SPECT) and histological study. A high condylectomy in the right condyle was performed to stop the active status of the hyperplasia. A month after condylectomy, orthognathic jaw impaction and asymmetric mandibular setback surgery was performed with the Surgery First Approach (SFA). After 10 days, orthodontic appointments were made every two weeks during 4 months. The active phase of treatment lasted 14 months. Excellent facial and occlusal outcomes were obtained and after 24 months in retention the results remained stable. PMID:28902254

Cone Beam Computed Tomographic Evaluation of Mandibular Asymmetry in Patients with Cleft Lip and Palate.

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Paknahad, Maryam; Shahidi, Shoaleh; Bahrampour, Ehsan; Beladi, Amir Saied; Khojastepour, Leila

2018-01-01

Objective The purpose of the present study was to compare mandibular vertical asymmetry in patients with unilateral and bilateral cleft lip and palate and subjects with normal occlusion. Materials and Methods Cone beam computed tomography scans of three groups consisting of 20 patients with unilateral cleft lip and palate, 20 patients affected by bilateral cleft lip and palate, and a control group of 20 subjects with normal occlusion were analyzed for this study. Condylar, ramal, and condylar plus ramal asymmetry indices were measured for all subjects using the method of Habets et al. Kruskal-Wallis and Mann-Whitney tests were used to determine any significant differences between the groups for all indices at the 95% level of confidence. Results There were no significant differences regarding sex for all mandibular asymmetry indices in all three groups. All Asymmetry indices (condylar, ramal, and condylar plus ramal asymmetry) were significantly higher in the unilateral cleft group compared with the other two groups. Conclusion Cone beam computed tomography images showed that patients with cleft lip and palate suffered from mandibular asymmetry. Subjects with unilateral cleft lip and palate had a more asymmetric mandible compared with the bilateral cleft lip and palate and control groups. Therefore, the mandible appears to be the leading factor in facial asymmetry in subjects with unilateral cleft lip and palate.

Condylectomy and “surgery first” approach: An expedited treatment for condylar hyperplasia in a patient with facial asymmetry

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Diego Fernando López

Full Text Available ABSTRACT Condylar Hyperplasia (CH is a self-limiting pathology condition that produces severe facial deformity at the expense of mandibular asymmetry. In this case report a 15-year-old female patient was diagnosed with Unilateral Condylar Hiperplasia (UCH by mean of single-photon emission computed tomography (SPECT and histological study. A high condylectomy in the right condyle was performed to stop the active status of the hyperplasia. A month after condylectomy, orthognathic jaw impaction and asymmetric mandibular setback surgery was performed with the Surgery First Approach (SFA. After 10 days, orthodontic appointments were made every two weeks during 4 months. The active phase of treatment lasted 14 months. Excellent facial and occlusal outcomes were obtained and after 24 months in retention the results remained stable.

Radiographic structural findings in the mandibular condyles of young individuals receiving orthodontic treatment

International Nuclear Information System (INIS)

Peltola, J.S.; Nystroem, M.; Koenoenen, M.; Wolf, J.

1995-01-01

Radiographic findings in mandibular condyles were studied from the pre- and post-treatment panoramic radiographs of 625 orthodontic patients. The subjects' mean age was 11 years at the start and 14 years at the end of active orthodontic treatment. Radiographic condylar findings were seen in 14 subjects before treatment and in 54 subjects after treatment. In age-related controls condylar findings were seen in 3%. The condylar findings was ''flattening only'' in half of the patients and in one-third of the controls with condylar findings. Activator treatment was associated with condylar findings. Condylar findings increased with age in the orthodontically treated subjects, but not in the unselected population controls. This may mean that condyles become more sensitive with age in children. Increase with age may be partly due to the radiographic interpretation, since minor condylar findings are difficult to observe in young children, and partly due to differences in treatment modalities and the duration of treatment. 44 refs., 1 fig., 3 tabs

Effects of intermittent versus continuous parathyroid hormone administration on condylar chondrocyte proliferation and differentiation

International Nuclear Information System (INIS)

Liu, Qi; Wan, Qilong; Yang, Rongtao; Zhou, Haihua; Li, Zubing

2012-01-01

Highlights: ► Different PTH administration exerts different effects on condylar chondrocyte. ► Intermittent PTH administration suppresses condylar chondrocyte proliferation. ► Continuous PTH administration maintains condylar chondrocyte proliferating. ► Intermittent PTH administration enhances condylar chondrocyte differentiation. -- Abstract: Endochondral ossification is a complex process involving chondrogenesis and osteogenesis regulated by many hormones and growth factors. Parathyroid hormone (PTH), one of the key hormones regulating bone metabolism, promotes osteoblast differentiation and osteogenesis by intermittent administration, whereas continuous PTH administration inhibits bone formation. However, the effects of PTH on chondrocyte proliferation and differentiation are still unclear. In this study, intermittent PTH administration presented enhanced effects on condylar chondrocyte differentiation and bone formation, as demonstrated by increased mineral nodule formation and alkaline phosphatase (ALP) activity, up-regulated runt-related transcription factor 2 (RUNX2), ALP, collagen type X (COL10a1), collagen type I (COL1a1), osteocalcin (OCN), bone sialoprotein (BSP), bone morphogenetic protein 2 (BMP2) and osterix (OSX) mRNA and/or protein expression. On the contrary, continuous PTH administration promoted condylar chondrocyte proliferation and suppressed its differentiation, as demonstrated by up-regulated collagen type II (COL2a1) mRNA expression, reduced mineral nodule formation and down-regulated expression of the mRNAs and/or proteins mentioned above. Our data suggest that PTH can regulate condylar chondrocyte proliferation and differentiation, depending on the type of PTH administration. These results provide new insight into the effects of PTH on condylar chondrocytes and new evidence for using local PTH administration to cure mandibular asymmetry.

Facial symmetry evaluation after experimentally displaced condylar process fracture in methotrexate treated rats Avaliação da simetria facial após fratura experimental com desvio do processo condilar em ratos tratados com metotrexato

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Samantha Cristine Santos Xisto Braga Cavalcanti

2012-03-01

Full Text Available PURPOSE: To investigate the facial symmetry of high and low dose methotrexate (MTX treated rats submitted to experimentally displaced mandibular condyle fracture through the recording of cephalometric measurements. METHODS: One hundred male Wistar rats underwent surgery using an experimental model of right condylar fracture. Animals were divided into four groups: A - saline solution (1mL/week; B - dexamethasone (DEX (0,15mg/Kg; C - MTX low dose (3 mg/Kg/week; D - MTX high dose (30 mg/Kg. Animals were sacrificed at 1, 7, 15, 30 and 90 days postoperatively (n=5. Body weight was recorded. Specimens were submitted to axial radiographic incidence, and cephalometric mensurations were made using a computer system. Linear measurements of skull and mandible, as well as angular measurements of mandibular deviation were taken. Data were subjected to statistical analyses among the groups, periods of sacrifice and between the sides in each group (α=0.05. RESULTS: Animals regained body weight over time, except in group D. There was reduction in the mandibular length and also changes in the maxilla as well as progressive deviation in the mandible in relation to the skull basis in group D. CONCLUSION: Treatment with high dose methotrexate had deleterious effect on facial symmetry of rats submitted to experimentally displaced condylar process fracture.OBJETIVO: Avaliar a simetria facial de ratos tratados com metotrexato (MTX, em dose alta e baixa, submetidos à fratura experimental do processo condilar com desvio por meio de mensurações cefalométricas. MÉTODOS: Cem ratos Wistar machos foram submetidos a procedimento cirúrgico utilizando modelo experimental de fratura de côndilo do lado direito. Os animais foram distribuídos em quatro grupos: A - soro fisiológico (1mL/semana; B - dexametasona (DEX (0,15mg/Kg; C - MTX baixa dose (3mg/Kg/semana; D - MTX alta dose (30mg/Kg. Os períodos de sacrifício foram de 1, 7, 15, 30 e 90 dias de pós-operatório (n=5

Open reduction and internal fixation of dislocated condylar fractures in children: long-term clinical and radiologic outcomes.

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Deleyiannis, Frederic W-B; Vecchione, Lisa; Martin, Brian; Jiang, Shao; Sotereanos, George

2006-11-01

The purpose of this study was to investigate the long-term clinical and radiologic outcomes of treating dislocated condylar fractures sustained in childhood with open reduction and internal fixation (ORIF). Six children 14 years or younger with a condylar neck or subcondylar fracture with dislocation of the condyle from the glenoid fossa were treated with ORIF. Patients were followed for 27 to 92 months post-ORIF (mean: 67.6 months) with routine clinical and radiologic examinations. On the dislocated side, all patients radiographically showed signs of remodeling of the condylar process and shortening of the ramus. Subsequent to their fractures, 3 patients were classified with Angle class II malocclusion, retrognathism, and deviation of the mandibular symphysis. Four patients had objective and/or subjective signs of temporomandibular (TMJ) dysfunction. Until open surgery demonstrates a consistent functional advantage, nonsurgical management should be considered the first treatment option for the dislocated pediatric condylar fracture.

Rotational Distraction for the Treatment of Severe Mandibular Retrognathia.

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Ito, Osamu; Mitsugi, Masaharu; Alcalde, Rafael E; Yano, Tomoyuki; Uemura, Noriko; Okazaki, Mutsumi

2015-07-01

The main problem with intraoral distraction of the mandible is the inability to achieve the three-dimensional mandibular correction as planned preoperatively. We developed a technique that allows spontaneous changes in the direction of mandibular elongation using an intraoral distractor. After mandibular osteotomy, the distractor is fixed to the distal segment of the mandible using a single bicortical screw, allowing anterior-posterior, vertical and limited lateromedial changes in the vector of distraction. Mandibular lengthening is performed while keeping the maxilla and mandible in class I occlusion with intermaxillary fixation. As the distraction device is activated allowing mandibular elongation, the proximal segment, guided by the surrounding soft tissues, moves and rotates posterosuperiorly. Mandibular lengthening is continued until the condylar head reaches an adequate position in the mandibular fossa as confirmed clinically and radiographically. Thirty-three patients with mandibular retrognathia received this treatment and good results were obtained.

Osteochondroma involving mandibular condyle

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Latika Bachani

2017-01-01

Full Text Available Osteochondroma is defined as an osteocartilagenous exostosis with cartilage capped exophytic lesion that arises from the bone cortex. It is a slow growing benign tumor that is rarely seen in the maxillofacial region. Osteochondroma of the mandibular condyle is a relatively rare condition that causes a progressive enlargement of the condyle, usually resulting in facial asymmetry, temporomandibular joint (TMJ dysfunction and malocclusion. Radiographically, there is a unilaterally enlarged condyle usually with an exophytic growth of the tumor from the condylar head. The treatment of osteochondroma is primarily surgical resection of the tumor. This paper reports a case of osteochondroma of the right mandibular condyle presenting as a painless restricted mouth opening.

Effects of intermittent versus continuous parathyroid hormone administration on condylar chondrocyte proliferation and differentiation

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Liu, Qi; Wan, Qilong; Yang, Rongtao; Zhou, Haihua [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, 237 Luoyu Road, Wuhan 430079 (China); Li, Zubing, E-mail: lizubing0827@163.com [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, 237 Luoyu Road, Wuhan 430079 (China); Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079 (China)

2012-07-20

Highlights: Black-Right-Pointing-Pointer Different PTH administration exerts different effects on condylar chondrocyte. Black-Right-Pointing-Pointer Intermittent PTH administration suppresses condylar chondrocyte proliferation. Black-Right-Pointing-Pointer Continuous PTH administration maintains condylar chondrocyte proliferating. Black-Right-Pointing-Pointer Intermittent PTH administration enhances condylar chondrocyte differentiation. -- Abstract: Endochondral ossification is a complex process involving chondrogenesis and osteogenesis regulated by many hormones and growth factors. Parathyroid hormone (PTH), one of the key hormones regulating bone metabolism, promotes osteoblast differentiation and osteogenesis by intermittent administration, whereas continuous PTH administration inhibits bone formation. However, the effects of PTH on chondrocyte proliferation and differentiation are still unclear. In this study, intermittent PTH administration presented enhanced effects on condylar chondrocyte differentiation and bone formation, as demonstrated by increased mineral nodule formation and alkaline phosphatase (ALP) activity, up-regulated runt-related transcription factor 2 (RUNX2), ALP, collagen type X (COL10a1), collagen type I (COL1a1), osteocalcin (OCN), bone sialoprotein (BSP), bone morphogenetic protein 2 (BMP2) and osterix (OSX) mRNA and/or protein expression. On the contrary, continuous PTH administration promoted condylar chondrocyte proliferation and suppressed its differentiation, as demonstrated by up-regulated collagen type II (COL2a1) mRNA expression, reduced mineral nodule formation and down-regulated expression of the mRNAs and/or proteins mentioned above. Our data suggest that PTH can regulate condylar chondrocyte proliferation and differentiation, depending on the type of PTH administration. These results provide new insight into the effects of PTH on condylar chondrocytes and new evidence for using local PTH administration to cure mandibular

Mandibular kinematics and maximum voluntary bite force following segmental resection of the mandible without or with reconstruction.

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Linsen, Sabine S; Oikonomou, Annina; Martini, Markus; Teschke, Marcus

2018-05-01

The purpose was to analyze mandibular kinematics and maximum voluntary bite force in patients following segmental resection of the mandible without and with reconstruction (autologous bone, alloplastic total temporomandibular joint replacement (TMJ TJR)). Subjects operated from April 2002 to August 2014 were enrolled in the study. Condylar (CRoM) and incisal (InRoM) range of motion and deflection during opening, condylar retrusion, incisal lateral excursion, mandibular rotation angle during opening, and maximum voluntary bite force were determined on the non-affected site and compared between groups. Influence of co-factors (defect size, soft tissue deficit, neck dissection, radiotherapy, occlusal contact zones (OCZ), and time) was determined. Twelve non-reconstructed and 26 reconstructed patients (13 autologous, 13 TMJ TJR) were included in the study. InRoM opening and bite force were significantly higher (P ≤ .024), and both condylar and incisal deflection during opening significantly lower (P ≤ .027) in reconstructed patients compared with non-reconstructed. Differences between the autologous and the TMJ TJR group were statistically not significant. Co-factors defect size, soft tissue deficit, and neck dissection had the greatest impact on kinematics and number of OCZs on bite force. Reconstructed patients (both autologous and TMJ TJR) have better overall function than non-reconstructed patients. Reconstruction of segmental mandibular resection has positive effects on mandibular function. TMJ TJR seems to be a suitable technique for the reconstruction of mandibular defects including the TMJ complex.

Meckel’s and condylar cartilages anomalies in achondroplasia result in defective development and growth of the mandible

Science.gov (United States)

Biosse Duplan, Martin; Komla-Ebri, Davide; Heuzé, Yann; Estibals, Valentin; Gaudas, Emilie; Kaci, Nabil; Benoist-Lasselin, Catherine; Zerah, Michel; Kramer, Ina; Kneissel, Michaela; Porta, Diana Grauss; Di Rocco, Federico; Legeai-Mallet, Laurence

2016-01-01

Activating FGFR3 mutations in human result in achondroplasia (ACH), the most frequent form of dwarfism, where cartilages are severely disturbed causing long bones, cranial base and vertebrae defects. Because mandibular development and growth rely on cartilages that guide or directly participate to the ossification process, we investigated the impact of FGFR3 mutations on mandibular shape, size and position. By using CT scan imaging of ACH children and by analyzing Fgfr3Y367C/+ mice, a model of ACH, we show that FGFR3 gain-of-function mutations lead to structural anomalies of primary (Meckel’s) and secondary (condylar) cartilages of the mandible, resulting in mandibular hypoplasia and dysmorphogenesis. These defects are likely related to a defective chondrocyte proliferation and differentiation and pan-FGFR tyrosine kinase inhibitor NVP-BGJ398 corrects Meckel’s and condylar cartilages defects ex vivo. Moreover, we show that low dose of NVP-BGJ398 improves in vivo condyle growth and corrects dysmorphologies in Fgfr3Y367C/+ mice, suggesting that postnatal treatment with NVP-BGJ398 mice might offer a new therapeutic strategy to improve mandible anomalies in ACH and others FGFR3-related disorders. PMID:27260401

Kinematic analysis of mandibular motion before and after orthognathic surgery for skeletal Class III malocclusion: A pilot study.

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Ugolini, Alessandro; Mapelli, Andrea; Segù, Marzia; Galante, Domenico; Sidequersky, Fernanda V; Sforza, Chiarella

2017-03-01

The aim of the study was to detect the changes in 3D mandibular motion after orthognathic surgery for skeletal Class III malocclusion. Using a 3D motion analyzer, free mandibular border movements were recorded in nine patients successfully treated for skeletal Class III malocclusion and in nine patients scheduled for orthognathic surgery. Data were compared using Mann-Whitney non-parametric U-test. The results showed no differences between the groups in the total amount of mouth opening, protrusion, and in lateral excursions, but the percentage of mandibular movement explained by condylar translation was significantly increased after surgery (20% vs. 23.6%). During opening, the post-surgery patients showed a more symmetrical mandibular interincisal point and condylar path than pre-surgery patients (p < 0.01). Patients treated with orthognathic surgery for skeletal Class III malocclusion recover a good and symmetric temporomandibular joint function.

The effects of irradiation on the mandibular bone of rats on the low calcium diet

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Hwang, Eui Whan; Lee, Sang Rae [Dept. of Oral Radiology, College of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

1992-08-15

The purpose of this study was to investigate the changes of morphology and structure of bone tissue in the irradiated mandibular bone in rats which were fed a low calcium diet. In order to carry out this experiment, 64 seven-week old Sprague- Dawley strain rats weighing about 150gms were selected and equally divided into one experimental group of 32 rats and one control group with the remainder. The experimental group and the group were then subdivided into two groups when the rats reached ten-week old, 16 were assigned rats for each subdivided group, exposed to irradiation. The two irradiation groups received a single dose of 20Gy in the jaws area only and irradiated with a cobalt-60 teletherapy unit. The rats in the control and experimental groups were serially termination, both sides of the dead rats mandibular bodies were removed and fixed with 10% neutral formalin. One side of the mandibular body was radiographed with a soft X-ray apparatus. Thereafter, the obtained microradiographs were observed by a light microscope. The remaining side of the mandibular bone was further decalcified and embedded in paraffin as using the general method. The specimen ectioned and stained with hematoxylin and eosin, and Rabit Anti-Human Tumor Necrosis Factor-{alpha}, observed by a light microscope. The obtained results were as follows: 1. Microradiogram revealed that thinning of the cortex and a decrease in the trabecula of the interradicular bone and mandibular body were observed and noted from the start to finish throughout the experiment in the non-irradiated rats on the low calcium diet rather than in the non-irradiated rats on the normal diet.In microscopic observation, there were marked osteolytic changes in the center of the bone marrow. 2. Microradiogram revealed that thinning of the cortex and a decrease in the trabecula of interradicular bone and mandibular body were more marked after 7 days in the irradiated rats in the low calcium diet rather than in the non

Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures.

Science.gov (United States)

Frake, Paul C; Goodman, Joseph F; Joshi, Arjun S

2015-01-01

The investigators of this study hypothesized that fractures of the mandibular condyle can be repaired using short-segment intramedullary implants and purely endoscopic surgical technique, using a basic science, human cadaver model in an academic center. Endoscopic instrumentation was used through a transoral mucosal incision to place intramedullary implants of 2 cm in length into osteotomized mandibular condyles. The surgical maneuvers that required to insert these implants, including condyle positioning, reaming, implant insertion, and seating of the mandibular ramus, are described herein. Primary outcome was considered as successful completion of the procedure. Ten cadaveric mandibular condyles were successfully repaired with rigid intramedullary internal fixation without the use of external incisions. Both insertion of a peg-type implant and screwing a threaded implant into the condylar head were possible. The inferior portion of the implant remained exposed, and the ramus of the mandible was manipulated into position on the implant using retraction at the sigmoid notch. The results of this study suggest that purely endoscopic repair of fractures of the mandibular condyle is possible by using short-segment intramedullary titanium implants and a transoral endoscopic approach without the need for facial incisions or punctures. The biomechanical advantages of these intramedullary implants, including improved strength and resistance to mechanical failure compared with miniplates, have been recently established. The combination of improved implant design and purely endoscopic technique may allow for improved fixation and reduced surgical- and implant-related morbidity in the treatment of condylar fractures.

Facial nerve injuries associated with the retromandibular transparotid approach for reduction and fixation of mandibular condyle fractures.

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Shi, Dan; Patil, Pavan Manohar; Gupta, Ritika

2015-04-01

To document facial nerve (FN) injuries after surgical treatment of mandibular condylar fractures using the retromandibular transparotid approach and to identify risk factors associated with these injuries. A retrospective study of patients surgically treated for mandibular condylar fractures using the retromandibular transparotid approach over seven years was conducted. The primary study variable was the postoperative change in FN function after fracture fixation. Risk factors were categorized as demographic, anatomic, experience of the operator, fracture displacement/dislocation and number of miniplates placed at the fracture site. Appropriate statistics were computed. Ninety patients with 102 fractures were analysed. Thirty two fractures (31%) were located in the condylar neck and 70 fractures (69%) were subcondylar (located below the sigmoid notch). The condylar segment was undisplaced in twelve cases (12%), displaced medially in thirty five (34%), laterally displaced in thirty (29%) and dislocated in 25 (24.5%). In 18 fractures (18%), postoperative examination revealed various degrees of damage to the FN. All nerve injuries recovered completely in 8-24 weeks. In a multivariate model, condylar neck fractures, fracture dislocation and operator inexperience were associated with a statistically significant risk of postoperative deterioration of FN function (P ≤ 0.05). The majority of facial nerve injuries after surgical treatment of condylar fractures by the retromandibular transparotid approach are transient in nature. Condylar neck fractures, fracture dislocation and operator inexperience were associated with an increased risk for FN injury. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Functional Treatment of a Child with Extracapsular Mandibular Fracture

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Diana Cassi

2017-01-01

Full Text Available Condylar fractures are among the most frequent fractures in the context of traumatic lesions of the face. The management of condylar fractures is still controversial, especially when fractures occur in children: if overlooked or inappropriately treated, these lesions may lead to severe sequelae, both cosmetic and functional. The therapy must be careful because severe long-term complications can occur. In this case report, the authors present a case of mandibular fracture in which the decision between surgical therapy and functional therapeutic regimen may be controversial due to the particular anatomy of the fracture line and the age of the patient.

Orthodontic camouflage via total arch movement in a Class II with idiopathic condylar resorption

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Ji-Sung Jang

2014-01-01

Full Text Available Idiopathic condylar resorption (ICR, also known as idiopathic condylysis or condylar atrophy, is multifactorial pathology leading to severe mandibular retrognathism. The etiology has been shown to be multifactorial, such as avascular necrosis, traumatic injuries, hormone and autoimmune disease and it is largely difficult to distinguish the exact cause in each individual. In spite of the remarkable morphological alteration, surgical intervention is not readily recruited due to the possibility of recurrence of resorption. In order to restore balanced facial profile and occlusion. In this report, we present a camouflage treatment for skeletal Class II with ICR and facial asymmetry involving total arch movement, for the improvement facial profile and reconstruction of occlusion.

Meckel's and condylar cartilages anomalies in achondroplasia result in defective development and growth of the mandible.

Science.gov (United States)

Biosse Duplan, Martin; Komla-Ebri, Davide; Heuzé, Yann; Estibals, Valentin; Gaudas, Emilie; Kaci, Nabil; Benoist-Lasselin, Catherine; Zerah, Michel; Kramer, Ina; Kneissel, Michaela; Porta, Diana Grauss; Di Rocco, Federico; Legeai-Mallet, Laurence

2016-07-15

Activating FGFR3 mutations in human result in achondroplasia (ACH), the most frequent form of dwarfism, where cartilages are severely disturbed causing long bones, cranial base and vertebrae defects. Because mandibular development and growth rely on cartilages that guide or directly participate to the ossification process, we investigated the impact of FGFR3 mutations on mandibular shape, size and position. By using CT scan imaging of ACH children and by analyzing Fgfr3 Y367C/+ mice, a model of ACH, we show that FGFR3 gain-of-function mutations lead to structural anomalies of primary (Meckel's) and secondary (condylar) cartilages of the mandible, resulting in mandibular hypoplasia and dysmorphogenesis. These defects are likely related to a defective chondrocyte proliferation and differentiation and pan-FGFR tyrosine kinase inhibitor NVP-BGJ398 corrects Meckel's and condylar cartilages defects ex vivo. Moreover, we show that low dose of NVP-BGJ398 improves in vivo condyle growth and corrects dysmorphologies in Fgfr3 Y367C/+ mice, suggesting that postnatal treatment with NVP-BGJ398 mice might offer a new therapeutic strategy to improve mandible anomalies in ACH and others FGFR3-related disorders. © The Author 2016. Published by Oxford University Press.

Fracture of mandibular condyle—to open or not to open: an attempt to settle the controversy.

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Rastogi, Sanjay; Sharma, Siddharth; Kumar, Sanjeev; Reddy, Mahendra P; Niranjanaprasad Indra, B

2015-06-01

To compare the outcome of the open method versus the closed method of treatment for mandibular condylar fracture. Fifty patients with fractures of the mandibular condylar processes were evaluated. All fractures were displaced, with a degree of deviation between the condylar fragment and the ascending ramus of 10 to 45 degrees (mediolaterally). The patients were randomly divided into two groups, with group 1 receiving open reduction internal fixation and group 2 receiving closed reduction. The follow-up was done over the period of 6 months. Statistically significant improvement was seen in group 1 compared with group 2 in terms of anatomic reduction of the condyle, shortening of the ascending ramus, occlusal status, and deviation on mouth opening. A statistically significant difference was seen in the patients treated with the open method, with improved temporomandibular joint functions and fewer short- and long-term complications compared with those treated with the closed method. Copyright © 2015 Elsevier Inc. All rights reserved.

Comparative study of the prognosis of an extracorporeal reduction and a closed treatment in mandibular condyle head and/or neck fractures.

Science.gov (United States)

Park, Jung-Min; Jang, Yong-Wook; Kim, Seong-Gon; Park, Young-Wook; Rotaru, Horatiu; Baciut, Grigore; Hurubeanu, Lucia

2010-12-01

The objective of this study was a comparison of the prognosis between an extracorporeal reduction technique and closed treatment of a mandibular condyle fracture. The relationship between condylar resorption and several clinical variables was also studied. Seventy-one patients who had a mandibular condyle fracture took part in this study. Thirty-five patients (female: 7, male: 28, age: 30.46 ± 14.27 years) were treated by extracorporeal reduction, and 36 patients (male: 24, female: 12, age: 24.28 ± 9.99 years) were treated using a closed treatment. The presence of complications such as condylar resorption, malocclusion, nerve disorder, and disc displacement was evaluated with panoramic radiographs and clinical examinations 12 months after treatment. The relationships between the complications and other clinical variables were evaluated statistically. The anatomic site and fracture type were closely related to condyle resorption in the bivariate analysis. Condylar head fractures showed significantly higher condyle resorption than condylar neck fractures (P = .023). A complex or compound fracture showed significantly higher condyle resorption compared with a simple fracture (P = .006). Patients who had a complex/compound fracture were 34.366 times more likely to have condyle resorption compared with those who had a simple fracture (P = .002). The patient's age and treatment method were also significant predictors for condyle resorption. Fracture type was the strongest predictor of condylar resorption. Because treatment method and patient age were also related to the prognosis, the optimal treatment for mandibular condylar head and/or neck fractures should be individualized according to the patient's condition. Copyright © 2010 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[Condylar hyperplasia: qualitative and quantitative study of temporomandibular joints remodeling before and after condylectomy].

Science.gov (United States)

Rojare, Camille; Wojcik, Thomas; Coussens, Camille; Ferri, Joël; Pertuzon, Bruno; Raoul, Gwénaël

2014-06-01

This retrospective study aimed to evaluate bone remodeling of temporo-mandibular joints (TMJ) using computed tomography (CT) before and after condylectomy for condylar hyperplasia. TMJ bone remodeling was studied by comparing the pre and postoperative CT scan of ten patients. Qualitative evaluation was performed by two-dimensional analysis. Three-dimensional analysis superimpositions were done after digital condylar units isolation. Condylar volume modifications were measured and compared on both sides. Lastly, before and after surgery, we studied the radio-clinic correlations. After surgery, all the operated condyles developed a new cortical bone. We noticed also a thickening of the glenoid fossa. Surgical condylectomy leaded to a 43.5% volume reduction on the operated side and 2.14% on the controlateral side. On the controlateral side, most of abnormalities seen preoperatively disappeared after surgery. For two patients, the condylar resection took away over 80% of the initial volume. For these patients, we observed major radiologic modifications on the controlateral TMJ associated with symptoms of dysfunction. These problems did not worsen their quality of life. Both TMJ presented with bone remodelling after condylectomy. In condylar hyperplasia, condylectomy provides orthopaedic results on dysmorphia and removal of the pathological prechondroblastic zone. In the future, an earlier detection of this pathology may help the surgeon to treat in childhood. This would limit surgical excision and would avoid important dysmorphia. © EDP Sciences, SFODF, 2014.

A Rare Case Report of an Unusual Dislocation of Fractured Mandibular Condyle

OpenAIRE

Mishra, Madan; Singh, Gaurav

2015-01-01

Several cases have been reported regarding superolateral, posterior, or superior dislocation of mandibular condyle. The anteromedial dislocation of fractured condyle is the most common among all. This article reports an unusual and unique case of dislocated fractured mandibular condyle wherein the fractured left condylar head was dislocated to the left anatomic angle of mandible. We have not found a single such case in the world English literature published till date. The presented case falls...

Study on imaging analysis using three-dimensional CT system for mandibular condylar fracture. Establishing quantitative classification

International Nuclear Information System (INIS)

Kurokawa, Hideto

1997-01-01

We examined 13 patients with fractures of the condylar process (7 men, 6 women) by using 3-dimensional images. A break-down of 15 examined joints revealed 11 patients with unilateral and 2 patients with bilateral fractures of the condylar process. Eight joints of healthy control individual (2 men and 2 women) were used as controls. Fractures of the condylar process and healthy controls were compared, which comparison led to the following conclusions: Bone fragments of deviated fractures may move slightly within the joint, preferentially internally and medially; following displaced fractures, internal and downward movement of bone fragments within the joint is observed; after the occurrence of deviated dislocation fractures, bone fragments protrude from the joint and clearly move internally and inferiorly, showing a rotation of the bone fragments; after the occurrence of displaced dislocation fractures, bone fragments also protrude from the joint and clearly move anteriorly and inferiorly; sometimes an internal rotation of the bone fragments is observed; and with linear fractures there is only minimal overall increase in, and characteristic changes are not observed. Regarding diagnosis, the classical classification of fractures of the condylar process does not provide a classification for linear fractures. Thus, this type has to be newly added to the common classification: Fissure fractures (type I), Deviated fractures (type II), Displaced fractures (type III), Deviated dislocation fractures (type IV), Displaced dislocation fractures (type V), Longitudinal (type VI). (author)

Neurovascular structures of the mandibular angle and condyle: a comprehensive anatomical review.

Science.gov (United States)

Yang, Hun-Mu; Won, Sung-Yoon; Kim, Hee-Jin; Hu, Kyung-Seok

2015-11-01

Various surgical interventions including esthetic surgery, salivary gland excision, and open reduction of fracture have been performed in the area around the mandibular angle and condyle. This study aimed to comprehensively review the anatomy of the neurovascular structures on the angle and condyle with recent anatomic and clinical research. We provide detailed information about the branching and distributing patterns of the neurovascular structures at the mandibular angle and condyle, with reported data of measurements and proportions from previous anatomical and clinical research. Our report should serve to help practitioners gain a better understanding of the area in order or reduce potential complications during local procedures. Reckless manipulation during mandibular angle reduction could mutilate arterial branches, not only from the facial artery, but also from the external carotid artery. The transverse facial artery and superficial temporal artery could be damaged during approach and incision in the condylar area. The marginal mandibular branch of the facial nerve can be easily damaged during submandibular gland excision or facial rejuvenation treatment. The main trunk of the facial nerve and its upper and lower distinct divisions have been damaged during parotidectomy, rhytidectomy, and open reductions of condylar fractures. By revisiting the information in the present study, surgeons will be able to more accurately prevent procedure-related complications, such as iatrogenic vascular accidents on the mandibular angle and condyle, complete and partial facial palsy, gustatory sweating (Frey syndrome), and traumatic neuroma after parotidectomy.

Correlation between Condylar Fracture Pattern after Parasymphyseal Impact and Condyle Morphological Features: A Retrospective Analysis of 107 Chinese Patients.

Science.gov (United States)

Han, Lu; Long, Ting; Tang, Wei; Liu, Lei; Jing, Wei; Tian, Wei-Dong; Long, Jie

2017-02-20

The treatment of the condylar fractures is difficult. Factors that result in the fractures are complex. The objective of this morphometric study was to investigate the relationship between condylar fracture patterns and condylar morphological characteristics. We conducted a retrospective analysis of 107 patients admitted to the West China Hospital of Stomatology for bilateral condylar fractures caused by parasymphyseal impact. The patients were divided into five groups according to the type of condylar fracture. Ten parameters were evaluated on three-dimensional (3D) reconstruction mandible models through the Mimics 16.0 (Materialize Leuven, Belgium) anthropometry toolkit. Each parameter of the 3D models was analyzed using multivariate analysis. Multinomial logistic regression analyses were used to examine the relationships between the five groups. The results showed that the differences of condylar head width (M1), condylar neck width (M3), the ratio of condylar head width to condylar anteroposterior diameter (M1/M2), the ratio of condylar head width to condylar neck width (M1/M3), the ratio of condylar height to ramus height (M8/M7), and mandibular angle (M10) were statistically significant (p fractures were positively associated with M1 (compared to Type B: OR =1.627, 95% CI: 1.123, 2.359; compared to Type C: OR = 1.705, 95% CI: 1.170, 2.484) and M1/M2 (compared to Type B: OR =1.034, 95% CI: 0.879, 2.484). Type B condylar head fractures were negatively associated with M10 (compared to Type C: OR = 0.909, 95% CI: 0.821, 1.007). Condylar neck fractures were negatively associated with M3 (compared to condylar head: OR = 0.382, CI: 0.203, 0.720 ; compared to condylar base: OR = 0.436, 95% CI: 0.218, 0.874), and positively associated with M1/M3 (compared to condylar head: OR = 1.229, 95% CI: 1.063, 1.420 compared to condylar base: OR = 1.223, 95% CI: 1.034, 1.447). Condylar base fractures were positively associated with M10 (OR = 1.095, 95% CI: 1.008, 1.189) and

Analysis of two different surgical approaches for fractures of the mandibular condyle.

Science.gov (United States)

Kumaran, S; Thambiah, L J

2012-01-01

Fractures of the condyle account for one third of all the mandibular fractures. Different surgical approaches to the condyle described hitherto testify to the advantages and disadvantages of the different surgical techniques used for approaching the condyle in such cases of fractures. We have described and compared two of such surgical techniques in this study. The aim of this study is to compare the outcome of dealing with condylar fractures by two different surgical techniques: the mini retromandibular approach, and the preauricular approach. A prospective study of 31 patients who had suffered with mandibular condylar fractures was carried out. Of these, 26 patients had unilateral condylar fractures, and 5 patients had a bilateral fracture. Further, 19 of these patients were treated by the mini retromandibular approach and 12 by the preauricular approach. The treated patients were followed up and evaluated for a minimum period of 1 year and assessed for parameters such as the maximum mouth opening, lateral movement on the fractured side, mandibular movements such as protrusion, dental occlusion, scar formation, facial nerve weakness, salivary fistula formation and time taken for the completion of the surgical procedure. t- test was used for statistical analysis of the data obtained in the study. Dental occlusion was restored in all the cases, and good anatomical reduction was achieved. The mean operating time was higher 63.53 (mean) ± 18.12 minutes standard deviation (SD) in the preauricular approach compared to 45.22 (mean) ± 18.86 minutes SD in the mini retromandibular approach. Scar formation was satisfactory in almost all the cases.

Diagnostic ability of panoramic radiography for mandibular fractures

International Nuclear Information System (INIS)

Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok

2010-01-01

The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.

Diagnostic ability of panoramic radiography for mandibular fractures

Energy Technology Data Exchange (ETDEWEB)

Lee, Ji Hyun; Jung, Yun Hoa; Cho Bong Hae; Hwang, Dae Seok [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

2010-03-15

The purpose of this study was to evaluate the diagnostic efficacy of panoramic radiographs for detection of mandibular fractures. The sample was comprised of 65 patients (55 fractured, 10 non-fractured) with 92 fracture sites confirmed by multi-detector computed tomography (CT). Panoramic radiographs were evaluated for mandibular fractures by six examiners; two oral and maxillofacial radiologists (observer A and B), two oral and maxillofacial surgeons (observer C and D), and two general dentists (observer E and F). Sensitivity of panoramic radiography for mandibular fractures was 95.7% in observer A and B, 93.5% in observer C and D and 80.4% in observer E and F. The lowest sensitivity was shown in symphyseal/parasymphyseal areas, followed by subcondylar/condylar regions. Panoramic radiography is adequate for detection of mandibular fractures. However, additional multidetector CT is recommended to ascertain some indecisive fractures of symphysis and condyle, and in complicated fractures.

Mechanical and hypoxia stress can cause chondrocytes apoptosis through over-activation of endoplasmic reticulum stress.

Science.gov (United States)

Huang, Ziwei; Zhou, Min; Wang, Qian; Zhu, Mengjiao; Chen, Sheng; Li, Huang

2017-12-01

To examine the role of mechanical force and hypoxia on chondrocytes apoptosis and osteoarthritis (OA)-liked pathological change on mandibular cartilage through over-activation of endoplasmic reticulum stress (ERS). We used two in vitro models to examine the effect of mechanical force and hypoxia on chondrocytes apoptosis separately. The mandibular condylar chondrocytes were obtained from three-week-old male Sprague-Dawley rats. Flexcell 5000T apparatus was used to produce mechanical forces (12%, 0.5Hz, 24h vs 20%, 0.5Hz, 24h) on chondrocytes. For hypoxia experiment, the concentration of O 2 was down regulated to 5% or 1%. Cell apoptosis rates were quantified by annexin V and propidium iodide (PI) double staining and FACS analysis. Quantitative real-time PCR and western blot were performed to evaluate the activation of ERS and cellular hypoxia. Then we used a mechanical stress loading rat model to verify the involvement of ERS in OA-liked mandibular cartilage pathological change. Histological changes in mandibular condylar cartilage were assessed via hematoxylin & eosin (HE) staining. Immunohistochemistry of GRP78, GRP94, HIF-1α, and HIF-2α were performed to evaluate activation of the ERS and existence of hypoxia. Apoptotic cells were detected by the TUNEL method. Tunicamycin, 20% mechanical forces and hypoxia (1% O 2 ) all significantly increased chondrocytes apoptosis rates and expression of ERS markers (GRP78, GRP94 and Caspase 12). However, 12% mechanical forces can only increase the apoptotic sensitivity of chondrocytes. Mechanical stress resulted in OA-liked pathological change on rat mandibular condylar cartilage which included thinning cartilage and bone erosion. The number of apoptotic cells increased. ERS and hypoxia markers expressions were also enhanced. Salubrinal, an ERS inhibitor, can reverse these effects in vitro and in vivo through the down-regulation of ERS markers and hypoxia markers. We confirmed that mechanical stress and local hypoxia both

Posttraumatic Mandibular Asymmetry Presenting in a Young Adult

Directory of Open Access Journals (Sweden)

Mahnaz Sheikhi, DDS,MS

2017-03-01

Full Text Available One of the most common sites of injury of the facial skeleton is mandibular condyle. However, it is the least diagnosed site of trauma in the head and neck regions. A trauma to the mandible and specifically condylar zone during childhood, may lead to asymmetry or mandibular bilateral distortion, which is usually manifested in the second decade of life when the etiology is unknown to most people. This report is about an adult male complaining about facial asymmetry with an unknown source. Obvious clicking at the right side and shorter right ramus and condyle's head deviation directed us to a childhood trauma and fracture.

Closed treatment of unilateral mandibular condyle fractures in adults : A systematic review

NARCIS (Netherlands)

Rozeboom, A. V. J.; Dubois, L.; Bos, R. R. M.; Spijker, R.; de Lange, J.

Of all mandibular fractures, 25-35% are condylar. Many studies have focused on whether to treat such fractures via open or closed modalities. A uniform protocol for closed treatment is lacking, but such a protocol could ensure good clinical practice. The aims of this systematic review were to

Does the surgical approach for treating mandibular condylar fractures affect the rate of seventh cranial nerve injuries? A systematic review and meta-analysis based on a new classification for surgical approaches.

Science.gov (United States)

Al-Moraissi, Essam Ahmed; Louvrier, Aurélien; Colletti, Giacomo; Wolford, Larry M; Biglioli, Federico; Ragaey, Marwa; Meyer, Christophe; Ellis, Edward

2018-03-01

The purpose of this study was to determine the rate of facial nerve injury (FNI) when performing (ORIF) of mandibular condylar fractures by different surgical approaches. A systematic review and meta-analysis were performed that included several databases with specific keywords, a reference search, and a manual search for suitable articles. The inclusion criteria were all clinical trials, with the aim of assessing the rate of facial nerve injuries when (ORIF) of mandibular condylar fractures was performed using different surgical approaches. The main outcome variable was transient facial nerve injury (TFNI) and permanent facial nerve injury (PFNI) according to the fracture levels, namely: condylar head fractures (CHFs), condylar neck fractures (CNFs), and condylar base fractures (CBFs). For studies where there was no delineation between CNFs and CBFs, the fractures were defined as CNFs/CBFs. The dependent variables were the surgical approaches. A total of 3873 patients enrolled in 96 studies were included in this analysis. TFNI rates reported in the literature were as follows: A) For the transoral approach: a) for strictly intraoral 0.72% (1.3 in CNFs and 0% for CBFs); b) for the transbuccal trocar instrumentation 2.7% (4.2% in CNFs and 0% for CBFs); and c) for endoscopically assisted ORIF 4.2% (5% in CNFs, and 4% in CBFs). B) For low submandibular approach 15.3% (26.1% for CNFs, 11.8% for CBFs, and 13.7% for CNFs/CBFs). C) For the high submandibular/angular subparotid approach with masseter transection 0% in CBFs. D) For the high submandibular/angular transmassetric anteroparotid approach 0% (CNFs and CBFs). E) For the transparotid retromandibular approach a) with nerve facial preparation 14.4% (23.9% in CNFs, 11.8% in CBFs and 13.7% for CNFs/CBFs); b) without facial nerve preparation 19% (24.3% for CNFs and 10.5% for CBFs). F) For retromandibular transmassetric anteroparotid approach 3.4% in CNFs/CBFs. G) For retromandibular transmassetric anteroparotid

Effects of growth factors and glucosamine on porcine mandibular condylar cartilage cells and hyaline cartilage cells for tissue engineering applications.

Science.gov (United States)

Wang, Limin; Detamore, Michael S

2009-01-01

Temporomandibular joint (TMJ) condylar cartilage is a distinct cartilage that has both fibrocartilaginous and hyaline-like character, with a thin proliferative zone that separates the fibrocartilaginous fibrous zone at the surface from the hyaline-like mature and hypertrophic zones below. In this study, we compared the effects of insulin-like growth factor-I (IGF-I), basic fibroblast growth factor (bFGF), transforming growth factor beta1 (TGF-beta1), and glucosamine sulphate on porcine TMJ condylar cartilage and ankle cartilage cells in monolayer culture. In general, TMJ condylar cartilage cells proliferated faster than ankle cartilage cells, while ankle cells produced significantly greater amounts of glycosaminoglycans (GAGs) and collagen than TMJ condylar cartilage cells. IGF-I and bFGF were potent stimulators of TMJ cell proliferation, while no signals statistically outperformed controls for ankle cell proliferation. IGF-I was the most effective signal for GAG production with ankle cells, and the most potent upregulator of collagen synthesis for both cell types. Glucosamine sulphate promoted cell proliferation and biosynthesis at specific concentrations and outperformed growth factors in certain instances. In conclusion, hyaline cartilage cells had lower cell numbers and superior biosynthesis compared to TMJ condylar cartilage cells, and we have found IGF-I at 100 ng/mL and glucosamine sulphate at 100 microg/mL to be the most effective signals for these cells under the prescribed conditions.

Conservative approach of condylar fracture in a child by the use of rubber elastics: 7-year follow-up.

Science.gov (United States)

Noleto, José Wilson; Leão, Ellen Inácio; Braga, Cícero Luis; Yang, Sérgio; Sardow, Aline

2011-01-01

Condylar fractures in pediatric patients occur frequently, often with minimal pain and discomfort. Thus, these fractures in children are overlooked during emergency care. Condylar fractures can be treated conservatively or by open reduction. As a rule, very good healing results are achieved by conservative treatment. In these cases, jaw function restoration using physiotherapy at an early stage can prevent complications such as asymmetry, interference in the facial growth, and ankylosis. The purpose of this case report was to discuss the peculiarities of treatment of mandibular condyle fractures in pediatric patients and report a case in which the condyles were successfully treated conservatively in a 10-year-old patient. The case was followed up for seven years.

A new method of CT scanning for the diagnosis of mandibular fractures

International Nuclear Information System (INIS)

Tsukagoshi, Taku; Satoh, Kaneshige; Onizuka, Takuya

1990-01-01

The condylar neck of the mandible is one of the most common fracture sites in the facial skeleton. Such a fracture is routinely diagnosed by A-P, lateral oblique, and Towne projection roentgenography or orthopantomography. Despite the combination of these films, fracture of the neck of the mandible is still difficult to diagnose definitely. Therefore, a new CT scanning method was developed for diagnosing fractures of the neck of the condylar mandible. The CT axis is projected along the length of the mandible, extending from the condyle to the symphysis. This projection visualizes both the condyle and the mandibular symphysis in the same plane. The patient is placed in a supine position with the head fully extended. The base line, a line extending from the midpoint of the glenoid fossa to the menton, is determined with a lateral facial cephalogram. CT scanning with a 5 mm window is performed in parallel with and 2 cm anterior to and 2 cm posterior to the base line. When CT scanning was performed in a healthy volunteer, the condition of the condyle and the condylar neck of the mandible was clearly shown, and the view extended from the condyle to the symphysis. For automobile accident patients in whom fracture of the neck of the mandible was associated with fracture of the symphysis, two fractures were found in the same plane. A newly developed CT scanning technique is useful in the diagnosis of fractures of the condylar neck of the mandible and in the identification of fractures at other mandibular sites. It also allows scanning of patients in a supine position, which may aid in managing patients with multiple traumas. (N.K.)

No association between types of unilateral mandibular condylar abnormalities and facial asymmetry in orthopedic-treated patients with juvenile idiopathic arthritis

DEFF Research Database (Denmark)

Stoustrup, Peter Bangsgaard; Ahlefeldt-Laurvig-Lehn, Nicole; Kristensen, Kasper Dahl

2018-01-01

with JIA. The contralateral TMJ was thereafter scored as either "normal," "deformed," or "erosive," consistent with predefined criteria. Based on the bilateral radiologic TMJ appearances, 3 JIA groups were assigned: normal/normal, normal/deformed, and normal/erosive. The severity of the dentofacial...... of the cone-beam computed tomography. Significantly greater dentofacial asymmetries were observed in the 2 groups of JIA patients with unilateral condylar abnormalities (deformation or erosion) than in the other groups. A similar degree of dentofacial asymmetry was observed in JIA patients with bilateral...... normal TMJs and in the nonarthritic control group. CONCLUSIONS: JIA patients with unilateral condylar abnormalities (deformation or erosion) exhibited significantly more severe dentofacial asymmetries than did the JIA patients without condylar abnormalities and the control subjects. We found the same...

Simulating certain aspects of hypogravity: Effects on the mandibular incisors of suspended rats (PULEH model)

Science.gov (United States)

Simmons, D. J.; Winter, F.; Morey-Holton, E. R.

1984-01-01

The effect of a hypogravity simulating model on the rate of mandibular incisor formation, dentinogenesis and, amelogenesis in laboratory rats was studied. The model is the partial unloading by elevating the hindquarters. In this system, rat hindquarters are elevated 30 to 40 deg from the cage floors to completely unload the hindlimbs, but the animals are free to move about using their forelimbs. This model replicates the fluid sift changes which occur during the weightlessness of spaceflight and produces an osteopenia in the weight bearing skeletons. The histogenesis and/or mineralization rates of the mandibular incisor during the first 19d of PULEH in young growing rats are recorded.

Repair of a pediatric bilateral condylar and symphyseal fracture using a transfacial Steinman pin.

Science.gov (United States)

Grow, Jacob N; Flores, Roberto L; Tholpady, Sunil S

2014-01-01

The proper management of complex pediatric mandibular fractures remains a topic of debate because of the relatively uncommon presentation of these fractures, combined with concerns related with deciduous teeth, tooth buds, and growth inhibition. In this current study, we present a novel approach to the repair of bilateral condylar fractures with concomitant symphyseal fracture in a 4-year-old girl. Manual closed reduction was first obtained, followed by placement of a transfacial Steinman pin through the angles of the mandible and placement of circummandibular wires. Maxillomandibular fixation remained for 2 weeks and the Steinman pin was removed after 11 weeks. At 3 months of postsurgical follow-up, the patient displayed class I occlusion, facial symmetry, full range of jaw motion, and absence of deviation or pain on full oral excursion. Radiographic findings also revealed complete resolution of the symphyseal fracture with appropriate condylar healing and alignment.

The relationship between the changes in three-dimensional facial morphology and mandibular movement after orthognathic surgery.

Science.gov (United States)

Kim, Dae-Seung; Huh, Kyung-Hoe; Lee, Sam-Sun; Heo, Min-Suk; Choi, Soon-Chul; Hwang, Soon-Jung; Yi, Won-Jin

2013-10-01

The purpose of this study was to investigate the relationship between changes in three-dimensional (3D) facial morphology and mandibular movement after orthognathic surgery. We hypothesized that facial morphology changes after orthognathic surgery exert effects on 3D mandibular movement. We conducted a prospective follow-up study of patients who had undergone orthognathic surgical procedures. Three-dimensional facial morphological values were measured from facial CT images before and three months after orthognathic surgery. Three-dimensional maximum mandibular opening (MMO) values of four points (bilateral condylions, infradentale, and pogonion) were also measured using a mandibular movement tracking and simulation system. The predictor variables were changes in morphological parameters divided into two groups (deviated side (DS) or contralateral side (CS) groups), and the outcome variables were changes in the MMO at four points. We evaluated 21 subjects who had undergone orthognathic surgical procedures. Alterations in the TFH (total facial height), LFH (lower facial height), CS MBL (mandibular body length), and DS RL (ramus length) were negatively correlated with changes in bilateral condylar movement. The UFH, DS MBL and CS ML (mandibular length) showed correlations with infradentale movement. The CS ML, DS ML, MBL, UFH, and SNB were correlated with pogonion movement. The height of the face is most likely to affect post-operative mandibular movement, and is negatively correlated with movement changes in the condyles, infradentale and pogonion. The changes in CS morphological parameters are more correlated with mandibular movement changes than the DS. The changes in CS MBL and bilateral RL were negatively correlated with condylar movement changes, while the bilateral MBL and CS ML were positively correlated with changes in infradentale and pogonion. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights

Closed reduction of displaced or dislocated mandibular condyle fractures in children using threaded Kirschner wire and external rubber traction.

Science.gov (United States)

Kim, J H; Nam, D H

2015-10-01

Most surgeons agree that closed treatment provides the best results for condylar fractures in children. Nevertheless, treatment of the paediatric mandibular condyle fracture that is severely displaced or dislocated is controversial. The purpose of this study was to investigate the long-term clinical and radiological outcomes following the treatment of displaced or dislocated condylar fractures in children using threaded Kirschner wire and external rubber traction. This procedure can strengthen the advantage of closed reduction and make up for the shortcomings of open reduction. From March 1, 2005 to December 25, 2011, 11 children aged between 4 and 12 years with displaced or dislocated mandibular condyle fractures were treated using threaded Kirschner wire and external rubber traction under portable C-arm fluoroscopy. All patients had unilateral displaced or dislocated condylar fractures. The follow-up period ranged from 24 to 42 months (mean 29.3 months). Normal occlusion and pain-free function of the temporomandibular joint, without deviation or limitation of jaw opening, was achieved in all patients. This closed reduction technique in displaced or dislocated condylar fractures in children offers a reliable solution in preventing the unfavourable sequelae of closed treatment and the open technique, such as altered morphology, functional disturbances, and facial nerve damage. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Current Concepts in the Mandibular Condyle Fracture Management Part II: Open Reduction Versus Closed Reduction

Directory of Open Access Journals (Sweden)

Kang-Young Choi

2012-07-01

Full Text Available In the treatment of mandibular condyle fracture, conservative treatment using closedreduction or surgical treatment using open reduction can be used. Management of mandibularcondylar fractures remains a source of ongoing controversy in oral and maxillofacial trauma.For each type of condylar fracture,the treatment method must be chosen taking intoconsideration the presence of teeth, fracture height, patient’sadaptation, patient’s masticatorysystem, disturbance of occlusal function, and deviation of the mandible. In the past, closedreduction with concomitant active physical therapy conducted after intermaxillary fixationduring the recovery period had been mainly used, but in recent years, open treatment ofcondylar fractures with rigid internal fixation has become more common. The objectiveof this review was to evaluate the main variables that determine the choice of an open orclosed method for treatment of condylar fractures, identifying their indications, advantages,and disadvantages, and to appraise the current evidence regarding the effectiveness ofinterventions that are used in the management of fractures of the mandibular condyle.

Trigeminocardiac reflex by mandibular extension on rat pial microcirculation: role of nitric oxide.

Directory of Open Access Journals (Sweden)

Dominga Lapi

Full Text Available In the present study we have extended our previous findings about the effects of 10 minutes of passive mandibular extension in anesthetized Wistar rats. By prolonging the observation time to 3 hours, we showed that 10 minutes mandibular extension caused a significant reduction of the mean arterial blood pressure and heart rate respect to baseline values, which persisted up to 160 minutes after mandibular extension. These effects were accompanied by a characteristic biphasic response of pial arterioles: during mandibular extension, pial arterioles constricted and after mandibular extension dilated for the whole observation period. Interestingly, the administration of the opioid receptor antagonist naloxone abolished the vasoconstriction observed during mandibular extension, while the administration of Nω-Nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, abolished the vasodilation observed after mandibular extension. Either drug did not affect the reduction of mean arterial blood pressure and heart rate induced by mandibular extension. By qRT-PCR, we also showed that neuronal nitric oxide synthase gene expression was significantly increased compared with baseline conditions during and after mandibular extension and endothelial nitric oxide synthase gene expression markedly increased at 2 hours after mandibular extension. Finally, western blotting detected a significant increase in neuronal and endothelial nitric oxide synthase protein expression. In conclusion mandibular extension caused complex effects on pial microcirculation involving opioid receptor activation and nitric oxide release by both neurons and endothelial vascular cells at different times.

Size, shape and age-related changes of the mandibular condyle during childhood

Energy Technology Data Exchange (ETDEWEB)

Karlo, Christoph A. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Stolzmann, Paul [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland); Habernig, Sandra; Kellenberger, Christian J. [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); Mueller, Lukas [University of Zurich, Clinics for Orthodontics and Paediatric Dentistry, Zurich (Switzerland); Saurenmann, Traudel [University Children' s Hospital Zurich, Department of Rheumatology, Zurich (Switzerland)

2010-10-15

To determine age-related differences in the size and shape of the mandibular condyle in children to establish anatomical reference values. A total of 420 mandibular condyles in 210 children (mean age, 7 years) were retrospectively analysed by using computed tomography (CT) imaging. The greatest left-right (LRD) and anterior-posterior (APD) diameters and the anteversion angles (AA) were measured by two readers. An APD/LRD ratio was calculated. The shape of the condyles was graded into three types on sagittal images. Correlations of parameters with the children's age were assessed by using Pearson's correlation analyses. The LRD (mean, 14.1 {+-} 2.4 mm), APD (mean, 7.3 {+-} 1.0 mm) and LRD/APD ratio (mean, 1.9 {+-} 0.3) increased (r{sub LRD} = 0.70, p < 0.01; r{sub APD} = 0.56, p < 0.01; r{sub rat} = 0.28, p < 0.01) while the AA (mean, 27 {+-} 7 ) decreased significantly (r{sub antang} = -0.26, p < 0.001) with age. The condylar shape as determined on sagittal images correlated significantly with age (r = 0.69, p < 0.05). Boys had significantly higher anteversion angles (p < 0.01), greater LRDs (p < 0.05) and greater mean ratios (p < 0.05). The mandibular condyle is subject to significant age-related changes in size and shape during childhood. As the size of the condyles increases with age, the anteversion angles decrease and the shape of the condyle turns from round to oval. (orig.)

Recovery of mouth-opening after closed treatment of a fracture of the mandibular condyle: a longitudinal study.

Science.gov (United States)

Niezen, E T; Stuive, I; Post, W J; Bos, R R M; Dijkstra, P U

2015-02-01

The aim of this retrospective study was to assess recovery of mouth opening after closed treatment of fractures of the mandibular condyle, and analyse which characteristics might influence recovery. We measured mouth opening in 142 patients (mean (SD) age 30 (14) years, 96 of whom were male) during follow-up at 3, 6, 13, 26, and 52 weeks after the injury. Fractures were assessed on radiographs. Data were analysed using a multilevel analysis. Half the fractures were of the low condylar neck (n=71). Thirty-seven patients had bilateral condylar fractures, 29 had dislocated fractures, and in 80 the fracture was displaced. One or more additional mandibular fractures were present in 68. During follow-up mean (SD) mouth opening increased to: 33.6 (9.6) at 3 weeks, 40.1 (10.0) at 6 weeks, 45.1 (9.6) at 13 weeks, 49.8 (9.5) at 26 weeks, and 52.6 (7.5) at 52 weeks. Older age, female sex, displaced fracture, bilateral fractures, additional mandibular fractures, and the interaction between follow-up time and additional mandibular fractures, were predictors of a less favourable recovery of mouth opening. Clinicians can use the results of this study to predict recovery of mouth opening after closed treatment of fractures of the mandibular condyle at first consultation. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Assessment of temporomandibular joint dysfunction in condylar fracture of the mandible using the Helkimo index

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S Suhas

2017-01-01

Full Text Available Introduction: Condylar fractures of the mandible are functionally important fractures as the condyle of the mandible being a part of the temporomandibular joint (TMJ and can lead to TMJ dysfunction if not properly treated. Materials and Methods: This was a cross-sectional study of a total of 33 treated patients with fracture of the mandibular condyle who underwent examination as per the Helkimo index. Their dysfunction was quantified and clinicoepidemiological characteristics were assessed. It was found that majority of our patients were young males involved in a two-wheeler accident. All patients underwent intermaxillary fixation as the minimum treatment and 30% underwent open reduction and internal fixation in addition. Results: There was no statistically significant association between the degree of clinical dysfunction and factors such as age, mechanism of injury, type of condyle fracture, presence of other mandible fractures, and surgical procedure. However, dislocation of the mandibular condyle was found to be a negative prognostic factor and all these patients had some degree of dysfunction. Conclusion: The overall prevalence of TMJ dysfunction according to the Helkimo index was 90%. About 61% of patients had mild dysfunction (Di1 and 30% had moderate dysfunction (Di2. None of the patients had severe dysfunction. To conclude, the Helkimo index is a simple, effective, inexpensive, reliable screening index to assess TMJ dysfunction in condylar fractures of mandible.

Mandibular ramus: A predictor for sex determination - A digital radiographic study

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Kotya Naik Maloth

2017-01-01

Full Text Available Aim: To evaluate mandibular ramus linear measurements on digital panoramic radiographs and to assess the usefulness of mandibular ramus in sex determination. Material and Methods: A retrospective study was conducted on 100 patients (50 males and 50 females using digital panoramic radiographs of Khammam population with age ranging from 20 to 50 years. Standard digital panoramic radiographs were taken without any errors by Sirona, ORTHOPHOS XG 5 machine. The following five mandibular linear measurements were performed in cm such as upper ramus breadth, lower ramus breadth, condylar ramus height, projective ramus height, and coronoid ramus height. The obtained data were analyzed with the software SPSS 13.0 for statistical analysis using discriminate methods. Results: In the present study, all the linear measurements of mandibular ramus on digital panoramic radiographs showed a statistically significant difference between the genders. Conclusion: We conclude that the use of mandibular ramus is recommended as an aid for sex determination in forensic science due to their unique feature of sexual dimorphism.

Thin-plate spline analysis of mandibular growth.

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Franchi, L; Baccetti, T; McNamara, J A

2001-04-01

The analysis of mandibular growth changes around the pubertal spurt in humans has several important implications for the diagnosis and orthopedic correction of skeletal disharmonies. The purpose of this study was to evaluate mandibular shape and size growth changes around the pubertal spurt in a longitudinal sample of subjects with normal occlusion by means of an appropriate morphometric technique (thin-plate spline analysis). Ten mandibular landmarks were identified on lateral cephalograms of 29 subjects at 6 different developmental phases. The 6 phases corresponded to 6 different maturational stages in cervical vertebrae during accelerative and decelerative phases of the pubertal growth curve of the mandible. Differences in shape between average mandibular configurations at the 6 developmental stages were visualized by means of thin-plate spline analysis and subjected to permutation test. Centroid size was used as the measure of the geometric size of each mandibular specimen. Differences in size at the 6 developmental phases were tested statistically. The results of graphical analysis indicated a statistically significant change in mandibular shape only for the growth interval from stage 3 to stage 4 in cervical vertebral maturation. Significant increases in centroid size were found at all developmental phases, with evidence of a prepubertal minimum and of a pubertal maximum. The existence of a pubertal peak in human mandibular growth, therefore, is confirmed by thin-plate spline analysis. Significant morphological changes in the mandible during the growth interval from stage 3 to stage 4 in cervical vertebral maturation may be described as an upward-forward direction of condylar growth determining an overall "shrinkage" of the mandibular configuration along the measurement of total mandibular length. This biological mechanism is particularly efficient in compensating for major increments in mandibular size at the adolescent spurt.

Exclusion of pituitary homeobox 2 gene polymorphism in vertical mandibular asymmetry patients: a preliminary study

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Sofyanti, Ervina; Boel, Trelia; Soegiharto, Benny; Ilyas, Syafruddin; Irani Nainggolan, Lidya; Auerkari, Elza Ibrahim

2018-03-01

Pituitary Homeobox 2 (PITX2), is an active gene as a paired-related homeobox gene that encodes multiple isoforms. Its Nodal pathway in determination of left-right patterning during embryogenesis has been reported in satellite cells and expressed in adult human skeletal muscle. PITX2A and PITX2B are produced by alternative splicing and used of different promoters. PITX2C uses an alternative promoter located upstream of exon 4. PITX2D is produced by PITX2C alternative promoter and differential splicing. The 5’-primers and 3’- antisense primer were unique for each isoforms. Variability measurement in vertical dimension showed stronger genetic component than sagittal. This study aims to obtain the genotype marker of vertical mandibular asymmetry related to PITX2A and PITX2D isoform by visualization of the amplified product on stained gel to allele specific oligonucleotide between the case and control with Restriction Fragment Length Polymorphism (RFLP). Determination of vertical mandibular asymmetry based on condylar height asymmetry index of pre-treatment panoramic radiograph using Kjellberg’s technique whilst vertical mandibular growth pattern using lateral cephalogram. The differences of condylar height asymmetry in case-control based on vertical growth pattern was compared using Pearson’s chi-squared test. DNA extraction of 129 out-coming orthodontic patients in Universitas Sumatera Utara Dental Hospital were obtained from Buccal swab. Then DNA samples were amplified by Polymerase chain reaction (PCR) and digested with NciI restriction enzyme prior to electrophoresis visualization. There was no significant statistical difference in vertical mandibular asymmetry compared to vertical mandibular growth pattern. The RFLP analysis did not show any polymorphism for PITX2A and PITX2D isoform. All of the samples showed wild type homozygote. Further analysis method, except RFLP, were required to understand the genetic factor in the variance of vertical mandibular

On the analysis of condylar path versus real motion of the temporomandibular joint: application for Sicat Function.

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Kordaß, Bernd; Ruge, Sebastian

2015-01-01

Analysis of temporomandibular joint (TMJ) function using condylar path tracings is a challenge in functionally oriented dentistry. In most cases, reference points on the skin surface over the TMJ region are defined as "arbitrary", "individual" or "kinematic" condylar hinge axis points, which are displayed as "condylar paths" in motion. To what extent these reference points represent the actual condylar paths in each individual patient is ultimately unclear because the geometric relationship of the actual condyle to the selected reference point is usually unknown. Depending on the location of the point on the condyle and the centers of rotation of mandibular movement, these trajectories can vary greatly during combined rotational and sliding movements (eg, opening and closing movements of the mandible); this represents a grid of points located in the vicinity of the TMJ. To record the actual condylar path as the movement trajectory of a given point (eg, the condylar center), technological solutions are needed with which to link the tracing technology with the appropriate imaging technology capable of scanning the condyle, including the points of interest, and displaying them in real dynamic motion. Sicat Function (Sicat, D-Bonn) is such a solution. Sicat Function links cone beam computed tomography (CBCT) scans (made using the Galileos CBCT scanner; Sirona, Bensheim, Germany) with ultrasound-based, three-dimensional (3D) functional jaw movement recordings of the mandible (made using the JMT+ Jaw Motion Tracker; Sicat, Bonn, Germany). Digital images of the dental arches acquired with the intraoral scanner Cerec system (Sirona) can also be superimposed. This results in the generation of a 3D model of the bony mandible, including the TMJ, which reproduces the 3D real dynamic movement of the condyles simultaneously with that of the condylar paths at defined points (with the condylar centers being a particular point of interest). Sicat Function is an integrated, digital

Recurrent osteochondroma of the mandibular condyle: A case report

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Kwon, Young Eun; Choi, Karp Shik; An, Chang Hyeon; Choi, So Young; An, Seo Young; Lee, Jae Seo

2017-01-01

A 21-year-old woman presented with facial asymmetry. Crepitus and clicking of the temporomandibular joint were noted. The midline deviated 5.5 mm to the left, and secondary malocclusion was observed. Panoramic and cone-beam computed tomographic images showed an irregular and exophytic bony mass on the anteromedial surface of the right mandibular condyle. A 3-phase bone scan revealed increased tracer uptake on the affected side. The lesion was treated with excision and reshaping under the diagnosis of osteochondroma confirmed by a histopathological examination. The lesion recurred after 3 years, and the patient underwent condylectomy. Mandibular condylar osteochondroma is often resected because it causes functional and aesthetic problems, but it rarely recurs. To the best of our knowledge, only 2 cases of recurrent osteochondromas of the mandibular condyle have been reported previously. Surgical treatment of the osteochondroma should be performed considering the possibility of recurrence, and long-term follow-up is recommended

Recurrent osteochondroma of the mandibular condyle: A case report

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Kwon, Young Eun; Choi, Karp Shik; An, Chang Hyeon; Choi, So Young; An, Seo Young [School of Dentistry, Kyungpook National University, Daegu (Korea, Republic of); Lee, Jae Seo [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Chonnam National University, Gwangju (Korea, Republic of)

2017-03-15

A 21-year-old woman presented with facial asymmetry. Crepitus and clicking of the temporomandibular joint were noted. The midline deviated 5.5 mm to the left, and secondary malocclusion was observed. Panoramic and cone-beam computed tomographic images showed an irregular and exophytic bony mass on the anteromedial surface of the right mandibular condyle. A 3-phase bone scan revealed increased tracer uptake on the affected side. The lesion was treated with excision and reshaping under the diagnosis of osteochondroma confirmed by a histopathological examination. The lesion recurred after 3 years, and the patient underwent condylectomy. Mandibular condylar osteochondroma is often resected because it causes functional and aesthetic problems, but it rarely recurs. To the best of our knowledge, only 2 cases of recurrent osteochondromas of the mandibular condyle have been reported previously. Surgical treatment of the osteochondroma should be performed considering the possibility of recurrence, and long-term follow-up is recommended.

The Effect of a Condylar Repositioning Plate on Condylar Position and Relapse in Two-Jaw Surgery

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Gyu Sik Jung

2017-01-01

Full Text Available BackgroundNumerous condylar repositioning methods have been reported. However, most of them are 2-dimensional or are complex procedures that require a longer operation time and a highly trained surgeon. This study aims to introduce a new technique using a condylar repositioning plate and a centric relation splint to achieve a centric relationship.MethodsWe evaluated 387 patients who had undergone surgery for skeletal jaw deformities. During the operation, a centric relation splint, intermediate splint, final centric occlusion splint, and condylar repositioning plate along with an L-type mini-plate for LeFort I osteotomy or a bicortical screw for bilateral sagittal split ramus osteotomy were utilized for rigid fixation. The evaluation included: a physical examination to detect preoperative and postoperative temporomandibular joint dysfunction, 3-dimensional computed tomography and oblique transcranial temporomandibular joint radiography to measure 3-dimensional condylar head movement, and posteroanterior and lateral cephalometric radiography to measure the preoperative and postoperative movement of the bony segment and relapse rate.ResultsA 0.3% relapse rate was observed in the coronal plane, and a 2.8% relapse rate in the sagittal plane, which is indistinguishable from the dental relapse rate in orthodontic treatment. The condylar repositioning plate could not fully prevent movement of the condylar head, but the relapse rate was minimal, implying that the movement of the condylar head was within tolerable limits.ConclusionsOur condylar repositioning method using a centric relation splint and mini-plate in orthognathic surgery was found to be simple and effective for patients suffering from skeletal jaw deformities.

[Latest trends in the surgical management of mandibular condyle fractures in France, 2005-2012].

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Trost, O; Péron, J-M

2013-12-01

The surgical treatment of mandibular condylar fractures is commonly performed. We had for aim to present the latest trends in the surgical management of condylar fractures in France, between 2005 and 2012. A survey was performed among the 49 members of the French college of oral and maxillofacial surgeons between January and September 2012, with a questionnaire sent by email. We analyzed the therapeutic management, the surgical indications; the techniques used according to the fracture, and the postoperative treatment protocols. The data was compared to that of a similar study performed in 2005. The overall reply rate was 86%. Low subcondylar fractures were operated on in all institutions (100%), compared to 76% in 2005. The most popular technique was the high submandibular approach with intraoral miniplate fixation osteosynthesis. High subcondylar and diacapitular fractures were operated on in respectively 82% and 35% of the cases compared to 29% and 10% in 2005 with various surgical techniques and postoperative management. French maxillofacial surgeons operated on more mandibular condylar fractures in 2012 than in 2005. As observed in 2005, the lower and the more dislocated the fractures were, the more they were operated on. The high submandibular approach has become the most popular approach. The use of miniplates for bone fixation has become common. Diacapitular fractures were usually treated functionally. The postoperative management varied greatly from one team to the other. Copyright © 2013. Published by Elsevier Masson SAS.

[Temporo-mandibular joints and orthognathic surgery].

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Bouletreau, P

2016-09-01

Temporo-Mandibular Joints (TMJ) and orthognathic surgery are closely linked. In the past, some authors have even described (with mixed results) the correction of some dysmorphosis through direct procedures on the TMJs. Nowadays, performing orthognathic surgery involves the TMJ in three different occasions: (1) TMJ disorders potentially responsible for dento-maxillary dysmorphosis, (2) effects of orthognathic surgery on TMJs, and (3) condylar positioning methods in orthognathic surgery. These three chapters are developed in order to focus on the close relationships between TMJ and orthognathic surgery. Some perspectives close this article. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Morphometric Study of the Irradiation Effect on the Cartilage Formation in the Rat Mandibular Condyle

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Kim, Jeong Hwa; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul

1999-01-01

This study was undertaken to quantitatively estimate the degree of the damage and recovery of the irradiated rat condylar cartilage using the Image Analyzer. Experimental animals were 16 male rats of the Sprague-Dawley strain at the age of 20 day irradiated with the dose of 10 Gy in their head and neck region. Four rats were sacrificed at the each of the following time intervals - 1, 4, 7 and 14 days, respectively. The same number of control group animals were sacrificed at the each age of 21, 24, 27 and 34 days, respectively. The specimens were stained with 0.5% toluidine blue and examined with light microscope. The condylar cartilage was divided into 4 zones; fibrous zone, proliferating zone, upper hypertrophic zone, and lower hypertrophic zone. And then, the proliferating zone was subdivided into 2 layers - upper and lower layer, and upper and lower hypertrophic zone were subdivided into three layers, respectively - upper, middle and lower layer. With the aid of Image Analyzer, morphometric analysis was performed. The thickness, the numerical density of cells, the cell area density, the extracellular matrix area density, the mean area of single cell, the mean area of extracellular matrix per single cell were measured and analysed. In the experimental group, the thickness of the fibrous zone was slightly increased and that of the proliferating zone and the upper and the lower hypertrophic zone was markedly decreased. With time, the thickness of the fibrous zone was gradually increased and that of the proliferating zone and the upper and the lower hypertrophic zone was steadily in the decreased state. The numerical density of cells of the proliferating zone was increased on post-irradiated 1 day, but decreased after post-irradiated 4 day, and that of the upper hypertrophic zone was decreased. The numerical density of cells of the lower hypertrophic zone was decreased in the early stage and then was decreased or not significantly different from that of the control

Glycosylation of DMP1 Is Essential for Chondrogenesis of Condylar Cartilage.

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Weng, Y; Liu, Y; Du, H; Li, L; Jing, B; Zhang, Q; Wang, X; Wang, Z; Sun, Y

2017-12-01

The mandibular condylar cartilage (MCC) shoulders force for the subchondral bone during mastication. The cartilage matrix contains various large molecules, such as type I, II, and X collagens and proteoglycans (PGs), which jointly play essential roles in maintaining cartilage characteristics. PGs play key roles in maintaining the elasticity of cartilage and providing a cushion against mastication forces. In addition to the well-known PGs, DMP1-PG, which is the PG form of dentin matrix protein 1 (DMP1), is a newly identified PG. DMP1 is proteolytically processed in vivo, and the N-terminus is glycosylated into its PG form-that is, DMP1-PG, which is highly expressed not only in tooth and bone but also in the matrix of the MCC. However, the specific functions of DMP1-PG in the MCC remain unclear. In human temporomandibular joint osteoarthritis and hyperocclusion model rat specimens, PGs are significantly downregulated, and DMP1-PG is the most prominently affected PG. To further investigate the role of DMP1-PG in condylar chondrogenesis, a glycosylation site mutant (S 89 -G 89 ) mouse model was established with knock-in methods. In the MCC of the S89G-DMP1 mice, the glycosylation level of DMP1 was significantly downregulated, and a series of abnormal developmental and pathologic changes could be observed. The morphologic changes included thinner cartilage layers, deformations of the MCC, and disordered arrangements of the chondrocytes, and an earlier onset of temporomandibular joint osteoarthritis-like changes was observed. In addition, markers of chondrogenesis were downregulated, and the matrix of the MCC displayed OA phenotypes in the S89G-DMP1 mice. Further investigations showed that the transforming growth factor β signaling molecules were affected in the MCC after the loss of DMP1-PG. In addition, the loss of DMP1-PG significantly accelerated the progression of cartilage injuries in the hyperocclusion models. Given these findings, we investigated the significant

Modified Risdon approach using periangular incision in surgical treatment of subcondylar mandibular fractures

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Nikolić Živorad S.

2016-01-01

Full Text Available Introduction. No consensus has been reached yet on the surgical approach for treatment of condylar fractures. Objective. The aim of this study was to present modified Risdon approach (without facial nerve identification in the treatment of subcondylar mandibular fractures. Method. This is a retrospective study of a period 2005-2012. During this seven-year period, 25 condylar mandibular fractures in 22 men and three women (19-68 years old were treated by modified Risdon approach without identifying the facial nerve. The main inclusion criterion was subcondylar fracture according to Lindahl classification. Results. No additional morbidity related to postoperative complications, such as infection or salivary fistula, was observed in this series. Only two (8% patients developed temporary weakness of the marginal branch of the facial nerve, which resolved six weeks postoperatively. Each patient achieved good mouth opening postoperatively. Scar was camouflaged in the first cervical wrinkle. Two patients developed temporomandibular joint dysfunction. No patient had postoperative occlusal disturbance. In all of the patients good aesthetic result was achieved in a two-year follow-up. Conclusion. In comparison with techniques described in the literature, the main advantages of the modified Risdon approach are the following: no need for facial vessels identification; direct, fast, and safe approach to mandibular angle and subcondylar region; relatively simple surgical technique and good cosmetic result - due to aesthetically placed incision. This approach could be recommended for subcondylar fracture as a simplified and safe procedure. [Projekat Ministarstva nauke Republike Srbije, br. 175075

A distal femoral supra-condylar plate: biomechanical comparison with condylar plate and first clinical application for treatment of supracondylar fracture.

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Liang, Bowei; Ding, Zhenqi; Shen, Junguo; Zhai, Wenliang; Kang, Liangqi; Zhou, Liang; Sha, Mo; Liang, Dongzhu

2012-08-01

An anatomical supra-condylar plate is designed and analysed by biomechanical testing. The biomechanical properties of the supra-condylar and condylar plate were compared in six matched pairs of cadaveric femurs. A transverse osteotomy gap was created to simulate an OTA/AO type A3 supracondylar fracture. The left and right specimens were fitted with supra-condylar and condylar plate, respectively. Nondestructive axial compression, three-point bending and torsion tests were performed, and the peak load of the bone-implant construction was measured. The fracture site suitable for supra-condylar plate application and its correlation with femoral length were calculated. The gender influence on it was also discussed. The difference of stiffness between the supra-condylar and condyle groups were not significant (P > 0.05) at 363.4 and 362.5 N/mm for compression, 229.5 and 237.6 N/mm in the sagittal plane and 195.5 and 188.4 N/mm in the coronal plane for three-point bending, and 7.5 and 7.9 Nm/deg for axial torsion, respectively. The peak load was 4438 ± 136.15 N and 5215 ± 174.33 N, respectively, for the two groups. The average extent of the fracture site suitable for the application of the supra-condylar plate was 70.86 ± 4.61 mm. The femoral length and gender showed no influence on it. Despite the limited bone contact area provided by the supra-condylar plate, its construct stiffness is comparable to the condylar plate. The supra-condylar plate can be used to treat carefully-selected extra-articular supracondylar fractures.

A magnetic resonance imaging study on changes in rat mandibular bone marrow and pulp tissue after high-dose irradiation

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Lee, Wan; Lee, Byung Do [Dept. of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Lee, Kang Kyoo [Dept. of Radiation Oncology, School of Medicine, Wonkwang University, Iksan (Korea, Republic of); Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju (Korea, Republic of)

2014-03-15

This study was designed to evaluate whether magnetic resonance imaging (MRI) is appropriate for detecting early changes in the mandibular bone marrow and pulp tissue of rats after high-dose irradiation. The right mandibles of Sprague-Dawley rats were irradiated with 10 Gy (Group 1, n=5) and 20 Gy (Group 2, n=5). Five non-irradiated animals were used as controls. The MR images of rat mandibles were obtained before irradiation and once a week until week 4 after irradiation. From the MR images, the signal intensity (SI) of the mandibular bone marrow and pulp tissue of the incisor was interpreted. The MR images were compared with the histopathologic findings. The SI of the mandibular bone marrow had decreased on T2-weighted MR images. There was little difference between Groups 1 and 2. The SI of the irradiated groups appeared to be lower than that of the control group. The histopathologic findings showed that the trabecular bone in the irradiated group had increased. The SI of the irradiated pulp tissue had decreased on T2-weighted MR images. However, the SI of the MR images in Group 2 was high in the atrophic pulp of the incisor apex at week 2 after irradiation. These patterns seen on MRI in rat bone marrow and pulp tissue were consistent with histopathologic findings. They may be useful to assess radiogenic sclerotic changes in rat mandibular bone marrow.

Transoral open reduction and fixation of mandibular condylar base and neck fractures in children and young teenagers--a beneficial treatment option?

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Schiel, Sebastian; Mayer, Peter; Probst, Florian; Otto, Sven; Cornelius, Carl-Peter

2013-07-01

To evaluate the possible benefits of open surgery, endoscopically assisted reduction and fixation using a transoral route was used in a selected series of pediatric patients with displaced condylar base and neck fractures. A cohort of 6 patients (1 male and 5 female; age range, 7 to 15 yr; mean, 13.4 yr) with displaced condylar base and neck fractures (n = 9) were included. Inclusion criteria were age younger than 16 years, fracture of the condylar base or neck, and displacement of the fracture by at least 45°. Fractures were classified using conventional radiography, cone-beam computed tomography, or computed tomography. Patients underwent transoral endoscopically assisted open reduction and fixation using miniplate osteosynthesis. Postoperatively, patients were followed clinically and radiographically for 18 months. Complete follow-up varied from 18 to 35 months (median, 24.5 months). All patients showed normal occlusion and pain-free unrestricted function of the temporomandibular joint at 3, 6, 12, and 18 months postoperatively. There were no signs of incomplete remodeling or deformation of the condyles. Transoral endoscopically assisted surgical treatment of severely displaced condylar base and neck fractures in children and young teenagers offers a reliable solution to preclude the sequelae of closed treatment, such as altered morphology and functional disturbances, eliminates visible scars, and lowers the risk of facial nerve damage compared with open reduction using an extraoral approach. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Mandibular thickness measurements in young dentate adults.

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Beaty, Narlin B; Le, Thomas T

2009-09-01

To measure thicknesses in clinical landmark areas of the dentate mandibles of young men and women. Using standard radiologic software, we obtained mean (SD) thickness measurements at the inferior or posterior borders of the mandible at the following 7 surgically useful sites: (1) the symphysis, (2) a point halfway between the symphysis and the mental nerve, (3) the mental nerve, (4) a point halfway between the mental nerve and the facial artery notch, (5) the facial artery notch, (6) the angle vertex, and (7) the ramus-condylar neck border. University hospital. A total of 150 dentate men and 75 dentate women aged 18 to 30 years who had undergone computed tomography of the head and neck region during the period of December 20, 2006 to February 20, 2007. Thicknesses of 7 mandibular sites. Mean (SD) thicknesses at the 7 mandibular sites were as follows: symphysis, 14.03 (1.53) mm for men and 13.21 (1.46) mm for women; halfway between the symphysis and the mental nerve, 11.17 (1.37) mm for men and 10.00 (1.08) mm for women; mental nerve, 9.48 (1.28) mm for men and 8.72 (1.00) mm for women; halfway between the mental nerve and the facial artery notch, 10.33 (1.24) mm for men and 9.45 (0.92) mm for women; facial artery notch, 7.27 (0.82) mm for men and 7.10 (0.88) mm for women; angle vertex, 5.42 (0.90) mm for men and 5.39 (0.66) mm for women; and ramus-condylar neck border, 5.90 (0.86) mm for men and 5.85 (0.71) mm for women. Clinical landmark areas in young dentate mandibles have mean thicknesses with limited SDs. The thickness measurements obtained at the sites in this study provide practical reference information for mandibular reconstruction and bicortical screw length estimation.

Three-dimensional analysis of morphological changes of rat mandibular head induced by administration of adjuvant in mandibular joint cavity

International Nuclear Information System (INIS)

Kuroki, Yosuke

2008-01-01

Temporal morphological changes of human osteoarthritis (OA) related to temporomandibular joint dysfunction (TMJ) are unknown because of lack of the animal model. The author made the model as in the title. Complete Freud's adjuvant (CFA) was injected in the mandibular joint cavity of male standard deviation (SD) rats with monitoring by X-ray. The site of injection was determined previously with the machine RmCT (in vivo 3D micro-X-ray CT for laboratory animals, Rigaku Corp.), which consisted of rotatable X-ray tube and facing flat panel detector, at whose center anesthetized rat was placed. The machine was also used for observation of the mandible just and 1-14 days after CFA injection and images were processed to 2D and 3D with the software I-view-R (Rigaku Corp.). Morphological changes were seen at 7-14 days on the CT images, and pathologically at 14 days, erosion or osteophytosis in 9/12 animals and enlargement of mandibular head. The cavity treated became larger for 1-14 days persistently. These results indicated that morphological changes accompanying the chronic inflammation had occurred, which was thought useful as a model of TMJ-OA. (R.T.)

Unilateral Condylar Hyperplasia of the Mandible

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Malachovsky I

2015-12-01

Full Text Available Condylar hyperplasia (CH of the mandible is a rare pathology that occurs at the head of the condyle and can lead to facial asymmetry affecting occlusion and possible association with pain and dysfunction. Unilateral condylar hyperplasia is an uncommon condition of unknown aetiology, proper diagnosis of which has to be established, as the patients may look for surgical help. A rare case of unilateral condylar hyperplasia of the mandible is reported here.

A new method of CT scanning for the diagnosis of mandibular fractures; A preliminary report: diagnosis of condyle fractures

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Tsukagoshi, Taku; Satoh, Kaneshige; Onizuka, Takuya (Showa Univ., Tokyo (Japan). School of Medicine)

1990-08-01

The condylar neck of the mandible is one of the most common fracture sites in the facial skeleton. Such a fracture is routinely diagnosed by A-P, lateral oblique, and Towne projection roentgenography or orthopantomography. Despite the combination of these films, fracture of the neck of the mandible is still difficult to diagnose definitely. Therefore, a new CT scanning method was developed for diagnosing fractures of the neck of the condylar mandible. The CT axis is projected along the length of the mandible, extending from the condyle to the symphysis. This projection visualizes both the condyle and the mandibular symphysis in the same plane. The patient is placed in a supine position with the head fully extended. The base line, a line extending from the midpoint of the glenoid fossa to the menton, is determined with a lateral facial cephalogram. CT scanning with a 5 mm window is performed in parallel with and 2 cm anterior to and 2 cm posterior to the base line. When CT scanning was performed in a healthy volunteer, the condition of the condyle and the condylar neck of the mandible was clearly shown, and the view extended from the condyle to the symphysis. For automobile accident patients in whom fracture of the neck of the mandible was associated with fracture of the symphysis, two fractures were found in the same plane. A newly developed CT scanning technique is useful in the diagnosis of fractures of the condylar neck of the mandible and in the identification of fractures at other mandibular sites. It also allows scanning of patients in a supine position, which may aid in managing patients with multiple traumas. (N.K.).

X-cephalometric study of different parts of the upper airway space and changes in hyoid position following mandibular fractures.

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Chen, L-J; Zhao, M-C; Pan, X-F; Wei, Y-Q; Wang, D-Y

2013-09-01

This study analyses the different parts of the upper airway space and the changes in hyoid position. The results provide a clinical reference for developing timely and effective treatment programmes for patients with mandibular fractures caused by maxillofacial trauma. Standard X-cephalometric measurements of the lateral skull of 210 subjects were taken. The subjects were divided into four fracture groups: condylar, mandibular angle, mandibular body, and parasymphyseal. The radiographs of the mandibular fracture groups were compared with the normal occlusion group to analyse the upper airway space and the changes in hyoid position. Different types of fractures have different effects on the upper airway space. Bilateral mandibular body fracture and the parasymphyseal fracture have a significant influence on the lower oropharyngeal and laryngopharyngeal airway spaces, with serious obstructions severely restricting the ventilatory function of patients. Fractures at different parts of the mandibular structure are closely related to the upper airway and hyoid position.

Volumetric analysis of the mandibular condyle using cone beam computed tomography

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Bayram, Mehmet, E-mail: dtmehmetbayram@yahoo.com [Karadeniz Technical University, Faculty of Dentistry, Department of Orthodontics, 61080 Trabzon (Turkey); Kayipmaz, Saadettin; Sezgin, Oemer Said [Karadeniz Technical University, Faculty of Dentistry, Department of Oral Radiology, Trabzon (Turkey); Kuecuek, Murat [Karadeniz Technical University, Faculty of Arts and Sciences, Department of Chemistry, Trabzon (Turkey)

2012-08-15

Objective: The aim was to determine the accuracy of volumetric analysis of the mandibular condyle using cone-beam computed tomography (CBCT). Materials and methods: Five dry mandibles containing 9 condyles were used. CBCT scans of the mandibles and an impression of each condylar area were taken. The physical volumes of the condyles were calculated as the gold standard using the water displacement technique. After isolating, the condylar volume was sectioned in the sagittal plane, and 0.3 mm thick sections with 0.9 mm intervals were obtained from 3D reconstructions. Using the Cavalieri principle, the volume of each condyle was estimated from the CBCT images by three observers. The accuracy of the CBCT volume measurements and the relation agreements between the results of the three observers were assessed using the Wilcoxon Signed Rank test and Pearson correlation test. The level of statistical significance was set at 0.05. Results: The results of the Pearson correlation showed that there were highly significant positive correlations between the observers' measurements. According to the results of the Wilcoxon Signed Rank test comparing the physical and observers' measurements, there were no statistically significant differences (p > 0.05). Conclusion: The Cavalieri principle, used in conjunction with a planimetry method, is a valid and effective method for volume estimation of the mandibular condyle on CBCT images.

Volumetric analysis of the mandibular condyle using cone beam computed tomography

International Nuclear Information System (INIS)

Bayram, Mehmet; Kayipmaz, Saadettin; Sezgin, Ömer Said; Küçük, Murat

2012-01-01

Objective: The aim was to determine the accuracy of volumetric analysis of the mandibular condyle using cone-beam computed tomography (CBCT). Materials and methods: Five dry mandibles containing 9 condyles were used. CBCT scans of the mandibles and an impression of each condylar area were taken. The physical volumes of the condyles were calculated as the gold standard using the water displacement technique. After isolating, the condylar volume was sectioned in the sagittal plane, and 0.3 mm thick sections with 0.9 mm intervals were obtained from 3D reconstructions. Using the Cavalieri principle, the volume of each condyle was estimated from the CBCT images by three observers. The accuracy of the CBCT volume measurements and the relation agreements between the results of the three observers were assessed using the Wilcoxon Signed Rank test and Pearson correlation test. The level of statistical significance was set at 0.05. Results: The results of the Pearson correlation showed that there were highly significant positive correlations between the observers’ measurements. According to the results of the Wilcoxon Signed Rank test comparing the physical and observers’ measurements, there were no statistically significant differences (p > 0.05). Conclusion: The Cavalieri principle, used in conjunction with a planimetry method, is a valid and effective method for volume estimation of the mandibular condyle on CBCT images.

The normal range of condylar movement

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Choe, Han Up; Park, Tae Won

1978-01-01

The purpose of this study was to investigate the normal range of condylar movement of normal adults. The author gas observed roentgenographic images of four serial positions of condylar head taken by modified transcranial lateral oblique projection. The serial positions are centric occlusion, rest position, 1 inch open position and maximal open position. The results were obtained as follow; 1. Inter-incisal distance was 46.85 mm in maximal open position. 2. The length between the deepest point of glenoid fossa and summit of condylar head in rest position was wider than that in centric occlusion by 0.8 mm. 3. In 1 inch open position, condylar head moved forward from the standard line in 12.64 mm of horizontal direction and moved downwards from the standard line in 1.84 mm of vertical direction. 4. In maximal open position, condylar head moved forward from the standard line in 19.06 mm of horizontal direction and moved downwards from the standard line in 0.4 mm of vertical direction. 5. In centric occlusion, the width between glenoid fossa and margin of condylar head was greater in the posterior portion than in the anterior portion by 0.4 mm. 6. Except for estimated figures of 1 inch open position, all of the estimated figures was greater in male than in female.

Postero-inferior condylar movement induced by artificial occlusal interference on the balancing side during fictive mastication in rabbits.

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Morita, Takumi; Hiraba, Katsunari; Matsunaga, Tomoko; Ito, Yu; Maruo, Hisanobu; Kurita, Kenichi

2016-06-01

Tooth contact does not occur on the balancing side during mastication. Hence, it is possible that the presence of occlusal interference on the balancing side causes mandibular rotation followed by atypical condylar movement because the jaw-closing muscle activity on the working side is greater than on the balancing side. The aim of the present study was to investigate the relationship between occlusal contact on the balancing side and condylar movement during mastication. EMG activity of the masseter (MS), lateral pterygoid (LP) and digastric (DG) muscles and jaw movements were recorded. Condylar movements in the sagittal plane were recorded using a high speed charge-coupled device (CCD) camera. Incisal point movements were recorded using a magnet on the mentum and a magnetometric sensor on the nasal bone. A removable biting plate was used to introduce an artificial occlusal interference on the balancing side. Nine of the 10 rabbits showed large postero-inferior condylar movement (Pi-Cm) when a biting plate was applied on the balancing side. Five rabbits showed very small Pi-Cm when a biting plate was applied on the balancing side. In the small Pi-Cm group, MS activity decreased markedly and LP and DG transient activity appeared in the early occlusal phase in the presence of the biting plate. Interference on the balancing side always caused Pi-Cm on the ipsilateral side during mastication. However, the degree of Pi-Cm was often decreased by a jaw opening reflex response. Copyright © 2016 Elsevier Ltd. All rights reserved.

Changes in the main masticatory muscles in CT after mandibular condyle fracture

International Nuclear Information System (INIS)

Raustia, A.M.; Oikarinen, K.S.; Pyhtinen, J.

1990-01-01

The aim was to study changes in the main masticatory muscles after mandibular condyle fracture as seen by CT, comparing the densities and sizes of the masseter, medial pterygoid and lateral pterygoid muscles on the fractured side with those on the non-fractured side. More or less permanent muscular changes are detectable several years after the accident, especially in the lateral pterygoid muscle, which is attached to the condylar head. This muscle was statistically significantly smaller (p [de

Comparison of Neck Screw and Conventional Fixation Techniques in Mandibular Condyle Fractures Using 3-Dimensional Finite Element Analysis.

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Conci, Ricardo Augusto; Tomazi, Flavio Henrique Silveira; Noritomi, Pedro Yoshito; da Silva, Jorge Vicente Lopes; Fritscher, Guilherme Genehr; Heitz, Claiton

2015-07-01

To compare the mechanical stress on the mandibular condyle after the reduction and fixation of mandibular condylar fractures using the neck screw and 2 other conventional techniques according to 3-dimensional finite element analysis. A 3-dimensional finite element model of a mandible was created and graphically simulated on a computer screen. The model was fixed with 3 different techniques: a 2.0-mm plate with 4 screws, 2 plates (1 1.5-mm plate and 1 2.0-mm plate) with 4 screws, and a neck screw. Loads were applied that simulated muscular action, with restrictions of the upper movements of the mandible, differentiation of the cortical and medullary bone, and the virtual "folds" of the plates and screws so that they could adjust to the condylar surface. Afterward, the data were exported for graphic visualization of the results and quantitative analysis was performed. The 2-plate technique exhibited better stability in regard to displacement of fractures, deformity of the synthesis materials, and minimum and maximum tension values. The results with the neck screw were satisfactory and were similar to those found when a miniplate was used. Although the study shows that 2 isolated plates yielded better results compared with the other groups using other fixation systems and methods, the neck screw could be an option for condylar fracture reduction. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures

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Rajasekhar Gali

2016-01-01

Full Text Available Introduction: Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. Purpose: This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. Patients and Methods: This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a the ease of access for retrieval, reimplantation and fixation of the proximal segment; b the postoperative approach related complications; c the adequacy of anatomical reduction and stability of fixation; d the occlusal changes; and the e TMJ function and radiological changes. Results: Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. Conclusion: The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby

Preauricular transmasseteric anteroparotid approach for extracorporeal fixation of mandibular condyle fractures.

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Gali, Rajasekhar; Devireddy, Sathya Kumar; Venkata, Kishore Kumar Rayadurgam; Kanubaddy, Sridhar Reddy; Nemaly, Chaithanyaa; Dasari, Mallikarjuna

2016-01-01

Free grafting or extracorporeal fixation of traumatically displaced mandibular condyles is sometimes required in patients with severe anteromedial displacement of condylar head. Majority of the published studies report the use of a submandibular, retromandibular or preauricular incisions for the access which have demerits of limited visibility, access and potential to cause damage to facial nerve and other parotid gland related complications. This retrospective clinical case record study was done to evaluate the preauricular transmasseteric anteroparotid (P-TMAP) approach for open reduction and extracorporeal fixation of displaced and dislocated high condylar fractures of the mandible. This retrospective study involved search of clinical case records of seven patients with displaced and dislocated high condylar fractures treated by open reduction and extracorporeal fixation over a 3-year period. The parameters assessed were as follows: a) the ease of access for retrieval, reimplantation and fixation of the proximal segment; b) the postoperative approach related complications; c) the adequacy of anatomical reduction and stability of fixation; d) the occlusal changes; and the e) TMJ function and radiological changes. Accessibility and visibility were good. Accurate anatomical reduction and fixation were achieved in all the patients. The recorded complications were minimal and transient. Facial nerve (buccal branch) palsy was noted in one patient with spontaneous resolution within 3 months. No cases of sialocele or Frey's syndrome were seen. The P-TMAP approach provides good access for open reduction and extracorporeal fixation of severely displaced condylar fractures. It facilitates retrieval, transplantation, repositioning, fixing the condyle and also reduces the chances of requirement of a vertical ramus osteotomy. It gives straight-line access to condylar head and ramus thereby permitting perpendicular placement of screws with minimal risk of damage to the facial

Thin-plate spline analysis of mandibular morphological changes induced by early class III treatment: a long-term evaluation.

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Franchi, Lorenzo; Pavoni, Chiara; Cerroni, Silvia; Cozza, Paola

2014-08-01

To evaluate the long-term mandibular morphological changes induced by early treatment of class III malocclusion with rapid maxillary expansion (RME) and facial mask (FM). Twenty-five subjects [10 boys, 15 girls; mean age at T1 (start of treatment) 9.3±1.6 years] with class III disharmony were treated with RME and FM therapy followed by fixed appliances. The patients were re-evaluated at the end of growth (T2), about 8.5 years after the end of the treatment (mean age, 18.6±2.0 years). Sixteen subjects with untreated class III malocclusion comprised the control group. Mandibular shape changes were analysed on the lateral cephalograms of the subjects of both groups by means of thin-plate spline (TPS) analysis. Procrustes average mandibular configurations were subjected to TPS analysis by means of both cross-sectional between-group comparisons at T1 and at T2 and longitudinal within-group comparisons. Statistical analysis of shape differences was performed using a generalized Goodall F test. In the long term, the treated group exhibited a significant upward and forward direction of condylar growth. On the contrary, untreated class III subjects showed an upward and backward direction of condylar growth associated with a downward and forward deformation of the mandibular symphysis. Limitations are related to the small sample size of both treated and control groups and to the retrospective nature of the study. Early treatment of class III malocclusion with RME and FM is able to produce significant and favourable long-term mandibular shape changes characterized by an anterior morphogenetic rotation. © The Author 2013. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.

The Gothic arch (needle point) tracing and condylar inclination.

Science.gov (United States)

el-Gheriani, A S; Winstanley, R B

1987-11-01

The records of 11 patients referred for treatment of TMJ disorders were used to compare condylar inclination found by drawing a tangent and by using a mathematic technique. Needle point tracing angles were also measured for the same patients and were compared with the condylar inclination. It can be concluded that (1) the mathematic technique outlined records a more accurate condylar angulation, and (2) there is a great variation in condylar inclination values between patients and between left and right sides of the same patient, and (3) there is no direct relationship between condylar inclination and the needle point tracing angle.

Mandibular asymmetry and the fourth dimension.

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Kaban, Leonard B

2009-03-01

This paper represents more than 30 years of discussion and collaboration with Drs Joseph Murray and John Mulliken in an attempt to understand growth patterns over time (ie, fourth dimension) in patients with hemifacial microsomia (HFM). This is essential for the development of rational treatment protocols for children and adults with jaw asymmetry. Traditionally, HFM was thought of as a unilateral deformity, but it was recognized that 20% to 30% of patients had bilateral abnormalities. However, early descriptions of skeletal correction addressed almost exclusively lengthening of the short (affected) side of the face. Based on longitudinal clinical observations of unoperated HFM patients, we hypothesized that abnormal mandibular growth is the earliest skeletal manifestation and that restricted growth of the mandible plays a pivotal role in progressive distortion of both the ipsilateral and contralateral facial skeleton. This hypothesis explains the progressive nature of the asymmetry in patients with HFM and provides the rationale for surgical lengthening of the mandible in children to prevent end-stage deformity. During the past 30 years, we have learned that this phenomenon of progressive distortion of the adjacent and contralateral facial skeleton occurs with other asymmetric mandibular undergrowth (tumor resection, radiation therapy, or posttraumatic defects) and overgrowth (mandibular condylar hyperplasia) conditions. In this paper, I describe the progression of deformity with time in patients with mandibular asymmetry as a result of undergrowth and overgrowth. Understanding these concepts is critical for the development of rational treatment protocols for adults with end-stage asymmetry and for children to minimize secondary deformity.

Mandibular dimensions of subjects with asymmetric skeletal class III malocclusion and normal occlusion compared with cone-beam computed tomography.

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Lee, HyoYeon; Bayome, Mohamed; Kim, Seong-Hun; Kim, Ki Beom; Behrents, Rolf G; Kook, Yoon-Ah

2012-08-01

The purpose of this study was to use cone-beam computed tomography to compare mandibular dimensions in subjects with asymmetric skeletal Class III malocclusion and those with normal occlusion. Cone-beam computed tomography scans of 38 subjects with normal occlusion and 28 patients with facial asymmetry were evaluated and digitized with Invivo software (Anatomage, San Jose, Calif). Three midsagittal and 13 right and left measurements were taken. The paired t test was used to compare the right and left sides in each group. The Mann-Whitney U test was used to compare the midsagittal variables and the differences between the 2 sides of the group with normal occlusion with those of asymmetry patients. The posterior part of the mandibular body showed significant differences between the deviated and nondeviated sides in asymmetric Class III patients. The difference of the asymmetry group was significantly greater than that of the normal occlusion group for the mediolateral ramal and the anteroposterior condylar inclinations (P = 0.007 and P = 0.019, respectively). The asymmetric skeletal Class III group showed significant differences in condylar height, ramus height, and posterior part of the mandibular body compared with the subjects with normal occlusion. These results might be useful for diagnosis and treatment planning of asymmetric Class III patients. Copyright © 2012 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

A comparative study of the skeletal morphology of the temporo-mandibular joint of children and adults.

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Meng, F; Liu, Y; Hu, K; Zhao, Y; Kong, L; Zhou, S

2008-01-01

The skeletal morphology of the temporo-mandibular joint (TMJ) is constantly remodeled. A comparative study was undertaken to determine and characterize the differences in the skeletal morphology of TMJ of children and adults. The study was conducted on 30 children cadavers and 30 adult volunteers. Parameters that could reflect TMJ skeletal morphology were measured with a new technology combining helical computed tomography (CT) scan with multi-planar reformation (MPR) imaging. Significant differences between children cadavers and adults were found in the following parameters (P<0.05): Condylar axis inclination, smallest area of condylar neck/largest area of condylar process, inclination of anterior slope in inner, middle, and outer one-third of condyle, anteroposterior/mediolateral dimension of condyle, length of anterior slope/posterior slope in inner and middle one-third of condyle, anteroposterior dimension of condyle/glenoid fossa, mediolateral dimension of condyle/glenoid fossa, inclination of anterior slope of glenoid fossa, depth of glenoid fossa, and anteroposterior/mediolateral dimension of glenoid fossa. There are significant differences of TMJ skeletal morphology between children and adults.

Aneurysmal bone cyst of the mandibular condyle with condylar neck fracture

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Park, Jeong Hoon [Department of Biomedical Engineering, College of Medicine and Healthcare Industry Research Institute, Kyung Hee University, Seoul (Korea, Republic of); Yu, Jae Jung; Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Biology, Kyung Hee University, Seoul (Korea, Republic of)

2009-12-15

Aneurysmal bone cyst (ABC) is relatively rare, non-neoplastic expansible lesion of bone. The case of a 15-year-old male with a ABC of the left mandibular condyle is presented. Panoramic radiograph showed a unilocular radiolucency with thinned coritces and a subcondylar fracture which was due to the trauma. Computed tomography (CT) revealed expansible lesion which had similar attenuation soft tissue. The patient was treated surgically including iliac crestal bone graft.

Aneurysmal bone cyst of the mandibular condyle with condylar neck fracture

International Nuclear Information System (INIS)

Park, Jeong Hoon; Yu, Jae Jung; Kang, Ju Han; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan

2009-01-01

Aneurysmal bone cyst (ABC) is relatively rare, non-neoplastic expansible lesion of bone. The case of a 15-year-old male with a ABC of the left mandibular condyle is presented. Panoramic radiograph showed a unilocular radiolucency with thinned coritces and a subcondylar fracture which was due to the trauma. Computed tomography (CT) revealed expansible lesion which had similar attenuation soft tissue. The patient was treated surgically including iliac crestal bone graft.

Vivosorb as a barrier membrane in rat mandibular defects. An evaluation with transversal microradiography.

NARCIS (Netherlands)

Hoogeveen, E.J.; Gielkens, P.F.; Schortinghuis, J.; Ruben, J.L.; Huysmans, M.C.D.N.J.M.; Stegenga, B.

2009-01-01

Vivosorb is a new degradable membrane composed of poly(DL-lactide-epsilon-caprolactone) (PDLLCL). The aim of this study was to appraise its performance in guided bone regeneration procedures. In 192 rats a 5.0 mm defect was drilled in the mandibular angle. The defects were covered with a membrane

Hydrostatic Compress Force Enhances the Viability and Decreases the Apoptosis of Condylar Chondrocytes through Integrin-FAK-ERK/PI3K Pathway

Science.gov (United States)

Ma, Dandan; Kou, Xiaoxing; Jin, Jing; Xu, Taotao; Wu, Mengjie; Deng, Liquan; Fu, Lusi; Liu, Yi; Wu, Gang; Lu, Haiping

2016-01-01

Reduced mechanical stimuli in many pathological cases, such as hemimastication and limited masticatory movements, can significantly affect the metabolic activity of mandibular condylar chondrocytes and the growth of mandibles. However, the molecular mechanisms for these phenomena remain unclear. In this study, we hypothesized that integrin-focal adhesion kinase (FAK)-ERK (extracellular signal–regulated kinase)/PI3K (phosphatidylinositol-3-kinase) signaling pathway mediated the cellular response of condylar chondrocytes to mechanical loading. Primary condylar chondrocytes were exposed to hydrostatic compressive forces (HCFs) of different magnitudes (0, 50, 100, 150, 200, and 250 kPa) for 2 h. We measured the viability, morphology, and apoptosis of the chondrocytes with different treatments as well as the gene, protein expression, and phosphorylation of mechanosensitivity-related molecules, such as integrin α2, integrin α5, integrin β1, FAK, ERK, and PI3K. HCFs could significantly increase the viability and surface area of condylar chondrocytes and decrease their apoptosis in a dose-dependent manner. HCF of 250 kPa resulted in a 1.51 ± 0.02-fold increase of cell viability and reduced the ratio of apoptotic cells from 18.10% ± 0.56% to 7.30% ± 1.43%. HCFs could significantly enhance the mRNA and protein expression of integrin α2, integrin α5, and integrin β1 in a dose-dependent manner, but not ERK1, ERK2, or PI3K. Instead, HCF could significantly increase phosphorylation levels of FAK, ERK1/2, and PI3K in a dose-dependent manner. Cilengitide, the potent integrin inhibitor, could dose-dependently block such effects of HCFs. HCFs enhances the viability and decreases the apoptosis of condylar chondrocytes through the integrin-FAK-ERK/PI3K pathway. PMID:27827993

Quantitative analysis by MRI on condylar motion of the temporomandibular joint in patients applied with occlusal splints

International Nuclear Information System (INIS)

Saito, Hiroki

1999-01-01

The purpose of this study was to assess the feasibility of a newly developed quantitative motion analysis method for the mandibular condyle before and after application of occlusal splints. The subjects were 50 consecutive patients with internal derangement. Stabilization type splints were applied in 23 cases (46%), anterior repositioning type in 18 cases (36%) and pivot type in 9 cases (18%). All patients underwent MR imaging with a 1.5-T MR unit with a 3-inch dual surface coil. Pseudodynamic MR study of the opening cycle was obtained using multiplanar GRASS sequence (MPGR). Incremental and decremental sagittal MR images before and after splint application were transferred to the workstation. Software originally developed by Nakasato and Katsuragawa was used to analyze the condylar motion and path. After splint application, normalized position of displaced discs was seen in 11 cases (22%), and occurred most frequently with anterior repositioning type splints. In patients with anterior repositioning type splints, improvement in the condylar motion was most significant, In patients with normalized disc position after application of occlusal splints, abnormal figure-eight-shaped'' condylar paths were corrected in 9 of 10 cases. In the case with normalized disc position after application of anterior repositioning splint, the maximum rotational angle before application of the splint is larger than that of the case without normalized disc position. Rotational function of the condyle in the inferior joint space may be associated with disc recapturing. (K.H.)

Asporin stably expressed in the surface layer of mandibular condylar cartilage and augmented in the deeper layer with age.

Science.gov (United States)

Miyamoto, Yutaka; Kanzaki, Hiroyuki; Wada, Satoshi; Tsuruoka, Sari; Itohiya, Kanako; Kumagai, Kenichi; Hamada, Yoshiki; Nakamura, Yoshiki

2017-12-01

Mandibular condylar cartilage (MCC) exhibits dual roles both articular cartilage and growth center. Of many growth factors, TGF-β has been implicated in the growth of articular cartilage including MCC. Recently, Asporin, decoy to TGF-β, was discovered and it blocks TGF-β signaling. Asporin is expressed in a variety of tissues including osteoarthritic articular cartilage, though there was no report of Asporin expression in MCC. In the present study, we investigated the temporal and spatial expression of Asporin in MCC. Gene expression profile of MCC and epiphyseal cartilage in tibia of 5 weeks old ICR mice were firstly compared with microarray analysis using the laser capture microdissected samples. Variance of gene expression was further confirmed by real-time RT-PCR and immunohistochemical staining at 1,3,10, and 20 weeks old. TGF-β and its signaling molecule, phosphorylated Smad-2/3 (p-Smad2/3), were also examined by immunohistochemical staining. Microarray analysis revealed that Asporin was highly expressed in MCC. Real-time RT-PCR analysis confirmed that the fibrous layer of MCC exhibited stable higher Asporin expression at any time points as compared to epiphyseal cartilage. This was also observed in immunohistochemical staining. Deeper layer in MCC augmented Asporin expression with age. Whereas, TGF-β was stably highly observed in the layer. The fibrous layer of MCC exhibited weak staining of p-Smad2/3, though the proliferating layer of MCC was strongly stained as compared to epiphyseal cartilage of tibia at early time point. Consistent with the increase of Asporin expression in the deeper layer of MCC, the intensity of p-Smad-2/3 staining was decreased with age. In conclusion, we discovered that Asporin was stably expressed at the fibrous layer of MCC, which makes it possible to manage both articular cartilage and growth center at the same time.

Distributional variations in trabecular architecture of the mandibular bone: an in vivo micro-CT analysis in rats.

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Zhongshuang Liu

Full Text Available To evaluate the effect of trabecular thickness and trabecular separation on modulating the trabecular architecture of the mandibular bone in ovariectomized rats.Fourteen 12-week-old adult female Wistar rats were divided into an ovariectomy group (OVX and a sham-ovariectomy group (sham. Five months after the surgery, the mandibles from 14 rats (seven OVX and seven sham were analyzed by micro-CT. Images of inter-radicular alveolar bone of the mandibular first molars underwent three-dimensional reconstruction and were analyzed.Compared to the sham group, trabecular thickness in OVX alveolar bone decreased by 27% (P = 0.012, but trabecular separation in OVX alveolar bone increased by 59% (P = 0.005. A thickness and separation map showed that trabeculae of less than 100 μm increased by 46%, whereas trabeculae of more than 200 μm decreased by more than 40% in the OVX group compared to those in the sham group. Furthermore, the OVX separation of those trabecular of more than 200 μm was 65% higher compared to the sham group. Bone mineral density (P = 0.028 and bone volume fraction (p = 0.001 were also significantly decreased in the OVX group compared to the sham group.Ovariectomy-induced bone loss in mandibular bone may be related to the distributional variations in trabecular thickness and separation which profoundly impact the modulation of the trabecular architecture.

Roentgencinematographic studies on the mechanics of the tempero-mandibular joint

International Nuclear Information System (INIS)

Gernet, W.; Puff, A.; Steinkraus-Maatz, C.

1978-01-01

Investigations of the articular mechanics of the tempero-mandibular joint are an important element in gnathology. Graphically recorded movements of the condylus obtained by extra-oral mechanical aids, only give information about the projections of the articulatory pathways. Only roentgencinematography allows a profound study of the articular mechanics. The movements of the condylus can be analysed directly without interference. Studies on condylar pathways evaluated by roentgencinematography from waerers of full dentures who received two sets of dentures which fitted after different jaw relation determinations, confirmed that the movement of the condylus is controlled by neuromuscular mechanism. The condylar pathway changes after removal of the dentures. The fitting of different dentures in a healthy stomatognatic system had no effect on the course of the pathway. In neuromuscular disorders the fitting of a full denture which can be made corresponding to the functional anatomical concept reflecting a suitable jaw relation determination according to Gerber, allows the articulation pathway to be altered. A therapeutic re-orientation of the pathological reflexes makes the improvement of the discomfort possible. (orig.) [de

Open versus closed reduction: diacapitular fractures of the mandibular condyle.

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Chrcanovic, Bruno Ramos

2012-09-01

The purpose of the study was to review the literature regarding the evolution of current thoughts on management of diacapitular fractures (DFs) of the mandibular condyle. An electronic search in PubMed was undertaken in March 2012. The titles and abstracts from these results were read to identify studies within the selection criteria. Eligibility criteria included studies reporting clinical series of DFs, including both animal and human studies, without date or language restrictions. The search strategy initially yielded 108 references. Twenty-eight studies were identified without repetition within the selection criteria. Additional hand-searching of the reference lists of selected studies yielded three additional papers. The current indications for open reduction and internal fixation (ORIF) of DFs described in the literature are: (a) fractures affecting the lateral condyle with reduction of mandibular height; (b) fractures in which the proximal fragment dislocates laterally out of the glenoid fossa, which cannot be reduced by closed or open treatment of another part of the mandibular fracture. The indications for conservative treatment are: (a) fractures that do not shorten the condylar height (a fracture with displacement of the medial parts of the condyle); (b) undisplaced fractures; (c) comminution of the condylar head, when the bony fragments are too small for stable fixation; and (d) fractures in children. As the temporomandibular joint disk plays an important role as a barrier preventing ankylosis, it is important to reposition the disk (if displaced/dislocated) during the surgical treatment of DFs. The lateral pterygoid muscle should never be stripped from the medially displaced fragment because its desinsertion disrupts circulation to the medial bony fragment, and also because this muscle helps to restore the muscle function after surgery. ORIF of selected DFs improves prognosis by anatomical bone and soft tissue recovery when combined with physical

Ultrasound to stimulate mandibular bone defect healing : A placebo-controlled single-blind study in rats

NARCIS (Netherlands)

Schortinghuis, J; Ruben, JL; Raghoebar, GM; Stegenga, B

Purpose: Because of the limitations of the body to heal large maxillofacial bone defects, an attempt was made to stimulate mandibular defect healing with low intensity pulsed ultrasound in rats. This ultrasound consists of a 1.5-MHz pressure wave administered in pulses of 200 musec, with an average

Endoscopically assisted enucleation of a large mandibular periapical cyst.

Science.gov (United States)

Nestal Zibo, Heleia; Miller, Ene

2011-01-01

Enucleation of large cysts in the jaws is an invasive method that might be associated with complications. Marsupialization is a less invasive alternative method but it involves a prolonged and uncomfortable healing period. This study addresses a contemporaneous and less invasive surgical technique for treating larger mandibular cysts. MATERIALS AND METHODS. A 48-year-old woman presented with a large mandibular apical cyst involving the left parasymphysis, body, ramus and condylar neck, with involvement of the alveolar inferior nerve. The cystic lesion was enucleated using a 30° 4.0 mm endoscopic scope and endoscopic instruments through two small accesses: the ostectomy site of previously performed marsupialization and the alveolus of the involved third molar extracted of the time of the enucleation of the cyst. RESULTS. The endoscopic scope provided good visualization of the whole cystic cavity allowing the removal of any residual pathologic tissue and preservation of the integrity of the involved inferior alveolar nerve. The morbidity of the surgical procedure was extremely reduced. At a 6-month follow-up the patient did not present any symptom of inflammation and a panoramic X-ray showed good bone repair and remodelation. CONCLUSIONS. Endoscopically assisted enucleation proved to be effective method of treating a large mandibular cyst, providing total enucleation with a minimal invasive technique.

TMJ response to mandibular advancement surgery: an overview of risk factors

Science.gov (United States)

VALLADARES-NETO, José; CEVIDANES, Lucia Helena; ROCHA, Wesley Cabral; ALMEIDA, Guilherme de Araújo; de PAIVA, João Batista; RINO-NETO, José

2014-01-01

Objective In order to understand the conflicting information on temporomandibular joint (TMJ) pathophysiologic responses after mandibular advancement surgery, an overview of the literature was proposed with a focus on certain risk factors. Methods A literature search was carried out in the Cochrane, PubMed, Scopus and Web of Science databases in the period from January 1980 through March 2013. Various combinations of keywords related to TMJ changes [disc displacement, arthralgia, condylar resorption (CR)] and aspects of surgical intervention (fixation technique, amount of advancement) were used. A hand search of these papers was also carried out to identify additional articles. Results A total of 148 articles were considered for this overview and, although methodological troubles were common, this review identified relevant findings which the practitioner can take into consideration during treatment planning: 1- Surgery was unable to influence TMJ with preexisting displaced disc and crepitus; 2- Clicking and arthralgia were not predictable after surgery, although there was greater likelihood of improvement rather than deterioration; 3- The amount of mandibular advancement and counterclockwise rotation, and the rigidity of the fixation technique seemed to influence TMJ position and health; 4- The risk of CR increased, especially in identified high-risk cases. Conclusions Young adult females with mandibular retrognathism and increased mandibular plane angle are susceptible to painful TMJ, and are subject to less improvement after surgery and prone to CR. Furthermore, thorough evidenced-based studies are required to understand the response of the TMJ after mandibular advancement surgery. PMID:24626243

Vivosorb (R) as a barrier membrane in rat mandibular defects. An evaluation with transversal microradiography

NARCIS (Netherlands)

Hoogeveen, E. J.; Gielkens, P. F. M.; Schortinghuis, J.; Ruben, J. L.; Huysmans, M-C D. N. J. M.; Stegenga, B.

Vivosorb(R) is a new degradable membrane composed of poly(DL-lactide-epsilon-caprolactone) (PDLLCL). The aim of this study was to appraise its performance in guided bone regeneration procedures. In 192 rats a 5.0 mm defect was drilled in the mandibular angle. The defects were covered with a membrane

A comparative study of the skeletal morphology of the temporo-mandibular joint of children and adults

Directory of Open Access Journals (Sweden)

Meng F

2008-01-01

Full Text Available Background: The skeletal morphology of the temporo-mandibular joint (TMJ is constantly remodeled. Aims and Objectives: A comparative study was undertaken to determine and characterize the differences in the skeletal morphology of TMJ of children and adults. Materials and Methods: The study was conducted on 30 children cadavers and 30 adult volunteers. Parameters that could reflect TMJ skeletal morphology were measured with a new technology combining helical computed tomography (CT scan with multi-planar reformation (MPR imaging. Results: Significant differences between children cadavers and adults were found in the following parameters ( P < 0.05: Condylar axis inclination, smallest area of condylar neck/largest area of condylar process, inclination of anterior slope in inner, middle, and outer one-third of condyle, anteroposterior/mediolateral dimension of condyle, length of anterior slope/posterior slope in inner and middle one-third of condyle, anteroposterior dimension of condyle/glenoid fossa, mediolateral dimension of condyle/glenoid fossa, inclination of anterior slope of glenoid fossa, depth of glenoid fossa, and anteroposterior/mediolateral dimension of glenoid fossa. Conclusion: There are significant differences of TMJ skeletal morphology between children and adults.

Study on the effects of gradient mechanical pressures on the proliferation, apoptosis, chondrogenesis and hypertrophy of mandibular condylar chondrocytes in vitro.

Science.gov (United States)

Li, Hui; Huang, Linjian; Xie, Qianyang; Cai, Xieyi; Yang, Chi; Wang, Shaoyi; Zhang, Min

2017-01-01

To investigate the effects of gradient mechanical pressure on chondrocyte proliferation, apoptosis, and the expression of markers of chondrogenesis and chondrocyte hypertrophy. Mandibular condylar chondrocytes from 5 rabbits were cultured in vitro, and pressed with static pressures of 50kPa, 100kPa, 150kPa and 200kPa for 3h, respectively. The chondrocytes cultured without pressure (0kPa) were used as control. Cell proliferation, apoptosis, and the expression of aggrecan (AGG), collagen II (COL2), collagen X (COL10), alkaline phosphatase (ALP) were investigated. Ultrastructures of the pressurized chondrocytes under transmission electron microscopy (TEM) were observed. Chondrocyte proliferation increased at 100kPa and decreased at 200kPa. Chondrocyte apoptosis increased with peak pressure at 200kPa in a dose-dependent manner. Chondrocyte necrosis increased at 200kPa. The expression of AGG increased at 200kPa. The expression of COL2 decreased at 50kPa and increased at 150kPa. The expression of COL10 and ALP increased at 150kPa. Ultrastructure of the pressurized chondrocytes under TEM showed: at 100kPa, cells were enlarged with less cellular microvillus and a bigger nucleus; at 200kPa, cells shrank with the sign of apoptosis, and apoptosis cells were found. The mechanical loading of 150kPa is the moderate pressure for chondrocyte: cell proliferation and apoptosis is balanced, necrosis is reduced, and chondrogenesis and chondrocyte hypertrophy are promoted. When the pressure is lower, chondrogenesis and chondrocyte hypertrophy are inhibited. At 200kPa, degeneration of cartilage is implied. Copyright © 2016 Elsevier Ltd. All rights reserved.

Impact of mounting methods in computerized axiography on assessment of condylar inclination.

Science.gov (United States)

Schierz, Oliver; Wagner, Philipp; Rauch, Angelika; Reissmann, Daniel R

2017-08-30

Valid and reliable recording is a key requirement for accurately simulating individual jaw movements. Horizontal condylar inclination (HCI) and Bennett's angle were measured using a digital jaw tracker (Cadiax® Compact 2) in 27 young adults. Three mounting methods (paraocclusal tray adapter, periocclusal tray adapter, and tray adapter with mandibular clamp) were tested. The mean values of the HCI differed by up to 10° between the mounting methods; however, the values for Bennett's angle did not differ substantially. While the intersession reliability of the Bennett's angle assessment did not depend on the mounting method, the reliability of the HCI assessment was only fair to good for the paraocclusal mounting method but poor for both periocclusal mounting methods. For attaching the tracing bow of jaw trackers to the mandible, a paraocclusal tray adapter should be applied, to achieve the most reliable results.

[Molecular cloning, expression of rat Msx-1 and Msx-2 during early embryo genesis and roles for mandibular chondrogenesis].

Science.gov (United States)

Ishiguro, S

1999-03-01

Quail-chick chimera experiments have shown a contribution of carnial neural crest cells to the craniofacial skeletal elements. Moreover, tissue interactions between epithelial-mesenchymal interaction during early facial process development are required for both skeletal differentiation and morphogenesis. In this study, it was observed that Msx homeobox containing genes expressed in the facial process were important molecules of cartilage morphogenesis. Rat cDNAs were isolated and encoded by Msx-1 and -2, and then the expression patterns using in situ hybridization were investigated during early rat face development. These genes were correlatively expressed in the cranial neural crest forming area (E 9.5 dpc) and the facial process (E 12.5 dpc). Antisence inhibition of Msx genes in the E 12.5 mandibular process exhibited the alteration of their gene expression and cartilage patterns. Antisence inhibition of Msx-1 induced lack of the medial portion of cartilage, and antisence inhibition of Msx-2 enhanced chondrogenesis of mandibular process under the organ culture condition. Thus it was concluded that expression of Msx genes during mandibular process development comprises important signals of chondrogenesis.

Osteogenesis Imperfecta Diagnosed from Mandibular and Lower Limb Fractures: A Case Report.

Science.gov (United States)

Kobayashi, Yoshikazu; Satoh, Koji; Mizutani, Hideki

2016-06-01

Osteogenesis imperfecta (OI) is a congenital disease characterized by bone fragility and low bone mass. Despite the variety of its manifestation and severity, facial fractures occur very infrequently. Here, we report a case of an infant diagnosed with OI after mandibular and lower limb fractures. A boy aged 1 year and 3 months was brought to his neighboring hospital with a complaint of facial injury. He was transferred to our hospital to undergo operation 3 days later. Computed tomography images revealed multiple mandibular fractures including complete fracture in the symphysis and dislocated condylar fracture on the right side. Open reduction and internal fixation with absorbable implants was performed 7 days after injury. He fractured his right lower limb 2 months later. He was diagnosed with OI type IA by an orthopedist. He will be administered bone-modifying agents if he suffers from frequent fractures.

Temporomandibular Joint Idiopathic Condylar Resorptions – A CBCT based case-control study

DEFF Research Database (Denmark)

Kristensen, Kasper Dahl; Schmidt, Bjarke Hjalting; Stoustrup, Peter Bangsgaard

Aim: To describe condylar deformation in the temporomandibular joint (TMJ) in subjects with idiopathic condylar resorptions (ICR) and compare these changes to a healthy control group. Materials and method: CBCT scans were analyzed using anatomical points on the skull to create a reference line....... Subsequently, anatomical structures were identified on the mandible to measure the condylar axial angle, the condylar neck angle as well as the condylar width, length, and height in 25 patients with ICR and 25 controls (50 joints in each group). Secondly, cross sections of the TMJs were evaluated for deformity...... %), cavitation defect (22 %), and flattering (22 %). In the control group condylar flattening was seen in 2 %. More than 70 % of the joints with deformity changes evaluated in the sagittal and the coronal plane respectively showed deformity changes along the entire condylar surface. Conclusion: The results...

Low-intensity pulsed ultrasound stimulation for mandibular condyle osteoarthritis lesions in rats.

Science.gov (United States)

Kanaguchi Arita, A; Yonemitsu, I; Ikeda, Y; Miyazaki, M; Ono, T

2018-05-01

This study evaluated low-intensity pulsed ultrasound effects for temporomandibular joint osteoarthritis in adult rats. Osteoarthritis-like lesions were induced in 24 adult rats' temporomandibular joints with low-dose mono-iodoacetate injections. The rats were divided into four groups: control and mono-iodoacetate groups, injected with contrast media and mono-iodoacetate, respectively, at 12 weeks and observed until 20 weeks; and low-intensity pulsed ultrasound and mono-iodoacetate + low-intensity pulsed ultrasound groups, injected with contrast media and mono-iodoacetate, respectively, at 12 weeks with low-intensity pulsed ultrasound performed from 16 to 20 weeks. Condylar bone mineral density, bone mineral content and bone volume were evaluated weekly with microcomputed tomography. Histological and immunohistochemical staining for matrix metalloproteinases-13 was performed at 20 weeks. At 20 weeks, the mono-iodoacetate + low-intensity pulsed ultrasound group showed significantly higher bone mineral density, bone mineral content and bone volume than the mono-iodoacetate group; however, these values remained lower than those in the other two groups. On histological and immunohistochemical analysis, the chondrocytes were increased, and fewer matrix metalloproteinases-13 immunopositive cells were identified in the mono-iodoacetate + low-intensity pulsed ultrasound group than mono-iodoacetate group. Low-intensity pulsed ultrasound for 2 weeks may have therapeutic potential for treating temporomandibular joint osteoarthritis lesions. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Three dimensional assessment of condylar surface changes and remodeling after orthognathic surgery

International Nuclear Information System (INIS)

Lee, Jung Hye; Lee, Jin Woo; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul; Shin, Jae Myung

2016-01-01

This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. The mean of the average point-to-point distances on condylar surface was 0.11±0.03 mm. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small

Three dimensional assessment of condylar surface changes and remodeling after orthognathic surgery

Energy Technology Data Exchange (ETDEWEB)

Lee, Jung Hye; Lee, Jin Woo; Huh, Kyung Hoe; Yi, Won Jin; Heo, Min Suk; Lee, Sam Sun; Choi, Soon Chul [Dental Research Institute, Seoul National University, Seoul (Korea, Republic of); Shin, Jae Myung [Dept. of Oral and Maxillofacial Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

2016-03-15

This study was performed to evaluate condylar surface changes and remodeling after orthognathic surgery using three-dimensional computed tomography (3D CT) imaging, including comparisons between the right and left sides and between the sexes. Forty patients (20 males and 20 females) who underwent multi-detector CT examinations before and after surgery were selected. Three-dimensional images comprising thousands of points on the condylar surface were obtained before and after surgery. For the quantitative assessment of condylar surface changes, point-to-point (preoperative-to-postoperative) distances were calculated using D processing software. These point-to-point distances were converted to a color map. In order to evaluate the types of condylar remodeling, the condylar head was divided into six areas (anteromedial, anteromiddle, anterolateral, posteromedial, posteromiddle, and posterolateral areas) and each area was classified into three types of condylar remodeling (bone formation, no change, and bone resorption) based on the color map. Additionally, comparative analyses were performed between the right and left sides and according to sex. The mean of the average point-to-point distances on condylar surface was 0.11±0.03 mm. Bone resorption occurred more frequently than other types of condylar remodeling, especially in the lateral areas. However, bone formation in the anteromedial area was particularly prominent. No significant difference was found between the right and left condyles, but condylar surface changes in males were significantly larger than in females. This study revealed that condylar remodeling exhibited a tendency towards bone resorption, especially in the lateral areas. Condylar surface changes occurred, but were small.

The influence of mandibular skeletal characteristics on inferior alveolar nerve block anesthesia.

Science.gov (United States)

You, Tae Min; Kim, Kee-Deog; Huh, Jisun; Woo, Eun-Jung; Park, Wonse

2015-09-01

The inferior alveolar nerve block (IANB) is the most common anesthetic techniques in dentistry; however, its success rate is low. The purpose of this study was to determine the correlation between IANB failure and mandibular skeletal characteristics. In total, 693 cases of lower third molar extraction (n = 575 patients) were examined in this study. The ratio of the condylar and coronoid distances from the mandibular foramen (condyle-coronoid ratio [CC ratio]) was calculated, and the mandibular skeleton was then classified as normal, retrognathic, or prognathic. The correlation between IANB failure and sex, treatment side, and the CC ratio was assessed. The IANB failure rates for normal, retrognathic, and prognathic mandibles were 7.3%, 14.5%, and 9.5%, respectively, and the failure rate was highest among those with a CC ratio < 0.8 (severe retrognathic mandible). The failure rate was significantly higher in the retrognathic group than in normal group (P = 0.019), and there was no statistically significant difference between the other two groups. IANB failure could be attributable, in part, to the skeletal characteristics of the mandible. In addition, the failure rate was found to be significantly higher in the retrognathic group.

Long-term results of nonsurgical management of condylar fractures in children

NARCIS (Netherlands)

Hovinga, J; Boering, G; Stegenga, B

1999-01-01

Twenty-five patients with 28 condylar or subcondylar fractures, sustained during their growth period and treated nonsurgically, have been followed for an average period of 15 years. The fractures were classified as intracapsular, high condylar neck and low condylar neck fractures, In 5 patients, two

A paediatric case of bilateral mandibular condyle fracture presenting with bloody otorrhoea following trauma.

Science.gov (United States)

Chan, Yat Chun; Au-Yeung, Kwan Leong

2017-04-22

A 7-year-old boy presented to the emergency department with bilateral bloody otorrhoea after falling from his scooter. Skull base fracture was suspected. CT showed no evidence of skull base fracture but bilateral mandibular condyle and external acoustic canals fractures. We report this case to illustrate a rare possibility of bilateral external acoustic canal fracture associated with condylar fracture in trauma patients presented with bloody otorrhoea. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Management of disk displacement with condylar fracture].

Science.gov (United States)

Yu, Shi-bin; Li, Zu-bing; Yang, Xue-wen; Zhao, Ji-hong; Dong, Yao-jun

2003-07-01

To investigate clinical features of disk displacement during the course of condylar fracture and to explore the techniques of disk reposition and suturation. 32 patients (10 females and 22 males) who had disk displacements with condylar fractures were followed up. Reduction and reposition of the dislocated disks simultaneously with fixation of fractures were performed. 7 patients underwent intermaxillary fixation with elastic bands for 1 to 2 weeks. The occlusions were satisfactory in all cases but one for the reason of ramus height loss. No TMJ symptom was found when examined 3 months post operation. Anterior disk displacements were most occurred with high condylar process fractures. Surgical reposition and suturation of disk play an important role for the later TMJ-function.

Radiographic normal range of condylar movement of mandible

International Nuclear Information System (INIS)

Choi, Byung Ihn; Lee, Jae Mun; Kim, Myung Jin

1981-01-01

It is the purpose of this article to determine various normal anatomic measurements of temporomandibular joint and normal range of condylar movement using relatively simple X-ray equipment and radiographic technique in consideration of popular clinical application. Author's cases consisted of 100 clinically normal adult males and temporomandibular joint radiographs of 3 serial positions of condylar head were taken by transcranial oblique lateral projection in each case. The serial positions are centric occlusion, 1 inch opening and maximal opening position. The results were as follows; 1. In centric occlusion, the length between the condylar head and glenoid fossa was 2.23 ± 0.58 mm in anterior part, 3.55 ± 0.80 mm in upper part and 2.76 ± 0.72 mm in posterior part. 2. In centric occlusion, the angle (α) between the horizontal standard line (AB) and anterior slope (BC) was 37.22 ± 3.87 .deg. . 3. In 1 inch opening position, the distance between the summit of condylar head from the standard point of articular eminence (B) was -0.64 ± 3.53 mm in horizontal direction and -1.07 ± 1.00 mm in vertical direction. 4. In maximal opening position, the distance between the summit of condylar head from the standard point of articular eminence (B) was 5.83 ± 3.05 mm in horizontal direction and +0.29 ± 1.58 mm in vertical direction. 5. In positional relationship between the condylar head and the standard point of articular eminence (B), the condyles were found to be at the eminences or anterior to them in 51% with 1 inch opening and 95% with maximal opening

IMF-screws or arch bars as conservative treatment for mandibular condyle fractures: Quality of life aspects.

Science.gov (United States)

van den Bergh, B; de Mol van Otterloo, J J; van der Ploeg, T; Tuinzing, D B; Forouzanfar, T

2015-09-01

Arch bars as treatment for a fractured mandibular condyle are inconvenient to patients and lead to lowered quality of life (QOL). To overcome these inconveniences, IMF-screws (IMFS) to facilitate intermaxillary fixation during surgery have been developed. The purpose of the present study is to investigate and compare QOL for patients treated for a fractured mandibular condyle with either IMFS or arch bars. This research trial was conducted from 2010 to 2014 as part of an earlier prospective, multicenter, randomized clinical trial in which the use of IMFS was compared to the use of arch bars in the treatment of mandibular condylar fractures. In total, 50 patients were included: 30 (60%) male patients and 20 (40%) female patients (mean age: 31.8 years, standard deviation [SD] = 13.9 years, range = 18-64 years). A total of 24 (48%) patients were allocated in the IMFS group, and 26 (52%) patients were assigned to the arch-bars control group. Significant results were observed in the subscales social isolation, possibility to eat and vary diet, influence on sleep, and satisfaction with the given treatment, all in favour of IMFS. In conclusion, using IMFS as a method for conservative treatment of condylar fractures led to a higher QOL during the 6-week period of fracture healing. In comparison to arch bars, patients treated with IMFS experienced less social isolation, had fewer problems with eating, and express the feeling they are able to continue their normal diet. Furthermore it seems that the use of IMFS has a lower negative impact on social and financial aspects of the patient. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

The effects of the low calcium diet and irradiation on the mandibular condyle of rats

International Nuclear Information System (INIS)

Ahn, Hee Mun; Lee, Sang Rae

1993-01-01

This study was performed to investigate the changes of mandibular condyle by low diet and the effects of irradiation on the bone in ofteoporotic state. In order to carry out this experiment, 80 served-week old Sprague-Dawley strain rats about 150gm were selected and equally divided into one experimental group of 40 rats and one control group with the remainder. The experimental group and the control group of 40 rats and one control group with the remainder. The experimental group and the control group were then subdivided into two group and exposed to irradiation. The two irradiation groups received a single dose of 20 Gy on the jaw area only and irradiated with a cobalt-60 teletherapy unit. The rats in the control and experimental groups were serially terminated by fours on the 3rd, the 7th, the 14th, and the 21st day after irradiation. After termination, both sides of the dead rats mandibular condyle were removed and fixed with 10% neutral formalin. The bone mineral density of mandibular condle was measured by use of dual energy X-ray with Hitex HA-80 (Hitex Co., Japan). Thereafter, the obtained radiographs were observed, and the mandibular condyle was further decalcified and embedded in paraffin as the general method. The specimen sectioned and stained with hematoxylin-eosin, PAS and Rabbit Anti-Human Tumor Necrosis Factor-α observed by a light microscope. The obtained results were as follows: 1. In the non-irradiated group with low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days, and decrease the number of trabeculae of the condyle and resorption of the calcified cartilaginous zone were observed after 3 days. On microscopic observation, the number and size of trabecular were decreased after 7 days of experiment. 2. In the irradiated group with the low calcium diet, the bone mineral density of the condyle was markedly decreased after 14 days and resorption of the calcified cartilaginous zone and decrease the number and

Bilateral condylar resorption in down syndrome.

Science.gov (United States)

Grippaudo, Cristina; Grippaudo, Francesca Romana; Marianetti, Tito Matteo; Cacucci, Laura; Deli, Roberto; Pelo, Sandro

2014-11-01

Asymptomatic idiopathic condylar resorption is a rare disease of difficult diagnosis and treatment. We review the literature about this rare condition and report a case of a patient, affected by Down syndrome, who underwent a complete untreated bilateral condylar resorption in adolescence and then developed pain on chewing only 20 years later. Despite a precise orthodontic and surgical therapeutic plan, treatment had to be discontinued because of patient lack of compliance. This case is the first of its kind to be reported and emphasizes the need for special attention in patients with disability.

[Outcome of endoscopically assisted surgical treatment of mandibular condyle fractures: a retrospective study of 22 patients].

Science.gov (United States)

Prade, V; Seguin, P; Boutet, C; Alix, T

2014-12-01

The condylar region is a frequent localization of mandibular fractures; there are various types of management. Mini-invasive endoscopic surgery is an alternative to open reduction. We had as goal to evaluate the outcome of this technique. We performed a monocentric retrospective study of patients consecutively operated for a condylar fracture (type II to V in the Spiessl and Schroll classification) with intraoral route and endoscopic assistance, during 30 months. We assessed the functional and radiological outcomes, and the complications. Twenty-two patients (25 fractures) were included. Seventeen patients (19 fractures) could be followed (mean follow-up: 16.7 months). The mean values were: interincisal opening, 45mm (±8.4); protrusion, 8.3mm (±1.9); ipsilateral excursion of the jaw: 8.6mm (±2); contralateral excursion: 8.7mm (±4). Three routes were used combined with a preauricular approach. The fracture reduction was good for 10 of the 19 fractures and poor for 3. The complications were: 3 cases of infection, 1 case of fixation failure with good consolidation; for combined approaches: 2 cases of temporary facial palsy and 2 cases of Frey syndrome. Endoscopic assistance for the surgical management of the fracture of mandibular condyle is a reliable technique, with a good functional outcome, and a low rate of specific complications, especially for facial nerve lesion or esthetic outcome. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Relationship of condylar position to disc position and morphology

Energy Technology Data Exchange (ETDEWEB)

Incesu, L.; Taskaya-Yilmaz, N. E-mail: nergizy@omu.edu.tr; Oeguetcen-Toller, M.; Uzun, E

2004-09-01

Introduction/objective: The purpose of this study was to assess whether condylar position, as depicted by magnetic resonance imaging, was an indicator of disc morphology and position. Methods and material: One hundred and twenty two TMJs of 61 patients with temporomandibular joint disorder were examined. Condylar position, disc deformity and degree of anterior disc displacement were evaluated by using magnetic resonance imaging. Results and discussion: Posterior condyle position was found to be the main feature of temporomandibular joints with slight and moderate anterior disc displacement. No statistical significance was found between the condylar position, and reducing and nonreducing disc positions. On the other hand, superior disc position was found to be statistically significant for centric condylar position. Conclusion: It was concluded that posterior condyle position could indicate anterior disc displacement whereas there was no relation between the position of condyle and the disc deformity.

Comparative Study of Mandibular Morphology in Patients with Hypodivergent and Hyperdivergent Growth Patterns: A Cephalometric Study

Directory of Open Access Journals (Sweden)

Roopa Sidde Gowda

2013-01-01

Materials and methods: As sample of 60 subjects in the age group of 12 to 18 years were selected, out of them 20 subjects were average growing patients, 20 subjects were hypodivergent patterns and 20 subjects were hyperdivergent patterns. Bjork′s signs of mandibular rotation were used to differentiate between them. Mandibular morphological differences were exhibited by the hypodivergent and hyperdivergent groups. Results and conclusion: According to the results, condylar head is inclined more backwardly in hyperdivergent patterns and more forwardly in hypodivergent pattern. Inferior border of mandible has a notched appearance in hyperdivergent and is almost flat in hypodivergent patterns. Anterior lower facial height is increased in hyperdivergent and decreased in hypodivergent patterns. Interincisal and intermolar angles are more mesially inclined in hyperdivergent than hypodivergent patterns. Symphysis is more forwardly inclined in case of hypodivergent and backwardly inclined in hyperdivergent patterns.

Changes in the main masticatory muscles in CT after mandibular condyle fracture

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Raustia, A.M. (Oulu Univ. Central Hospital (Finland). Dept. of Prosthodontics and Stomatognathic Physiology); Oikarinen, K.S. (Oulu Univ. Central Hospital (Finland). Dept. of Oral and Maxillofacial Surgery); Pyhtinen, J. (Oulu Univ. Central Hospital (Finland). Dept. of Diagnostic Radiology)

1990-11-01

The aim was to study changes in the main masticatory muscles after mandibular condyle fracture as seen by CT, comparing the densities and sizes of the masseter, medial pterygoid and lateral pterygoid muscles on the fractured side with those on the non-fractured side. More or less permanent muscular changes are detectable several years after the accident, especially in the lateral pterygoid muscle, which is attached to the condylar head. This muscle was statistically significantly smaller (p<0,001) on the fractured side. Examination of the masticatory muscles immediately after the fracture and at intervals afterwards could reveal more about the pathogenesis of the changes in these muscles. (orig.).

Early diagnostics of temporomandibular joint structural elements injures caused by traumatic mandibular bone fractures.

Science.gov (United States)

Pohranychna, Kh R; Stasyshyn, A R; Matolych, U D

2017-06-30

A rapidly increasing number of mandibular condylar fractures and some complications related to injuries of temporomandibular elements make this study important. Intra-articular disorders lead to secondary pathological findings such as osteoarthritis, deforming osteoarthrosis, and temporomandibular joint ankylosis that limits mouth opening, mastication, swallowing, breathing, and decreased/lost working capacity or disability. Early diagnosis of intra-articular disorders can prevent from long-lasting functional complications caused by temporomandibular joint injuries. This study was performed for the purpose of early detection and investigation of organic pathological changes in the cartilaginous and osseous tissues of the temporomandibular joint caused by traumatic fractures of the mandibular condyle. Twenty patients underwent a general clinical examination, magnetic resonance imaging (MRI), and immune-enzyme testing for biochemical markers of connective tissue injury (pyridinoline and deoxypyridinoline) in urine. Disk dislocation, deformation, adhesion, perforation or squeeze, tension or disruption of ligaments, and injury of articular surfaces are among complications of mandibular fractures that can be revealed on MRI. As regards biochemical findings, we revealed a sharp rise in the levels of pyridinoline and deoxypyridinoline before treatment and a lack of stabilization within 21 days of treatment.

Effects of Edentulism on Mandibular Morphology: Evaluation of Panoramic Radiographs

Directory of Open Access Journals (Sweden)

Rıdvan Okşayan

2014-01-01

Full Text Available Purpose. The objective of this study was to evaluate morphological changes of the mandible in edentulous and dentate subjects using panoramic radiographs. Materials and Methods. Panoramic radiographs were divided into the following three groups: Group I (completely edentulous group, Group II (old dentate group and Group III (young dentate group. The research parameters of gonial angle, condylar height, ramus height, ramus notch depth, and antegonial notch depth were measured on panoramic radiographs. The Kruskal-Wallis statistical test was used to determine significant differences in mandibular morphological parameters among the three groups. The Mann-Whitney U test was used to compare the subgroups. Results. Significant differences were found only in ramus height between three groups. According to the Mann-Whitney U test, a significant difference was exhibited among Groups I and II in the ramus height parameter. No significant differences were found in the gonial angle, condylar height, ramus notch depth, or antegonial notch depth when comparing the young dentate, old dentate, and completely edentulous subjects. Conclusions. Significant differences were found only in ramus height between the groups. Ramus height may be an indicator that changed by years and tooth loss. It must be considered that ramus height can be decreased in edentulism.

The effect of extracapsular injuries on growth and development of the mandible condyle: an experimental study in growing dogs.

Science.gov (United States)

Liu, Siying; Tian, Lei; Ding, Mingchao; Liu, Yanpu; Li, Guiyu; Chen, Jinwu; Ding, Yin

2016-11-01

To investigate the effects of condylar extracapsular injuries on the development of the mandibular condyle and try to find a way to treat condylar hyperplasia by electively using such injuries to restrict the overdeveloped mandibular condyle. Sixty 6-month-old beagle puppies were divided randomly into five groups: blank control; unilateral fracture to the condylar neck; unilateral fracture to the condylar neck treated with rigid internal fixation; unilateral periosteum injury; unilateral decortication of the condylar neck. Computed tomography, 99 m Tc single-photon emission computed tomography, and tetracycline-calcein double-labeling were performed after surgery. The puppies were sacrificed 12 and 24 weeks after surgery. Morphologic analyses and examination of growth activity were done. Unilateral fracture of the condylar neck without fixation caused local morphologic changes during the early postoperative period, but compensatory growth of the condyle altered such changes after healing. The other types of injury failed to inhibit the growth of the condyle and the mandible, whereas functional deviation of the chin was found after unilateral fracture of the condylar neck with or without fixation. The four types of extracapsular injury described here failed to inhibit the growth of the mandibular condyle and could not be selected as alternatives to treat condylar hyperplasia. Copyright © 2016 Elsevier Inc. All rights reserved.

Occlusal consequence of using average condylar guidance settings: An in vitro study.

Science.gov (United States)

Lee, Wonsup; Lim, Young-Jun; Kim, Myung-Joo; Kwon, Ho-Beom

2017-04-01

A simplified mounting technique that adopts an average condylar guidance has been advocated. Despite this, the experimental explanation of how average settings differ from individual condylar guidance remains unclear. The purpose of this in vitro study was to examine potential occlusal error by using average condylar guidance settings during nonworking side movement of the articulator. Three-dimensional positions of the nonworking side maxillary first molar at various condylar and incisal settings were traced using a laser displacement sensor attached to the motorized stages with biaxial freedom of movement. To examine clinically relevant occlusal consequences of condylar guidance setting errors, the vertical occlusal error was defined as the vertical-axis positional difference between the average setting trace and the other condylar guidance setting trace. In addition, the respective contribution of the condylar and incisal guidance to the position of the maxillary first molar area was analyzed by multiple regression analysis using the resultant coordinate data. Alteration from individual to average settings led to a positional difference in the maxillary first molar nonworking side movement. When the individual setting was lower than average, vertical occlusal error occurred, which might cause occlusal interference. The vertical occlusal error ranged from -2964 to 1711 μm. In addition, the occlusal effect of incisal guidance was measured as a partial regression coefficient of 0.882, which exceeded the effect of condylar guidance, 0.431. Potential occlusal error as a result of adopting an average condylar guidance setting was observed. The occlusal effect of incisal guidance doubled the effect of condylar guidance. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

The use of a cine-technique in the MRT investigation of the temporo-mandibular joint

International Nuclear Information System (INIS)

Vogl, T.J.; Assal, J.; Eberhard, D.; Weigl, P.; Randzio, J.

1992-01-01

A new cine-technique in a prospective study using rapid gradient echo sequences was evaluated for the MRT investigation of the temporo-mandibular joint. A newly developed hydraulic apparatus was used to produce progressive opening of the jaw and MRT appearances were recorded during predetermined points of mandibular movement. The investigation included 16 normals and 34 patients. A modified gradient echo sequence was combined with an optimised surface coil or a special double coil and this provided good spatial resolution of the articular disc and of the muscular and bony structure. Amongst the abnormal findings were luxation of the disc (15 cases), tears in the disc (5 cases), late effects of internal derangements (12 cases) and condylar hypermobility (7 cases). The new cine-technique provides specific images in any chosen position of the mandible depending on the clinical disability of the patient. (orig.) [de

Glycosaminoglycan synthesis in the mandibular condyle during growth adaptation.

Science.gov (United States)

Kantomaa, T; Pirttiniemi, P; Tuominen, M; Poikela, A

1994-01-01

Condylar growth was studied after an operation simulating functional orthodontic appliances. Twenty-five rabbits underwent a surgical operation for the induction of premature synostosis to displace the glenoid fossa posteriorly during growth. Twenty-five control rabbits underwent sham operations. At the age of 15 days, 10 experimental and 10 control animals and, at the age of 20 days, 5 experimental and 5 control animals were killed. Their mandibular condyles were organ-cultured for 3 h in the presence of radiolabelled sulphur. The condyles were used for autoradiographic purposes. Digital image analysis of autoradiograms of histological sections showed synthesis of glycosaminoglycans to have increased from the anterior to the posterior direction. This increase was more marked in experimental animals than in the condyles of control animals. Ten experimental and 10 control animals were killed at the age of 15 days, and mandibular condyles were organ-cultured for 1, 4 and 7 days. Differentiation of proliferating prechondroblasts into hypertrophied chondrocytes continued under organ culture conditions. A marked decrease in the proliferating cell layer was noticed, especially in control condyles. Hypertrophy was faster and came closer to the surface of the condyle in the anterior region of the condyle. This was most marked in the condyles of experimental animals. The results indicate that a procedure carried out on the glenoid fossa with the same effect as functional appliances increases the synthesis of extracellular matrix in the posterosuperior region of the mandibular condyle.

Osteochondroma of the mandibular condyle: surgical excision followed by occlusal stabilization.

Science.gov (United States)

Yoo, Ji-Yeon; Choi, Byung-Joon; Kwon, Yong-Dae; Lee, Deok-Won; Ohe, Joo-Young; Suh, Joon-Ho

2012-03-01

Osteochondroma of the mandibular condyle in adults can be treated by surgical excision, condylectomy followed by costochondral graft or orthognathic surgery. Such complex treatment plan may not be appropriate for patients with old age, affected with chronic osteochondroma of the condyle. In this clinical report, we present a patient with osteochondroma of the condyle treated by surgical excision. The patient's postoperative occlusion was a contraindication for orthognathic surgery because of the severe abrasion of the teeth and the chronic compensation of the dentition to the deviated mandible. Surgical excision of the lesion was carried out under general anesthesia, and the remaining condylar head was salvaged as much as possible. No graft materials or posthodontic condyle reconstruction was carried out. Because there was no occlusal stop to secure the mandible in a centric relation position of the condyle, a stabilization splint was delivered to position the condyle in a relatively stable position. The stability of the condyle position was evaluated by follow-up cone beam computed tomographic scans of the pathologic and the contralateral condyle, along with clinical factors such as occlusal contact points and mandible movements assayed by ARCUSdigma (KaVo). After significant condylar position was achieved, full prosthodontic reconstruction was performed to both the patient's and the dentist's satisfaction.

Adipose-derived stem cells and BMP-2 delivery in chitosan-based 3D constructs to enhance bone regeneration in a rat mandibular defect model.

Science.gov (United States)

Fan, Jiabing; Park, Hyejin; Lee, Matthew K; Bezouglaia, Olga; Fartash, Armita; Kim, Jinku; Aghaloo, Tara; Lee, Min

2014-08-01

Reconstructing segmental mandiblular defects remains a challenge in the clinic. Tissue engineering strategies provide an alternative option to resolve this problem. The objective of the present study was to determine the effects of adipose-derived stem cells (ASCs) and bone morphogenetic proteins-2 (BMP-2) in three-dimensional (3D) scaffolds on mandibular repair in a small animal model. Noggin expression levels in ASCs were downregulated by a lentiviral short hairpin RNA strategy to enhance ASC osteogenesis (ASCs(Nog-)). Chitosan (CH) and chondroitin sulfate (CS), natural polysaccharides, were fabricated into 3D porous scaffolds, which were further modified with apatite coatings for enhanced cellular responses and efficient delivery of BMP-2. The efficacy of 3D apatite-coated CH/CS scaffolds supplemented with ASCs(Nog-) and BMP-2 were evaluated in a rat critical-sized mandibular defect model. After 8 weeks postimplantation, the scaffolds treated with ASCs(Nog-) and BMP-2 significantly promoted rat mandibular regeneration as demonstrated by micro-computerized tomography, histology, and immunohistochemistry, compared with the groups treated with ASCs(Nog-) or BMP-2 alone. These results suggest that our combinatorial strategy of ASCs(Nog-)+BMP-2 in 3D apatite microenvironments can significantly promote mandibular regeneration, and these may provide a potential tissue engineering approach to repair large bony defects.

Differential response of risedronate on tibial and mandibular bone quality in glucocorticoid-treated growing rats

International Nuclear Information System (INIS)

Fujita, Yuko

2008-01-01

Glucocorticoids induce bone loss and retard bone growth in children. In this study we investigated the effect of treatment with risedronate on glucocorticoid -prednisolone-induced decreases in bone density, quality, strength and growth of the tibia and mandible in growing rats. Trabecular and cortical bone structure was measured by peripheral quantitative computed tomography (pQCT) and three-dimensional (3D) micro-computed tomography (micro-CT). Indicators of bone strength were calculated from cortical bone density and the modulus of sections obtained from pQCT analysis. Tibial and mandibular bone sizes were also measured. Prednisolone decreased the bone growth of both tibia and mandible. It also caused deterioration of trabecular and cortical bone structure and strength in the mandible, and in cortical bone in the tibia, but had no effect on trabecular bone in the tibia. Risedronate inhibited the prednisolone-induced decreases in tibial width and mandibular length and height but did not improve the retardation of longitudinal bone growth. Risedronate prevented prednisolone-induced deterioration of trabecular and cortical bone architecture. In the mandible, this protective effect of risedronate was accompanied by an increase in cortical bone density and in bone strength. These findings show that risedronate inhibits prednisolone-induced loss of bone density, structure, decrease in bone strength, and retardation of bone growth in the mandible in young growing rats. (author)

Multislice quantitative computed tomography allows early detection of bone mineral density alterations induced by atherogenic diet in a growing rat experimental model

International Nuclear Information System (INIS)

Gubert, M.J.; Monforte, F.; Calo, C.; Lylyk, P.; Friedman, M.F.; Gamba, C.A.

2012-01-01

Purpose. To demonstrate the utility of Multislice Quantitative Computed Tomography (MS-QCT) in the early detection of mandibular bone mineral density (BMD) alterations induced by an atherogenic diet in a growing rat experimental model. Materials and Methods. Male weanling Wistar rats (n =16) were divided by body weight (Wt) into 2 groups: control (C) and experimental (E), with no significant differences in the mean initial Wt (p>0.05). C was fed rodent stock diet ad libitum, and E an atherogenic diet for 3 weeks (3w). Zoometry (body weight and length) and diet intake (g/100g rat/day) were monitored. At 3 w in serum (mg/dL) lipidlipoprotein profile was studied: total cholesterol (t-C), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), non-HDL cholesterol (non-HDL-C) and MSQCT (Philips 64 CT, quantified with the eFilm Workstation 2.1) in seven mandibular areas (MA): n. 1 to 4: from chin to mandibular foramen, n. 5: coronoid process, n. 6: condylar process, n. 7: angular process. Statistics: Pearson's correlation between BMD in each MA and serum t-C. p 0.05). Correlation coefficients (r) and their significance levels (p) were relevant in 5/7 MA. MA1:-0.580 (p=0.019), MA2:-0.709 (p=0.002), MA3:-0.635 (p=0.008), MA5:-0.674 (p=0.004), MA6:-0.564 (p=0.023). Conclusions. These results suggest that MS-QCT is an imaging diagnostic method that allows the early detection of mandible bone architecture alterations induced by an atherogenic diet. Inverse correlation between BMD and t-C would indicate an association between an atherogenic diet intake and potential temporomandibular disorders. (authors)

Unilateral condylar hyperplasia: a 3-dimensional quantification of asymmetry.

Directory of Open Access Journals (Sweden)

Tim J Verhoeven

Full Text Available PURPOSE: Objective quantifications of facial asymmetry in patients with Unilateral Condylar Hyperplasia (UCH have not yet been described in literature. The aim of this study was to objectively quantify soft-tissue asymmetry in patients with UCH and to compare the findings with a control group using a new method. MATERIAL AND METHODS: Thirty 3D photographs of patients diagnosed with UCH were compared with 30 3D photographs of healthy controls. As UCH presents particularly in the mandible, a new method was used to isolate the lower part of the face to evaluate asymmetry of this part separately. The new method was validated by two observers using 3D photographs of five patients and five controls. RESULTS: A significant difference (0.79 mm between patients and controls whole face asymmetry was found. Intra- and inter-observer differences of 0.011 mm (-0.034-0.011 and 0.017 mm (-0.007-0.042 respectively were found. These differences are irrelevant in clinical practice. CONCLUSION: After objective quantification, a significant difference was identified in soft-tissue asymmetry between patients with UCH and controls. The method used to isolate mandibular asymmetry was found to be valid and a suitable tool to evaluate facial asymmetry.

Impact of the lower third molar presence and position on the fragility of mandibular angle and condyle: A Three-dimensional finite element study.

Science.gov (United States)

Antic, Svetlana; Vukicevic, Arso M; Milasinovic, Marko; Saveljic, Igor; Jovicic, Gordana; Filipovic, Nenad; Rakocevic, Zoran; Djuric, Marija

2015-07-01

The aim of the present study was to investigate the influences of the presence and position of a lower third molar (M3) on the fragility of mandibular angle and condyle, using finite element analysis. From computed tomographic scans of a human mandible with normally erupted M3, two additional virtual models were generated: a mandibular model with partially impacted M3 and a model without M3. Two cases of impact were considered: a frontal and a lateral blow. The results are based on the chromatic analysis of the distributed von Mises and principal stresses, and calculation of their failure indices. In the frontal blow, the angle region showed the highest stress in the case with partially impacted M3, and the condylar region in the case without M3. Compressive stresses were dominant but caused no failure. Tensile stresses were recorded in the retromolar areas, but caused failure only in the case with partially impacted M3. In the lateral blow, the stress concentrated at the point of impact, in the ipsilateral and contralateral angle and condylar regions. The highest stresses were recorded in the case with partially impacted M3. Tensile stresses caused the failure on the ipsilateral side, whereas compressive stresses on the contralateral side. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Cytomegalovirus induces abnormal chondrogenesis and osteogenesis during embryonic mandibular development

Directory of Open Access Journals (Sweden)

Bringas Pablo

2008-03-01

Full Text Available Abstract Background Human clinical studies and mouse models clearly demonstrate that cytomegalovirus (CMV disrupts normal organ and tissue development. Although CMV is one of the most common causes of major birth defects in humans, little is presently known about the mechanism(s underlying CMV-induced congenital malformations. Our prior studies have demonstrated that CMV infection of first branchial arch derivatives (salivary glands and teeth induced severely abnormal phenotypes and that CMV has a particular tropism for neural crest-derived mesenchyme (NCM. Since early embryos are barely susceptible to CMV infection, and the extant evidence suggests that the differentiation program needs to be well underway for embryonic tissues to be susceptible to viral infection and viral-induced pathology, the aim of this study was to determine if first branchial arch NCM cells are susceptible to mCMV infection prior to differentiation of NCM derivatives. Results E11 mouse mandibular processes (MANs were infected with mouse CMV (mCMV for up to 16 days in vitro. mCMV infection of undifferentiated embryonic mouse MANs induced micrognathia consequent to decreased Meckel's cartilage chondrogenesis and mandibular osteogenesis. Specifically, mCMV infection resulted in aberrant stromal cellularity, a smaller, misshapen Meckel's cartilage, and mandibular bone and condylar dysmorphogenesis. Analysis of viral distribution indicates that mCMV primarily infects NCM cells and derivatives. Initial localization studies indicate that mCMV infection changed the cell-specific expression of FN, NF-κB2, RelA, RelB, and Shh and Smad7 proteins. Conclusion Our results indicate that mCMV dysregulation of key signaling pathways in primarily NCM cells and their derivatives severely disrupts mandibular morphogenesis and skeletogenesis. The pathogenesis appears to be centered around the canonical and noncanonical NF-κB pathways, and there is unusual juxtaposition of abnormal stromal

Radiographic study of bone deformans on charged condylar head position in TMJ arthrosis

International Nuclear Information System (INIS)

You, Dong Soo

1983-01-01

The author analyzed the morphologic changes of bone structure from 848 radiographics (424 joints) of 212 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and ortho pantomography. The interrelation of the bone changes and condylar head positions the results were as follows: 1. In the 212 patients with TMJ arthrosis, 210 patients (99.05%) show the condylar positional changes. Among them, 187 patients (89.05%) show the bone changes. 2. In TMJ arthrosis patients with bone changes, 108 patients (57.75%) show both the condylar positional changes and bone changes. 66 patients show the condylar positional changes bilaterally and bone changes unilaterally. On the other hand, 11 patients (5.88%) show the condylar positional changes unilaterally and bone change bilaterally. 3. The bone changes in the TMJ arthrosis patients with the condylar positional changes were as follows: There were the flattening of articular surface in 103 cases (26.55%) the erosion in 99 cases (25.52%), and the erosion in 88 cases (22.68%). There were not much differences among the three types of bone changes. And the deformity in 70 cases (18.04%), the sclerosis in 22 cases (5.67%), the marginal proliferation in 6 cases (1.55%) were seen. 4. The regions of bone changes in TMJ arthrosis patients with condylar positional changes were as follows: They occurred at the condyle head (51.04%), the articular eminence (39.20%) and the articular fossa (9.60%) in that order. The condylar positional changes and bone changes according to the regions were as follows: a) In the bone changes at the condylar head, the flattening (34.63%) was a most frequent finding and the deformity (27.63%) the erosion (34.63%) in the order. In the condylar positional changes, the downward positioning of condyle (41.44%) was a most frequent finding in the mouth closed state and the restricted movement within the articular fossa (35.46%) in the mouth open state. b) In

Radiographic study of bone deformans on charged condylar head position in TMJ arthrosis

Energy Technology Data Exchange (ETDEWEB)

You, Dong Soo [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1983-11-15

The author analyzed the morphologic changes of bone structure from 848 radiographics (424 joints) of 212 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and ortho pantomography. The interrelation of the bone changes and condylar head positions the results were as follows: 1. In the 212 patients with TMJ arthrosis, 210 patients (99.05%) show the condylar positional changes. Among them, 187 patients (89.05%) show the bone changes. 2. In TMJ arthrosis patients with bone changes, 108 patients (57.75%) show both the condylar positional changes and bone changes. 66 patients show the condylar positional changes bilaterally and bone changes unilaterally. On the other hand, 11 patients (5.88%) show the condylar positional changes unilaterally and bone change bilaterally. 3. The bone changes in the TMJ arthrosis patients with the condylar positional changes were as follows: There were the flattening of articular surface in 103 cases (26.55%) the erosion in 99 cases (25.52%), and the erosion in 88 cases (22.68%). There were not much differences among the three types of bone changes. And the deformity in 70 cases (18.04%), the sclerosis in 22 cases (5.67%), the marginal proliferation in 6 cases (1.55%) were seen. 4. The regions of bone changes in TMJ arthrosis patients with condylar positional changes were as follows: They occurred at the condyle head (51.04%), the articular eminence (39.20%) and the articular fossa (9.60%) in that order. The condylar positional changes and bone changes according to the regions were as follows: a) In the bone changes at the condylar head, the flattening (34.63%) was a most frequent finding and the deformity (27.63%) the erosion (34.63%) in the order. In the condylar positional changes, the downward positioning of condyle (41.44%) was a most frequent finding in the mouth closed state and the restricted movement within the articular fossa (35.46%) in the mouth open state. b) In

Comparison of conventional panoramic radiography and panoramic digital subtraction radiography in detection of simulated lesions of mandibular condyle

Directory of Open Access Journals (Sweden)

Panjnoush M.

2008-12-01

Full Text Available "n  "nBackground and Aim: Digital subtraction Radiography (DSR is a method of accurate assessing condylar head changes. several studies have been carried out in applying DSR in dentistry, however there is a few number of studies in efficacy of DSR method in assesment of condylar head changes, The aim of this study was to compare panoramic radiography and DSR detecting simulated lesions of the mandibular condyl. "nMaterials and Methods: this was a process reaserch study, in which two dry human skulls with no obvious temporomandibular joint pathology were used. Osteophytic lesions were simulated using three sizes of bone chips that were placed on the medial portion of anterior and superolateral aspects of the condyle. Osteolytic lesions were simulated making 1 and 2 mm holes using round burr in the central portion of anterior aspect and Lateral pole of the condyle. Panoramic radiographs were prepared with and without the lesions in place. These paired radiographs were digitized and digital- subtraction images of the original panoramic images were obtained. Eight observers evaluated 155 images of each modality for the presence or absence and the type of simulated lesions of the mandibular condyle. Sensitivity, specificity, reliability and measure of agreement were analyzed using kappa test and crossed tables and qualitative variables were assess by chi-square and fisher's Exact test. "nResults: Specificity of panoramic and DSR methods were 15.4% and 66.7% respectively. Sensitivity of panoramic and DSR methods were 61.1% and 80.6% for osteophytic lesions and 37.5% and 83.3% for Osteolytic lesions. The percentage of correct decisions made in DSR method was significantly more than conventional panoramic method (82.6% vs 41.9% (p<0.0001. "nConclusion: Based on the results of this study digital subtraction technique was significantly more accurate than the panoramic radiographs in detection of simulated lesions of the mandibular condyle.

Revascularization of calvarial, mandibular, tibial, and iliac bone grafts in rats

DEFF Research Database (Denmark)

Pinholt, E M; Solheim, E; Talsnes, O

1994-01-01

Some studies have suggested that membranous bone grafts undergo less resorption than endochondral grafts, and faster revascularization of the former has been proposed as the explanation. We studied fresh syngeneic full-thickness bone grafts from calvaria, mandibula, tibia diaphysis, and iliac bone...... implanted in the back muscles of young Lewis rats. As a measure of the quantity of cancellous bone in grafts before implantation, the ratio of the total area of soft-tissue spaces to the total area of the graft was measured histomorphometrically. Revascularization in grafts 3 weeks postoperatively...... was evaluated by deposit of 141Ce-labeled microspheres. Both the quantity of cancellous bone (before implantation) and the revascularization (3 weeks postoperatively) were greater in the mandibular and iliac bone grafts than in the calvarial and tibia diaphyseal grafts. The results suggest that the anatomical...

Seven-year retrospective clinical study evaluating efficacy of stainless steel mesh in mandibular fractures.

Science.gov (United States)

Chakraborty, Sudip; Ghosh, Samiran; Burman, Richi; Ray, Amit

2011-10-01

The use of titanium mesh in communited mandibular fractures has been substantially documented. However, the use of stainless steel mesh for routine fixation in mandibular fractures has not been widely reported. The aim of the present study was to evaluate the efficacy of stainless steel mesh for routine osteosynthesis of mandibular fractures. A total of 252 patients who had been diagnosed with 287 single or multiple mandibular fractures at Guru Nanak Institute of Dental Science and Research from 2002 to 2009 were selected for the present study. Those with condylar fractures and other maxillofacial injuries were excluded from the study. The patients were evaluated preoperatively, intraoperatively, and postoperatively at 1 day, 6 weeks, and 3 and 6 months. The local complications, occlusion (for static function), and chewing (for dynamic function) were evaluated postoperatively. The intraoperative time taken for implant fixation (from site exposure to fixation of the last screw) was 32 minutes. Of the 252 patients, 40 (15.8%) had local complications and 24 patients required implant removal. Of the 252 patients, 82% had bilaterally satisfactory occlusion according to the surgeon at 6 months postoperatively. Discomfort in chewing unilaterally or bilaterally was reported by 17% of the patients. The results of our study have shown that stainless steel mesh has acceptable complication rates and the ability to maintain occlusion and chewing postoperatively compared with the present standards of care of mandibular fractures using miniplates. The lower cost and versatile placement of screws were the principal advantages. However, placement near the mental foramen with an extraoral approach for certain sites is the primary disadvantage. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

International Nuclear Information System (INIS)

Cho, Bong Hae

2011-01-01

The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

Energy Technology Data Exchange (ETDEWEB)

Cho, Bong Hae [School of Dentistry, Pusan National University, Pusan (Korea, Republic of)

2011-06-15

The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

Micro-CT evaluation of the radioprotective effect of resveratrol on the mandibular incisors of irradiated rats

International Nuclear Information System (INIS)

Rezende Barbosa, Gabriella Lopes de; Almeida, Solange Maria de

2016-01-01

The purpose of this study was to perform a micro computerized tomographic evaluation of the radioprotective effect of resveratrol on the volume of mandibular incisors of irradiated rats. A second aim was to make a quantitative assessment of the effect of x-ray exposure on these dental tissues. Twenty adult male rats were divided into four groups: control, irradiated control, resveratrol, and irradiated resveratrol. The resveratrol groups received 100 mg/kg of resveratrol, whereas the irradiated groups were exposed to 15 Gy of irradiation. The animals were sacrificed 30 days after the irradiation procedure, and their mandibles were removed and scanned in a micro computerized tomography unit. The images were loaded into Mimics software to allow segmentation of the mandibular incisor and assessment of its volume. The results were compared by One-way ANOVA and Tukey's post hoc test, considering a 5% significance level. The irradiated groups showed significantly diminished volumes of the evaluated teeth, as compared with the control group (p < 0.05). The resveratrol group presented higher values than those of the irradiated groups, and volumes similar to those of the control group. High radiation doses significantly affected tooth formation, resulting in alterations in the dental structure, and thus lower volumes. Moreover, resveratrol showed no effective radioprotective impact on dental tissues. Future studies are needed to evaluate different concentrations of this substance, in an endeavor to verify its potential as a radioprotector for these dental tissues. (author)

Micro-CT evaluation of the radioprotective effect of resveratrol on the mandibular incisors of irradiated rats

Energy Technology Data Exchange (ETDEWEB)

Rezende Barbosa, Gabriella Lopes de; Almeida, Solange Maria de, E-mail: gabriellalopes@live.com [Universidade de Campinas (UNICAMP), Piracicaba, SP (Brazil). Escola de Odontologia. Departmento de Diagnostico Oral; Pimenta, Luiz Andre [University of North Carolina at Chapel Hill, School of Dentistry, Department of Dental Ecology, Chapel Hill, NC (United States)

2016-05-01

The purpose of this study was to perform a micro computerized tomographic evaluation of the radioprotective effect of resveratrol on the volume of mandibular incisors of irradiated rats. A second aim was to make a quantitative assessment of the effect of x-ray exposure on these dental tissues. Twenty adult male rats were divided into four groups: control, irradiated control, resveratrol, and irradiated resveratrol. The resveratrol groups received 100 mg/kg of resveratrol, whereas the irradiated groups were exposed to 15 Gy of irradiation. The animals were sacrificed 30 days after the irradiation procedure, and their mandibles were removed and scanned in a micro computerized tomography unit. The images were loaded into Mimics software to allow segmentation of the mandibular incisor and assessment of its volume. The results were compared by One-way ANOVA and Tukey's post hoc test, considering a 5% significance level. The irradiated groups showed significantly diminished volumes of the evaluated teeth, as compared with the control group (p < 0.05). The resveratrol group presented higher values than those of the irradiated groups, and volumes similar to those of the control group. High radiation doses significantly affected tooth formation, resulting in alterations in the dental structure, and thus lower volumes. Moreover, resveratrol showed no effective radioprotective impact on dental tissues. Future studies are needed to evaluate different concentrations of this substance, in an endeavor to verify its potential as a radioprotector for these dental tissues. (author)

Long-term outcomes of mandibular kinematics following class II malocclusion therapy with removable functional appliance therapy.

Science.gov (United States)

Linsen, Sabine S; Wolf, Michael; Müßig, Dieter

2016-11-01

To evaluate mandibular kinematics in class I adults following class II therapy with removable functional appliances (RFAs) during the growth period in comparison with orthodontically untreated class I and II individuals. Condylar (CRoM) and incisal range of motion (InRoM), velocity during opening and closing, and the mandibular rotation angle were recorded using an ultrasound-based jaw-tracking system in 36 test patients (mean age = 28.03 ± 6.58 years). Significant group effects were found for CRoM towards the posterior in the right joint (p = 0.002) and InRoM towards the anterior (p = 0.043). The post hoc Tukey test indicates a significantly longer CRoM (posterior) for the right condyle in class II (p = 0.003) and RFA individuals (p = 0.023). The kinematic data imply greater dentoalveolar effects due to RFA therapy than adaptive remodeling of the temporomandibular joint. The class I relationship in the RFA group following treatment indicates stable long-term outcomes.

A novel region-growing based semi-automatic segmentation protocol for three-dimensional condylar reconstruction using cone beam computed tomography (CBCT.

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Tong Xi

Full Text Available OBJECTIVE: To present and validate a semi-automatic segmentation protocol to enable an accurate 3D reconstruction of the mandibular condyles using cone beam computed tomography (CBCT. MATERIALS AND METHODS: Approval from the regional medical ethics review board was obtained for this study. Bilateral mandibular condyles in ten CBCT datasets of patients were segmented using the currently proposed semi-automatic segmentation protocol. This segmentation protocol combined 3D region-growing and local thresholding algorithms. The segmentation of a total of twenty condyles was performed by two observers. The Dice-coefficient and distance map calculations were used to evaluate the accuracy and reproducibility of the segmented and 3D rendered condyles. RESULTS: The mean inter-observer Dice-coefficient was 0.98 (range [0.95-0.99]. An average 90th percentile distance of 0.32 mm was found, indicating an excellent inter-observer similarity of the segmented and 3D rendered condyles. No systematic errors were observed in the currently proposed segmentation protocol. CONCLUSION: The novel semi-automated segmentation protocol is an accurate and reproducible tool to segment and render condyles in 3D. The implementation of this protocol in the clinical practice allows the CBCT to be used as an imaging modality for the quantitative analysis of condylar morphology.

Photoelastic analysis of bone deformation in the region of the mandibular condyle during mastication.

Science.gov (United States)

Meyer, Christophe; Kahn, Jean-Luc; Boutemi, Philippe; Wilk, Astrid

2002-06-01

The purpose of this experimental study was to demonstrate the stress patterns arising in the region of the mandibular condyle during mastication. Stress analysis was performed using reflection photoelasticity to demonstrate deformation occurring on the surface of the mandible. The rami of three fresh dentate human mandibles were coated with a shell of photoelastic resin. Using a novel loading device, these mandibles were then subjected to external forces (muscular traction, resultant mandibular forces and intra-articular reaction force) reproducing a unilateral biting task between the first right molars. Deformations were measured from the working side. The trace of isostatic lines from the isoclinic fringes revealed major differences in stress distributions between the three mandibles. These differences were attributed to differences in shape between the three mandibles. Conversely, we consistently found compressive stress patterns along the posterior border of the ramus and tensile stress patterns along the anterior border of the ramus and in the zone situated below the siqmoid notch. These findings suggest that during this particular task, the mandible is subjected to sagittal forces which tend to straighten the mandibular angle. This implies that new concepts are needed for the positioning of osteosynthesis plates in the condylar region, close to the tensile strain lines, as has been recommended also for other parts of the mandible when applying semi-rigid internal fixation. Copyright 2002 European Association for Cranio-Maxillofacial Surgery. Published by Elsevier Science Ltd.

Comparison of 99mTc-MDP SPECT qualitative vs quantitative results in patients with suspected condylar hyperplasia.

Science.gov (United States)

López Buitrago, D F; Ruiz Botero, J; Corral, C M; Carmona, A R; Sabogal, A

To compare qualitative vs quantitative results of Single Photon Emission Computerised Tomography (SPECT), calculated from percentage of 99m Tc-MDP (methylene diphosphonate) uptake, in condyles of patients with a presumptive clinical diagnosis of condylar hyperplasia. A retrospective, descriptive study was conducted on the 99m Tc-MDP SPECT bone scintigraphy reports from 51 patients, with clinical impression of facial asymmetry related to condylar hyperplasia referred by their specialist in orthodontics or maxillofacial surgery, to a nuclear medicine department in order to take this type of test. Quantitative data from 99m Tc-MDP condylar uptake of each were obtained and compared with qualitative image interpretation reported by a nuclear medicine expert. The concordances between the 51 qualitative and quantitative reports results was established. The total sample included 32 women (63%) and 19 men (37%). The patient age range was 13-45 years (21±8 years). According to qualitative reports, 19 patients were positive for right side condylar hyperplasia, 12 for left side condylar hyperplasia, with 8 bilateral, and 12 negative. The quantitative reports diagnosed 16 positives for right side condylar hyperplasia, 10 for left side condylar hyperplasia, and 25 negatives. Nuclear medicine images are an important diagnostic tool, but the qualitative interpretation of the images is not as reliable as the quantitative calculation. The agreement between the two types of report is low (39.2%, Kappa=0.13; P>.2). The main limitation of quantitative reports is that they do not register bilateral condylar hyperplasia cases. Copyright © 2017 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Surgical treatment of unilateral condylar hyperplasia with piezosurgery.

Science.gov (United States)

Chiarini, Luigi; Albanese, Massimo; Anesi, Alexandre; Galzignato, Pier-Francesco; Mortellaro, Carmen; Nocini, Pierfrancesco; Bertossi, Dario

2014-05-01

Unilateral condylar hyperplasia (UCH) is a disorder of unknown etiology mainly seen in growing patients, which results in facial asymmetry. High condylectomy alone or in association with orthognathic surgery can improve the occlusion and the facial aesthetics. Between 2005 and 2012, a total of 5 patients underwent high condylectomy for UCH using a piezoelectric cutting device. All patients were treated postoperatively with functional rehabilitation. The long-term follow-up showed that all patients had a satisfactory temporomandibular joint articular function associated with stable occlusion without any recurrence of further condylar growth. High condylectomy in the surgical treatment of unilateral UCH seems to be the procedure of choice in growing patients. The use of a piezoelectric cutting device allows a safe and less invasive high condylectomy.

Ultrasound stimulation of mandibular bone defect healing

NARCIS (Netherlands)

Schortinghuis, Jurjen

2004-01-01

The conclusions of the experimental work presented in this thesis are: 1. Low intensity pulsed ultrasound is not effective in stimulating bone growth into a rat mandibular defect, either with or without the use of osteoconductive membranes. 2. Low intensity pulsed ultrasound does not seem to have an

Development of a computer-assisted system for model-based condylar position analysis (E-CPM).

Science.gov (United States)

Ahlers, M O; Jakstat, H

2009-01-01

Condylar position analysis is a measuring method for the three-dimensional quantitative acquisition of the position of the mandible in different conditions or at different points in time. Originally, the measurement was done based on a model, using special mechanical condylar position measuring instruments, and on a research scale with mechanical-electronic measuring instruments. Today, as an alternative, it is possible to take measurements with electronic measuring instruments applied directly to the patient. The computerization of imaging has also facilitated condylar position measurement by means of three-dimensional data records obtained by imaging examination methods, which has been used in connection with the simulation and quantification of surgical operation results. However, the comparative measurement of the condylar position at different points in time has so far not been possible to the required degree. An electronic measuring instrument, allowing acquisition of the condylar position in clinical routine and facilitating later calibration with measurements from later examinations by data storage and use of precise equalizing systems, was therefore designed by the present authors. This measuring instrument was implemented on the basis of already existing components from the Reference CPM und Cadiax Compact articulator and registration systems (Gamma Dental, Klosterneuburg, Austria) as well as the matching CMD3D evaluation software (dentaConcept, Hamburg).

Assessment of condylar morphology and position using MSCT in an Asian population.

Science.gov (United States)

Liu, Qi; Wei, Xiaoer; Guan, Juanjuan; Wang, Ran; Zou, Derong; Yu, Lvfeng

2018-02-01

The purpose of the present study was to investigate the volume, surface, morphometric index (MI), and position of the condyle in a normal population by applying Mimics 17.0 software. Then, the difference between left and right sides, sex, and age can be explored, which will contribute to establish the reference value of condylar morphology and position in normal individuals, and help us to study characteristics of condylar morphology and position in abnormal individuals. Three-hundred subjects were enrolled in our study from the radiology department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital. They were divided into three groups according to the age: group 1 (18-24 years old), group 2 (25-34 years old), and group 3 (35-44 years old). Each group included 100 subjects (with 50 males and 50 females). They were examined using multislice computed tomography (MSCT) after that. All images of condyle were reconstructed by Mimics 17.0 software, so as to measure the volume, surface, and MI of condyle, and to analyze the position of condyle in the articular fossa by means of joint spaces. The differences of condylar volume, surface, and MI between left and right sides were not obvious (P > 0.05). The condylar volume and surface were greater in males than females (P  0.05). No statistical differences were found in volume and surface among three age groups. However, the MI of group 1 was statistically lower than that of group 3 (P position (P > 0.05). Nevertheless, there were significant differences of condylar position regarding the gender and age (P position between left and right sides, but factors of gender and age were proven to have a certain influence on the morphology and position of the condyle. This information can be clinically useful in establishing the diagnostic criteria for condylar morphology and position in the normal Asian population. Examination of condylar morphology and position is important for evaluating the

Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects

International Nuclear Information System (INIS)

Cho, Bong Hae; Jung, Yun Hoa

2013-01-01

This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects

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Cho, Bong Hae; Jung, Yun Hoa [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan (Korea, Republic of)

2013-03-15

This study was performed to determine the prevalence of bifid mandibular condyles (BMCs) in asymptomatic and symptomatic temporomandibular joint (TMJ) subjects with no traumatic history, and to assess their impact on clinical and radiographic manifestations of TMJ. A total of 3,046 asymptomatic and 4,378 symptomatic patients were included in the study. Cone-beam computed tomography (CBCT) images were reviewed for bifid condyles. T-tests were used to compare the frequency of BMCs when stratified by symptom, gender, and side. In BMC patients, the clinical features of pain and noise, osseous changes, and parasagittal positioning of the condyles were compared between the normally shaped condyle side and the BMC side using chi-squared tests. Fifteen (0.49%) asymptomatic and 22 (0.50%) symptomatic patients were found to have BMCs. Among the bilateral cases, the number of condyles were 19 (0.31%) and 25 (0.29%), respectively. No statistically significant differences were found between asymptomatic and symptomatic patients, between female and male patients, or between the right and left sides (p>0.05). Compared with the normally shaped condyle side, the BMC side showed no statistically significant differences in the distribution of pain and noise, parasagittal condylar position, or condylar osseous changes, with the exception of osteophytes. In the symptomatic group, osteophytes were found more frequently on the normally shaped condyle side than the BMC side (p<0.05). BMCs tended to be identified as an incidental finding. The presence of BMC would not lead to any TMJ symptoms or cause osseous changes.

The use of a cine-technique in the MRT investigation of the temporo-mandibular joint. Die Anwendung der 'Cine-Technik' in der MRT-Diagnostik des Kiefergelenkes

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Vogl, T.J.; Assal, J. (Univ. Muenchen, Radiologische Klinik Innenstadt (Germany)); Eberhard, D.; Weigl, P.; Randzio, J. (Univ. Muenchen, Klinik und Poliklinik fuer Kieferchirurgie (Germany))

1992-03-01

A new cine-technique in a prospective study using rapid gradient echo sequences was evaluated for the MRT investigation of the temporo-mandibular joint. A newly developed hydraulic apparatus was used to produce progressive opening of the jaw and MRT appearances were recorded during predetermined points of mandibular movement. The investigation included 16 normals and 34 patients. A modified gradient echo sequence was combined with an optimised surface coil or a special double coil and this provided good spatial resolution of the articular disc and of the muscular and bony structure. Amongst the abnormal findings were luxation of the disc (15 cases), tears in the disc (5 cases), late effects of internal derangements (12 cases) and condylar hypermobility (7 cases). The new cine-technique provides specific images in any chosen position of the mandible depending on the clinical disability of the patient. (orig.).

Radiographic study on the interrelation between bone deformans and condylar head position in the TMJ arthrosis

International Nuclear Information System (INIS)

You, Dong Soo

1981-01-01

The author analysed the interrelation between the morphologic changes of bone structures and the position of condylar head from the routine radiographs of 134 cases of the temporomandibular joint arthrosis. The frequencies of coincidence between the site of bone deformity and condylar head positional change were examined. Also, the positional changes of condylar head and the direction of condylar movement in relation to the kind of bone deformities were observed. The results obtained were as follows; 1. In 52.65 per cent of total cases, the site of positional change of condylar head was coincided with the site of bone deformans. The frequencies of the coincidence between these in the five items among seven items examined were above 53 per cent. From the results, it seems that the positional changes of condylar head were related with the morphological change of bone structure. 2. Eburnation and erosion revealed frequently positional changes in the opening and closing position of the mouth, although in the early stages of the TMJ arthrosis. 3. In the bone deformans, during open position of the mouth 44.81 per cent of total cases revealed backward movement and 37.74 per cent showed forward movement. In closed position of the mouth, downward movement was revealed in 35.23 percent of total cases and upward movement 28.41 percent of total cases.

Radiographic study on the interrelation between bone deformans and condylar head position in the TMJ arthrosis

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You, Dong Soo [Dept. of Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1981-11-15

The author analysed the interrelation between the morphologic changes of bone structures and the position of condylar head from the routine radiographs of 134 cases of the temporomandibular joint arthrosis. The frequencies of coincidence between the site of bone deformity and condylar head positional change were examined. Also, the positional changes of condylar head and the direction of condylar movement in relation to the kind of bone deformities were observed. The results obtained were as follows; 1. In 52.65 per cent of total cases, the site of positional change of condylar head was coincided with the site of bone deformans. The frequencies of the coincidence between these in the five items among seven items examined were above 53 per cent. From the results, it seems that the positional changes of condylar head were related with the morphological change of bone structure. 2. Eburnation and erosion revealed frequently positional changes in the opening and closing position of the mouth, although in the early stages of the TMJ arthrosis. 3. In the bone deformans, during open position of the mouth 44.81 per cent of total cases revealed backward movement and 37.74 per cent showed forward movement. In closed position of the mouth, downward movement was revealed in 35.23 percent of total cases and upward movement 28.41 percent of total cases.

Unusual postero-inferior condylar movements that depend on the position of occlusal contact during fictive mastication in rabbits.

Science.gov (United States)

Morita, Takumi; Hiraba, Katsunari; Matsunaga, Tomoko; Ito, Yu; Maruo, Hisanobu; Kurita, Kenichi

2015-03-01

The mandible can be modelled as a triangular plate supported at two joints and the point of occlusion. The mandible is stable if the vector of the jaw-closing muscle forces lies within the triangle of support. If this vector lies outside of the triangle of support, one of the three contact points will tend to separate as the mandible rotates around a line connecting the other two points. Here, we examined whether postero-inferior condylar movements (Pi-Cm) due to mandibular rotation may occur during fictive mastication in anaesthetized rabbits. EMG activities of the masseter (MS) and lateral pterygoid (LP) muscles and movements of the condyle and incisal points were recorded. Condylar movements in the sagittal plane were recorded using a high speed CCD camera. Pi-Cm were observed on the working side during occlusal phase in half of the rabbits (altered-movement group), if the biting point was restricted at the posterior most tooth (M3) on the working side using a metal biting plate. Pi-Cm appeared in the period between the estimated maximum force of the MS and the LP during late occlusal phase. The MS EMG ratio between the working and balancing sides in the altered-movement group was significantly less than that in the unaltered-movement group. Since the space lying between the condyle and the articular eminence expanded during the Pi-Cm, it is likely that the posterior band of the articular disc tended to slip anteriorly. The clinical significance of the Pi-Cm is discussed concerning the anterior dislocation of the disc in patients with TMJ disorder. Copyright © 2014 Elsevier Ltd. All rights reserved.

Facilitation of bone resorption activities in synovial lavage fluid patients with mandibular condyle fractures.

Science.gov (United States)

Takano, H; Takahashi, T; Nakata, A; Nogami, S; Yusa, K; Kuwajima, S; Yamazaki, M; Fukuda, M

2016-05-01

The aim of this study was to investigate the bone resorption effect of the mediators delivered in joint cavity of patients with mandibular condyle fractures by detecting osteoclast markers using cellular biochemistry methods, and by analysing bone resorption activities via inducing osteoclast differentiation of the infiltrated cells from arthrocentesis. Sixteen joints in 10 patients with mandibular condyle fractures were evaluated. The control group consisted of synovial fluid (SF) samples from seven joints of four volunteers who had no clinical signs or symptoms involving the temporomandibular joint (TMJ) or disc displacement. We collected SF cells from all patients during therapeutic arthrocentesis. The infiltrating cells from TMJ SF were cultured, differentiated into tartrate-resistant acid phosphatase (TRAP)-positive osteoclast-like cells and examined bone resorption activities. We also investigated factors related to osteoclast induction of SF, using ELISA procedures. Osteoclast-like cells were induced from the SF cells obtained from all patients with condylar fractures. These multinucleated giant cells were positive for TRAP and actin, and had the ability to absorb dentin slices. The levels of macrophage colony-stimulating factor (M-CSF), prostaglandin E2 (PGE2), soluble form of receptor activator of nuclear factor kappa-B ligand (sRANKL) and osteoprotegerin (OPG), in SF samples from the patients, were significantly higher than in the controls. These findings indicate that bone resorption activities in SF from patients with mandibular condyle fractures were upregulated and may participate in the pathogenesis and wound healing. © 2016 The Authors. Journal of Oral Rehabilitation Published by John Wiley & Sons Ltd.

Evaluation of surgical treatment in mandibular condyle fractures.

Science.gov (United States)

Vesnaver, Aleš; Ahčan, Uroš; Rozman, Janez

2012-12-01

In the past, fractures of the mandibular condylar process were, as a rule, treated conservatively. At the Department of Maxillofacial and Oral Surgery of the University Medical Centre Ljubljana, Slovenia, our doctrine was changed in 2002 on the basis of preliminary results and reports in the literature, and these fractures were started to be treated surgically by open reduction and internal fixation with miniplates and screws, which led to good results and a shorter rehabilitation period. The goal of this study was to determine the safety and efficiency of surgical treatment, as well as to compare long-term results of surgical and conservative treatment, as objectively as possible. Two groups of patients, which had all sustained a unilateral, extra-articular mandibular condyle fracture, were compared. In the test group, there were 42 surgically treated patients, and in the control group, 20 conservatively treated patients. Clinical parameters and X-ray images were assessed in both groups and compared by the two tailed Student t test, and in case of attributive variables by the χ(2) test. Within the surgically treated group, postoperative and intraoperative complications were noted: temporary facial nerve palsy, development of a parotid salivary fistula, disturbance of auricle sensibility due to injury of the greater auricular nerve, miniplate fracture, as well as intraoperative bleeding, postoperative haematoma formation, infection, reoperation due to fragment malposition and other complications. Postoperative scars were also assessed. Statistically significant differences between the surgically and conservatively treated patients were found when comparing clinical parameters as well as X-ray images, the results being better in the surgically treated group. Complications of surgical treatment were also noted, the most important among them temporary paresis of facial nerve branches, which occurred in 10 patients (24%). Plate fractures occurred in five patients (12

Condylar bony changes in patients with temporomandibular disorders: a CBCT study

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Nah, Kyung Soo [Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan (Korea, Republic of)

2012-09-15

Diagnosis of osteoarthritis most commonly depends on clinical and radiographic findings. The present study attempted to observe the bony changes in temporomandibular joint (TMJ) patients from all age groups. The first-visit clinical records and cone beam computed tomography (CBCT) data of 440 TMJs from 220 consecutive TMJ patients were reviewed retrospectively. The most frequent condylar bony change observed was sclerosis (133 joints, 30.2%) followed by surface erosion (129 joints, 29.3%), flattening of the articular surface (112 joints, 25.5%), and deviation in form (58 joints, 13.2%), which included 33 TMJs in a cane-shape, 16 with a lateral or medial pole depression, 6 with posterior condylar surface flattening, and 3 with a bifid-shaped condyle. Fifty-three joints (12.0%) showed hypoplastic condyles but only 1 joint showed hyperplasia. Osteophyte was found in 35 joints (8.0%) and subcortical cyst in 24 joints (5.5%), 5 of which had surface erosion as well. One hundred nineteen joints (27.0%) had only one kind of condylar bony change, 66 joints (15.0%) had two, 52 joints (11.8%) had three, 12 joints (5.0%) had four, and 6 joints (1.4%) had five kinds of condylar bony changes at the same time. Eighty-five (65.9%) of 129 joints with surface erosion had pain recorded at the chief complaint. With more widespread use of CBCT, more specific or detailed guidelines for osteoarthritis are needed.

Condylar bony changes in patients with temporomandibular disorders: a CBCT study

International Nuclear Information System (INIS)

Nah, Kyung Soo

2012-01-01

Diagnosis of osteoarthritis most commonly depends on clinical and radiographic findings. The present study attempted to observe the bony changes in temporomandibular joint (TMJ) patients from all age groups. The first-visit clinical records and cone beam computed tomography (CBCT) data of 440 TMJs from 220 consecutive TMJ patients were reviewed retrospectively. The most frequent condylar bony change observed was sclerosis (133 joints, 30.2%) followed by surface erosion (129 joints, 29.3%), flattening of the articular surface (112 joints, 25.5%), and deviation in form (58 joints, 13.2%), which included 33 TMJs in a cane-shape, 16 with a lateral or medial pole depression, 6 with posterior condylar surface flattening, and 3 with a bifid-shaped condyle. Fifty-three joints (12.0%) showed hypoplastic condyles but only 1 joint showed hyperplasia. Osteophyte was found in 35 joints (8.0%) and subcortical cyst in 24 joints (5.5%), 5 of which had surface erosion as well. One hundred nineteen joints (27.0%) had only one kind of condylar bony change, 66 joints (15.0%) had two, 52 joints (11.8%) had three, 12 joints (5.0%) had four, and 6 joints (1.4%) had five kinds of condylar bony changes at the same time. Eighty-five (65.9%) of 129 joints with surface erosion had pain recorded at the chief complaint. With more widespread use of CBCT, more specific or detailed guidelines for osteoarthritis are needed.

Closed treatment of unilateral mandibular condyle fractures in adults: a systematic review.

Science.gov (United States)

Rozeboom, A V J; Dubois, L; Bos, R R M; Spijker, R; de Lange, J

2017-04-01

Of all mandibular fractures, 25-35% are condylar. Many studies have focused on whether to treat such fractures via open or closed modalities. A uniform protocol for closed treatment is lacking, but such a protocol could ensure good clinical practice. The aims of this systematic review were to provide an overview of the published studies exclusively pertaining to closed treatment and to summarize the existing modalities for closed treatment and their clinical outcomes. Sixteen studies were selected for detailed analysis. The treatments given were highly variable, ranging from doing nothing to applying maxillomandibular fixation with stainless steel wires. The results of the different studies and the treatment modalities used were difficult to interpret; however no clear differences in the outcome measures were seen between the treatment modalities applied. Complications encountered after closed treatment included malocclusion, limited mouth opening, reduced range of motion, and persistent pain. Due to the heterogeneity between groups, high loss-to-follow-up, poor descriptions of the treatments given, and variability in outcome measurement methods, no clear associations between adverse outcomes and the treatments applied could be determined. This review suggests that due to the high level of methodological variability in the relevant studies published to date, there are currently no uniform standards for the closed treatment of condylar fractures that can be expected to yield good clinical results. The establishment of such standards could potentially improve treatment outcomes. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Transmasseteric anterior parotid approach for condylar fractures: experience of 129 cases.

Science.gov (United States)

Narayanan, Vinod; Ramadorai, Ashok; Ravi, Poornima; Nirvikalpa, Natarajan

2012-07-01

We have evaluated the transmasseteric anterior parotid (TMAP) approach in the treatment of 163 condylar fractures in 129 patients. Ninety-five patients presented with unilateral, and 34 with bilateral, fractures. The inclusion criteria were patient's choice for open reduction and internal fixation, displaced unilateral condylar fractures with occlusal derangement, and displaced bilateral condylar fractures with anterior open bite. Mean (SD) maximum interincisal opening after 3 months was 44(5)mm. There were no differences in lateral movements during the reviews 6 weeks and 3 months postoperatively. Protrusive movement at the end of 3 months was 7(2)mm. All patients achieved functional occlusion identical to the pretraumatic occlusion and good reduction of the condyles. No patient developed temporary or permanent facial palsy, sialocele, salivary fistula, or Frey syndrome. The mean (SD) operating time was 46(11)min. The TMAP approach avoids the complications of incision of the parotid gland, minimises the risk of facial nerve palsy, and offers excellent access to the fractured condyle. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Finite element analysis of three patterns of internal fixation of fractures of the mandibular condyle.

Science.gov (United States)

Aquilina, Peter; Chamoli, Uphar; Parr, William C H; Clausen, Philip D; Wroe, Stephen

2013-06-01

The most stable pattern of internal fixation for fractures of the mandibular condyle is a matter for ongoing discussion. In this study we investigated the stability of three commonly used patterns of plate fixation, and constructed finite element models of a simulated mandibular condylar fracture. The completed models were heterogeneous in the distribution of bony material properties, contained about 1.2 million elements, and incorporated simulated jaw-adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. This model was considerably larger and more complex than previous finite element models that have been used to analyse the biomechanical behaviour of differing plating techniques. The use of two parallel 2.0 titanium miniplates gave a more stable configuration with lower mean element stresses and displacements over the use of a single miniplate. In addition, a parallel orientation of two miniplates resulted in lower stresses and displacements than did the use of two miniplates in an offset pattern. The use of two parallel titanium plates resulted in a superior biomechanical result as defined by mean element stresses and relative movement between the fractured fragments in these finite element models. Copyright © 2012 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Fraturas do côndilo mandibular: análise clínica retrospectiva das indicações e do tratamento Evaluation of condylar fractures treatment

Directory of Open Access Journals (Sweden)

Eduardo Fausto de Andrade Filho

2003-01-01

Full Text Available OBJETIVO: Analisamos 40 pacientes com fraturas no processo condilar da mandíbula, tratados pelo método fechado (bloqueio maxilomandibular ou conservador ou aberto (redução direta no foco de fratura com ou sem osteossíntese, no período de janeiro de 1993 a janeiro de 1999 no Setor de Trauma Maxilofacial da Disciplina de Cirurgia Plástica da UNIFESP-EPM. MÉTODO: Avaliamos clinicamente estes pacientes através da palpação da articulação têmporomandibular, observação da simetria mandibular, oclusão dentária, desvio à abertura de boca e abertura máxima interincisal; além de questionário sobre queixas na ATM, disfunção mastigatória e satisfação do tratamento realizado. RESULTADOS: Foi encontrado um índice de resultados satisfatórios de no mínimo 70% nos pacientes submetidos ao bloqueio. No método conservador esse índice foi de no mínimo 42,9%, e nos submetidos à redução com fio de aço de no mínimo 28,6%, sem diferença significante entre os diversos exames clínicos. O índice de dor na ATM entre os pacientes tratados pelo método fechado foi de 3,7% e pelo aberto de 15,4%. A disfunção mastigatória foi de 22,2% no método fechado e 15,4% no aberto; sendo que foram encontrados somente 7,1% de pacientes insatisfeitos com o tratamento fechado. Não houve diferença significante entre os resultados dos métodos. CONCLUSÃO: Os métodos fechado (BMM e conservador e aberto, com redução e osteossíntese com fio de aço, trouxeram resultados clínicos satisfatórios em avaliação superior a seis meses. Concluiu-se também que não há diferença entre os resultados de queixas após o tratamento aberto ou fechado, na opinião dos pacientes.BACKGROUND: We analysed 40 patients with mandibular condylar process fractures, treated through the closed (intermaxilary fixation or conservatively or open methods (wire internal fixation,titanium miniplates, bone reduction or articular exploration, from January 1993 to January

Outcomes of Distal Femur Fracture Treated with Dynamic Condylar Screw

International Nuclear Information System (INIS)

Razaq, M. N. U.; Muhammad, T.; Ahmed, A.; Adeel, M.; Ahmad, S.; Ahmad, S.; Sultan, S.

2016-01-01

Background: Implants for open reduction and internal fixation of distal femoral fracture includes angle blade plate, rush nails, enders nail and interlocking nails. But all these devices are technically demanding and less effective in providing inter-fragmentary compression in osteoporotic bones. These problems can be solved with dynamic condylar screw (DCS).The objective of the study was to determine the frequency of different outcomes of distal femoral fracture treated with dynamic condylar screw Methods: This case series study was carried out in the Department of Trauma and Orthopaedics, Ayub Teaching Hospital Abbottabad from 1st October 2014 to August 2015, after approval of the ethical committee of the institution. Data of all patients with distal femoral fractures aged 20-70 years, recruited through emergency, OPD or consultant clinic collected on a proforma. Standard treatment of trauma was given to the patients. Detailed history was taken including the past medical and surgical history. Detailed examination including air-way, breathing and circulation, general physical examination and abdomino-pelvic examination was done in each patient. Investigations including urinalysis, haemoglobin percent, full blood count, X-ray (both AP and lateral view) of the involved femur (including hip and knee) was done. Results: Mean age of the patients was 43.18±14.647 ranging from 20 to 70 years. Mean duration of hospital stay in days was 2.21±1.111 ranging from 1 to 6 days. Patients follow-up assessment after 4 months of surgery for union of femoral fracture treated with dynamic condylar screw was found in 96 (94.1 percent), wound infection was found in 7 (6.9 percent), knee stiffness was found in 21 (20.6 percent) and limb shortening was found in 7 (6.9 percent). Conclusion: Dynamic condylar screw is an easy, scientifically less difficult and satisfying method of treatment for fractures of femur. (author)

Optimizing Functional Outcomes in Mandibular Condyle Reconstruction With the Free Fibula Flap Using Computer-Aided Design and Manufacturing Technology.

Science.gov (United States)

Lee, Z-Hye; Avraham, Tomer; Monaco, Casian; Patel, Ashish A; Hirsch, David L; Levine, Jamie P

2018-05-01

Mandibular defects involving the condyle represent a complex reconstructive challenge for restoring proper function of the temporomandibular joint (TMJ) because it requires precise bone graft alignment for full restoration of joint function. The use of computer-aided design and manufacturing (CAD/CAM) technology can aid in accurate reconstruction of mandibular condyle defects with a vascularized free fibula flap without the need for additional adjuncts. The purpose of this study was to analyze clinical and functional outcomes after reconstruction of mandibular condyle defects using only a free fibula graft with the help of virtual surgery techniques. A retrospective review was performed to identify all patients who underwent mandibular reconstruction with only a free fibula flap without any TMJ adjuncts after a total condylectomy. Three-dimensional modeling software was used to plan and execute reconstruction for all patients. From 2009 through 2014, 14 patients underwent reconstruction of mandibular defects involving the condyle with the aid of virtual surgery technology. The average age was 38.7 years (range, 11 to 77 yr). The average follow-up period was 2.6 years (range, 0.8 to 4.2 yr). Flap survival was 100% (N = 14). All patients reported improved facial symmetry, adequate jaw opening, and normal dental occlusion. In addition, they achieved good functional outcomes, including normal intelligible speech and the tolerance of a regular diet with solid foods. Maximal interincisal opening range for all patients was 25 to 38 mm with no lateral deviation or subjective joint pain. No patient had progressive joint hypomobility or condylar migration. One patient had ankylosis, which required release. TMJ reconstruction poses considerable challenges in bone graft alignment for full restoration of joint function. The use of CAD/CAM technology can aid in accurate reconstruction of mandibular condyle defects with a vascularized free fibula flap through precise

Condylar position on the lateral individualized corrected tomography in internal derangement of temporomandibular joint

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Kim, Keun Min; Hwang, Eui Hwan; Lee, Sang Rae [College of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

2002-06-15

To examine the possible relationship between condylar position and disk displacement in the temporomandibular joint. 79 temporomandibular joints in 40 patients having temporomandibular disorders were classified into three categories: no disk displacement (NDD), disk displacement with reduction (DDWR), and disk displacement without reduction (DDWOR). Disk positions were assessed from clinical and MRI findings. The relationship between the three categories and condylar positions was evaluated using lateral individualized corrected tomography. Clinical findings regarding the relationship between condyle and disk positions having anterior, centric, and posterior positions were 27%, 27%, and 46%, respectively, in NDD, 43%, 17%, and 40%, respectively, in DDWR, and 44%, 22%, and 34%, respectively, in DDWOR. There were no significant differences in condylar positions between each of the groups (P>0.05). In the relationship between condyle and disk positions with MRI findings, anterior, centric, and posterior positions were 38%, 38%, and 24%, respectively, in NDD, 29%, 21%, and 50%, respectively, in DDWR, and 44%, 9%, and 47% respectively, in DDWOR. There were significant differences in the condylar positions when MRI was utilized (P<0.05). There was a significant correlation between the condyle and disk positions with MRI findings on lateral individualized corrected tomography.

[Biomechanical analysis on healing process of sagittal fracture of the mandibular condyle after rigid fixation].

Science.gov (United States)

Jing, Jie; Qu, Ai-li; Ding, Xiao-mei; Hei, Yu-na

2015-04-01

To analyze the biomechanical healing process on rigid fixation of sagittal fracture of the mandibular condyle (SFMC), and to provide guidelines for surgical treatment. Three-dimensional finite element model (3D-FEAM) of mandible and condyle was established. The right condyle was simulated as SFMC with 0.1 mm space across the condyle length ways. The 3D-FEAM of rigid fixation was established. The biomechanical factors such as stress distribution of condylar surface, displacement around fracture, stress on the plate and stress shielding were calculated during 0, 4, 8 and 12-week after rigid fixation. The maximum equivalent stress of normal condyle was located at the area of middle 1/3 of condylar neck. The maximum equivalent stress at 0-week after fixation was 23 times than that on normal condyle. They were located at the condylar stump and the plate near inferior punctual areas of fracture line. There were little stress on the other areas. The maximum equivalent stress at 4, 8 and 12-week was approximately 6 times than that on normal condyle. They were located at the areas same as the area at 0-week. There were little stress on the other areas at the condyle. The maximum total displacement and maximum total corner were increased 0.57-0.75 mm and 0.01-0.09° respectively during healing process. The maximum equivalent stress at 0-week on the condylar trump was 5-6 times compared with that at 4, 8, and 12-week. The maximum equivalent stress, maximum total displacement and maximum total corner on the fractured fragment were not changed significantly during healing process. The maximum equivalent stress at 0-week on the plate was 7-9 times compared with that at 4, 8, 12-week. The stress of the condyle and stress shielding of the plate may be the reasons of absorbing and rebuilding on the condyle in healing process of SFMC. The biomechanical parameters increase obviously at 4-week after fixation. Elastic intermaxillary traction is necessary to decrease total displacement

Twenty-degree-tilt radiography for evaluation of lateral humeral condylar fracture in children

International Nuclear Information System (INIS)

Imada, Hideaki; Tanaka, Ryuji; Itoh, Yohei; Kishi, Kazuhiko

2010-01-01

To investigate the efficacy of '20 -tilt anteroposterior (A-P) radiography' in the assessment of lateral condylar fractures of the distal humerus. Eighteen children with lateral humeral condylar fractures were studied. Every child underwent conventional A-P and lateral radiography, and six children underwent multi-detector computed tomography (MDCT). For the investigation of 20 -tilt radiography, ten children with lateral humeral condylar fractures had conventional and 20 -tilt A-P and lateral radiography both preoperatively and postoperatively. Fragment dislocation was measured at the lateral and medial margins of the fracture on both the conventional A-P and 20 -tilt A-P radiographs. The lateral condylar fragment was triangular and was most prominent posteriorly. The fracture line was typically tilted approximately 20 to a reference line perpendicular to the long axis of the humerus in the lateral view. The extent of dislocation at the lateral and medial margins of the fracture site by 20 -tilt A-P radiography (9.3 ± 3.6 mm and 5.6 ± 2.5 mm) was significantly wider than that measured by the conventional method (6.8 ± 4.1 mm and 2.0 ± 1.5 mm), which may influence treatment. Twenty-degree-tilt A-P radiography may more precisely demonstrate fragment dislocation than standard radiographs and may influence patient treatment. (orig.)

A Two-Year Prospective Analysis of Mandibular Fractures in Western Population of Maharashtra, India

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Ashwinirani Suragimath

2017-01-01

Full Text Available Introduction: Trauma to the facial region causes injuries to hard and soft tissues of the face. Injuries to the maxillofacial region are increasing in frequency and severity because of the increased number of road traffic accidents (RTAs and increased number of violence. The purpose of this study was to evaluate age, gender distribution, etiology, and pattern of mandibular fractures in Western part of Maharashtra population. Materials and Methods: The study was conducted in the Department of Oral Medicine and Radiology for a period of two years from June 2013 to June 2015. Clinical examination of all trauma patients was done and diagnosis was made based on signs, clinical features, and confirmed by orthopantomographs. Results: Totally, 193 patients were detected with different types of mandibular fractures. Study group involved 77.2% males and 22.8% females with a male to female ratio of 3.3:1. Majority of patients were in the age group of 21–30 years followed by 31–40 years. Trauma due to RTAs were more common followed by assaults and fall. Parasymphyseal fractures were most common type followed by condylar fracture and fracture of angle of mandible. Conclusion: Males were most commonly affected by trauma than females with a predominant age group of 21–30 years. Majority of trauma were due to RTAs with parasymphyseal as most common type of fracture.

Radiologic assessment of maxillofacial, mandibular, and skull base trauma

International Nuclear Information System (INIS)

Schuknecht, Bernhard; Graetz, Klaus

2005-01-01

Cranio-maxillofacial injuries affect a significant proportion of trauma patients either in isolation or concurring with other serious injuries. Contrary to maxillofacial injuries that result from a direct impact, central skull base and lateral skull base (petrous bone) fractures usually are caused by a lateral or sagittal directed force to the skull and therefore are indirect fractures. The traditional strong role of conventional images in patients with isolated trauma to the viscerocranium is decreasing. Spiral multislice CT is progressively replacing the panoramic radiograph, Waters view, and axial films for maxillofacial trauma, and is increasingly being performed in addition to conventional films to detail and classify trauma to the mandible as well. Imaging thus contributes to accurately categorizing mandibular fractures based on location, into alveolar, mandibular proper, and condylar fractures - the last are subdivided into intracapsular and extracapsular fractures. In the midface, CT facilitates attribution of trauma to the categories central, lateral, or combined centrolateral fractures. The last frequently encompass orbital trauma as well. CT is the imaging technique of choice to display the multiplicity of fragments, the degree of dislocation and rotation, or skull base involvement. Transsphenoid skull base fractures are classified into transverse and oblique types; lateral base (temporal bone) trauma is subdivided into longitudinal and transverse fractures. Supplementary MR examinations are required when a cranial nerve palsy occurs in order to recognize neural compression. Early and late complications of trauma related to the orbit, anterior cranial fossa, or lateral skull base due to infection, brain concussion, or herniation require CT to visualize the osseous prerequisites of complications, and MR to define the adjacent brain and soft tissue involvement. (orig.)

A radiographic study on the condylar position in temporomandibular joint dysfunction patients

International Nuclear Information System (INIS)

Bang, Seo Howan; Kim, Jae Duck

1987-01-01

The author obtained the transcranial-oblique lateral radiograms from 78 patients (26 male, 52 female) with temporom andibular dysfunction problem. And then, the author analyzed the dimensional changes of the TMJ space on centric occlusion, horizontal condylar movement and antero-posterior positional relationship of condyle to the articular eminence on 2.54 cm mouth opening with clicking, TMJ pain and mouth opening limitation respectively, which were the symptoms of the temporomandibular joint pain dysfunction problem, and compared these data with control group. The results were as follow: 1. In centric occlusion, anterior and posterior TMJ space of experimental group was slightly lesser than those of the control group, also superior TMJ space of experimental group was significantly lesser than that of the control group. (p 2. In 2.54 cm mouth opening, the condylar horizontal movement and the antero-posterior positional relationship to the articular eminence were significantly lesser than those of the control group. (p 3. Examined experimental group, the degree of condylar horizontal movement of affected side was lesser than that of the normal side in 2.54 cm mouth opening.

Condylar Joint Fusion and Stabilization (by Screws and Plates) in Nontraumatic Atlanto-Occipital Dislocation: Technical Report of 2 Cases.

Science.gov (United States)

Chowdhury, Forhad H; Haque, Mohammod Raziul; Alam, Sarwar Murshed; Khaled Chowdhury, S M Noman; Khan, Shamsul Islam; Goel, Atul

2017-11-01

Nontraumatic spontaneous atlanto-occipital dislocation (AOD) is rare. In this report, we discuss the technical steps of condylar joint fusion and stabilization (by screws and plates) in nontraumatic AOD. To the best of our knowledge, it is the first report of such techniques. A young girl and a young man with progressive quadriparesis due to nontraumatic spontaneous atlanto-occipital dislocation were managed by microsurgical reduction, fusion, and stabilization of the joint by occipital condylar and C1 lateral mass screw and plate fixation after mobilization of vertebral artery. In both cases, condylar joints fixation and fusion were done successfully. Condylar joint stabilization and fusion may be a good or alternative option for AOD. Copyright © 2017 Elsevier Inc. All rights reserved.

Osteosíntesis intraoral asistida por endoscopia en las fracturas del proceso condilar de la mandíbula: revisión de 53 casos Endoscopically assisted intraoral osteosynthesis in mandibular condylar process fractures: a review of 53 cases

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Carlos Cristobal Goizueta-Adame

2012-12-01

fractures treated using open reduction and rigid internal fixation by an exclusively endoscopically assisted intraoral access. Material and methods: The purpose of the surgery was the anatomical reduction and internal fixation by means of rigid osteosynthesis via an intraoral incision. A review is presented of the cases where this procedure was used between 2007 and 2011. Results: Thirty five sub-condyle fractures and 20 condylar neck fractures repairs were made using this method. Over half of the fractures (55% had one or more associated fractures. The correction or improved alignment of the fragments were observed in 51 (92% using orthopantomography. Inter-maxillary fixation was avoided in 37 (69.8% of the patients. In these patients the oral aperture recovered at five and a half weeks form the surgery. In the rest, the period was almost 9 weeks after the removal of the block. Five patients had occlusal changes, while one patient had an oral aperture limitation. Conclusions: Open reduction with rigid internal fixation of extracapsular mandibular condyle fractures using an endoscopically assisted intraoral approach is an effective, safe, and reproducible treatment.

Correlation of the Condylar Guidance Obtained by Protrusive Interocclusal Record and Panoramic Radiographs in Completely Edentulous Patients: An in Vivo Study

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Khyati Shah

2014-01-01

Results: The results showed statistically significant difference between the condylar guidance values obtained from Orthopantomograph (Radiograph and the condylar guidance values obtained at the stage of jaw relation. Conclusion: Within the limitations of the study, it can be concluded that the condylar guidance values obtained from the Radiographs were higher than those obtained at the stage of jaw relation recording stage.

Local administration of calcitriol positively influences bone remodeling and maturation during restoration of mandibular bone defects in rats

International Nuclear Information System (INIS)

Liu, Hongrui; Cui, Jian; Feng, Wei; Lv, Shengyu; Du, Juan; Sun, Jing; Han, Xiuchun; Wang, Zhenming; Lu, Xiong; Yimin; Oda, Kimimitsu; Amizuka, Norio; Li, Minqi

2015-01-01

The aim of this study was to investigate the influence of calcitriol on osteoinduction following local administration into mandibular bone defects. Calcitriol-loaded absorbable collagen membrane scaffolds were prepared using the polydopamine coating method and characterized by scanning electron microscopy. Composite scaffolds were implanted into rat mandibular bone defects in the following groups: no graft material (control), bare collagen membrane (CM group), collagen membrane bearing polydopamine coating (DOP/CM group), and collagen membrane bearing polydopamine coating absorbed with calcitriol (CAL/DOP/CM group). At 1, 2, 4 and 8 weeks post-surgery, the osteogenic potential of calcitriol was examined by histological and immunohistochemical methods. Following in vivo implantation, calcitriol-loaded composite scaffolds underwent rapid degradation with pronounced replacement by new bone and induced reunion of the bone marrow cavity. Calcitriol showed strong potential in inhibiting osteoclastogenesis and promotion of osteogenic differentiation at weeks 1, and 2. Furthermore, statistical analysis revealed that the newly formed bone volume in the CAL/DOP/CM group was significantly higher than other groups at weeks 1, and 2. At weeks 4, and 8, the CAL/DOP/CM group showed more mineralized bone and uniform collagen structure. These data suggest that local administration of calcitriol is promising in promoting osteogenesis and mineralization for restoration of mandibular bone defects. - Highlights: • More information on collagen material was added in the revised manuscript. • Masson–Goldner trichrome stain was performed for histomorphometry. • More specific information on calcitriol was supplemented in the Discussion section. • The MOD of ALP and Runx2 was explained in more detail. • The inhibition of osteoclastogenesis was described more accurately in the second paragraph of the discussion

Local administration of calcitriol positively influences bone remodeling and maturation during restoration of mandibular bone defects in rats

Energy Technology Data Exchange (ETDEWEB)

Liu, Hongrui; Cui, Jian; Feng, Wei; Lv, Shengyu; Du, Juan; Sun, Jing; Han, Xiuchun [Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan (China); Wang, Zhenming; Lu, Xiong [Key Lab of Advanced Technologies of Materials, Ministry of Education, School of Materials Science and Engineering, Southwest Jiaotong University, Chengdu, Sichuan (China); Yimin [Department of Advanced Medicine, Graduate School of Medicine, Hokkaido University, Sapporo (Japan); Oda, Kimimitsu [Division of Biochemistry, Niigata University Graduate School of Medical and Dental Sciences, Niigata (Japan); Amizuka, Norio [Department of Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Hokkaido University, Sapporo (Japan); Li, Minqi, E-mail: liminqi@sdu.edu.cn [Department of Bone Metabolism, School of Stomatology Shandong University, Shandong Provincial Key Laboratory of Oral Biomedicine, Jinan (China)

2015-04-01

The aim of this study was to investigate the influence of calcitriol on osteoinduction following local administration into mandibular bone defects. Calcitriol-loaded absorbable collagen membrane scaffolds were prepared using the polydopamine coating method and characterized by scanning electron microscopy. Composite scaffolds were implanted into rat mandibular bone defects in the following groups: no graft material (control), bare collagen membrane (CM group), collagen membrane bearing polydopamine coating (DOP/CM group), and collagen membrane bearing polydopamine coating absorbed with calcitriol (CAL/DOP/CM group). At 1, 2, 4 and 8 weeks post-surgery, the osteogenic potential of calcitriol was examined by histological and immunohistochemical methods. Following in vivo implantation, calcitriol-loaded composite scaffolds underwent rapid degradation with pronounced replacement by new bone and induced reunion of the bone marrow cavity. Calcitriol showed strong potential in inhibiting osteoclastogenesis and promotion of osteogenic differentiation at weeks 1, and 2. Furthermore, statistical analysis revealed that the newly formed bone volume in the CAL/DOP/CM group was significantly higher than other groups at weeks 1, and 2. At weeks 4, and 8, the CAL/DOP/CM group showed more mineralized bone and uniform collagen structure. These data suggest that local administration of calcitriol is promising in promoting osteogenesis and mineralization for restoration of mandibular bone defects. - Highlights: • More information on collagen material was added in the revised manuscript. • Masson–Goldner trichrome stain was performed for histomorphometry. • More specific information on calcitriol was supplemented in the Discussion section. • The MOD of ALP and Runx2 was explained in more detail. • The inhibition of osteoclastogenesis was described more accurately in the second paragraph of the discussion.

Principles of pediatric mandibular fracture management.

Science.gov (United States)

Cole, Patrick; Kaufman, Yoav; Izaddoost, Shayan; Hatef, Daniel A; Hollier, Larry

2009-03-01

Mandible fractures are commonplace in today's craniofacial practice; however, managing the infrequent, operative pediatric mandible injury requires a thorough knowledge base and thoughtful approach. Not only do these patients demonstrate variable anatomy due to differing stages of dental eruption, but condylar disruption may translate into long-term growth disturbance. In addition, patient immaturity often complicates cooperation, and both fixation strategies and postoperative planning must take this into account. As a supplement to the authors' video presentation, the present article focuses on repair of the symphyseal fracture and bilateral condylar injuries in the pediatric patient.

Locating Mandibular Foramen in Children with Mandibular Retrognathism in Mixed Dentition

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Mehrsa Paryab

2015-06-01

Full Text Available Background and aims. One of the most common reasons forthe inferior alveolar nerve block anesthesia failure is the variation in mandibular foramen location. The aim of this study was to assess the location of mandibular foramen in chil-dren with mandibular retrognathism in comparison to children with normal skeletal occlusion in the mixed dentition. Materials and methods. One hundred and twenty panoramic radiographs of patients in mixed dentition period, undergo-ing orthodontic treatment, were selected based on inclusion criteria, skeletal occlusion and stage of dental development. The radiographs were divided into two groups: I: 60 panoramic radiographs of patients with normal skeletal occlusion (15 in each of the Hellman dental age stages; II: 60 panoramic radiographs of patients with mandibular retrognathism (15 in each of the Hellman dental age stages. The radiographs were traced and the linear distance from the mandibular foramen to the borders of the mandibular ramus and its angular position were identified. The measurements were compared between the two groups and among the four dental age groups by t-test, ANOVA and post hoc tests. Results. No statistically significant differences werefound between the patients with normal skeletal occlusion and patients with mandibular retrognathism (P>0.05. Statistical tests showed significant differences in the vertical location of mandibu-lar foramen and gonial angle between the four dental age groups (P<0.05. Conclusion. Mandibular retrognathism does not have a significant impact on the location of the mandibular foramen in the mixed dentition period. The child’s dental age would be considered in the localization of the mandibular foramen.

Experimental study on healing process of rat mandibular bone fracture examined by radiological procedures

International Nuclear Information System (INIS)

Iuchi, Yukio; Furumoto, Keiichi

1994-01-01

The healing process of rat mandibular fractures was stereoscopically observed daily, using plain roentgenography in the lateral-oblique and tooth axis directions and bone scintigraphy using 99m-Tc-methylene diphosphoric acid (Tc-99m-MDP). The findings were compared with microradiograms of regional polished specimens. X-ray findings included the following. Up to 3 days after bone fracture, the fracture mesiodistally showed distinct radiolucency, with sharp and irregular fracture stump. Radiopacity of the fracture site gradually increased 7 days or later, and bone trabecular formation by callus and stump bridging started to occur at 14 days. Findings similar to those in the control group were observed 49 days or later. The inside was difficult to differentiate, irrespective of the observation time. Bone scans in the mesiodistal and buccolingual planes revealed tracer uptake in the areas of mandibular and soft tissue damage one day after bone fracture. Tracer uptake began to be seen in the fracture site 3 days later, and became marked at 14 days. Then Tc-99m DMP began to be localized and returned to the findings similar to those at 49 days. Bone scanning tended to show wider areas earlier than roentgenography. Microradiographic mesiodistal examination revealed distinct radiopacy of the fracture line for 3 days after bone fracture. Seven days later, bone resorption cavity occurred in the cortical bone around the fracture stump, along with neogenesis of callus. Neogenesis and calcification began to occur gradually, and 14 days later, the fracture osteoremodeling of the internal bone trabeculae was observed. Bone trabecular formation within the bone, however, occurred later. (N.K.)

Association between condylar morphology and changes in bony microstructure and subsynovial inflammation in experimental temporomandibular joint arthritis

DEFF Research Database (Denmark)

Kristensen, Kasper Dahl; Hauge, Ellen Margrethe; Dalstra, Michel

2010-01-01

Association between condylar morphology and changes in bony microstructure and subsynovial inflammation in experimental temporomandibular joint arthritis. 86. Congress of the European Orthodontic Society, Slovenien, 2010.......Association between condylar morphology and changes in bony microstructure and subsynovial inflammation in experimental temporomandibular joint arthritis. 86. Congress of the European Orthodontic Society, Slovenien, 2010....

Radiologic study of mandibular foramen of mandibular prognathism by three-dimensional computed tomography

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Lee, Seung Hun; Moon, Cheol Hyun; Im, Jeong Soo; Seo, Hwa Jeong [Graduate School of Public Health and Social Welfare, Gachon University of Medicine and Science, Incheon (Korea, Republic of)

2010-06-15

This study is aimed to evaluate the position of mandibular foramen of mandibular prognathism patients using 3-dimensional CT images in order to reduce the chance of an anesthetic failure of the mandibular nerve and to prevent the damage to the inferior alveolar nerve during the orthognathic surgery. The control group consist of 30 patients with class I occlusion. The experimental group consist of 44 patients with class III malocclusion. Three-dimensional computed tomography was used to evaluate the position of the mandibular foramina. The distance between mandibular plane and mandibular foramen, class I was 25.385 mm, class III was 23.628 mm. About the distance between occlusal plane and mandibular foramen, class I was 1.478 mm, class III was 5.144 mm. The distance between posterior border plan of mandibular ramus and mandibular foramen had not statistically significant. About the distance between sagittal plane of mandible and mandibular foramen did not also showed statistically significant. The result of this study could help the clinicians to apprehend more accurate anatomical locations of the foramina on the mandible with various facial skeletal types. Thereby to perform more accurate block anesthesia of the mandibular nerve and osteotomy with minimal nerve damage. In addition, this study could provide fundamental data for any related researches about the location of the mandibular foramina for other purposes.

Radiologic study of mandibular foramen of mandibular prognathism by three-dimensional computed tomography

International Nuclear Information System (INIS)

Lee, Seung Hun; Moon, Cheol Hyun; Im, Jeong Soo; Seo, Hwa Jeong

2010-01-01

This study is aimed to evaluate the position of mandibular foramen of mandibular prognathism patients using 3-dimensional CT images in order to reduce the chance of an anesthetic failure of the mandibular nerve and to prevent the damage to the inferior alveolar nerve during the orthognathic surgery. The control group consist of 30 patients with class I occlusion. The experimental group consist of 44 patients with class III malocclusion. Three-dimensional computed tomography was used to evaluate the position of the mandibular foramina. The distance between mandibular plane and mandibular foramen, class I was 25.385 mm, class III was 23.628 mm. About the distance between occlusal plane and mandibular foramen, class I was 1.478 mm, class III was 5.144 mm. The distance between posterior border plan of mandibular ramus and mandibular foramen had not statistically significant. About the distance between sagittal plane of mandible and mandibular foramen did not also showed statistically significant. The result of this study could help the clinicians to apprehend more accurate anatomical locations of the foramina on the mandible with various facial skeletal types. Thereby to perform more accurate block anesthesia of the mandibular nerve and osteotomy with minimal nerve damage. In addition, this study could provide fundamental data for any related researches about the location of the mandibular foramina for other purposes.

An Alternative Method of Intermaxillary Fixation for Simple Pediatric Mandible Fractures.

Science.gov (United States)

Farber, Scott J; Nguyen, Dennis C; Harvey, Alan A; Patel, Kamlesh B

2016-03-01

Mandibular fractures represent a substantial portion of facial fractures in the pediatric population. Pediatric mandibles differ from their adult counterparts in the presence of mixed dentition. Avoidance of injury to developing tooth follicles is critical. Simple mandibular fractures can be treated with intermaxillary fixation (IMF) using arch bars or bone screws. This report describes an alternative to these methods using silk sutures and an algorithm to assist in treating simple mandibular fractures in the pediatric population. A retrospective chart review was performed and the records of 1 surgeon were examined. Pediatric patients who underwent treatment for a mandibular fracture in the operating room from 2011 to 2015 were identified using Common Procedural Terminology codes. Data collected included age, gender, type of fracture, type of treatment used, duration of fixation, and presence of complications. Five patients with a mean age of 6.8 years at presentation were identified. Fracture types were unilateral fractures of the condylar neck (n = 3), bilateral fractures of the condylar head (n = 1), and a unilateral fracture of the condylar head with an associated parasymphyseal fracture (n = 1). IMF was performed in 4 patients using silk sutures, and bone screw fixation was performed in the other patient. No post-treatment complications or malocclusion were reported. Average duration of IMF was 18.5 days. An algorithm is presented to assist in the treatment of pediatric mandibular fractures. Silk suture fixation is a viable and safe alternative to arch bars or bone screws for routine mandibular fractures. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

[Research progress of mechanism of hypoxia-inducible factor-1α signaling pathway in condylar cartilage growth and remodeling].

Science.gov (United States)

Gaoli, Xu; Lili, Wu; Zhiwu, Wu; Zhiyuan, Gu

2016-12-01

The condylar cartilage was adapted to hypoxic conditions in vivo. However, condylar cartilage cells exposed in normoxia in vitro affect the chondrocyte phenotype and cartilage matrix formation. This condition also resulted in great difficulty in chondrocyte research. Culturing chondrocyte should be simulated in in vivo hypoxia environment as much as possible. The hypoxia-inducible factor-1α (HIF-1α) demonstrates an important transcription factor of adaptive response to hypoxic conditions. HIF-1α also plays an active role in maintaining homeostasis and function of chondrocytes. This review summarized current knowledge of the HIF-1α structure, signaling pathway, and mechanism of HIF-1α in the condylar cartilage repair.

Roles of Ihh signaling in chondroprogenitor function in postnatal condylar cartilage.

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Kurio, Naito; Saunders, Cheri; Bechtold, Till E; Salhab, Imad; Nah, Hyun-Duck; Sinha, Sayantani; Billings, Paul C; Pacifici, Maurizio; Koyama, Eiki

2018-04-01

Condylar articular cartilage in mouse temporomandibular joint develops from progenitor cells near the articulating surface that proliferate, undergo chondrogenesis and mature into hypertrophic chondrocytes. However, it remains unclear how these processes are regulated, particularly postnatally. Here we focused on the apical polymorphic layer rich in progenitors and asked whether the phenotype and fate of the cells require signaling by Indian hedgehog (Ihh) previously studied in developing long bones. In condyles in newborn mice, the apical polymorphic/progenitor cell layer was ~10 cell layer-thick and expressed the articular matrix marker Tenascin-C (Tn-C), and the underlying thick cell layer expressed Tn-C as well as the chondrogenic master regulator Sox9. By 1 month, condylar cartilage had gained its full width, but became thinner along its main longitudinal axis and displayed hypertrophic chondrocytes. By 3 months, articular cartilage consisted of a 2-3 cell layer-thick zone of superficial cells and chondroprogenitors expressing both Tn-C and Sox9 and a bottom zone of chondrocytes displaying vertical matrix septa. EdU cell tracing in juvenile mice revealed that conversion of chondroprogenitors into chondrocytes and hypertrophic chondrocytes required about 48 and 72 h, respectively. Notably, EdU injection in 3 month-old mice labeled both progenitors and maturing chondrocytes by 96 h. Conditional ablation of Ihh in juvenile/early adult mice compromised chondroprogenitor organization and function and led to reduced chondroprogenitor and chondrocyte proliferation. The phenotype of mutant condyles worsened over time as indicated by apoptotic chondrocyte incidence, ectopic chondrocyte hypertrophy, chondrocyte column derangement and subchondral bone deterioration. In micromass cultures of condylar apical cells, hedgehog (Hh) treatment stimulated chondrogenesis and alkaline phosphatase (APase) activity, while treatment with HhAntag inhibited both. Our findings

An experimental study of mandibular fracture wound healing in the calcium deficient rat

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Lee, Sang Hoon; Wang, Eui Hwan; Lee, Sang Rae

1997-01-01

The purpose of this study was to investigate effects of osteoporosis on fracture wound healing in the calcium deficient rat. To research the experiment some ten-week old Wistar strain rats with approximately 300 gms weight were selected. Then, the rats were divided into two groups : Normal diet group (rats given a normal diet before and after bone fracture) and Low calcium diet group (rats given a low calcium diet before and after bone fracture). Both groups had been provided with each diet for three weeks. When the rats became thirteen weeks old, the mandibular angle of rats in both groups was artificially fractured for test. The healing of fracture wounds was reviewed by using soft x-ray radiography and 99m Tc-MDP bone scan and also histopathologic examination. The obtained results were as follows : 1. The radiolucency of the fracture site for the Normal diet group started to decrease from the 14th day since the experiment was made, while the Low calcium diet group began decrease in the radiolucency from the 21st day of the experiment . The radiolucency for the normal diet group disappeared at the 42nd day, but one for the Low calcium diet group disappeared at the 56th day of the experiment. 2. The highest uptake rate of 99m Tc-MDP stood at the 14th day of the experiment in the Normal diet group and the Low calcium diet group's maximum rate was recorded at the 21st day of the experiment. These both groups were gradually experiencing decrease in the uptake rate as the experiment time was going on. However, the uptake rate in the Low calcium diet group was lower than one in the Normal diet group. 3. For the Normal diet group, the newly formed trabecular, which were similar to one of the surrounding bone, were seen at the 42nd day of the experiment. On the other hand, the Low claium diet group showed at the 56th day of the experiment that the osteoporotic findings looked weak, irregular trabecular, and also large bone marrow space were observed clearly. As a result

Computed Tomography-Based Occipital Condyle Morphometry in an Indian Population to Assess the Feasibility of Condylar Screws for Occipitocervical Fusion.

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Srivastava, Abhishek; Nanda, Geetanjali; Mahajan, Rajat; Nanda, Ankur; Mishra, Nirajana; Karmaran, Srinivasa; Batra, Sahil; Chhabra, Harvinder Singh

2017-12-01

A retrospective computed tomography (CT)-based morphometric study of 82 occipital condyles in the Indian population, focusing on critical morphometric dimensions with relation to placing condylar screws. This study focused on determining the feasibility of placing occipital condylar screws in an Indian population using CT anatomical morphometric data. The occipital condylar screw is a novel technique being explored as one of the options in occipitocervical stabilization. Sex and ethnic variations in anatomical structures may restrict the feasibility of this technique in some populations. To the best of our knowledge, there are no CT-based data on an Indian population that assess the feasibility of occipital condylar screws. We measured the dimensions of 82 occipital condyles in 41 adults on coronal, sagittal, and axial reconstructed CT images. The differences were noted between the right and left sides and also between males and females. Statistical analysis was performed using the t -test, with a p -value of occipital condyle shows that condylar screws are anatomically feasible in a large portion of the Indian population. However, because a small number of population may not be suitable for this technique, meticulous study of preoperative anatomy using detailed CT data is advised.

Condylar guidance: correlation between protrusive interocclusal record and panoramic radiographic image: a pilot study.

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Tannamala, Pavan Kumar; Pulagam, Mahesh; Pottem, Srinivas R; Swapna, B

2012-04-01

The purpose of this study was to compare the sagittal condylar angles set in the Hanau articulator by use of a method of obtaining an intraoral protrusive record to those angles found using a panoramic radiographic image. Ten patients, free of signs and symptoms of temporomandibular disorder and with intact dentition were selected. The dental stone casts of the subjects were mounted on a Hanau articulator with a springbow and poly(vinyl siloxane) interocclusal records. For all patients, the protrusive records were obtained when the mandible moved forward by approximately 6 mm. All procedures for recording, mounting, and setting were done in the same session. The condylar guidance angles obtained were tabulated. A panoramic radiographic image of each patient was made with the Frankfurt horizontal plane parallel to the floor of the mouth. Tracings of the radiographic images were made. The horizontal reference line was marked by joining the orbitale and porion. The most superior and most inferior points of the curvatures were identified. These two lines were connected by a straight line representing the mean curvature line. Angles made by the intersection of the mean curvature line and the horizontal reference line were measured. The results were subjected to statistical analysis with a significance level of p record method. The mean condylar guidance angle between the right and left side by both the methods was not statistically significant. The comparison of mean condylar guidance angles between the right side of the protrusive record method and the right side of the panoramic radiographic method and the left side of the protrusive record method and the left side of the panoramic radiographic method (p= 0.071 and p= 0.057, respectively) were not statistically significant. Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used in programming semi-adjustable articulators. © 2012

Isolated tympanic plate fracture frequency and its relationship to mandibular trauma.

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Altay, Canan; Erdoğan, Nezahat; Batkı, Ozan; Eren, Erdem; Altay, Sedat; Karasu, Sebnem; Mete, Berna; Uluç, Engin

2014-11-01

This study evaluated the prevalence of isolated tympanic fractures and their correlation with mandibular fractures by using maxillofacial computed tomography (CT). We retrospectively evaluated the maxillofacial CT of 1590 patients who presented to our emergency department with maxillofacial trauma between December 2010 and December 2012. Maxillofacial CT was used as the criterion standard for evaluating patients with maxillofacial fractures. The CT images were evaluated by using an electronic picture archiving and communications system and interpreted independently by 2 radiologists. The maxillofacial CT images revealed mandibular fractures in 167 of the patients and isolated tympanic plate fractures in 35 of these 167 patients. Four patients (11%) had a bilateral tympanic plate fracture, and 31 patients (89%) had unilateral tympanic plate fracture. Of all the tympanic plate fractures, 19 (54%) were on the right side and 16 (46%) were on the left side (P > .05). In our results, a significant correlation between the presence of a right-sided tympanic plate fracture and fracture of the ipsilateral condylar process was found (P = .036). However, a statistically significant difference between the presence of a tympanic plate fracture and other mandible fractures, additional soft-tissue findings, or the number of fractures was not determined (P > .05). Sex had no impact on the presence of tympanic plate fracture (P > .05). The frequency of isolated tympanic plate fractures in maxillofacial trauma is low, but it is an important anatomic location. Condyle fractures are significantly associated with isolated tympanic plate fractures. The presence of these injuries should raise suspicion of a concomitant isolated tympanic plate fracture. Copyright © 2014 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

[Application of temporomandibular joint dics reduction in the operation of condylar sagittal fracture].

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Wenli, Zeng; Wuchao, Zhou; Jingkun, Zhang; Yisen, Shao; Weihong, Xi

2017-10-01

To explore the selection of temporomandibular joint (TMJ) disc reduction and fixation methods in condylar sagittal fracture surgery. A total of 36 patients with condylar fractures were chosen. The follow-up period was more 6 months. All 36 cases of condylar sagittal fracture were fixed with long screw. In the operation, the displaced joint disc was repositioned and fixed. The fixed method included direct suture (22 cases) and anchorage (14 cases). Clinical followups were performed before surgery and 1 month, 3 months, 6 months and 1 year after surgery. Clinicians recorded data related to the Fricton craniomandibular index (CMI) and evaluated the postoperative joint function during followup before surgery and 6 months after surgery. In both groups, function of TMJ significantly improved after surgery. The CMI decreased from 0.213±0.162 and 0.273±0.154 to 0.059±0.072 and 0.064±0.068 (P0.05) before or after surgery. Both methods could effectively improve the dysfunction of the TMJ caused by trauma. The selection of joint disc reduction and fixation methods is based on the displacement and damage degree of the joint disc.

A time-dependent degeneration manner of condyle in rat CFA-induced inflamed TMJ.

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Xu, Liqin; Guo, Huilin; Li, Cheng; Xu, Jie; Fang, Wei; Long, Xing

2016-01-01

Temporomandibular joint (TMJ) inflammation is a potential risk factor of osteoarthritis (OA) but the detailed degenerative changes in the inflamed TMJ remain unclear. In this study, we evaluated the changes of condylar cartilage and subchondral bone in rat inflamed TMJ induced by Freund's complete adjuvant (CFA). Articular cavity was injected with CFA and the TMJ samples were collected 1, 2, 3, and 4-week post-injection. Hematoxylin & Eosin (H&E) staining, toluidine blue (TB) staining, Safranin O (S.O) staining, Masson trichrome staining and micro-CT were used to assess TMJ degeneration during inflammation. Osteoclast and osteoblast activities were analyzed by tartrate-resistant acid phosphatase (TRAP) staining and osteocalcin (OCN) immunohistochemistry staining respectively. The expression of receptor activator of NF-kB ligand (RANKL) and osteoprotegerin (OPG) in condylar cartilage and subchondral bone was also evaluated through immunohistochemistry and RANKL/OPG ratio was evaluated. Reduced cartilage thickness, decreased number of chondrocytes, and down-regulated proteoglycan expression were observed in the condylar cartilage in the inflamed TMJ. Enhanced osteoclast activity, and expanded bone marrow cavity were reached the peak in the 2-week after CFA-injection. Meanwhile the RANKL/OPG ratio in the cartilage and subchondral bone also increased in the 2-week CFA-injection. Immature, unmineralized new bones with irregular trabecular bone structure, atypical condylar shape, up-regulated OCN expression, and decreased bone mineral density (BMD) were found in the inflamed TMJ. The time-dependent degeneration manner of TMJ cartilage and subchondral bone was found in CFA-induced arthritis rat model. The degeneration in the TMJ with inflammation might be a risk factor and should be concerned.

Evaluation of Hanau's formula in determination of lateral condylar guidance: A clinical research study

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Bhawsar, Sanjay Vasant; Marathe, Ashlesha Subhash; Ansari, Sadekh Abdul

2015-01-01

Statement of Problem: The accuracy and reliability of the methods used for programming the semi-adjustable articulators determine the accuracy in occlusion. The current recommended average settings using the Hanau's formula commonly used by clinicians is questionable, and thus reassessment is needed. This study was carried out to evaluate and compare the lateral condylar guidance: (1) Using the Hanau's formula and the computerized jaw tracking device (Kinesiograph). (2) On the right and left sides using both these methods. Materials and Methods: A total of 20 completely edentulous patients (14 male and 6 females) within 40–60 years of age were selected. Jaw relation was recorded followed by face bow transfer. Extraoral Gothic arch tracing was recorded; three protrusive records were obtained and condylar guidance was calculated. Lateral condylar guidance was then calculated using Hanau's formula, followed by the computerized jaw tracking device. A comparative evaluation was done of the obtained values. The same investigator worked with each of the study participants for the purpose of standardization. Results: The lateral condylar guidance values obtained using the Hanau's formula ranged from 14 to 17° while those obtained using the computerized K7 jaw tracking device ranged from 8 to 40°. Bennett angle values, obtained using the jaw tracking device and Hanau's formula showed statistically significant differences (P 0.05). Conclusion: Based on the results, dentist and dental technicians should consider reassessing the current recommended average settings and use of the Hanau's formula for programming the semi-adjustable articulators. PMID:26929535

The influence of secondary reconstruction slice thickness on NewTom 3G cone beam computed tomography-based radiological interpretation of sheep mandibular condyle fractures.

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Sirin, Yigit; Guven, Koray; Horasan, Sinan; Sencan, Sabri; Bakir, Baris; Barut, Oya; Tanyel, Cem; Aral, Ali; Firat, Deniz

2010-11-01

The objective of this study was to examine the diagnostic accuracy of the different secondary reconstruction slice thicknesses of cone beam computed tomography (CBCT) on artificially created mandibular condyle fractures. A total of 63 sheep heads with or without condylar fractures were scanned with a NewTom 3G CBCT scanner. Multiplanar reformatted (MPR) views in 0.2-mm, 1-mm, 2-mm, and 3-mm secondary reconstruction slice thicknesses were evaluated by 7 observers. Inter- and intraobserver agreements were calculated with weighted kappa statistics. The receiver operating characteristic (ROC) curve analysis was used to statistically compare the area under the curve (AUC) of each slice thickness. The kappa coefficients varied from fair and to excellent. The AUCs of 0.2-mm and 1-mm slice thicknesses were found to be significantly higher than those of 2 mm and 3 mm for some type of fractures. CBCT was found to be accurate in detecting all variants of fractures at 0.2 mm and 1 mm. However, 2-mm and 3-mm slices were not suitable to detect fissure, complete, and comminuted types of mandibular condyle fractures. Copyright © 2010 Mosby, Inc. All rights reserved.

Question mark ears, temporo-mandibular joint malformation and hypotonia: auriculo-condylar syndrome or a distinct entity?

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Priolo, M; Lerone, M; Rosaia, L; Calcagno, E P; Sadeghi, A K; Ghezzi, F; Ravazzolo, R; Silengo, M

2000-10-01

We report a boy with prominent, peculiarly malformed ears, abnormality of the ramus of the mandible and hypotonia. An isolated peculiar bilateral ear deformity named 'question mark ear' has been delineated in plastic reconstruction surgery reviews [Cosman et al., 1970 Plast Reconstr Surg 46:454-457; Cosman (1984) Plast Reconstr Surg 73:572-576; Takato et al. (1989) Ann Plast Surg 22:69-73; Brodovsky (1997) Plast Reconstr Surg 100:1254-1257; Park (1998) Plast Reconstr Surg 101:1620-1623; Al-Quattan (1998) Plast Reconstr Surg 102:439-441] and a similar deformity of the ear and changes in the temporo-mandibular joint and condyle has been described by Jampol et al. [(1998) Am J Med Genet 75:449-452] and by Guion-Almeida et al. [(1999) Am J Med Genet 86:130-133]. The present case may be the third description of this malformation complex with additional clinical features characterized by hypotonia and mild developmental delay, or possibly a new distinct entity.

Articulated dental cast analysis of asymptomatic and symptomatic populations

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Cordray, Frank E

2016-01-01

Dental instrumentation has long provided insight into the mechanism of musculo-skeletal function of the gnathic system. While large population studies associate dental arch displacement (DAD), especially laterally, with symptoms, mandibular condyle displacement (CD) resulting from DAD has not been targeted as possibly etiologic in the production of common muscle contraction headache (CMCH) and temporo-mandibular dysfunction (TMD). The objective was to evaluate the three-dimensional nature of DAD and CD between the seated condylar position (SCP) and the intercuspal position (ICP) and to compare results derived from large deprogrammed asymptomatic and symptomatic populations. A total of 1 192 sets of dental casts collected from asymptomatic and symptomatic populations were articulated in the SCP. The initial occlusal contact, DAD, and condylar displacement were evaluated for frequency, direction, and magnitude of displacement between the SCP and ICP. The data revealed significant displacement between the SCP and ICP of the condyles (displaced most frequently inferior (down) and posterior (distal)) and substantially increased frequency and magnitude of displacement of the dental arches (with posterior premature occlusal contacts, increased overjet, decreased overbite, midline differences, and occlusal classification changes) in symptomatic subjects. These discrepancies were statistically significant and clinically significant. The data support the concept of increased DAD and CD with dysfunction. Transverse condylar displacement, commonly presenting with dental cross bite, may be associated with CMCH and TMD. Displacement of the mandibular condyle may be an etiologic factor in CMCH and dysfunction of the temporo-mandibular joint. PMID:27357324

Resorbable triangular plate for osteosynthesis of fractures of the condylar neck.

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Lauer, Günter; Pradel, Winnie; Leonhardt, Henry; Loukota, Richard; Eckelt, Uwe

2010-10-01

We describe a new design of resorbable plate for use in the treatment of fractures of the condylar neck, and report the outcome of initial treatment in two patients. Copyright © 2009 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

The effects of orthognathic surgery on mandibular movements in patients with mandibular prognathism

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Sinobad Vladimir

2012-01-01

Full Text Available Introduction. Mandibular prognathism, one of the most severe dentofacial deformities, affects the person’s appearance, psychological health and the quality of life in the most sensitive age period. Objective. The aim of this study was to evaluate the effects of sagittal split ramus osteotomy on the range of mandibular border movements in the early postoperative period. Methods. The study was conducted on 20 patients, of mean age 20.8 years, with mandibular prognathism. All patients included in this study were operated on by bilateral sagittal spliting ramus osteotomy according to Obwegeser and Dal Pont followed by mandibular immobilization during eight weeks. In all patients mandibular border movements were recorded before and six months after surgery using the computerized pantograph Arcus-Digma (KaVo EWL GmbH, Leutkirch, Germany. Results. The analysis of the chosen kinematic parameters revealed that sagittal split ramus osteotomy followed by eight weeks of mandibular immobilization had severe effects on the mouth opening. Six months after surgery the range of maximal mouth opening decreased for approximately 13.9 mm in relation to the preoperative stage. On the contrary, the ranges of maximal protrusion and the border of laterotrusive excursions increased significantly after surgery. Conclusion. In patients with mandibular prognathism where enormous mandibular growth was the main causal factor of the deformity, the sagittal split ramus osteotomy yielded good results. The rigid fixation of bone fragments and reduced period of mandibular immobilization followed by appropriate physical therapy could considerably contribute to a more rapid recovery of mandibular kinematics in the postoperative period.

Anteroposterior condylar position: a comparative study between subjects with normal occlusion and patients with Class I, Class II Division 1, and Class III malocclusions.

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Fraga, Marcelo Reis; Rodrigues, Andréia Fialho; Ribeiro, Luiz Claudio; Campos, Marcio José da Silva; Vitral, Robert Willer Farinazzo

2013-10-29

The present study aimed to determine and compare the anteroposterior position of the condyle in the mandibular fossa between groups of asymptomatic subjects with normal occlusion and asymptomatic subjects with Class I, Class II Division 1, and Class III malocclusions. Thirty persons with normal occlusion, 30 with Class I malocclusion, 30 with Class II Division 1, and 30 with Class III had computed tomography scans of their temporomandibular joints. The anterior joint space/posterior joint space (AJS/PJS) ratio was determined for the right and left joints. The paired t test was used to analyze the AJS/PJS ratio between both sides for each group. The ANOVA test was applied to verify the differences between the groups for the measurements of the right and left sides. In case the ANOVA test confirmed significance, the Dunnett's t test was performed to compare the groups of malocclusion with that of normal occlusion. The paired t test between the AJS/PJS relationships in the right and left sides showed the following p values: Class I (0.168), Class II Division 1 (0.662), Class III (0.991), and normal occlusion (0.390). The ANOVA test showed a p value of 0.445 for the comparisons of the right side and 0.040 for the left side. The Dunnett's t test demonstrated a statistically significant difference between the Class II group and the normal occlusion group (p value of 0.026) in the joints of the left side. Bilateral symmetry and lack of condyle centralization were common characteristics among all groups. The greatest condylar decentralization was observed in the Class II group, whereas the least condylar decentralization was found in the normal occlusion group.

The role of the lateral pterygoid muscle in the sagittal fracture of mandibular condyle (SFMC) healing process.

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Liu, Chng-Kui; Liu, Ping; Meng, Fan-Wen; Deng, Bang-Lian; Xue, Yang; Mao, Tian-Qiu; Hu, Kai-Jin

2012-06-01

The aim of this study was to examine the role of the lateral peterygoid muscle in the reconstruction of the shape of the condyle during healing of a sagittal fracture of the mandibular condyle. Twenty adult sheep were divided into 2 groups: all had a unilateral operation on the right side when the anterior and posterior attachments of the discs were cut, and an oblique vertical osteotomy was made from the lateral pole of the condyle to the medial side of the condylar neck. Ten sheep had the lateral pterygoid muscle cut, and the other 10 sheep did not. Sheep were killed at 4 weeks (n=2 from each group), 12 weeks (n=4), and 24 weeks (n=4) postoperatively. Computed tomograms (CT) were taken before and after operations. We dissected the joints, and recorded with the naked eye the shape, degree of erosion, and amount of calcification of the temporomandibular joint (TMJ). In the group in which the lateral peterygoid muscle had not been cut the joints showed overgrowth of new bone and more advanced ankylosis. Our results show that the lateral pterygoid muscle plays an important part in reconstructing the shape of the condyle during the healing of a sagittal fracture of the mandibular condyle, and combined with the dislocated and damaged disc is an important factor in the aetiology of traumatic ankylosis of the TMJ. Copyright © 2011. Published by Elsevier Ltd.

Difficulties encountered in preauricular approach over retromandibular approach in condylar fracture

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Perumal Jayavelu

2016-01-01

Full Text Available Fracture of mandible can be classified according to its anatomical location, in which condylar fracture is the most common one overall and is missed on clinical examination. Due to the unique geometry of the mandible and temporomandibular joint, without treatment the fractures can result in marked pain, dysfunction, and deformity. The condylar fracture may be further classified depending on the sides involved: unilateral/bilateral, depending on the height of fracture: intracapsular (within the head of condyle, extracapsular - head and neck (high condyle fracture, and subcondylar (low condyle fracture, and depending on displacement: nondisplaced, displaced (anteromedially, medially, and lateral, and dislocated. The clinical features include swelling and tenderness over the temporomandibular joint region, restricted mouth opening, and anterior open bite. A 34-year-old male patient reported to the Department of Oral and Maxillofacial Surgery at Madha Dental College and Hospital; suffered fall trauma resulting in bilateral condyle fracture, dentoalveolar fracture in mandible with restricted mouth opening, and anterior open bite.

Condylar position analysis with a new electronic condylar position measuring instrument E-CPM: influence of different examiners and a working bite on reproducibility.

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Vahle-Hinz, K; Rybczynski, A; Jakstat, H; Ahlers, M O

2009-01-01

Condylar position analysis facilitates a quantitative comparison of the condylar position with and without a bite record, different records and changed influencing factors. Handling by the examiner when positioning the model is a significant factor with regard to the accuracy of the examination. Measurement accuracy could be improved when positioning the models by using special working bites, hence the objective of the experiments described in this study consisted in examining the extent to which the measuring results are influenced by different examiners and by using working bites. In the first trial, one examiner performed ten measurements without and with an interposed working bite for five model pairs in each case. In the second trial, nine examiners (three specialized dentists, three dental assistants, three students) performed ten measurements in each case without and with an interposed working bite. The three-dimensional position was read digitally with the E-CPM (Gamma Dental, Klosterneuburg/Vienna, Austria), recorded by means of spreadsheet software (Microsoft Excel) and diagnostic software (CMDfact, CMD3D module, dentaConcept, Hamburg), and evaluated with graphing software (Sigma Plot, Systat Software, USA). In the first trial, it was shown that the reproducibility of mounting was improved markedly (p <0.01) by using bite records in the form of working bites. In the second trial, it was shown that the mean error increased significantly (p <0.01) when several examiners performed the measurements compared with the results of one examiner alone. No significantly different results occurred (p < 0.01) in the comparison of the different groups of examiners with different educational and training backgrounds. This applied for the mounting methods without and with working bite. On the other hand, the reproducibility of mounting improved distinctly (p<0.01) in every group of examiners when working bites were used. Reproducibility of condylar position analysis was

Mandibular tori are associated with mechanical stress and mandibular shape.

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Cortes, Arthur Rodriguez Gonzalez; Jin, Zhaoyu; Morrison, Matthew Daniel; Arita, Emiko Saito; Song, Jun; Tamimi, Faleh

2014-11-01

The influence of mechanical stimulation on the formation of torus mandibularis (TM) is still poorly understood. We sought to understand the etiology of TMs by investigating the role of parafunctional activity and mandibular morphology on the formation of TMs. We designed a case-control study for patients attending the dental clinic of the present study (University of São Paulo School of Dentistry, São Paulo, SP, Brazil). Patients presenting with TMs were defined as cases, and those without TMs were defined as controls. Finite element analysis (FEA) was used in 3-dimensional mandibular models to examine the stress distribution in the mandibles with and without TMs. In addition, the associations of mandibular arch shape, mandibular cortical index, and parafunctional activity with the presence of T were assessed using odds ratio analysis. A total of 10 patients with TMs and 37 without TMs were selected (22 men and 25 women, mean age 54.3 ± 8.4 years). FEA showed a stress concentration in the region in which TMs form during simulation of parafunctional activity. The radiographic assessment showed that those with TMs were more likely to have a square-shaped mandible with sharp angles (P = .001) and a normal mandibular cortex (P = .03). The subjects without TMs had a round-shaped mandible with obtuse angles and an eroded mandibular cortex. Parafunctional activity could be causing the formation of TMs by concentrating mechanical stress in the region in which TMs usually form. Thus, mandibular geometries that favor stress concentration, such as square-shaped mandibles, will be associated with a greater prevalence of TMs. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The effect of local injection of the human growth hormone on the mandibular condyle growth in rabbit

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Masood Feizbakhsh

2014-01-01

Full Text Available Background: The aim of this study was to evaluate the effect of local injection of human growth hormone (GH in stimulating cartilage and bone formation in a rabbit model of temporomandibular joint (TMJ. Materials and Methods: In an experimental animal study, 16 male Albino New Zealand white rabbits aged 12 weeks were divided into two groups: In the first group (7 rabbits 2 mg/kg/1 ml human GH and in the control group (9 rabbits 1 ml normal saline was administered locally in both mandibular condyles. Injections were employed under sedation and by single experienced person. Injections were made for 6 times with 3 injections a week in the all test and control samples. Rabbits were sacrified at the 20th day from the beginning of study and TMJs were histologically examined. ANOVA (two-sided with Dunnett post hoc test was used to compare data of bone and cartridge thickness while chi-square test was used to analyze hyperplasia and disk deformity data. P < 0.05 was considered as significant. Results: Cartilage layer thickness was greater in the GH-treated (0.413 ± 0.132 than the control group (0.287 ± 0.098 (P value = 0.02. Although bone thickness and condylar cartilage hyperplasia were greater in the GH-treated group, these differences were not statistically significant (P value = 0.189 and 0.083, respectively. There was no statistically significant difference between two groups regarding the disc deformity (P value = 0.46. Conclusion: Local injection of human GH in the TMJ is able to accelerate growth activity of condylar cartilage in rabbit.

Can high-resolution peripheral quantitative computed tomography imaging of subchondral and cortical bone predict condylar fracture in Thoroughbred racehorses?

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Trope, G D; Ghasem-Zadeh, A; Anderson, G A; Mackie, E J; Whitton, R C

2015-07-01

High-resolution 3D imaging may improve the prediction and/or early identification of condylar fractures of the distal metacarpus/tarsus and reduce the frequency of breakdown injury in racehorses. To test the hypotheses that horses suffering condylar fractures have higher bone volume fraction (BV/TV) of the distal metacarpal epiphysis, greater subchondral bone thickness at the fracture site and higher second moment of inertia in the metacarpal midshaft as identified with high-resolution 3D imaging. Cross-sectional study using cadaver material. Thoroughbreds that died on racetracks were grouped as: 1) horses with third metacarpal (McIII) fractures with a condylar component (cases, n = 13); 2) horses with no limb fracture (controls, n = 8); 3) horses with fractures in other bones or suspensory apparatus disruption (other fatal injuries, n = 16). The palmar condyles of McIII and the midshaft were examined with high resolution peripheral quantitative computed tomography (HR-pQCT). Statistical analysis included logistic regression and Spearman's correlation. There were no significant differences in BV/TV of distal McIII and second moment of inertia of the midshaft between cases and controls. Epiphyseal bone BV/TV was greater in injured limbs of horses with any fatal limb injury (Groups 1 and 3 combined) compared with controls (odds ratio = 1.20, 95% confidence interval 1.01-1.42, P = 0.034). An epiphyseal BV/TV>0.742 resulted in a sensitivity of 82.8% and specificity of 62.5% in identifying horses with fatal limb injury. In horses without condylar fracture, increased subchondral bone thickness was associated with palmar osteochondral disease lesions in the adjacent condyle (rs = 0.65, Phorses at risk of any fatal breakdown injury but not metacarpal condylar fractures. Measurement of parasagittal groove subchondral bone thickness is complicated by adjacent palmar osteochondral disease lesions. Thus, high-resolution imaging of the distal metacarpus appears to have limited

Changes in mandibular dimensions during the mediaeval to post-mediaeval transition in London: a possible response to decreased masticatory load.

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Rando, Carolyn; Hillson, Simon; Antoine, Daniel

2014-01-01

Biomechanical forces, such as those produced during mastication, are considered a primary agent in stimulating craniofacial growth and development. There appears to be a strong connection between the strength of the masticatory muscles and the dimensions of the craniofacial complex, with changes in biomechanical force and muscular strength influencing and altering the underlying bony tissues. This is markedly apparent in the mandible and it is possible to infer that changes to mandibular form are due in part to dietary changes. This study aims to investigate this idea by using an archaeological sample from a period that experienced important dietary changes as a result of the Industrial Revolution. 279 skeletons from the mediaeval and post-mediaeval periods in London were selected for analysis, and a detailed metric examination of each mandible was carried out. Males and females were analysed separately and statistically significant reductions were observed in nearly all post-mediaeval measurements. This effect was most pronounced in the areas of the mandible associated with masticatory muscles attachment, including the gonial angle, ramus height and width, bi-gonial breadth and bi-condylar breadth. These recorded changes in mandibular morphology of mediaeval and post-mediaeval Londoners are most likely the result of a shift in diet (and associated decrease in masticatory function) observed in the period surrounding the Industrial Revolution. Copyright © 2013 Elsevier Ltd. All rights reserved.

Radiological study of the mandibular fractures

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Kim, Ju Won; Kim, Kyoung A; Koh, Kwang Jun [Department of Oral and Maxillofacial Radiology, School of Dentistry, and Institute of Oral Bio Science, Chonbuk National University, Jeonju (Korea, Republic of)

2009-06-15

To classify and evaluate mandibular fractures. The author classified mandibular fractures of 284 patients who were referred to the Chonbuk National University Dental Hospital during the period from March 2004 to June 2007. This study was based on the conventional radiographs as well as computed tomographs which were pertained to the 284 patients who have had the mandibular fractures including the facial bone fractures. And mandibular fractures were classified with respect to gender, age, site and type of the fractures. More frequently affected gender with mandibular fracture was male with the ratio of 3.3 : 1. The most frequently affected age with mandibular fracture was third decade (38%), followed by fourth decade (16%), second decade (15%), fifth decade (11%), sixth decade (7%), seventh decade (5%), eighth decade (4%), first decade (4%), and ninth decade (0.3%). The most frequent type of mandibular fracture was single fracture (58%), followed by double fracture (39%), triple fracture (3%). The most common site of mandibular fracture was mandibular condyle as 113 cases (27.7%) and the next was mandibular symphysis as 109 cases (26.7%), mandibular angle as 103 cases (25.3%), mandibular body as 83 cases (20.3%) in order. The sum of fracture sites were 408 sites and there were 1.4 fracture sites per one patient. The number of mandible fractures accompanied with facial bone fractures were 41 cases (14.4%). The results showed the most frequent type and common site of mandibular fracture was single fracture and mandibular condyle respectively.

Radiological study of the mandibular fractures

International Nuclear Information System (INIS)

Kim, Ju Won; Kim, Kyoung A; Koh, Kwang Jun

2009-01-01

To classify and evaluate mandibular fractures. The author classified mandibular fractures of 284 patients who were referred to the Chonbuk National University Dental Hospital during the period from March 2004 to June 2007. This study was based on the conventional radiographs as well as computed tomographs which were pertained to the 284 patients who have had the mandibular fractures including the facial bone fractures. And mandibular fractures were classified with respect to gender, age, site and type of the fractures. More frequently affected gender with mandibular fracture was male with the ratio of 3.3 : 1. The most frequently affected age with mandibular fracture was third decade (38%), followed by fourth decade (16%), second decade (15%), fifth decade (11%), sixth decade (7%), seventh decade (5%), eighth decade (4%), first decade (4%), and ninth decade (0.3%). The most frequent type of mandibular fracture was single fracture (58%), followed by double fracture (39%), triple fracture (3%). The most common site of mandibular fracture was mandibular condyle as 113 cases (27.7%) and the next was mandibular symphysis as 109 cases (26.7%), mandibular angle as 103 cases (25.3%), mandibular body as 83 cases (20.3%) in order. The sum of fracture sites were 408 sites and there were 1.4 fracture sites per one patient. The number of mandible fractures accompanied with facial bone fractures were 41 cases (14.4%). The results showed the most frequent type and common site of mandibular fracture was single fracture and mandibular condyle respectively.

[TMJ and orthodontics, "past, present and future"].

Science.gov (United States)

Manière-Ezvan, A; Oueiss, A; Busson, F

2016-12-01

In the past, the ATM was mainly associated with the growth of the mandibular condyle. Many studies (on rats) showed the role of condylar cartilage in the growth response following stimulation by orthopedic appliances. From where, Class II dysmorphosis "orthopedic" treatments to grow the mandible; but this concept is discussed in the literature in the absence of fully conclusive results and especially since the contribution of orthognathic surgery. Currently, the operating concept is the mechanical stimulation and therefore the function will shape the ATM during growth and that, from an early age. Prevention of dysmorphoses must go through behavioral counseling to be adopted by parents from the birth of their child: to stimulate mandibular propulsion breastfeeding, then by a hard diet inducing an alternating unilateral chewing. Ignorance of the specificity of temporomandibular dysfunction (TMD) notably among teenagers has, in the past, left a doubt about the positive or negative role that could have orthodontic treatment on the TMJ. Currently, the best knowledge of TMJ and TMD provides a better therapeutic conduct: behavioral counseling especially for the girl hyperdivergente with small condyles, control of the condylar position, occlusal adjustments at the end of orthodontic treatment. The future of TMJ in relation with orthodontics is based on prevention, screening and deepening of our knowledge. The orthodontist will thus not make a treatment in patients at risk or will identify it and finish the treatment perfectly. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

A comparative study to evaluate the discrepancy in condylar guidance values between two commercially available arcon and non-arcon articulators: A clinical study

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Mukesh Kumar Goyal

2011-01-01

Full Text Available Aim: The purpose of this study was comparative evaluation of sagittal condylar values of arcon and non-arcon articulators with cephalometric readings and to determine the amount of discrepancy in sagittal condylar guidance values between arcon and non-arcon articulators using same protrusive record. Materials and Methods: Twenty subjects in the age group of 19-35 years, free from temporomandibular joint dysfunction, and occlusal disharmony, with healthy dentition participated in the study. Hanau H2 (non-arcon type and Hanau Wide-Vue (arcon type articulators were programmed for sagittal condylar guidance values using the same protrusive record made in polysiloxane bite registration material with edge to edge degree of protrusion. The resultant values for both the articulators on either side were compared with values obtained from tracing of digital lateral cephalogram using Kodak Dental imaging Window software 6.6.3.0-C program. The tabulated data were subjected to statistical analysis, ANOVA (Fishers ′F′ test for group comparison, Tukey′s HSD test for inter-comparison, student′s unpaired ′t′ test for intra-group comparison, and level of significance (P was calculated using the same. Results: The mean sagittal condylar guidance values of the three different groups were found to be very highly significant (P=0.001 and highly significant (P=0.002 on the right and left sides respectively. There was a very highly significant difference (P=0.001 and highly significant difference (P=0.003 between the arcon and non-arcon group on the right and left side respectively. No significant difference was found between the arcon and cephalometric group (P=0.284 right, P=0.853 left and a statistically significant difference was found between the non-arcon and cephalometric group (P=0.049 right, P=0.015 left. On intragroup comparison there was no statistically significant difference in sagittal condylar values on the right and left sides. Conclusion

Temporomandibular joint assessment in patients with articular disc displacement by way of computed tomography - radiological parameters of shape, size and location of mandibular heads

Directory of Open Access Journals (Sweden)

Szabelska Anna

2015-09-01

Full Text Available Conventional and modern methods of radiological imaging are often used in the diagnosis of temporomandibular joint disorders, and the CT technique is particularly characterized by an excellent visualization of bony structures. The aim of the study was to show the importance and role of CT in the evaluation of TMJ bone structures in both patients with articular disc displacement and in a group of healthy subjects. Both study groups were assessed with the use of the transverse plane. Herein, multi-slice spiral computed tomography was performed in 47 subjects. These individuals were qualified for CT by way of magnetic resonance imaging, due to their being diagnosed with a displacement of their temporomandibular joint disc. The product of our study is presented as a set of tables. These are comparisons of radiological parameters based on the shape, size and location of the mandibular head, in the examined patients, in a control group, and with regard to sex. The results of our work indicate that CT can be successfully used in the imaging of TMJ bone structures, specifically, the condylar process of the mandibular head and the joint socket. However, statistically significant differences of the utilized parameters between patients with articular disc displacement and controls, warrant further analysis of this issue.

Ankylosis Due Sequel Of Fracture Of The Mandibular Condyle: Case Report

Directory of Open Access Journals (Sweden)

Alina Alencar Ferreira Gomes

2017-08-01

Full Text Available The Ankylosis of the Temporomandibular joint (TMJ is a disorder of craniofacial complex that results in the merger between the condyle and the mandibular fossa, causing partial or complete immobilization of the mandible. The etiological factors are local and systemic inflammation, infection in the area of TMJ, rheumatic diseases and neoplasms, having the trauma as the main etiologic factor. The traumas are responsible for 31% to 98% of cases of ankylosis. The diagnosis is made from the anamnesis and imaging scans (computed tomography pointing to the union of joint components. The treatment of ankylosis is a big challenge due the high rate of recurrence that can be affected by factors such as type of ankylosis, surgical technique, age of the patient, post-operative physiotherapy and systematic follow-up of the patient. The various forms of treatment require careful analysis of type of ankylosis if it is intra or extra-articular, unilateral or bilateral and if it is bony or fibrous, There is no consensus in current literature regarding the best treatment. The aim of this work is to present through the report of a clinical case, a surgical treatment of Unilateral Temporomandibular joint Ankylosis, due to sequel of condylar fracture with re-establishment of the stomatognathic functions in postoperative follow-up.

CT morphology and function of the condylar joints after conservative functional treatment of condylar fractures

International Nuclear Information System (INIS)

Eberhardt, K.; Sahm, G.

1990-01-01

In 8 adult and 13 adolescent individuals who had undergone conservative treatment for condylar fractures 4.2 and 4.5 years earlier, respectively computed tomography was performed. In addition, joint mobility was examined clinically in 18 of these patients. The results of the radiological examination allow discrimination between high-grade and low-grade remodeling and excessive bone formation. With one exception, high-grade remodeling was invariably observed after childhood fractures. In the adult patients new bone formation was rarely observed. Correlation between the mrophologic appearance and joint mobility was detectable only in cases of severely limited function. In the presence of less severe functional lesions, the size of the insertion area of the lateral pterygoid muscle might indicate the degree of functional rehabilitation. The radiological procedure is discussed. (orig.) [de

A comparative evaluation of static and functional methods for recording centric relation and condylar guidance: a clinical study.

Science.gov (United States)

Thakur, Mridul; Jain, Veena; Parkash, Hari; Kumar, Pravesh

2012-09-01

To evaluate and compare the centric relation and horizontal condylar guidance using interocclusal wax and extra oral Gothic arch methods and subjective evaluation of dentures thus fabricated. Centric relation and horizontal condylar guidance was recorded by using interocclusal wax and gothic arch tracing in 28 completely edentulous patients. These records were transferred to the articulator and difference in both values was recorded. After that patients were divided in two groups according to the centric relation and horizontal condylar guidance recording method used to achieve balanced occlusion. Response of the dentures was subjectively evaluated using "Woelfel subjective evaluation criteria". Centric relation recorded by both the methods did coincide in 7.14 % of patients. Centric relation recorded by interocclusal wax was posterior to Gothic centric relation in 21.43 % of patients, and anterior to Gothic centric relation in 71.42 % patients. Gothic arch tracings gave higher mean guidance values on both the sides as compared to protrusive wax record in all the subjects, although the difference was statistically insignificant (P > 0.05). Subjective evaluation showed statistical insignificance for all the parameters in both groups. Gothic arch method records the centric relation at a more posterior position than the Static method, but it does not make any difference in clinical performance of the complete denture. Horizontal condylar guidance angle was approximately similar by both the methods.

Evaluation of the condylar movement on MRI during maximal mouth opening in patients with internal derangement of TMJ; comparison with transcranial view

International Nuclear Information System (INIS)

Cho, Bong Hae

2001-01-01

To evaluate the condylar movement at maximal mouth opening on MRI in patients with internal derangement. MR images and transcranial views for 102 TMJs in 51 patients were taken in closed and maximal opening positions, and the amount of condylar movement was analyzed annotatively and qualitatively. For MR images, the mean condylar movements were 9.4 mm horizontally, 4.6 mm vertically and 10.9 mm totally, while those for transcranial views were 12.5 mm, 4.6 mm, and 13.7 mm respectively. The condyle moved forward beyond the summit of the articular eminence in 41 TMJs (40.2%) for MR images than in transcranial views

Indirect reduction with a condylar blade plate for osteosynthesis of subtrochanteric femoral fractures.

Science.gov (United States)

Siebenrock, K A; Müller, U; Ganz, R

1998-01-01

Subtrochanteric fractures frequently occur as high energy trauma usually in younger patients and may lead to severe comminution of the medial cortex. The medial cortex of the proximal femur is exposed to high compressive forces which make fracture stabilization a difficult problem. Bone healing may be seriously compromised due to extensive comminution and fragment devitalization. This requires reduction techniques which do not cause additional damage to the vitality of the bone. With indirect reduction techniques and the use of a condylar blade plate the results have been significantly improved in these fracture types in our department (1). In this report the essential aspects of indirect reduction for subtrochanteric fractures using a condylar blade plate and the treatment results from our department from earlier years (1) and from the last 2 1/2 years will be presented. In the latter period, fifteen patients with a mean age of 49 years (19-87 years) were treated with this method. Fractures resulted from traffic incidents or falls from a great height in 11 cases (73%). Union was achieved in 14 cases (93%) with full weight-bearing after a mean of 3 months (1-4 1/2 months). Malunion was seen in two cases (13%) without the need for further surgery. Non union occurred in one patient (7%) with a III B open injury due to early infection. After repeated debridements, bone grafting and decortication, the fracture was stabilized with a replacement condylar blade plate and healed uneventfully.

Roentgenographic study of the mandibular canal

International Nuclear Information System (INIS)

Ahn, Hyung Kyu

1980-01-01

The mandibular canal must be considered carefully during the surgical treatment, especially surgical extraction of the impacted tooth and intraosseous implant, because it contains the important inferior alveolar nerve and vessels. The author investigated the curvature of the mandibular canal and its relation to the mandibular molars and positional relation between the mental foramen and the mandibular premolars in orthopantomogram. The materials consisted of 441 orthopantomograms divided four groups; Group I consisted of 56 males and 44 females from 1 to 6 years of age, Group II consisted of 58 males and 45 females from 7 to 12 years of age, Group III consisted of 65 males and 33 females from 13 to 18 years of age, Group IV consisted of 86 males and 54 females over 19 years of age. The results were as followings; 1. The curvature of mandibular canal was 144.50 .deg. in Group II, 148.11 .deg. in Group III, 147.33 .deg. in Group IV. 2. The curvature of mandibular canal was located most frequently on the area between mandibular 1st molar and mandibular 2nd molar in Group I (42%) and on the mandibular 2nd molar area in Group II (54%), Group III (59%), Group IV (53%). 3. The position of mental foramen was most frequently below the mandibular 1st premolar in Group I (58%), between the mandibular 1st premolar and the 2nd premolar in Group II (62%), Group III (47%), and below the mandibular 2nd premolar in Group IV (58%).

Effect of occlusal (mechanical) stimulus on bone remodelling in rat mandibular condyle.

Science.gov (United States)

Gazit, D; Ehrlich, J; Kohen, Y; Bab, I

1987-09-01

Mechanical load influences the remodelling of skeletal tissues. In the mandibular condyle, occlusal alterations and the consequent mechanical stimulus induce changes in chondrocytes and cartilage mineralization. In the present study we quantified in the mandibular condyle the effect of occlusal interference on remodelling of the subchondral bone. Computerized histomorphometry after 5-21-day exposure to the influence of a unilateral occlusal splint revealed an increased rate of trabecular remodelling, consisting of enhancement in osteoblast and osteoclast numbers and activities. The bone formation parameters reached their high values on Days 5 or 9 and remained stable thereafter. Bone resorption showed a gradual increase throughout the experimental period. These results further characterize the temporomandibular joint reaction to occlusal alterations. It is suggested that the present increase in bone turnover together with the known enhancement in chondrogenesis are part of a process of functional adaptation in response to mechanical stimulus.

Factors affecting femoral rotational angle based on the posterior condylar axis in gap-based navigation-assisted total knee arthroplasty for valgus knee.

Science.gov (United States)

Lee, Sung-Sahn; Lee, Yong-In; Kim, Dong-Uk; Lee, Dae-Hee; Moon, Young-Wan

2018-01-01

Achieving proper rotational alignment of the femoral component in total knee arthroplasty (TKA) for valgus knee is challenging because of lateral condylar hypoplasia and lateral cartilage erosion. Gap-based navigation-assisted TKA enables surgeons to determine the angle of femoral component rotation (FCR) based on the posterior condylar axis. This study evaluated the possible factors that affect the rotational alignment of the femoral component based on the posterior condylar axis. Between 2008 and 2016, 28 knees were enrolled. The dependent variable for this study was FCR based on the posterior condylar axis, which was obtained from the navigation system archives. Multiple regression analysis was conducted to identify factors that might predict FCR, including body mass index (BMI), Kellgren-Lawrence grade (K-L grade), lateral distal femoral angles obtained from the navigation system and radiographs (NaviLDFA, XrayLDFA), hip-knee-ankle (HKA) axis, lateral gap under varus stress (LGVS), medial gap under valgus stress (MGVS), and side-to-side difference (STSD, MGVS - LGVS). The mean FCR was 6.1° ± 2.0°. Of all the potentially predictive factors evaluated in this study, only NaviLDFA (β = -0.668) and XrayLDFA (β = -0.714) predicted significantly FCR. The LDFAs, as determined using radiographs and the navigation system, were both predictive of the rotational alignment of the femoral component based on the posterior condylar axis in gap-based TKA for valgus knee. A 1° increment with NaviLDFA led to a 0.668° decrement in FCR, and a 1° increment with XrayLDFA led to a 0.714° decrement. This suggests that symmetrical lateral condylar hypoplasia of the posterior and distal side occurs in lateral compartment end-stage osteoarthritis with valgus deformity.

A clinico-radiographic study to compare and co-relate sagittal condylar guidance determined by intraoral gothic arch tracing method and panoramic radiograph in completely edentulous patients.

Science.gov (United States)

Shetty, Sanath; Kunta, Mythili; Shenoy, Kamalakanth

2018-01-01

The purpose of this study was to compare and correlate sagittal condylar guidance determined by intraoral gothic arch tracing method and panoramic radiograph in edentulous patients. Twelve completely edentulous patients were selected by the inclusion and exclusion criteria. Conventional steps in the fabrication of complete denture till jaw relation were carried out. Intraoral gothic arch tracing and protrusive interocclusal records were obtained for each patient. Protrusive interocclusal record was used to program the Hanau Wide-Vue semi-adjustable articulator, thus obtaining the sagittal condylar guidance angle. Using RadiAnt DICOM software, on the orthopantomogram obtained for each patient in the study, two reference lines were drawn. The Frankfort's horizontal plane and the mean curvature line (joining the most superior and the inferior points on the glenoid fossa curvature) were drawn. The mean curvature line was extended to intersect the Frankfort's horizontal plane, thus obtaining the radiographic sagittal condylar guidance angle. The condylar guidance angles obtained by these two methods were compared and subjected to paired t -test. There was no statistically significant difference between the sagittal condylar guidance angles obtained between right and left sides with intraoral gothic arch tracing and radiographic methods ( P = 0.107 and 0.07, respectively). Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used for programming semi-adjustable articulators.

Analysis of patterns and treatment strategies for mandibular condyle fractures: review of 175 condyle fractures with review of literature.

Science.gov (United States)

Reddy, N Viveka V; Reddy, P Bhaskar; Rajan, Ritesh; Ganti, Srinivas; Jhawar, D K; Potturi, Abhinand; Pradeep

2013-09-01

This study aims to evaluate incidence, patterns and epidemiology of mandibular condylar fractures (MCF) to propose a treatment strategy for managing MCF and analyze the factors which influence the outcome. One hundred and seventy-five MCF's were evaluated over a four year period and their pattern was recorded in terms of displacement, level of fracture, age of incidence and dental occlusion. Of the 2,718 facial bone fractures, MCF incidence was the third most common at 18.39 %. Of 175 MCF 58.8 % were unilateral and 41.12 % were bilateral. 67 % of bilateral fractures and 43.8 % of unilateral fractures were associated with midline symphysis and contralateral parasymphysis fractures respectively. Most of the MCF was seen in the age group of above 16 years and 50 % of them were at subcondylar level (below the neck of the condyle). Majority of MCF sustained due to inter personal violence were undisplaced (72.7 %) and contrary to this majority of MCF sustained during road traffic accident were displaced. 62.9 % of total fractures required open reduction and rigid fixation and 37.1 % were managed with closed reduction. 80 % of MCF managed with closed reduction were in the age group of below 16 years. From this study it can be concluded that the treatment algorithm proposed for managing MCF is reliable and easy to adopt. We observed that absolute indication for open reduction of MCF is inability to achieve satisfactory occlusion by closed method and absolute contraindication for open reduction is condylar head fracture irrespective of the age of the patient.

Complaints related to mandibular function impairment after closed treatment of fractures of the mandibular condyle

NARCIS (Netherlands)

Niezen, E. T.; Bos, R. R. M.; de Bont, L. G. M.; Stegenga, B.; Dijkstra, P. U.

This study analysed the relationship between complaints and mandibular function after closed treatment of fractures of the mandibular condyle in a prospective study. In a I-year follow-up, complaints were assessed during physical examination and function was assessed using the mandibular function

Histological study of the human temporo-mandibular joint and its surrounding muscles.

Science.gov (United States)

Bravetti, P; Membre, H; El Haddioui, A; Gérard, H; Fyard, J P; Mahler, P; Gaudy, J F

2004-10-01

This is a histological study of the human temporo-mandibular joint and its surrounding muscles. Using a microscopic study of serial sections from anatomical specimens from six subjects, the detailed anatomy of the joint is presented with particular regard to the histology. This study has allowed, in particular, the description of the ligaments and capsule as well as the insertions of the masticatory muscles (temporalis, masseter, lateral pterygoid) on this joint. These observations are then compared with the anatomical and histological data already reported on this subject. This study shows that the bulk of the muscular fibres of the lateral pterygoid passes under the foot of the disc is attached over the whole height of the condylar, unite and extend as far as the medial pole of the joint under the insertion of the articular disc. An insertion of the temporo-masseter musculo-tendinous complex on the anterior and lateral capsulo-discal structures was observed. The lateral pterygoid is composed of a succession of tendinous and fleshy fibres. This study confirms the thickening of the lateral capsule that corresponds to a lateral collateral ligament, and the absence of a medial collateral ligament. Medial stability is conferred by the lateral ligament of the contralateral joint.

[Mandibular-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia with rapid prototyping technology].

Science.gov (United States)

Gao, Quan-Wen; Song, Hui-Feng; Xu, Ming-Huo; Liu, Chun-Ming; Chai, Jia-Ke

2013-11-01

To explore the clinical application of mandibular-driven simultaneous maxillo-mandihular distraction to correct hemifacial microsomia with rapid prototyping technology. The patient' s skull resin model was manufactured with rapid prototyping technology. The osteotomy was designed on skull resin model. According to the preoperative design, the patients underwent Le Fort I osteotomy and mandibular ramus osteotomy. The internal mandible distractor was embedded onto the osteotomy position. The occlusal titanium pin was implanted. Distraction were carried out by mandibular-driven simultaneous maxillo-mandihular distraction 5 days after operation. The distraction in five patients was complete as designed. No infection and dysosteogenesis happened. The longest distance of distraction was 28 mm, and the shortest distance was 16 mm. The facial asymmetry deformity was significantly improved at the end of distraction. The ocelusal plane of patients obviously improved. Rapid prototyping technology is helpful to design precisely osteotomy before operation. Mandibular-driven simultaneous maxillo-mandibular distraction can correct hemifacial microsomia. It is worth to clinical application.

Biomechanical comparison of osteosynthesis with poly‑L‑lactic acid ...

African Journals Online (AJOL)

2015-01-21

Jan 21, 2015 ... Fractures of the mandibular condylar process are common fractures affecting the ... mandible replicas are having a medullar and a cortical portion (Synbone ... Based on the biomechanical simulations they performed Neff et al ...

Cone-Beam Computed Tomography Assessment of Lower Facial Asymmetry in Unilateral Cleft Lip and Palate and Non-Cleft Patients with Class III Skeletal Relationship.

Science.gov (United States)

Lin, Yifan; Chen, Gui; Fu, Zhen; Ma, Lian; Li, Weiran

2015-01-01

To evaluate, using cone-beam computed tomography (CBCT), both the condylar-fossa relationships and the mandibular and condylar asymmetries between unilateral cleft lip and palate (UCLP) patients and non-cleft patients with class III skeletal relationship, and to investigate the factors of asymmetry contributing to chin deviation. The UCLP and non-cleft groups consisted of 30 and 40 subjects, respectively, in mixed dentition with class III skeletal relationships. Condylar-fossa relationships and the dimensional and positional asymmetries of the condyles and mandibles were examined using CBCT. Intra-group differences were compared between two sides in both groups using a paired t-test. Furthermore, correlations between each measurement and chin deviation were assessed. It was observed that 90% of UCLP and 67.5% of non-cleft subjects had both condyles centered, and no significant asymmetry was found. The axial angle and the condylar center distances to the midsagittal plane were significantly greater on the cleft side than on the non-cleft side (P=0.001 and P=0.028, respectively) and were positively correlated with chin deviation in the UCLP group. Except for a larger gonial angle on the cleft side, the two groups presented with consistent asymmetries showing shorter mandibular bodies and total mandibular lengths on the cleft (deviated) side. The average chin deviation was 1.63 mm to the cleft side, and the average absolute chin deviation was significantly greater in the UCLP group than in the non-cleft group (P=0.037). Compared with non-cleft subjects with similar class III skeletal relationships, the subjects with UCLP showed more severe lower facial asymmetry. The subjects with UCLP presented with more asymmetrical positions and rotations of the condyles on axial slices, which were positively correlated with chin deviation.

Radiological classification of mandibular fractures

International Nuclear Information System (INIS)

Mihailova, H.

2009-01-01

Mandibular fractures present the biggest part (up to 97%) of the facial bone fractures. Method of choice for diagnosing of mandibular fractures is conventional radiography. The aim of the issue is to present an unified radiological classification of mandibular fractures for the clinical practice. This classification includes only those clinical symptoms of mandibular fracture which could be radiologically objectified: exact anatomical localization (F1-F6), teeth in fracture line (Ta,Tb), grade of dislocation (D I, D II), occlusal disturbances (O(+), O(-)). Radiological symptoms expressed by letter and number symbols are systematized in a formula - FTDO of mandibular fractures similar to TNM formula for tumours. FTDO formula expresses radiological diagnose of each mandibular fracture but it doesn't include neither the site (left or right) of the fracture, nor the kind and number of fractures. In order to express topography and number of fractures the radiological formula is transformed into a decimal fraction. The symbols (FTD) of right mandible fracture are written in the numerator and those of the left site - in the denominator. For double and multiple fractures between the symbols for each fracture we put '+'. Symbols for occlusal disturbances are put down opposite, the fractional line. So topographo-anatomical formula (FTD/FTD)xO is formed. In this way the whole radiological information for unilateral, bilateral, single or multiple fractures of the mandible is expressed. The information in the radiological topography anatomic formula, resp. from the unified topography-anatomic classification ensures a quick and exact X-ray diagnose of mandibular fracture. In this way contributes to get better, make easier and faster X-ray diagnostic process concerning mandibular fractures. And all these is a precondition for prevention of retardation of the diagnosis mandibular fracture. (author)

Bone scanning with /sup 99m/Tc phosphate to assess condylar hyperplasia. Report of two cases

International Nuclear Information System (INIS)

Matteson, S.R.; Proffit, W.R.; Terry, B.C.; Staab, E.V.; Burkes, E.J. Jr.

1985-01-01

Condylar hyperplasia poses a problem in planning treatment because it is a self-limiting process for some but not all patients. Continued growth creates a progressive deformity that requires condylectomy, whereas an enlarged condyle can be left in place after hyperplastic growth ceases, even if ramus surgery is needed to correct asymmetry. Bone scan with /sup 99m/Tc phosphate can be used to assist in making the differential diagnosis. In the two patients reported here, abnormal metabolic activity revealed by bone scans supported clinical and historical evidence that the condylar hyperplasia was active and required surgical correction, including condylectomy. The two cases demonstrate different approaches to postsurgical orthodontic treatment, depending on the amount of normal growth expected

Morphological and Histopathological Changes in Orofacial Structures of Experimentally Developed Acromegaly-Like Rats: An Overview

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Masahiro Iikubo

2012-01-01

Full Text Available Tongue enlargement and mandibular prognathism are clinically recognized in almost all patients with acromegaly. An acromegaly-like rat model recently developed by exogenous administration of insulin-like growth factor I (IGF-I was used to investigate morphological and histopathological changes in orofacial structures and to clarify whether these changes were reversible. Exogenous administration of IGF-I evoked specific enlargement of the tongue with identifiable histopathological changes (increased muscle bundle width, increased space between muscle bundles, and increased epithelial thickness, elongation of the mandibular alveolar bone and ascending ramus, and lateral expansion of the mandibular dental arch. Regarding histopathological changes in the mandibular condyle, the cartilaginous layer width, bone matrix ratio, and number of osteoblasts were all significantly greater in this rat model. After normalization of the circulating IGF-I level, tongue enlargement and histopathological changes in the tongue and mandibular condyle were reversible, whereas morphological skeletal changes in the mandible remained.

Surgical treatment of adolescent internal condylar resorption (AICR) with articular disc repositioning and orthognathic surgery in the growing patient?a pilot study

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Bodine, Trevor P.; Wolford, Larry M.; Araujo, Eustaquio; Oliver, Donald R.; Buschang, Peter H.

2016-01-01

Abstract Background The aim of this study was to better understand how surgical repositioning and stabilization of anteriorly displaced articular discs using the Mitek mini-anchor technique affects condylar growth in growing patients with adolescent internal condylar resorption (AICR). Methods Twenty-two adolescent patients diagnosed with AICR and anterior temporomandibular disc displacement were compared to untreated control subjects without AICR matched for age, sex, and Angle classificatio...

A lateral approach for screw repair in lag fashion of spiral third metacarpal and metatarsal medial condylar fractures in horses.

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Smith, Lewis C R; Greet, Timothy R C; Bathe, Andrew P

2009-08-01

To describe a lateral approach for screw fixation in lag fashion of simple spiral medial condylar fractures of the third metacarpus/metatarsus (MC3/MT3). Case series. Thoroughbred racehorses (n=9). Nondisplaced medial MC3/MT3 condylar fractures (3 thoracic, 6 pelvic limbs), with mean length 126 mm (range, 91-151 mm) were repaired by internal fixation, under general anesthesia, using multiple 4.5 mm cortical screws inserted in lag fashion from the lateral aspect of the limb, using radiographic or fluoroscopic guidance. Horses were recovered from anesthesia in half-limb casts; 7 unassisted and 2 using a rope-recovery system. Horses had 2 months box rest, 1 month in-hand walking, and follow-up radiographic examination at 3 months. Horses recovered uneventfully from anesthesia. Five horses raced; 1 returned to training, was persistently lame, and was retired to stud; 2 were retired directly to stud; and 1 horse was lost to follow-up. MC3/MT3 medial condylar fractures were successfully repaired by screws inserted n lag fashion form the lateral aspect. Use of a lateral approach to medial condylar MC3/MT3 fractures allows screw insertion perpendicular to the fracture plane without interference with palmar/plantar soft tissue structures or from the splint bones. Although repair was performed under general anesthesia, the technique should be adaptable to application in standing horses.

Assessment of effect of age, gender, and dentoalveolar changes on mandibular morphology: A digital panoramic study

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V Sairam

2018-01-01

Full Text Available Introduction: With progressive development in the growth and function of the jaws, changes are observed in size as well as shape of the mandible, which vary on the basis of age, gender, and dental status. The objective of this study was to evaluate and assess the morphological changes of the mandible, with varying age, gender, and dental status, using panoramic radiographs. Materials and Methods: A retrospective study was conducted using digital panoramic radiographs taken by Kodak 8000c digital panoramic and cephalometric system on 150 patients, comprising fifty edentulous individuals (above 50 years of age, fifty old dentate individuals (above 50 years of age, and fifty young dentate individuals (below 25 years of age. All the mandibular measurements (gonial angle, ramus length, condylar length (CL, ramus notch depth, and cortical bone thickness were carried out using RadiAnt DICOM VIEWER 2.2.9 (32-bit software. The measurements were then subjected to paired t-test, Tukey's multiple post hoc procedures, and multiple linear regression analysis. Results: Descriptive statistics for all the parameters on the right and left sides of the mandible in both males and females were analyzed. A statistical significance of P < 0.05 was observed for all the variables except one variable (CL. Conclusion: In the present study, all the variables showed increased measurements in males except gonial angle, which was found to be wider in females, indicating that women tend to get affected by varying dental statuses than men. Hence, the parameters used in this study may act as good indicators for the assessment of the effect of age, gender, and dental status on mandibular morphology.

Observation of positional relation between mandibular third molars and the mandibular canal on limited cone beam computed tomography

International Nuclear Information System (INIS)

Hashizume, Atsuko; Nakagawa, Yoichi; Ishii, Hisako; Kobayashi, Kaoru

2004-01-01

We describe the preoperative use of limited cone beam computed tomography (CT) with a dental CT scanner for the assessment of mandibular third molars before extraction. Cone beam CT provides 42.7-mm-high and 30-mm-wide rectangular solid images, with a resolution of less than 0.2 mm. The positional relationship between the mandibular third molars and the mandibular canal was examined by dental CT. Sixty-eight lower third molars of 62 patients whose teeth were superimposed on the mandibular canal on periapical or panoramic radiographs were studied. Dental CT scans clearly demonstrated the positional relationship between the mandibular canal and the teeth. The mandibular canal was located buccally to the roots of 16 teeth, lingually to the roots of 27 teeth, inferiorly to the roots of 23 teeth, and between the roots of 2 teeth. The presence of bone between the mandibular canal and the teeth was not noted in 7 of 16 buccal cases, 24 of 27 lingual cases, and 10 of 23 inferior cases on dental CT scans, suggesting that the canal was in contact with the teeth. Fifty-nine of the 68 mandibular third molars were surgically removed, and postoperative transient hypoesthesia occurred in 4 patients. Dental CT scans showed no bone between the mandibular canal and the teeth in all 4 patients. Hypoesthesia was not related to the bucco-lingual location of the mandibular canal or to the extent of bone loss between the canal and the teeth. However, hypoesthesia did not occur in patients with bone between the mandibular canal and the teeth. Thus, information on the distance between the canal and teeth on dental CT scans was useful for predicting the risk of inferior alveolar nerve damage. Because of its high resolution and low radiation dose, cone beam CT was useful for examination before mandibular third molar surgery. (author)

Roles of Chondrocytes in Endochondral Bone Formation and Fracture Repair

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Hinton, R.J.; Jing, Y.; Jing, J.; Feng, J.Q.

2016-01-01

The formation of the mandibular condylar cartilage (MCC) and its subchondral bone is an important but understudied topic in dental research. The current concept regarding endochondral bone formation postulates that most hypertrophic chondrocytes undergo programmed cell death prior to bone formation. Under this paradigm, the MCC and its underlying bone are thought to result from 2 closely linked but separate processes: chondrogenesis and osteogenesis. However, recent investigations using cell lineage tracing techniques have demonstrated that many, perhaps the majority, of bone cells are derived via direct transformation from chondrocytes. In this review, the authors will briefly discuss the history of this idea and describe recent studies that clearly demonstrate that the direct transformation of chondrocytes into bone cells is common in both long bone and mandibular condyle development and during bone fracture repair. The authors will also provide new evidence of a distinct difference in ossification orientation in the condylar ramus (1 ossification center) versus long bone ossification formation (2 ossification centers). Based on our recent findings and those of other laboratories, we propose a new model that contrasts the mode of bone formation in much of the mandibular ramus (chondrocyte-derived) with intramembranous bone formation of the mandibular body (non-chondrocyte-derived). PMID:27664203

Surgical treatment on displaced and dislocated sagittal fractures of the mandibular condyle.

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Jing, Jie; Han, Yu; Song, Yu; Wan, Yingbiao

2011-06-01

The purpose of this study was to evaluate the effect of surgical treatment on displaced and dislocated sagittal fractures of the mandibular condyle (SFMC). Twenty-four patients with 28 displaced and dislocated SFMCs were distinguished into type M, type C, and type L fractures according the location of the fracture line. The fractured fragment was reduced and fixated with two 0.6-mm 4-hole micro-plates via a preauricular temporal incision. The fragment was extirpated when it was too small to be fixated. The postoperative position and profile of the fragment was examined by orthopantomogram radiograph or computed tomography (CT). The function of the temporal and zygomatic branches of the facial nerve was inspected. The occluding relation was surveyed, the interincisal distance at maximum mouth opening was measured, and the deviation from the midline during mouth opening was recorded. Twenty-three condyles (82%) suffered dislocated fractures with the condylar fragment out of the glenoid fossa. Five condyles (18%) were displaced, but not dislocated. There were 2 (7%) type M, 19 (68%) type C (3 comminuted), and 7 (25%) type L fractures (1 comminuted), respectively. Twenty-one (75%) fractured fragments received free-graft procedures with 2 micro-plates. Four (14%) fragments were reduced and fixated without being dissected free of their attachments. Three (11%) fragments were extirpated. There were no permanent facial never branch injuries. Micro-plate removal was necessary because of postoperative infection and necrosis of the fractured fragment in 1 condylar process. No other patients could be found with obvious postoperative bone resorption. The average postoperative maximum mouth opening and deviation at 6 months were improved significantly. The postoperative occlusion was good in 22 cases. Access with the preauricular incision, and the dislocated and displaced fragment can be reduced and fixated to its normal position easily. Free-graft procedure is a suitable

Overview of Mandibular Condyle Fracture

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Su-Seong Park

2012-07-01

Full Text Available The mandibular condyle is a region that plays a key role in the opening and closing ofthe mouth, and because fracture causes functional and aesthetic problems such as facialasymmetry, it is very important to perform accurate reduction. Traditionally, there has beendisagreement on how to manage fracture of the mandibular condyle. This review exploresthe misunderstanding of mandibular condyle fracture treatment and modern-day treatmentstrategies.

Biomechanical comparison of 3.0 mm headless compression screw and 3.5 mm cortical bone screw in a canine humeral condylar fracture model.

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Gonsalves, Mishka N; Jankovits, Daniel A; Huber, Michael L; Strom, Adam M; Garcia, Tanya C; Stover, Susan M

2016-09-20

To compare the biomechanical properties of simulated humeral condylar fractures reduced with one of two screw fixation methods: 3.0 mm headless compression screw (HCS) or 3.5 mm cortical bone screw (CBS) placed in lag fashion. Bilateral humeri were collected from nine canine cadavers. Standardized osteotomies were stabilized with 3.0 mm HCS in one limb and 3.5 mm CBS in the contralateral limb. Condylar fragments were loaded to walk, trot, and failure loads while measuring construct properties and condylar fragment motion. The 3.5 mm CBS-stabilized constructs were 36% stiffer than 3.0 mm HCS-stabilized constructs, but differences were not apparent in quality of fracture reduction nor in yield loads, which exceeded expected physiological loads during rehabilitation. Small residual fragment displacements were not different between CBS and HCS screws. Small fragment rotation was not significantly different between screws, but was weakly correlated with moment arm length (R² = 0.25). A CBS screw placed in lag fashion provides stiffer fixation than an HCS screw, although both screws provide similar anatomical reduction and yield strength to condylar fracture fixation in adult canine humeri.

[Anterior guidance in complete dentures].

Science.gov (United States)

Dubreuil, J; Trevelo, A

1990-01-01

Although the anterior guidance in complete dentures is not really a guide, the arrangement of the anterior maxillary and mandibular prosthetic teeth, defines a propulsive line called the virtual anterior guidance, a part from the cinematic criterias. The influence of this guide on cuspal movement is superior, in all mandibular points, to the influence of the condylar pathway. If this line is not respected, the practitioner may have to do excessive grindings during occlusal adjustments.

Computed tomographic appearances of cherubism

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Bianchi, S D; Boccardi, A; Mela, F; Romagnoli, R

1987-01-01

The computed tomographic (CT) aspects of six cases of cherubism are described. Through its optimal representation of the lesions, CT enabled certain characteristics of this disease to be substantiated, namely, limitation of the process to the bones of the jaw and primarily superficial development of the mandibular lesions, coupled with an unusual mandibular condylar impairment. Moreover, the composition of this series permitted investigation of the condition in its several stages of progression.

The computed tomographic appearances of cherubism

International Nuclear Information System (INIS)

Bianchi, S.D.; Boccardi, A.; Mela, F.; Romagnoli, R.

1987-01-01

The computed tomographic (CT) aspects of six cases of cherubism are described. Through its optimal representation of the lesions, CT enabled certain characteristics of this disease to be substantiated, namely, limitation of the process to the bones of the jaw and primarily superficial development of the mandibular lesions, coupled with an unusual mandibular condylar impairment. Moreover, the composition of this series permitted investigation of the condition in its several stages of progression. (orig.)

Assessment of Condylar Changes in Patients with Temporomandibular Joint Pain Using Digital Volumetric Tomography

International Nuclear Information System (INIS)

Shetty, U.Sh.; Burde, K.N.; Naikmasur, V.G.; Sattur, A.P.

2014-01-01

Objective. To evaluate the efficiency of DVT in comparison with OPG in the assessment of bony condylar changes in patients of TMJ pain. Methods. 100 temporomandibular joints of 62 patients with the complaint of temporomandibular joint pain were included in the study. DVT and OPG radiographs were taken for all the 100 joints. Three observers interpreted the DVT and OPG radiograph for the bony changes separately for two times with an interval of one week. The bony changes seen in the condyle were given coding from 0 to 6. (0: Normal, 1: Erosion, 2: Flattening, 3: Osteophyte, 4: Sclerosis, 5: Resorption, and 6: other changes). Interobserver and intra observer variability was assessed with one-way Anoka statistics. Z test was used to see the significant difference between OPG and DVT. Results. In the present study the inter examiner reliability for Og and DVT was 0.903 and 0.978, respectively. Intra examiner reliability for OPG and DVT was 0.908 and 0.980, respectively. The most common condylar bony change seen in OPG and DVT was erosion followed by flattening and osteophyte. There was significant difference between OPG and DVT in detecting erosion and osteophytes. The other changes observed in our study were Elys cyst, pointed condyle, and bifid condyle. All the bony changes are more commonly seen in females than males. Conclusion. DVT provides more valid and accurate information on condylar bony changes. The DVT has an added advantage of lesser radiation exposure to the patient and cost effectiveness and could be easily accessible in a dental hospital

Assessment of Condylar Changes in Patients with Temporomandibular Joint Pain Using Digital Volumetric Tomography

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Ujwala Shivarama Shetty

2014-01-01

Full Text Available Objective. To evaluate the efficiency of DVT in comparison with OPG in the assessment of bony condylar changes in patients of TMJ pain. Methods. 100 temporomandibular joints of 62 patients with the complaint of temporomandibular joint pain were included in the study. DVT and OPG radiographs were taken for all the 100 joints. Three observers interpreted the DVT and OPG radiograph for the bony changes separately for two times with an interval of one week. The bony changes seen in the condyle were given coding from 0 to 6. (0: Normal, 1: Erosion, 2: Flattening, 3: Osteophyte, 4: Sclerosis, 5: Resorption, and 6: other changes. Interobserver and intraobserver variability was assessed with one-way ANOVA statistics. Z test was used to see the significant difference between OPG and DVT. Results. In the present study the interexaminer reliability for OPG and DVT was 0.903 and 0.978, respectively. Intraexaminer reliability for OPG and DVT was 0.908 and 0.980, respectively. The most common condylar bony change seen in OPG and DVT was erosion followed by flattening and osteophyte. There was significant difference between OPG and DVT in detecting erosion and osteophytes. The other changes observed in our study were Ely’s cyst, pointed condyle, and bifid condyle. All the bony changes are more commonly seen in females than males. Conclusion. DVT provides more valid and accurate information on condylar bony changes. The DVT has an added advantage of lesser radiation exposure to the patient and cost effectiveness and could be easily accessible in a dental hospital.

Overview of Mandibular Condyle Fracture

OpenAIRE

Park, Su-Seong; Lee, Keun-Cheol; Kim, Seok-Kwun

2012-01-01

The mandibular condyle is a region that plays a key role in the opening and closing of the mouth, and because fracture causes functional and aesthetic problems such as facial asymmetry, it is very important to perform accurate reduction. Traditionally, there has been disagreement on how to manage fracture of the mandibular condyle. This review explores the misunderstanding of mandibular condyle fracture treatment and modern-day treatment strategies.

Overview of Mandibular Condyle Fracture

Directory of Open Access Journals (Sweden)

Su-Seong Park

2012-07-01

Full Text Available The mandibular condyle is a region that plays a key role in the opening and closing of the mouth, and because fracture causes functional and aesthetic problems such as facial asymmetry, it is very important to perform accurate reduction. Traditionally, there has been disagreement on how to manage fracture of the mandibular condyle. This review explores the misunderstanding of mandibular condyle fracture treatment and modern-day treatment strategies.

Changes in mineralised tissue at the site of origin of condylar fracture are present before athletic training in Thoroughbred horses.

Science.gov (United States)

Firth, E C; Doube, M; Boyde, A

2009-10-01

To show that changes are present at the site of origin of metacarpal condylar fracture in young Thoroughbred horses before they enter race training. Bone slices, 2 mm thick, in three mediolateral planes through the centre of rotation of the metacarpo-phalangeal joint (MCPJ) of both distal third metacarpal bones (Mc3) of 12 Thoroughbred horses aged 17 months, were imaged using point-projection digital X-ray imaging (muXR). In some horses, linear or ovoid radiolucency was found in articular calcified cartilage (ACC) and subchondral bone of the palmaro-distal aspect of the sagittal groove, exactly at the site of more advanced stages of condylar fatigue fracture. An incidental finding was ovoid radiolucency in the apex of the dorso-distal aspect of the sagittal ridge, with or without fragmentation or disturbance of the subchondral mineralised tissue line, resembling equine osteochondrosis. The findings imply that the aetiology of condylar fatigue fracture in young Thoroughbred horses includes abnormality in development of the bone and joint that is present before athletic activity occurs.

STUDY OF THE DISTANCE BETWEEN LINGULA AND MANDIBULAR OCCLUSAL PLANE IN IRANIAN MALES WITH NORMAL OCCLUSION

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M GHOREYSHIAN

2002-09-01

Full Text Available Introduction. Pain and the need for controlling it is a determinant factor in dental treatment procedures. One of the most common methods of local anesthesia in mandibular area is infra alveolar nerve block which has failure rate of 5% to 15%. The purpose of this study was to locate the optimal needle entrance point in order to achieve a fast, deep and durable anesthesia with minimal anesthetic consumption. Methods. This cross-sectional study has been performed on 38 cadavers of Iranian males with approximate age of more than 17 years. old. They had normal occlusion and at least 2 molars in each quadrant of the mandible if a sample was edentulous in one quadrant of the mandible or in the opposite jaw; or when a severe tilt in mandi bular dentition was present and in the case of mandibular or condylar fracture, the sample was excluded from the study. Distance between lingual and occlusal plane was measured by a device with two parallel plates. The precision of the measurment was 1mm. Data was analysed by the use of SPSS software. Results. On the right side, the average distance between lingual and occlusal plane was 2.4 ± 4.4 (Mean ± SD and on the left side, was 2:r.4.4 which there was no significant difference between right and left sides (P value=0.9. Discussion. In this study the human body is used and the best point for entrance of the needle for inferior alveolar nerve block technique is located at 8mm above the occlusal plane. At this point the anesthetic solution will be evacuated in the nearest position to the inferior alveolar never.

The role of simultaneous gap arthroplasty and distraction osteogenesis in the management of temporo-mandibular joint ankylosis with mandibular deformity in children.

Science.gov (United States)

Rao, Krishna; Kumar, Sudhir; Kumar, Vijay; Singh, Arun Kumar; Bhatnagar, Sudhir Kumar

2004-02-01

Temporo-mandibular joint ankylosis is a common cause of acquired deformity in children. Surgical correction of the ankylosis only leaves the patient with an uncorrected mandibular deformity. This study was to evaluate the use of distraction osteogenesis for simultaneous correction of the mandibular deformity. This study was done on six children with temporo-mandibular joint ankylosis and mandibular deformity. Uniaxial double pin distractors with Schanz pins were used in this study. The patients underwent simultaneous gap arthroplasty and mandibular osteotomy (retromolar) with distractor insertion. Distraction was started on the fifth post-operative day. The patients were put on dynamic temporo-mandibular joint exercises on the first post-operative day. All patients had a satisfactory mouth opening on follow-up. Satisfactory cosmetic correction of the mandibular deformity was also achieved in all these patients. Some degree of malocclusion resulted from treatment due to which the patients were placed on orthodontic treatment. Distraction osteogenesis can be used simultaneously with gap arthroplasty in patients with temporo-mandibular ankylosis, for the correction of the mandibular deformity.

Evaluation of posterior lateral femoral condylar hypoplasia using axial MRI images in patients with complete discoid meniscus.

Science.gov (United States)

Xu, Zhihong; Chen, Dongyang; Shi, Dongquan; Dai, Jin; Yao, Yao; Jiang, Qing

2016-03-01

Hypoplasia of the lateral femoral condyle has been reported in discoid lateral meniscus patients, but associated imaging findings in the axial plane have not been characterized. In this study, we aimed to identify differences in the lateral femoral condyle between patients with discoid lateral meniscus and those with normal menisci using axial MRI images. Twenty-three patients (24 knees) with complete discoid lateral meniscus, 43 (45 knees) with incomplete discoid lateral meniscus, and 50 with normal menisci (50 knees) were enrolled and distributed into three groups. Two new angles, posterior lateral condylar angle (PLCA) and posterior medial condylar angle (PMCA), were measured on axial MRI images; the posterior condylar angle (PCA) was also measured. Differences between the three groups in the PLCA, PMCA, PCA, and PLCA/PMCA were analysed. The predictive value of PLCA and PLCA/PMCA for complete discoid lateral meniscus was assessed. In the complete discoid lateral meniscus group, PLCA and PLCA/PMCA were significantly smaller compared with the normal meniscus group and the incomplete discoid lateral meniscus group (P meniscus group compared with the incomplete discoid lateral meniscus group (P meniscus group (P meniscus. Hypoplasia of the posterior lateral femoral condyle is typically seen in patients with complete discoid lateral meniscus. PLCA and PLCA/PMCA can be measured from axial MRI images and used as excellent predictive parameters for complete discoid lateral meniscus. Diagnostic study, Level III.

Quantitative 3D ultrashort time-to-echo (UTE) MRI and micro-CT (μCT) evaluation of the temporomandibular joint (TMJ) condylar morphology

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Geiger, Daniel [Sapienza University of Rome, Department of Radiological, Oncological and Pathological Sciences, Rome (Italy); Bae, Won C.; Statum, Sheronda; Du, Jiang; Chung, Christine B. [University of California-San Diego, Department of Radiology, San Diego, CA (United States)

2014-01-15

Temporomandibular dysfunction involves osteoarthritis of the TMJ, including degeneration and morphologic changes of the mandibular condyle. The purpose of this study was to determine the accuracy of novel 3D-UTE MRI versus micro-CT (μCT) for quantitative evaluation of mandibular condyle morphology. Nine TMJ condyle specimens were harvested from cadavers (2 M, 3 F; age 85 ± 10 years, mean ± SD). 3D-UTE MRI (TR = 50 ms, TE = 0.05 ms, 104-μm isotropic-voxel) was performed using a 3-T MR scanner and μCT (18-μm isotropic-voxel) was also performed. MR datasets were spatially registered with a μCT dataset. Two observers segmented bony contours of the condyles. Fibrocartilage was segmented on the MR dataset. Using a custom program, bone and fibrocartilage surface coordinates, Gaussian curvature, volume of segmented regions, and fibrocartilage thickness were determined for quantitative evaluation of joint morphology. Agreement between techniques (MRI vs. μCT) and observers (MRI vs. MRI) for Gaussian curvature, mean curvature, and segmented volume of the bone were determined using intraclass correlation coefficient (ICC) analysis. Between MRI and μCT, the average deviation of surface coordinates was 0.19 ± 0.15 mm, slightly higher than the spatial resolution of MRI. Average deviation of the Gaussian curvature and volume of segmented regions, from MRI to μCT, was 5.7 ± 6.5 % and 6.6 ± 6.2 %, respectively. ICC coefficients (MRI vs. μCT) for Gaussian curvature, mean curvature, and segmented volumes were 0.892, 0.893, and 0.972, respectively. Between observers (MRI vs. MRI), the ICC coefficients were 0.998, 0.999, and 0.997, respectively. Fibrocartilage thickness was 0.55 ± 0.11 mm, as previously described in the literature for grossly normal TMJ samples. 3D-UTE MR quantitative evaluation of TMJ condyle morphology ex-vivo, including surface, curvature, and segmented volume, shows high correlation against μCT and between observers. In addition, UTE MRI allows

MORPHOMETRIC ANALYSIS OF MANDIBULAR FORAMEN AND INCIDENCE OF ACCESSORY MANDIBULAR FORAMINA IN ADULT HUMAN MANDIBLES OF AN INDIAN POPULATION. Análisis morfométrico del foramen mandibular e incidencia de la foramina mandibular accesoria en mandíbulas adult

Directory of Open Access Journals (Sweden)

Prajna Paramita Samanta

2016-03-01

Full Text Available El foramen mandibular es un importante hito anatómico. Para procedimientos como el bloqueo alveolar inferior del nervio, el tratamiento con implantes y osteotomías mandibulares, un profundo conocimiento de la ubicación del foramen mandibular (MF y el foramen mandibular accesorio (AMF es un requisito previo. Hay pocas referencias en la literatura con respecto a la localización anatómica exacta del foramen mandibular. Por lo tanto, el presente estudio tuvo como objetivo identificar la ubicación exacta de la MF y la incidencia de la AMF alrededor MF en una población india. Sesenta (60 mandíbulas humanas adultas fueron estudiadas para determinar la distancia del LV de la los anteriores, bordes posteriores de la rama mandibular, maxilar inferior categoría y el ángulo de la mandíbula. AMF todo el MF también fueron estudiados por su presencia y números. La distancia media de MF del borde anterior de rama mandibular fue 15,72 ±2,92 mm(lado derecho, 16,23 ±2,88 mm(lado izquierdo, de borde posterior fue 13,29 ±1,74 mm(lado derecho y 12,73 ±2,04 mm(a la izquierda lado. La MF se encuentra 22,70 ±3 mm(lado derecho y 22, 27 ± 2,62 mm(lado izquierdo de la muesca mandibular. La distancia de MF de ángulo de la mandíbula fue 21,54 ±2,92 mm(lado derecho y 21,13 ±3.43 mm(lado izquierdo. AMF estuvieron presentes en el 16, 66% de las mandíbulas. En 10% de las mandíbulas una sola AMF estaba presente y en el 6,66% hubo dos agujeros presentes. La ubicación del MF y AMF es importante para evitar compli-caciones como hemorragia y parestesia durante los procedimientos quirúrgicos orales y también para los radioterapeutas en la planificación de la radioterapia.  The mandibular foramen is an important anatomical land mark. For procedures like inferior alveolar nerve block, implant treatment and mandibular osteotomies, a thorough knowledge of the location of the mandibular foramen (MF and accessory mandibular foramina (AMFs is a prerequisite

Measuring mandibular ridge reduction

International Nuclear Information System (INIS)

Steen, W.H.A.

1984-01-01

This thesis investigates the mandibular reduction in height of complete denture wearers and overdenture wearers. To follow this reduction in the anterior region as well as in the lateral sections of the mandible, an accurate and reproducible measuring method is a prerequisite. A radiologic technique offers the best chance. A survey is given of the literature concerning the resorption process after the extraction of teeth. An oblique cephalometric radiographic technique is introduced as a promising method to measure mandibular ridge reduction. The reproducibility and the accuracy of the technique are determined. The reproducibility in the positioning of the mandible is improved by the introduction of a mandibular support which permits a precise repositioning of the edentulous jaw, even after long periods of investigation. (Auth.)

Mandibular canal branches supplying the mandibular third molar observed on cone beam computed tomographic images: Reports of four cases

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Lee, Jae Seo; Yoon, Suk Ja; Kang, Byung Cheol [Department of Oral and Maxillofacial Radiology, School of Dentistry, Dental Science Research Institute, Chonnam National University, Gwangju (Korea, Republic of)

2009-12-15

Bifid mandibular canal can be an anatomic variation. This condition can lead to complication when performing mandibular anesthesia or during extraction of lower third molar, placement of implants and surgery in the mandible. Four patients underwent preoperative imaging for extraction of third molars using CBCT (CB Mercuray, Hitachi, Japan). The axial images were processed with CBworks program 2.1 (CyberMed Inc., Seoul, Korea). The branches for supplying the lower third molar were identified mainly on cross-sectional and panoramic images of CBCT. Since the location and configuration of mandibular canal variations are important in any mandibular surgical procedures, we report 4 cases of bifid mandibular canal with panoramic and the CBCT images.

[Orthodontic treatment of Class III patients with mandibular asymmetry].

Science.gov (United States)

Duan, Yin-Zhong; Huo, Na; Chen, Lei; Chen, Xue-Peng; Lin, Yang

2008-12-01

To investigate the treatment outcome of Class III patients with dental, functional and mild skeletal mandibular asymmetry. Thirty-five patients (14 males and 21 females) with dental, functional and mild skeletal mandibular asymmetry were selected. The age range of the patients was 7 - 22 years with a mean age of 16.5 years. Dental mandibular asymmetry was treated with expansion of maxillary arch to help the mandible returning to normal position. Functional mandibular asymmetry was treated with activator or asymmetrical protraction and Class III elastics. Mild skeletal mandibular asymmetry was treated with camouflage treatment. Good occlusal relationships were achieved and facial esthetics was greatly improved after orthodontic treatment in patients with dental and functional mandibular asymmetry. However, patients with skeletal mandibular asymmetry should be treated with both extraction and genioplasty. Orthodontic treatment was suitable for patients with dental and functional mandibular asymmetry, while combined orthodontics and surgery could get good results in patients with skeletal mandibular asymmetry.

Concomitant Suppurative Parotitis and Condylar Osteomyelitis.

Science.gov (United States)

Vorrasi, John; Zinberg, Geoffrey

2017-03-01

Parotitis is a common occurrence in the immunocompromised, dehydrated, and malnourished patient as a result of dysfunctional ductal and parotid cells. Inflammation can be acute or chronic based on clinical history, and it can be suppurative based on the presence of micro or macro abscess formation within the substance of the gland. This report presents a case of concomitant condylar osteomyelitis and chronic suppurative parotitis in the setting of previous methicillin-susceptible Staphylococcus aureus foot infection. Ultimately, resection of osteomyelitis, drainage of parotid infection, and intravenous antibiotic therapy led to full resolution of the infection and symptoms. The final pathology of osteomyelitis of the temporomandibular joint and methicillin-resistant S aureus infection is an unusual consequence of chronic parotitis. The patient was restored with a total joint replacement approximately 3 months after resection with no recurrence of infection after 24 months. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

21 CFR 872.3960 - Mandibular condyle prosthesis.

Science.gov (United States)

2010-04-01

... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw to... requirement for premarket approval for any mandibular condyle prosthesis intended to be implanted in the human...

Custom total knee replacement in a dog with femoral condylar bone loss.

Science.gov (United States)

Liska, William D; Marcellin-Little, Denis J; Eskelinen, Esa V; Sidebotham, Christopher G; Harrysson, Ola L A; Hielm-Björkman, Anna K

2007-06-01

To report surgical planning, technique, and outcome of custom total knee replacement (TKR) performed to manage a medial femoral condylar nonunion in a dog. Clinical case report. A 3-year-old, 20 kg Karelian Bear Hound. Computed tomographic scan of the left pelvic limb was used to build a stereolithography model of the distal portion of the femur. The model was used to create a custom augment to replace the missing medial femoral condyle and a custom stem for intramedullary condylar cemented fixation. The augment and stem were adapted to femoral and tibial components already available. The model was used to rehearse the surgery and then the custom prosthesis was implanted. Weight bearing returned 8 hours after surgery and improved thereafter. Joint alignment was normal and prosthetic joint motion was 60-165 degrees postoperatively. The dog resumed moose hunting 3 months after surgery. Peak vertical force and impulse of the operated limb measured 17 months after surgery were 65% and 47% of the normal, contralateral limb. Based on short-term follow-up, cemented canine TKR was successfully achieved for management of a severely abnormal stifle joint. With further refinement and development of commercially available prostheses, TKR should be possible for canine patients.

Mandibular ameloblastomas

International Nuclear Information System (INIS)

Masip, M.J.; Arana, E.; Beltran, J.; Garcia, J.L.; Cifrian, C.; Aparisi, F.

1995-01-01

We present a retrospective review of 39 cases of mandibular ameloblastoma that were assessed in terms of patient age and sex, duration and clinical signs at the time of diagnosis. The associated plain radiology, CT and MR signs are also reviewed. It usually presented as a slowly growing, painless mass. According to radiological findings, most of the ameloblastomas studied were extensive, involving the mandibular branch, angle and molar area; the lesions were expanding, unilocular or multilocular, with erosion of the dental apex. CT disclosed cystic areas of low attenuation. The images of the three patients studied by MR presented low signal intensity in T1-weighed sequences and hyperintense signal in t2-weighted sequences. 9 refs

Effect of irradiation on the temporomandibular joint in streptozotocin-induced diabetic rat

Energy Technology Data Exchange (ETDEWEB)

Ahn, Ki Dong; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

2004-06-15

To investigate the histopathological changes in the temporomandibular joint in streptozotocin-induced diabetic rat following irradiation. Sprague-Dawley rats weighing about 250 gm were divided into three groups: control, diabetic, and diabetic-irradiated groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in the control group were injected with citrate buffer only. After 5 days, the head and neck region of the rats in diabetic-irradiated group were irradiated with single absorbed dose of 10 Gy. The rats were killed at 1, 3, 7, 14, 21, and 28 days after irradiation. The specimen including the temporomandibular joint were sectioned and observed using a histopathological method. In the diabetic group, severe bone resorption in the mandibular condyle was observed throughout the period of experiment. Necrosis of bone marrow and trabeculae was observed at 28 days after diabetic state. Atrophy and fibrosis in the retrodiscal tissue was gradually progressed during the time of the experiment. In the diabetic-irradiated group, severe bone resorption in the mandibular condyle was observed during the early experimental phases, but regeneration of bone marrow was initiated at 14 days after diabetic state and irradiation. Also, calcification of abnormal trabeculae was observed at 28 days after diabetic state and irradiation. The retrodiscal tissue was degenerated in the early experimental phases, but it had been gradually regenerated during the experimental time. This experiment suggests that bone resorption and degeneration in the mandibular condyle are caused by the induction of diabetes, and abnormal bone formation is induced after irradiation in diabetic state.

Effect of irradiation on the temporomandibular joint in streptozotocin-induced diabetic rat

International Nuclear Information System (INIS)

Ahn, Ki Dong; Hwang, Eui Hwan; Lee, Sang Rae

2004-01-01

To investigate the histopathological changes in the temporomandibular joint in streptozotocin-induced diabetic rat following irradiation. Sprague-Dawley rats weighing about 250 gm were divided into three groups: control, diabetic, and diabetic-irradiated groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in the control group were injected with citrate buffer only. After 5 days, the head and neck region of the rats in diabetic-irradiated group were irradiated with single absorbed dose of 10 Gy. The rats were killed at 1, 3, 7, 14, 21, and 28 days after irradiation. The specimen including the temporomandibular joint were sectioned and observed using a histopathological method. In the diabetic group, severe bone resorption in the mandibular condyle was observed throughout the period of experiment. Necrosis of bone marrow and trabeculae was observed at 28 days after diabetic state. Atrophy and fibrosis in the retrodiscal tissue was gradually progressed during the time of the experiment. In the diabetic-irradiated group, severe bone resorption in the mandibular condyle was observed during the early experimental phases, but regeneration of bone marrow was initiated at 14 days after diabetic state and irradiation. Also, calcification of abnormal trabeculae was observed at 28 days after diabetic state and irradiation. The retrodiscal tissue was degenerated in the early experimental phases, but it had been gradually regenerated during the experimental time. This experiment suggests that bone resorption and degeneration in the mandibular condyle are caused by the induction of diabetes, and abnormal bone formation is induced after irradiation in diabetic state.

Management of Chronic Recurrent Dislocation of Temporomandibular Joint Using 'U' Shaped Graft: A New Restrictive Technique.

Science.gov (United States)

Gadre, Kiran; Singh, Divya; Gadre, Pushkar; Halli, Rajshekhar

2017-06-01

Numerous procedures have been described for the treatment of chronic recurrent dislocation of the temporo-mandibular joint (TMJ), either in the form of enhancement or restriction of the condylar movement, with their obvious merits and demerits. We present a new technique of using U shaped iliac bone graft to restrict the condylar movement and its advantages over the conventional techniques.We have used this technique successfully in 8 cases where Dautrey's procedure had failed with follow up period of 2 years. No patient complained of recurrent dislocation postoperatively. This a very simple and effective technique where other procedures have failed.

Anquilosis mandibular: una frecuente secuela por Noma Mandibular ankylosis: a Noma frequent sequel

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R. Fernández García-Guilarte

2009-12-01

Full Text Available Conocemos poco sobre el Noma o Enfermedad Cancrum Oris. Esta entidad afecta a niños con malnutrición crónica, poca higiene oral, poco desarrollo sanitario y enfermedades concurrentes debilitantes. Existe un consenso general sobre que el Noma empieza como una gingivitis; en su fase aguda, puede haber respuesta al tratamiento antibiótico, no obstante, las secuelas tras su curación incluyen daños estéticos y funcionales variables, que pueden requerir cirugía reconstructiva. Presentamos 3 casos de anquilosis mandibular que en el examen preoperatorio presentaron dimorfismo mandibular, fusión de hueso maxilar y mandibular y anquilosis de la articulación témporomandibular. La ortopantografía y la Tomografía Axial Computerizada (TAC fueron muy útiles en la planificación de la cirugía. El tratamiento quirúrgico consistió en todos los casos en la resección del hueso anquilótico y la reconstrucción con injerto condrocostal en uno de los casos. En el postoperatorio se siguió fisioterapia intensiva. Clínicamente todos los pacientes mostraron una gran mejoría en la masticación, la alimentación y el habla, obviamente debido a una buena oclusión. El problema más común fue la baja colaboración en la rehabilitación mandibular por parte de los pacientes.Little is known about Noma or Cancrum Oris Disease. This entity affects to children with chronic malnutrition, poor oral hygiene, poor environmental sanitation and debilitating concurrent illness. There is general consensus that noma starts as gingivitis. The acute stage responds readily to antibiotic treatment. The sequelae after healing include variable functional and aesthetic impairments, which require reconstructive surgery. We report 3 cases of mandibular ankylosis. Preoperative examination revealed mandibular dismorphism, fusion of maxilla and mandible and ankylosis of the temporomandibular joint. Orthopantography and Computed Thomography scan (TCS were very useful in planning

Possibility of estimating three-dimensional mandibular morphology by cephalogram analysis

International Nuclear Information System (INIS)

Kim, S.; Motegi, Etsuko; Kikuchi, Yu; Yamaguchi, Hideharu; Takaki, Takashi; Shibahara, Takahiko

2007-01-01

The purpose of this study was to investigate the possibility of a surmise of three-dimensional mandibular morphology by two-dimensional cephalogram analysis. The materials were three-dimensional CT and cephalogram of 20 female mandibular prognathism patients (average age: 25.20±7.49) before there orthognathic surgery. Mandibular bone volume and sponge bone width were calculated from three-dimensional images constructed from CT images using imaging software (Real Intage, KGT inc.). There was a positive correlation (r=0.72) between mandibular volume value and mandibular ramus width. There was a positive correlation between sponge bone width at the site of the mandibular cuspid and mandibular ramus width and SNB angle (r=0.80), and between sponge bone width at the site of the mandibular molar and symphysis height and mandibular ramus width (r=0.81). It was thought that these results will be useful for a surmise of three-dimensional mandibular morphology by cephalogram analysis. (author)

Pharyngeal airway changes following mandibular setback surgery

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Babu Ramesh

2005-01-01

Full Text Available Treatment of dentofacial deformities with jaw osteotomies has an effect on airway anatomy and therefore mandibular setback surgery has the potential to diminish airway size. The purpose of this study was to evaluate the effect of mandibular setback surgery on airway size. 8 consecutive patients were examined prospectively. All patients underwent mandibular setback surgery. Cephalometric analysis was performed preoperatively and 3 months post operatively with particular attention to pharyngeal airway changes. Pharyngeal airway size decreased considerably in all, patients thus predisposing to development of obstructive sleep apnea. Therefore, large anteroposterior discrepancies should be corrected by combined maxillary and mandibular osteotomies.

Mandibular condyle dimensions in Peruvian patients with Class II and Class III skeletal patterns.

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Hugo Zegarra-Baquerizo

2017-10-01

Full Text Available Objective: To compare condylar dimensions of young adults with Class II and Class III skeletal patterns using cone-beam computed tomography (CBCT. Materials and methods: 124 CBCTs from 18-30 year-old patients, divided into 2 groups according to skeletal patterns (Class II and Class III were evaluated. Skeletal patterns were classified by measuring the ANB angle of each patient. The anteroposterior diameter (A and P of the right and left mandibular condyle was assessed from a sagittal view by a line drawn from point A (anterior to P (posterior. The coronal plane allowed the evaluation of the medio-lateral diameter by drawing a line from point M (medium to L (lateral; all distances were measured in mm. Results: In Class II the A-P diameter was 9.06±1.33 and 8.86±1.56 for the right and left condyles respectively, in Class III these values were 8.71±1.2 and 8.84±1.42. In Class II the M-L diameter was 17.94±2.68 and 17.67±2.44 for the right and left condyles respectively, in Class III these values were 19.16±2.75 and 19.16±2.54. Conclusion: Class III M-L dimensions showed higher values than Class II, whereas these differences were minimal in A-P.

Biomechanical considerations in mandibular incisor extraction cases.

Science.gov (United States)

Rachala, Madhukar Reddy; Aileni, Kaladhar Reddy; Dasari, Arun Kumar; Sinojiya, Jay

2015-01-01

Mandibular incisor extraction can be regarded as a valuable treatment option in certain malocclusions to obtain excellence in orthodontic results in terms of function, aesthetics and stability. This treatment alternative is indicated in clinical situations like mild to moderate class III malocclusion, mild anterior mandibular tooth size excess, periodontally compromised teeth, ectopic eruption of mandibular incisor and minimal openbite tendencies. Unlike in premolar extraction cases, space closure in mandibular incisor extraction cases is unique in which the extraction space will be in the middle of the arch. The end result of space closure in these cases should be well aligned, upright, anterior teeth with parallel roots and the goal can be achieved with the bodily tooth movement through proper application of biomechanics. The purpose of this article is to explain the biomechanics of space closure in mandibular incisor extraction cases.

A finite element analysis of the stress distribution to the mandible from impact forces with various orientations of third molars*

Science.gov (United States)

Liu, Yun-feng; Wang, Russell; Baur, Dale A.; Jiang, Xian-feng

2018-01-01

Objective: To investigate the stress distribution to the mandible, with and without impacted third molars (IM3s) at various orientations, resulting from a 2000-Newton impact force either from the anterior midline or from the body of the mandible. Materials and methods: A 3D mandibular virtual model from a healthy dentate patient was created and the mechanical properties of the mandible were categorized to 9 levels based on the Hounsfield unit measured from computed tomography (CT) images. Von Mises stress distributions to the mandibular angle and condylar areas from static impact forces (Load I-front blow and Load II left blow) were evaluated using finite element analysis (FEA). Six groups with IM3 were included: full horizontal bony, full vertical bony, full 450 mesioangular bony, partial horizontal bony, partial vertical, and partial 450 mesioangular bony impaction, and a baseline group with no third molars. Results: Von Mises stresses in the condyle and angle areas were higher for partially than for fully impacted third molars under both loading conditions, with partial horizontal IM3 showing the highest fracture risk. Stresses were higher on the contralateral than on the ipsilateral side. Under Load II, the angle area had the highest stress for various orientations of IM3s. The condylar region had the highest stress when IM3s were absent. Conclusions: High-impact forces are more likely to cause condylar rather than angular fracture when IM3s are missing. The risk of mandibular fracture is higher for partially than fully impacted third molars, with the angulation of impaction having little effect on facture risk. PMID:29308606

A clinical evaluation of a headless, titanium, variable-pitched, tapered, compression screw for repair of nondisplaced lateral condylar fractures in thoroughbred racehorses.

Science.gov (United States)

Galuppo, Larry D; Simpson, Edwin L; Greenman, Sylvia L; Dowd, Joseph P; Ferraro, Gregory L; Meagher, Dennis M

2006-07-01

To report clinical evaluation of headless compression screws for repair of metacarpal/metatarsal (MC/MT3) condylar fractures in horses. Retrospective case study. Racing Thoroughbreds (n=16) with nondisplaced lateral condylar fractures of MC/MT 3. Medical records (1999-2004) of horses with nondisplaced longitudinal fractures of the lateral condyle of MC/MT3 were reviewed. Pre-operative variables retrieved were: patient age, gender, limb involvement, injury occurrence, fracture length, and width, evidence of palmar comminution and degenerative joint disease, number of pre-injury starts, and pre-injury earnings. Post-operative variables retrieved were: surgical complications, surgical time, number of race starts, and post-operative earnings. MC3 (n=11) and MT3 (5) nondisplaced longitudinal fractures of the lateral condyle were repaired with Acutrak Equine (AE) screws. Left front limb fractures were most common (8) followed by left hind (5) and right front (3). Nine fractures occurred during training and 7 during racing; 4 fractures had palmar comminution. No surgical complications occurred. Of 15 horses that returned to training, 11 (73%) raced 306+/-67 days after injury and had greater mean (+/-SD) post-injury earnings/start ($5290.00+/-$8124.00) than pre-injury ($4971.00+/-$2842.00). Screw removal was not required in any horse. The AE screw is a viable option for repair of nondisplaced lateral condylar MC/MT3 fractures in Thoroughbred racehorses. Adequate stability of nondisplaced lateral condylar fractures can be achieved with a headless tapered compression screw while avoiding impingement on the collateral ligaments and joint capsule of the fetlock joint.

Anterior mandibular apical base augmentation in the surgical orthodontic treatment of mandibular retrusion.

Science.gov (United States)

Brusati, R; Giannì, A B

2005-12-01

The authors describe a surgical technique alternative to traditional pre-surgical orthodontics in order to increase the apical base in mandibular retrusion (class II, division I). This subapical osteotomy, optimizing inferior incisal axis without dental extractions and a long orthodontic treatment, associated to genioplasty permits to obtain an ideal labio-dento-mental morphology. This procedure avoids in some cases the need of a mandibular advancement and, if necessary, it reduces his entity with obvious advantages.

A patient with mandibular deviation and 3 mandibular incisors treated with asymmetrically bent improved superelastic nickel-titanium alloy wires.

Science.gov (United States)

Ikeda, Yuhei; Kokai, Satoshi; Ono, Takashi

2018-01-01

Skeletal and dental discrepancies cause asymmetric malocclusions in orthodontic patients. It is difficult to achieve adequate functional occlusion and guidance in patients with congenital absence of a mandibular incisor due to the tooth-size discrepancy. Here, we describe the orthodontic treatment of a 22-year-old woman with an asymmetric Angle Class II malocclusion, mandibular deviation to the left, and 3 mandibular incisors. The anterior teeth and maxillary canines were crowded. We used an improved superelastic nickel-titanium alloy wire (Tomy International, Tokyo, Japan) to compensate for the asymmetric mandibular arch and an asymmetrically bent archwire to move the maxillary molars distally. A skeletal anchorage system provided traction for intermaxillary elastics, and extractions were not needed. We alleviated the crowding and created an ideal occlusion with proper overjet, overbite, and anterior guidance with Class I canine and molar relationships. This method of treatment with an asymmetrically bent nickel-titanium alloy wire provided proper Class I occlusion and anterior guidance despite the mandibular deviation to the left and 3 mandibular incisors, without the need for extractions. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Using three-dimensional-computerized tomography as a diagnostic tool for temporo-mandibular joint ankylosis: a case report.

Science.gov (United States)

Kao, S Y; Chou, J; Lo, J; Yang, J; Chou, A P; Joe, C J; Chang, R C

1999-04-01

Roentgenographic examination has long been a useful diagnostic tool for temporo-mandibular joint (TMJ) disease. The methods include TMJ tomography, panoramic radiography and computerized tomography (CT) scan with or without injection of contrast media. Recently, three-dimensional CT (3D-CT), reconstructed from the two-dimensional image of a CT scan to simulate the soft tissue or bony structure of the real target, was proposed. In this report, a case of TMJ ankylosis due to traumatic injury is presented. 3D-CT was employed as one of the presurgical roentgenographic diagnostic tools. The conventional radiographic examination including panoramic radiography and tomography showed lesions in both sides of the mandible. CT scanning further suggested that the right-sided lesion was more severe than that on the left. With 3D-CT image reconstruction the size and extent of the lesions were clearly observable. The decision was made to proceed with an initial surgical approach on the right side. With condylectomy and condylar replacement using an autogenous costochondral graft on the right side, the range of mouth opening improved significantly. In this case report, 3D-CT demonstrates its advantages as a tool for the correct and precise diagnosis of TMJ ankylosis.

Mandibular reconstruction in adults: a review.

NARCIS (Netherlands)

Goh, B.T.; Lee, S.; Tideman, H.; Stoelinga, P.J.W.

2008-01-01

Mandibular defects may result from trauma, inflammatory disease and benign or malignant tumours. Mastication, speech and facial aesthetics are often severely compromised without reconstruction. The goal of mandibular reconstruction is to restore facial form and function, implying repair of

Estudio experimental sobre la regeneración ósea mandibular de la rata con diferentes biomateriales Experimental study in rats of mandibular bone regeneration with different biomaterials

Directory of Open Access Journals (Sweden)

B. Peral Cagigal

2008-10-01

Full Text Available Objetivo. Los defectos óseos mandibulares resultantes de infecciones, traumatismos o resecciones oncológicas, van a producir severos problemas funcionales y/o estéticos, que van a precisar de un tratamiento complejo. Durante los últimos años, las aportaciones al terreno de la reconstrucción ósea se han debatido entre métodos tan dispares como la distracción ósea o la utilización de colgajos libres microvascularizados, pasando por un sin fin de biomateriales. El objetivo de este estudio fue comparar la formación de hueso nuevo tras la aplicación de una membrana reabsorbible y dos tipos de sustitutivos óseos. Material y método. Se utilizaron 24 ratas adultas macho tipo Wistar, en las que se crearon defectos circulares de 4 mm de diámetro en ambos lados de la mandíbula. Se formaron 4 grupos, un grupo control y 3 grupos experimentales. Los animales fueron sacrificados a las 3 y 6 semanas de la cirugía, realizándose un análisis radiológico e histológico. Resultados. Los defectos control no mostraron formación ósea, apareciendo una reparación por tejido fibroso. La membrana de hueso utilizada de forma aislada, actuó como una barrera eficaz excluyendo los tejidos no osteogénicos, pero no se produjo reparación total del defecto en ningún caso. El grupo de Colloss® y membrana, mostró una regeneración ósea completa del defecto a las 6 semanas. El grupo de NovaBone® y membrana, no mostró formación ósea, apareciendo las partículas del biomaterial ocupando el defecto. Conclusiones. La regeneración ósea fue significativamente mayor en los defectos rellenos con Colloss® y cubiertos con la membrana de Lambone®, comparado con los otros grupos experimentales.Objective. Mandibular bone defects can occur as a result of trauma, neoplasm, or infectious conditions. Such conditions often are associated with severe funtional and esthetic problems. Corrective treatment often is complicated by limitations in tissue adaptation. The

Assessment of the relationship between the mandibular third molar and the mandibular canal using panoramic radiograph and cone beam computed tomography

International Nuclear Information System (INIS)

Jung, Yun Hoa; Nah, Kyung Soo; Cho, Bong Hae

2008-01-01

The purpose of this study is to evaluate the position of the mandibular canal in relation to the mandibular third molar by cone beam CT in cases showing a close relationship between the third molar and the mandibular canal on the panoramic radiograph. The panoramic images and cone beam CT scans of 87 impacted mandibular third molars in 60 patients were evaluated to assess the tooth relationship to the mandibular canal. The clearness of the canal wall and the vertical depth of the lower third molar were evaluated on panoramic radiographs. The lower third molars were assessed using cone beam CT to determine the proximity and position of the canal relative to the roots. In the 66 cases where the canal wall was unclear on the panoramic radiographs, 58 (87.9%) of the third molars had contact between the canal and root; 34 (51.5%) canals were showed an inferior position and 22 (33.3%) showed a linguoinferior position on cone beam CT. Interruption of the canal wall on panoramic radiographs was highly predictive of contact between the mandibular canal and the third molar. Cross sectional CT may be indicated for localization of the mandibular canal in such cases.

Mandibular condyle position in cone beam computed tomography

Energy Technology Data Exchange (ETDEWEB)

Hwang, Hyoung Joo; Kim, Gyu Tae; Choi, Yong Suk; Hwang, Eui Hwan [Kyung Hee Univ. School of Dentistry, Seoul (Korea, Republic of)

2006-06-15

To evaluate position of the mandibular condyle within articular fossa in an asymptomatic population radiographically by a cone beam computed tomography. Cone beam computed tomography of 60 temporomandibular joints was performed on 15 males and 15 females with no history of any temporomandibular disorders, or any other orthodontic or photoconductors treatments. Position of mandibular condyle within articular fossa at centric occlusion was evaluated. A statistical evaluation was done using a SPSS. In the sagittal views, mandibular condyle within articular fossa was laterally located at central section. Mandibular condyles in the right and left sides were showed asymmetric positional relationship at medial, central, and lateral sections. Mandibular condyle within articular fossa in an asymptomatic population was observed non-concentric position in the sagittal and coronal views.

[Stereomodel-assisted fibula free flap harvest and mandibular reconstruction: A technical note. Literature review of CAS and CAM applied to mandibular reconstruction.

Science.gov (United States)

Pauchot, J; Lachat, J; Floret, F; Badet, J-M; Tavernier, L; Aubry, S

2013-08-05

Mandibular reconstruction with fibula free flap harvest is currently the reference technique. Various preoperative processes have been developed to optimize this reconstruction. We report our experience with a simple, inexpensive, preoperative technique requiring a 3D printer, a device for maintaining mandibular reduction, a paper-cutting guide. Stereomodels of the mandible were obtained from computed tomography scan data and printed 3D in ABS. It allowed planning mandibular osteotomies, determine the angle between two bone fragments, and preoperatively modeling the osteosynthesis plate. A paper-cutting guide, and a simple device for maintaining mandibular reduction were also built. Two patients were operated on with this technique, with follow-up at 6 and 8 months. Reconstructions were successful with good clinical outcome in terms of mandibular contour and reconstructed segments positions. Preoperative planning of reconstruction may be used for mandibular osteotomies, fibular osteotomies, maintaining mandibular reduction, osteosynthesis, or placing implants for dental rehabilitation. The most complex procedures can virtually plan all these steps, but they are expensive and long to implement. Nevertheless, such procedures are quite expansive and require time not always compatible with carcinoma. Using a mandibular stereomodel is fast, easy, and cheap. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Reliability of mandibular canines as indicators for sexual dichotomy.

Science.gov (United States)

Hosmani, Jagadish V; Nayak, Ramakant S; Kotrashetti, Vijayalakshmi S; S, Pradeep; Babji, Deepa

2013-02-01

Amongst the various calcified structures in the human body, teeth have gained lot of popularity in estimating the sex of an individual as they are highly resistant to destruction and decomposition. Using permanent mandibular canines many researchers have predicted a high level of accuracy in identifying the sex correctly. The purpose of our study was to gauge the effectiveness of mandibular canines in discerning sex. Fifty dental casts each of males and females were utilized for the study. Mesio-distal dimension and inter-canine distance of mandibular right and left canine was recorded using digital vernier caliper and mandibular canine index was calculated. The mean value of mesio-distal dimensions of right and left mandibular canine was slightly greater in males compared to females. The mandibular canine index was equal in both sexes. Inter-canine distance was marginally higher in males compared to females. Despite of higher values in males none of the parameters were statistically significant. The results herein bolster contemporary studies that mesio-distal dimensions of mandibular canines and mandibular canine index do not reflect sexual dimorphism and that its application should be discontinued in sex prediction among Indian populations. How to cite this article: Hosmani J V, Nayak R S, Kotrashetti V S, Pradeep S, Babji D. Reliability of Mandibular Canines as Indicators for Sexual Dichotomy. J Int Oral Health 2013; 5(1):1-7.

Mandibular Deformity Correction by Distraction Osteogenesis

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Md Asaduzzaman

2011-02-01

Full Text Available Distraction osteogenesis (DO is a biological process of new bone formation. It could be used as an alternative treatment method for the correction of mandibular hypoplastic deformity. Modern distraction osteogenesis evolved primarily from the work of Gavriel llizarov. DO has been first applied to craniofacial region since McCarthy et al. In this case report, the patient was 17 years old male with bird face deformity due to hypoplasia of mandible resulted from bilateral TMJ ankylosis due to the fracture of both condyle at the age of 4 years. Patient’s intraincisal opening was absent 1 year back. He underwent condylectomy in both sides to release the ankylosis and to increase intraincisal opening. His mandibular length was markedly short. To increase his mandibular antero-posterior length, mandibular body distraction was done in Oral and Maxillofacial Surgery department, BSMMU. Through this procedure length of the body of mandibule was increased by 10 mm, occlusion was edge to edge and his lower facial appearance increased markedly. Mandibular body distraction osteogenesis was considerably effective when performed in a hypoplastic mandible to facilitate post-operative functional and esthetic restoration. Long term follow-up is necessary to evaluate relapse and complications. DOI: 10.3329/bsmmuj.v3i2.7061BSMMU J 2010; 3(2: 103-106

Malignant mandibular tumors: two case reports of rare mandibular ...

African Journals Online (AJOL)

Arun Kumar Agnihotri

2014-02-26

Feb 26, 2014 ... present two cases of rare malignant mandibular tumors in a single institution. KEY WORDS: .... Spiculated osteoblastic periosteal reaction was noted with mild ... displacement of right 2nd premolar and 2nd molar teeth were ...

The efficacy of supplemental intraosseous anesthesia after insufficient mandibular block

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Samir Prohić

2005-02-01

Full Text Available It is a well-known scientific fact that only a small percentage of infiltration of inferior alveolar nerve is clinically proven to be efficient. The objective of this study was to determine the anesthetic efficacy of supplemental intraosseous injection, used after the insufficient classical mandibular block that didn't provide deep pulp anesthesia of mandibular molar planed for extraction. The experimental teeth consisted of 98 mandibular molars with clinical indication for extraction. Based on the history of disease, we indicated the extraction of the tooth. After that each tooth was tested with a electric pulp tester P1. We tested the pulp vitality and precisely determined the level of vitality. After that, each patient received classical mandibular block, and the pulp vitality was tested again. If the pulp tester indicated negative vitality for the certain mandibular molar, and the patient didn't complain about pain or discomfort during the extraction, the molar was extracted and the result was added to anesthetic success rate for the classical mandibular block. If, five minutes after receiving the mandibular block, the pulp tester indicated positive vitality (parameters of vitality or the patient complained about pain or discomfort (parameters of pain and discomfort, we used the Stabident intraosseous anesthesia system. Three minutes after the application of supplemental intraosseous injection the molar was tested with the pulp tester again. The anesthetic solution used in both anesthetic techniques is lidocaine with 1:100.000 epinephrine. The results of this study indicate that the anesthetic efficacy of the mandibular block is 74.5%, and that supplemental intraosseous anesthesia, applied after the insufficient mandibular block, provides pulpal anesthesia in 94.9% of mandibular molars. The difference between anesthetic efficacy of the classical mandibular block and anesthetic efficacy of the supplemental intraosseous anesthesia, applied

The efficacy of supplemental intraosseous anesthesia after insufficient mandibular block.

Science.gov (United States)

Prohić, Samir; Sulejmanagić, Halid; Secić, Sadeta

2005-02-01

It is a well-known scientific fact that only a small percentage of infiltration of inferior alveolar nerve is clinically proven to be efficient. The objective of this study was to determine the anesthetic efficacy of supplemental intraosseous injection, used after the insufficient classical mandibular block that didn't provide deep pulp anesthesia of mandibular molar planed for extraction. The experimental teeth consisted of 98 mandibular molars with clinical indication for extraction. Based on the history of disease, we indicated the extraction of the tooth. After that each tooth was tested with a electric pulp tester P1. We tested the pulp vitality and precisely determined the level of vitality. After that, each patient received classical mandibular block, and the pulp vitality was tested again. If the pulp tester indicated negative vitality for the certain mandibular molar, and the patient didn't complain about pain or discomfort during the extraction, the molar was extracted and the result was added to anesthetic success rate for the classical mandibular block. If, five minutes after receiving the mandibular block, the pulp tester indicated positive vitality (parameters of vitality) or the patient complained about pain or discomfort (parameters of pain and discomfort), we used the Stabident intraosseous anesthesia system. Three minutes after the application of supplemental intraosseous injection the molar was tested with the pulp tester again. The anesthetic solution used in both anesthetic techniques is lidocaine with 1:100.000 epinephrine. The results of this study indicate that the anesthetic efficacy of the mandibular block is 74.5%, and that supplemental intraosseous anesthesia, applied after the insufficient mandibular block, provides pulpal anesthesia in 94.9% of mandibular molars. The difference between anesthetic efficacy of the classical mandibular block and anesthetic efficacy of the supplemental intraosseous anesthesia, applied after the

Topographical evaluation of the mandibular canal through panoramic radiograph

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Ingrid Macedo Oliveira

2016-10-01

Full Text Available The mandibular canal is located inside the body of the mandible and may have anatomical variations. The topographic knowledge of the mandibular canal by the Dental surgeons is fundamental to achieving success in surgical planning, anesthetics and clinical interventions involving the jaw. To study the anatomy of the mandibular canal through panoramic radiographs. A retrospective descriptive study, developed after review and approval by the Ethics and Research Committee with the number of opinion 431095. Were analyzed 252 panoramic radiographs of patients of male and female attended in dental clinics UNINOVAFAPI University Center, Teresina-Pi, Brazil. The radiographs were analyzed with the aid of a light box and each antimere the jaw was observed separately. The classification of Nortjé and Langlais for description of the topography of the mandibular canal were used. Descriptive statistical analysis was performed with SPSS version 18.0. There was a prevalence of 38.89% in both antimeres, of mandibular channel the Type II. The type IV was present in 25.4% in the right hemi-arch and 26.6% on the left. Mandibular canal with unilateral bifurcation was observed in 0.77% of the sample and molar straight channel has not been identified. We observed anatomical variations as for the number and path, of the mandibular canal with the highest prevalence of Types II and IV, and the absence of bifurcations. Most was mandibular channels showed no bifurcation. The panoramic radiograph showed up an aid important to identify the mandibular canal and its variations.

In vivo Dentin Caries Model using Rat Molars

OpenAIRE

Takashi, HIGASHI; Junji, TAGAMI; Nobuhiro, HANADA; Cariology and Operative Dentistry, Department of Restorative Sciences, Tokyo Medical and Dental University; Cariology and Operative Dentistry, Department of Restorative Sciences, Tokyo Medical and Dental University; Department of Oral Science The National Institute of Infectious Diseases(NIID)

2000-01-01

Experimental dentinal caries was induced in rat molars which were inoculated orally with Streptococcus mutans and maintained on a carionenic diet 2000. After 30 days on the diet, the rats were sacrificed. The caries lesions were confirmed with a caries detector, then nanohardness determination of caries dentin were measured with nanoindentation. After hardness measurement, the lesion was examined by SEM and EDS. Dentin caries in sixteen fissures was induced among 20 fissures in the mandibular...

Prosthodontic management of mandibular deviation using palatal ramp appliance

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Prince Kumar

2012-08-01

Full Text Available Segmental resection of the mandible generally results in deviation of the mandible to the defective side. This loss of continuity of the mandible destroys the balance of the lower face and leads to decreased mandibular function by deviation of the residual segment toward the surgical site. Prosthetic methods advocated to reduce or eliminate mandibular deviation include intermaxillary fixation, removable mandibular guide flange, palatal ramp, implant-supported prosthesis and palatal guidance restorations which may be useful in reducing mandibular deviation and improving masticatory performance and efficiency. These methods and restorations would be combined with a well organized mandibular exercise regimen. This clinical report describes the rehabilitation following segmental mandibulectomy using palatal ramp prosthesis.

Quantitative Assessment of Radioisotope Uptake in Condyles by SPECT Bone Scintigraphy

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Z. Dalili

2006-03-01

Full Text Available Statement of problem: Condylar hyperplasia of the mandible is a self limiting abnormality which can cause facial asymmetry, temporomandibular joint (TMJdysfunction and esthetic problems. Treatment planning is based on the results of isotope scanning, clinical findings and patient age. Single photon emission tomography(SPECT is considered to be a sensitive method in the calculation of condylar uptake differences.Purpose: The aim of this study was to determine the growth activity occurring in the mandibular condyles, and to devise an index of side-to-side differences in condylar activity in different individuals.Material and Methods: 38 patients, with an age range of 13 to 34 years, undergoing skeletal scintigraphy for a variety of conditions, were chosen for this study. 25 mci TC-99 was injected to all subjects in order to assess the difference between right (Rt andleft (Lt condylar uptake percentage and to calculate the Lt to Rt condylar uptake ratio.The normal index was determined.Results: The maximum amount of difference between the uptake of Rt and Lt condyles was 6.2 percent (Lt side and Rt side were 53.1 % and 46.9 %, respectively in the male patients and 5.7 percent in the female patients (Lt side and Rt side were 52.85 % and 47.15 %, respectively. The condylar activity difference and ratio of Lt to Rt condylar uptakes did not show a significant difference between the male and female groups.Conclusion: The difference between the growth activity of RT and LT normal TMJs was less than 6.2 percent.

Skeletal maturity assessment using mandibular canine calcification stages

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Vildana Džemidžić

2016-11-01

Full Text Available Objective. The aims of this study were: to investigate the relationship between mandibular canine calcification stages and skeletal maturity; and to evaluate whether the mandibular canine calcification stages may be used as a reliable diagnostic tool for skeletal maturity assessment. Materials and methods. This study included 151 subjects: 81 females and 70 males, with ages ranging from 9 to 16 years (mean age: 12.29±1.86 years. The inclusion criteria for subjects were as follows: age between 9 and 16 years; good general health without any hormonal, nutritional, growth or dental development problems. Subjects who were undergoing or had previously received orthodontic treatment were not included in this study. The calcification stages of the left permanent mandibular canine were assessed according to the method of Demirjian, on panoramic radiographs. Assessment of skeletal maturity was carried out using the cervical vertebral maturation index (CVMI, as proposed by the Hassel-Farman method, on lateral cephalograms. The correlation between the calcification stages of mandibular canine and skeletal maturity was estimated separately for male and female subjects. Results. Correlation coefficients between calcification stages of mandibular canine and skeletal maturity were 0.895 for male and 0.701 for female subjects. Conclusions. A significant correlation was found between the calcification stages of the mandibular canine and skeletal maturity. The calcification stages of the mandibular canine show a satisfactory diagnostic performance only for assessment of pre-pubertal growth phase.

Clinical significance of condylar chondromalacia after arthroscopic resection of flap-tears of the medial meniscus. A prospective study of 93 cases.

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Aune, A K; Madsen, J E; Moen, H

1995-01-01

We describe the results after arthroscopic resection of flap-tears of the medial meniscus posterior horn in 93 patients with (40) or without (53) chondromalacia of the adjacent condylar cartilage at the time of operation. These were 93 consecutive patients presenting with medial flap-tears during the period 1988-1990 in our departments. The follow-up averaged 42 (range 26-50) months. There was a significant difference in the functional results at review depending on the presence or absence of condylar chondromalacia at arthroscopy. Among the 40 patients with chondromalacia, the Lysholm score was significantly lower (P chondromalacia with age (P < 0.001). In conclusion, the presence of minor degenerative changes in the articular cartilage adjacent to meniscal flap-tears correlated with a less favourable outcome.

Ultrasound and multidetector computed tomography of mandibular ...

African Journals Online (AJOL)

Because of local invasivity and high metastatic potential, preoperative imaging evaluation of mandibular region and tumoral staging is essential along with biopsy sampling. The present manuscript describes the ultrasound and computed tomographic imaging findings of mandibular gland adenocarcinoma in two dogs and ...

Influence of mandibular length on mouth opening

NARCIS (Netherlands)

Dijkstra, PU; Hof, AL; Stegenga, B; De Bont, LGM

Theoretically, mouth opening not only reflects the mobility of the temporomandibular joints (TMJs) but also the mandibular length. Clinically, the exact relationship between mouth opening, mandibular length, and mobility of TMJs is unclear. To study this relationship 91 healthy subjects, 59 women

Third metacarpal condylar fatigue fractures in equine athletes occur within previously modelled subchondral bone.

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Whitton, R Christopher; Trope, Gareth D; Ghasem-Zadeh, Ali; Anderson, Garry A; Parkin, Timothy D H; Mackie, Eleanor J; Seeman, Ego

2010-10-01

Bone modelling and remodelling reduce the risk of fatigue fractures; the former by adapting bone to its loading circumstances, the latter by replacing fatigued bone. Remodelling transiently increases porosity because of the normal delay in onset of the formation phase of the remodelling sequence. Protracted intense loading suppresses remodelling leaving modelling as the only means of maintaining bone strength. We therefore hypothesized that race horses with fatigue fractures of the distal third metacarpal bone (MC3) will have reduced porosity associated with suppressed remodelling while continued adaptive modelling will result in higher volume fraction (BV/TV) at this site. Using high resolution peripheral quantitative computed tomography (HR-pQCT), we measured the distal aspect of the MC3 obtained at postmortem from 13 thoroughbred race horses with condylar fractures of the MC3 (cases), 8 horses without fractures (training controls), 14 horses with a fracture at another site (fractured controls) and 9 horses resting from training (resting controls). Porosity of the subchondral bone of MC3 was lower in cases than resting controls (12±1.4% vs. 18±1.6%, P=0.017) although areas of focal porosity were observed adjacent to fractures in 6/13 horses. BV/TV of the distal metacarpal epiphysis tended to be higher in horses with condylar fractures (0.79±0.015) than training controls (0.74±0.019, P=0.070), but also higher in controls with a fracture elsewhere (0.79±0.014) than the training controls (0.74±0.019, P=0.040). BV/TV was higher in horses over three years of age than those aged two or three years (0.79±0.01 vs. 0.74±0.01, P=0.016). All metacarpal condylar fractures occurred within focal areas of high BV/TV. We infer that intense training in equine athletes suppresses remodelling of third metacarpal subchondral bone limiting damage repair while modelling increases regional bone volume in an attempt to minimise local stresses but may fail to offset bone

Incidence and characteristics of mandibular accessory canals: A radiographic investigation.

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Borgonovo, Andrea Enrico; Taschieri, Silvio; Vavassori, Virna; Re, Dino; Francetti, Luca; Corbella, Stefano

2017-11-01

The aim of the present study was to explore, through tridimensional reconstructions of cone-beam computed tomography (CBCT) scans, the presence and the characteristics of mandibular accessory canals. For each included participant, the presence of accessory canals was recorded. The diameter of the canal, as well as the distance between the canal walls and the walls of the mandibular bone (lingual, buccal, cranial and caudal), were measured and recorded. Mandibular accessory canals could be found in 8.8% of participants. Retromolar canals were the most frequently found accessory mandibular canals. Accessory mandibular canals were found in a relatively high number of participants through the examination of CBCT scans and tridimensional reconstruction. The presence of such structures should be considered cautiously when planning and performing surgical interventions in mandibular area. © 2017 John Wiley & Sons Australia, Ltd.

Indications and Outcome of Mandibular Condylar and Ramus ...

African Journals Online (AJOL)

... do with the excision or resection of the fused condyle and the articular surface of the .... documented in literature[25,26] and we felt our patients will benefit from ORIF because of .... Distraction osteogenesis has also been found useful.[10‑12].

Indications and Outcome of Mandibular Condylar and Ramus ...

African Journals Online (AJOL)

... (13.0%) patients and four procedures were done for dislocation in 2 (8.6%) patients. There was no permanent nerve dysfunction; mouth opening, jaw movements and mastication were remarkably satisfactory. Conclusion: Esthetic and functional outcome were quite satisfactory when compared with the preoperative status.

Evaluation of the relationship between mandibular third molar and mandibular canal by different algorithms of cone-beam computed tomography.

Science.gov (United States)

Mehdizadeh, Mojdeh; Ahmadi, Navid; Jamshidi, Mahsa

2014-11-01

Exact location of the inferior alveolar nerve (IAN) bundle is very important. The aim of this study is to evaluate the relationship between the mandibular third molar and the mandibular canal by cone-beam computed tomography. This was a cross-sectional study with convenience sampling. 94 mandibular CBCTs performed with CSANEX 3D machine (Soredex, Finland) and 3D system chosen. Vertical and horizontal relationship between the mandibular canal and the third molar depicted by 3D, panoramic reformat view of CBCT and cross-sectional view. Cross-sectional view was our gold standard and other view evaluated by it. There were significant differences between the vertical and horizontal relation of nerve and tooth in all views (p < 0.001). The results showed differences in the position of the inferior alveolar nerve with different views of CBCT, so CBCT images are not quite reliable and have possibility of error.

Split-Framework in Mandibular Implant-Supported Prosthesis

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Danny Omar Mendoza Marin

2015-01-01

Full Text Available During oral rehabilitation of an edentulous patient with an implant-supported prosthesis, mandibular flexure must be considered an important biomechanical factor when planning the metal framework design, especially if implants are installed posterior to the interforaminal region. When an edentulous mandible is restored with a fixed implant-supported prosthesis connected by a fixed full-arch framework, mandibular flexure may cause needless stress in the overall restorative system and lead to screw loosening, poor fit of prosthesis, loss of the posterior implant, and patient’s discomfort due to deformation properties of the mandible during functional movements. The use of a split-framework could decrease the stress with a precise and passive fit on the implants and restore a more natural functional condition of the mandible, helping in the longevity of the prosthesis. Therefore, the present clinical report describes the oral rehabilitation of an edentulous patient by a mandibular fixed implant-supported prosthesis with a split-framework to compensate for mandibular flexure. Clinical Significance. The present clinical report shows that the use of a split-framework reduced the risk of loss of the posterior implants or screws loosening with acceptable patient comfort over the period of a year. The split-framework might have compensated for the mandibular flexure during functional activities.

Pediatric mandibular fractures treated by rigid internal fixation.

Science.gov (United States)

Wong, G B

1993-09-01

Mandibular fractures in the pediatric patient population are relatively uncommon. These patients present with their own unique treatment requirements. Most fractures have been treated conservatively by dental splints. Closed reduction techniques with maxillomandibular fixation (MMF) in very young children can pose several concerns, including cooperation, compliance and adequate nutritional intake. Rigid internal fixation of unstable mandibular fractures using miniplates and screws circumvents the need for MMF and allows immediate jaw mobilization. At major pediatric trauma institutions, there has been an increasing trend toward the use of this treatment when open reduction is necessary. This article presents a report of a five-year-old child who presented with bilateral mandibular fractures and was treated by rigid internal fixation and immediate mandibular mobilization.

Bifid mandibular canal: a rare or underestimated entity?

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Ibrahim Nasseh

2016-10-01

Full Text Available One of the rare anatomical variations that can be of significant importance for the dentist is the bifid mandibular canal. Many complications can occur from this condition such as failure of anesthesia when performing inferior alveolar nerve block, difficulties during the surgical extraction of the third mandibular molar, and during implants placement. Therefore, good knowledge of this condition is essential. In this report, we describe the radiographic finding of a unilateral bifid mandibular canal.

[Stomatologic and maxillofacial pathology in a medieval population (10th-12th centuries) of southwestern France].

Science.gov (United States)

Barthelemy, I; Telmont, N; Crubezy, E; Rouge, D

1999-08-01

We present an assessment of the dental and maxillofacial pathology in a medieval population in southwestern France. One hundred and ninety eight mandibles and 29 craniofacial complexes were analysed. Dental and periodontal infectious pathology predominated. Third molar agenesia was quite frequent, concerning 25% of the mandibles. Third molar eruption was almost constant and in a normal position. Condylar process degeneration concerned 6% of the population. Three cases of traumatic pathology were observed, one case of long mandible was noted, and two cases of hypertrophic inferior alveolar process. Dento-mandibular maladjustment was uncommon. No unwedging of the maxillo-mandibular bone basis was observed.

Bony ankylosis of temporomandibular joint

Energy Technology Data Exchange (ETDEWEB)

Lee, Byeong Do; Yoon, Young Nam; Um, Ki Doo; Ra, Jong Ill; Lee, Wan [School of Dentistry, Wonkwang University, Iksan (Korea, Republic of)

2002-06-15

Ankylosis of joint is defined as limited movement due to infection, trauma, or surgical procedure. A 59-year-old female with a chief complaint of limited movements during mouth opening had a positive history of trauma to her right TMJ area about 5 years ago. From that time, progressive mouth opening limitation and intermittent pain have occurred. At the time of admission the patient showed mandibular deviation to the right side during mouth opening, with a maximum opening limited to 5 mm. On plain radiographs, right condylar enlargement and joint space reduction by newly formed bony tissues were observed. CT scans showed right condylar enlargement, cortical sclerosis, and thickening of the condyle, articular fossa and articular eminence.

Mandibular incisor apicoectomy in a Canadian Beaver.

Science.gov (United States)

Steenkamp, Gerhard; Venter, Leon; Crossley, David; Buss, Peter

2009-01-01

A 52-month-old Canadian beaver was presented for treatment of lip trauma resulting from overgrowth of the right mandibular incisor tooth following earlier loss of the right maxillary incisor tooth. Extraction of the affected tooth was considered, but rejected due to the length of the embedded portion of rodent mandibular incisor teeth. The lip injury was managed by crown reduction (odontoplasty) of the overgrowing incisor tooth pending a more permanent treatment plan. A 2-cm apicoectomy of the right mandibular incisor tooth was performed to arrest growth of the tooth when the beaver was 82-months-old. The remainder of the tooth continued to erupt and was completely expelled during a 9-month period with one additional odontoplasty being required. The beaver continued to feed normally with just the left maxillary and mandibular incisor teeth until its death at 118-months, with odontoplasty performed twice on the remaining incisor teeth during the 30-months following exfoliation.

Progression of cartilage degradation, bone resorption and pain in rat temporomandibular joint osteoarthritis induced by injection of iodoacetate.

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Xue-Dong Wang

Full Text Available BACKGROUND: Osteoarthritis (OA is an important subtype of temporomandibular disorders. A simple and reproducible animal model that mimics the histopathologic changes, both in the cartilage and subchondral bone, and clinical symptoms of temporomandibular joint osteoarthritis (TMJOA would help in our understanding of its process and underlying mechanism. OBJECTIVE: To explore whether injection of monosodium iodoacetate (MIA into the upper compartment of rat TMJ could induce OA-like lesions. METHODS: Female rats were injected with varied doses of MIA into the upper compartment and observed for up to 12 weeks. Histologic, radiographic, behavioral, and molecular changes in the TMJ were evaluated by light and electron microscopy, MicroCT scanning, head withdrawal threshold test, real-time PCR, immunohistochemistry, and TUNEL assay. RESULTS: The intermediate zone of the disc loosened by 1 day post-MIA injection and thinned thereafter. Injection of an MIA dose of 0.5 mg or higher induced typical OA-like lesions in the TMJ within 4 weeks. Condylar destruction presented in a time-dependent manner, including chondrocyte apoptosis in the early stages, subsequent cartilage matrix disorganization and subchondral bone erosion, fibrosis, subchondral bone sclerosis, and osteophyte formation in the late stages. Nociceptive responses increased in the early stages, corresponding to severe synovitis. Furthermore, chondrocyte apoptosis and an imbalance between anabolism and catabolism of cartilage and subchondral bone might account for the condylar destruction. CONCLUSIONS: Multi-level data demonstrated a reliable and convenient rat model of TMJOA could be induced by MIA injection into the upper compartment. The model might facilitate TMJOA related researches.

Detection of tibial condylar fractures using 3D imaging with a mobile image amplifier (Siemens ISO-C-3D): Comparison with plain films and spiral CT

International Nuclear Information System (INIS)

Kotsianos, D.; Rock, C.; Wirth, S.; Linsenmaier, U.; Brandl, R.; Fischer, T.; Pfeifer, K.J.; Reiser, M.; Euler, E.; Mutschler, W.

2002-01-01

Purpose: To analyze a prototype mobile C-arm 3D image amplifier in the detection and classification of experimental tibial condylar fractures with multiplanar reconstructions (MPR). Method: Human knee specimens (n=22) with tibial condylar fractures were examined with a prototype C-arm (ISO-C-3D, Siemens AG), plain films (CR) and spiral CT (CT). The motorized C-arm provides fluoroscopic images during a 190 orbital rotation computing a 119 mm data cube. From these 3D data sets MP reconstructions were obtained. All images were evaluated by four independent readers for the detection and assessment of fracture lines. All fractures were classified according to the Mueller AO classification. To confirm the results, the specimens were finally surgically dissected. Results: 97% of the tibial condylar fractures were easily seen and correctly classified according to the Mueller AO classification on MP reconstruction of the ISO-C-3D. There is no significant difference between ISO-C and CT in detection and correct classification of fractures, but ISO-CD-3D is significant by better than CR. (orig.) [de

Evaluation of mandibular morphology in different facial types

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Rajat Mangla

2011-01-01

Full Text Available The purpose of this study was to evaluate mandibular morphology in different facial types using various parameters. This study was conducted on lateral cephalograms of a total of 110 subjects, which included 55 males and 55 females between the age of 18-25 years having a mean of 22.3 years for males and 21.5 years for females. The sample was divided into normodivergent, hypodivergent, and hyperdivergent subgroups based on Jarabak′s ratio. Symphysis height, depth, ratio (height/depth and angle, antegonial notch depth, ramal height and width, mandibular depth, upper, lower, and total gonial angle, and mandibular arc angle were analyzed statistically and graphically. It was found that the mandible with the vertical growth pattern was associated with a symphysis with large height, small depth, large ratio, small angle, decreased ramus height and width, smaller mandibular depth, increased gonial angle, and decreased mandibular arc angle in contrast to mandible with a horizontal growth pattern. Sexual dichotomy was found with mean symphysis height and depth in the female sample being smaller than in the male sample, but symphysis ratio was larger in the female sample; males having greater ramus height and width, mandibular depth than females. The mandible seemed to have retained its infantile characteristics with all its processes underdeveloped in hyperdivergent group.

Relationship between cervical vertebral maturation and mandibular growth.

Science.gov (United States)

Ball, Gina; Woodside, Donald; Tompson, Bryan; Hunter, W Stuart; Posluns, James

2011-05-01

The cervical vertebrae have been proposed as a method of determining biologic maturity. The purposes of this study were to establish a pattern of mandibular growth and to relate this pattern to the stages of cervical vertebral maturation. Cephalometric radiographs, taken annually from ages 9 to 18 years, were evaluated for 90 boys from the Burlington Growth Center, Toronto, Ontario, Canada. Mandibular lengths were measured from articulare to gnathion, and incremental growth was determined. Cervical vertebral maturation stages were assessed by using a 6-stage method. Advanced, average, and delayed maturation groups were established. The prepubertal mandibular growth minimum velocity occurred during cervical stages 1 through 4 (P = 0.7327). Peak mandibular growth velocity occurred most frequently during stage 4 in all 3 maturation groups, with a statistical difference in the average and delayed groups (P cervical stages 1 through 6 does not occur annually; time spent in each stage varies depending on the stage and the maturation group. Cervical vertebral maturation stages cannot accurately identify the mandibular prepubertal growth minimum and therefore cannot predict the onset of the peak in mandibular growth. The cervical vertebral maturation stages should be used with other methods of biologic maturity assessment when considering both dentofacial orthopedic treatment and orthognathic surgery. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Resolution of neurosensory deficit after mandibular orthognathic surgery: A prospective longitudinal study.

Science.gov (United States)

Alolayan, Albraa Badr; Leung, Yiu Yan

2017-05-01

To investigate the longitudinal resolution of neurosensory deficit (NSD) and the possible risk factors that might contribute to NSD following mandibular orthognathic procedures. A prospective longitudinal observational study on patients who had mandibular orthognathic procedures was performed. Standardized neurosensory assessments were performed. The 2 years longitudinal resolution and risk factors of NSD including patients' age and gender, specific mandibular procedures and surgeons' experience were analyzed. 66 patients (44 females) with 132 sides of mandibular procedures were enrolled in the study. Surgical procedures included mandibular ramus surgery, anterior mandibular surgery, or the combination of the two. The overall occurrences of subjective NSD improved from 78.8% at postoperative 2 weeks to 13.8% at post-operative 2 years. Combinations of ramus surgery and anterior mandibular surgery increased the risk of NSD at the first three post-operative months (p orthognathic surgery. The occurrence of NSD after mandibular orthognathic procedures reduced progressively within the post-operative 2 years. Combination of mandibular ramus surgery and anterior mandibular surgery increased the risk of NSD in the early post-operative period. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Reversibilidad mandibular de la rigidez cadavérica por medios químicos en un modelo de rata

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Jairo Alfonso Tovar-Franco

2009-04-01

Full Text Available Mandibular reversibility of the cadaverous stiffness by chemical means in a rat model. The main problem that a dentist faces when collectingpostmortem evidence is the buccal opening, which is limited by the cadaverous stiffness phenomenon that begins 3 hours after death. Thisphenomenon persists until it is destroyed by the late autolytic processes of decomposition, after 36 hours postmortem. Objective. To analyzethe feasibility of accelerating the reversion of the mandibular cadaverous stiffness by means of chemical substances to facilitate the buccalopening. Materials and methods. We assessed substances capable of altering the pH, chelating intramuscular calcium or inducing proteolysisof the actin-myosin complex of the masticatory muscles with cadaverous stiffness in Wistar rats. Results. We found that mandibularcadaverous stiffness in Wistar rats appears after 2.5 hours of death. After 3.5 hours, once the rigidity was established, we carried outinfiltrations with EDTA (20 mM, NaHCO3 (50 μM, Na2CO3 (50 μM and papain (10 μM. NaHCO3 and Na2CO3 solutions significantlyincreased (p<0.05 the reversion speed (mm/h from hour 5, in 108% and 100%, respectively. Based on the results of this assay, we doubledthe concentration of NaHCO3 and assessed a 1:1 mixture of NaHCO3 and Na2CO3 without finding significant differences with theNaHCO3 and Na2CO3 prior assays. Conclusion. NaHCO3 solution (50 μM allows a reversal of buccal opening enough to collect evidencebetween 5 and 5.5 hours.

Morphometric study on mandibular foramen and incidence of accessory mandibular foramen in mandibles of south Indian population and its clinical implications in inferior alveolar nerve block.

Science.gov (United States)

Shalini, R; RaviVarman, C; Manoranjitham, R; Veeramuthu, M

2016-12-01

The mandibular foramen is a landmark for procedures like inferior alveolar nerve block, mandibular implant treatment, and mandibular osteotomies. The present study was aimed to identify the precise location of the mandibular foramen and the incidence of accessory mandibular foramen in dry adult mandibles of South Indian population. The distance of mandibular foramen from the anterior border of the ramus, posterior border of the ramus, mandibular notch, base of the mandible, third molar, and apex of retromolar trigone was measured with a vernier caliper in 204 mandibles. The mean distance of mandibular foramen from the anterior border of ramus of mandible was 17.11±2.74 mm on the right side and 17.41±3.05 mm on the left side, from posterior border was 10.47±2.11 mm on the right side and 9.68±2.03 mm on the left side, from mandibular notch was 21.74±2.74 mm on the right side and 21.92±3.33 mm on the left side, from the base of the ramus was 22.33±3.32 mm on the right side and 25.35±4.5 mm on the left side, from the third molar tooth was 22.84±3.94 mm on the right side and 23.23±4.21 mm on the left side, from the apex of retromolar trigone was 12.27±12.13 mm on the right side and 12.13±2.35 mm on the left side. Accessory mandibular foramen was present in 32.36% of mandibles. Knowledge of location mandibular foramen is useful to the maxillofacial surgeons, oncologists and radiologists.

Mandibular advancement appliance for obstructive sleep apnoea

DEFF Research Database (Denmark)

Petri, Niels; Svanholt, Palle; Solow, Beni

2008-01-01

The aim of this trial was to evaluate the efficacy of a mandibular advancement appliance (MAA) for obstructive sleep apnoea (OSA). Ninety-three patients with OSA and a mean apnoea-hypopnoea index (AHI) of 34.7 were centrally randomised into three, parallel groups: (a) MAA; (b) mandibular non...

Occlusal plane rotation: aesthetic enhancement in mandibular micrognathia.

Science.gov (United States)

Rosen, H M

1993-06-01

Patients afflicted with extreme degrees of mandibular micrognathia typically have vertically deficient rami as well as sagittally deficient mandibular bodies. This results in deficient posterior facial height, an obtuse gonial angle, excessively steep occlusal and mandibular planes, and a compensatory increase in anterior facial height. The entire maxillomandibular complex is overrotated in a clockwise direction. Standard orthognathic surgical correction fails to address this rotational deformity. As a consequence, the achieved projection of the lower face is inadequate, posterior facial height is further reduced, and occlusal and mandibular planes remain steep. Eleven patients with severe mandibular micrognathia underwent a surgical correction involving occlusal plane rotation to its normal orientation relative to Frankfort horizontal. This was accomplished by Le Fort I osteotomy to shorten the anterior maxilla (creating open bites in seven patients and making preexisting open bites worse in four patients) and sagittal split ramus osteotomies to advance and rotate the mandibular body counterclockwise, thus closing the surgically produced open bite. Counterclockwise rotation of the mandible afforded significantly greater sagittal displacement at the B point (mean 17 mm) than at the first molar (mean 10 mm) and produced adequate degrees of projection of the lower face when accompanied by a modest sliding genioplasty (mean 6.9 mm). Total advancement at the pogonion was a mean of 25.2 mm. In addition, posterior facial height was preserved, and mandibular and occlusal planes were normalized to mean angles of 27 and 10 degrees, respectively. At follow-up, which ranged from 9 to 24 months with a mean of 14.1 months, the mean sagittal relapse at the B point was 1.9 mm. Although heretofore considered unstable and therefore not clinically accepted, maxillomandibular counterclockwise rotation to normalize the occlusal plane rotational deformity provides stable, aesthetically

Sexual dimorphism of the internal mandibular chamber in Fayum Pliohyracidae (Mammalia)

Science.gov (United States)

de Blieux, D.D.; Baumrind, M.R.; Simons, E.L.; Chatrath, P.S.; Meyer, G.E.; Attia, Y.S.

2006-01-01

An internal mandibular fenestra and chamber are found in many fossil hyracoids. The internal mandibular fenestra is located on the lingual surface of the mandibular corpus and opens into a chamber within the mandible. The mandibular chamber is maximally developed in late Eocene Thyrohyrax meyeri and early Oligocene Thyrohyrax domorictus from the Fayum Province of Egypt. The function of this chamber is unknown as it is not found in extant hyraxes, nor is it known to occur in any other mammal. In Thyrohyrax, this feature appears to be sexually dimorphic because it is confined to roughly one half of the specimens that otherwise cannot be separated by dental characteristics or measurements. It has been suggested that the chamber is found in females based on the presumed distribution of this character in other fossil hyracoids. Fossils from Fayum Quarry L-41, preserving the sexually dimorphic anterior dentition, show that, in Thyrohyrax meyeri and Thyrohyrax domorictus, the internal mandibular chamber is found in males. In Thyrohyrax litholagus, an internal mandibular fenestra and inflated mandibular chamber occurs in males whereas females show the variable presence of an internal mandibular fossa or fenestra but lack an expanded chamber. Other genera show differing patterns of sexual variation in which some Fayum hyracoids have an internal mandibular fenestra in both sexes but with the greatest development of the mandibular chamber occurring in males. We review functions proposed for the internal mandibular chamber and suggest that it housed a laryngeal air sac that may have had a vocal function by acting as a resonating chamber. ?? 2006 by the Society of Vertebrate Paleontology.

Mandibular Condyle Fractures and Treatment Modalities

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Halil ibrahim Kisa

2014-08-01

Full Text Available Maxillofacial injuries are most commonly associated with falls, motor and vehicle accidents, sports-related trauma, and interpersonel violence. The complexity of mandibular condyle region and its anatomic proximity to other craniofacial structures complicate diagnosis and treatment. Thus, treatment approaches of mandibular condyle fracture are still controversial. In the literature, different success rates are reported about observation versus treatment, closed reduction versus open reduction and fixation methods. In the present article, controversial issues related to mandibular condyle fractures were reviewed under the light of current literature. In conclusion, the simplest way that can be done with the least risk of complication should be chosen during treatment planning. In addition, current adjunctive treatment methods accelerating healing of fracture should be considered. [Archives Medical Review Journal 2014; 23(4.000: 658-671

A new technique for mandibular osteotomy

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Puricelli Edela

2007-03-01

Full Text Available Abstract Sagittal split osteotomy (SSO is a surgical technique largely employed for mandibular mobilizations in orthognatic procedures. However, the traditional design of buccal osteotomy, located at the junction of mandibular ramus and body, may prevent more extensive sliding between the bone segments, particularly on the advance, laterality and verticality of the mandibular body. The author proposes a new technical and conceptual solution, in which osteotomy is performed in a more distal region, next to the mental formamen. Technically, the area of contact between medullary-cancellous bone surfaces is increased, resulting in larger sliding rates among bone segments; it also facilitates the use of rigid fixation systems, with miniplates and monocortical screws. Conceptually, it interferes with the resistance arm of the mandible, seen as an interpotent lever of the third gender.

Long-term clinical outcomes and survivorship of press-fit condylar sigma fixed-bearing and mobile-bearing total knee prostheses in the same patients.

Science.gov (United States)

Kim, Young-Hoo; Park, Jang-Won; Kim, Jun-Shik; Kulkarni, Sourabh S; Kim, Yoon-Hong

2014-10-01

We are aware of no study that has compared press-fit condylar Sigma fixed-bearing and mobile-bearing total knee prostheses in the same patients after more than ten years of follow-up. The purpose of the current study was to compare these two implants with respect to the functional and radiographic results, prevalence of osteolysis, and overall revision rates at a mean of 12.1 years of follow-up. The study consisted of a consecutive series of 444 patients (mean age [and standard deviation], 66.5 ± 7.4 years) who underwent simultaneous bilateral total knee arthroplasty, with one side treated immediately after the other. All of the patients received a press-fit condylar Sigma mobile-bearing prosthesis on one side and a press-fit condylar Sigma fixed-bearing prosthesis on the contralateral side. The minimum duration of follow-up was ten years (mean, 12.1 years; range, ten to thirteen years). At the time of each follow-up visit, the patients were assessed clinically and radiographically. Postoperative total knee scores (95 and 94 points), Western Ontario and McMaster Universities Osteoarthritis Index (19 and 18 points), University of California, Los Angeles activity score (both prostheses, 5 points), range of motion (129° ± 6.3° and 127° ± 6.8°), and radiographic findings did not differ significantly between the press-fit condylar Sigma mobile and fixed-bearing designs at the final follow-up. The prevalence of aseptic loosening (1.4% and 1.8%) did not differ significantly between the mobile and fixed-bearing implant designs. No knee in either group had osteolysis. The estimated survival rate with revision as the end point was 98.2% (95% confidence interval, 91% to 99%) and 97.5% (95% confidence interval, 91% to 99%) at 12.1 years for the mobile and fixed-bearing implant groups, respectively. The results of the present long-term clinical study suggest that excellent clinical and radiographic results were achieved with both the press-fit condylar Sigma mobile and

Temporomandibular joint fibrocartilage degeneration from unilateral dental splints.

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Henderson, Sarah E; Lowe, Jesse R; Tudares, Mauro A; Gold, Michael S; Almarza, Alejandro J

2015-01-01

The objective of this study was to determine the extent to which altered loading in the temporomandibular joint (TMJ), as might be associated with a malocclusion, drives degeneration of articulating surfaces in the TMJ. We therefore sought to quantify the effects of altered joint loading on the mechanical properties and biochemical content and distribution of TMJ fibrocartilage in the rabbit. Altered TMJ loading was induced with a 1mm splint placed unilaterally over the maxillary and mandibular molars for 6 weeks. At that time, TMJ fibrocartilage was assessed by compression testing, biochemical content (collagen, glycosaminoglycan (GAG), DNA) and distribution (histology), for both the TMJ disc and the condylar fibrocartilage. There were no changes in the TMJ disc for any of the parameters tested. The condylar fibrocartilage from the splinted animals was significantly stiffer and the DNA content was significantly lower than that in control animals. There was significant remodeling in the condylar fibrocartilage layers as manifested by a change in GAG and collagen II distribution and a loss of defined cell layers. A connection between the compressive properties of TMJ condylar fibrocartilage after 6 weeks of splinting and the changes in histology was observed. These results suggest a change in joint loading leads to condylar damage, which may contribute to pain associated with at least some forms of TMJ disease. Copyright © 2014 Elsevier Ltd. All rights reserved.

Maxillary-driven simultaneous maxillo-mandibular distraction for hemifacial microsomia.

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Nakajima, Hideo; Sakamoto, Yoshiaki; Tamada, Ikkei; Ogata, Hisao; Kishi, Kazuo; Sakamoto, Teruo

2011-12-01

We treat hemifacial microsomia with a combination of surgery and orthodontic treatment during the growth period, resulting in early improvement in facial asymmetry and the induction of normal growth. We previously used gradual distraction of the mandibular ramus for Pruzansky's type II classification (Pruzansky, 1969). In type II cases, the maxilla should also be treated actively as, using this technique, improvement of the occlusal plane is difficult to achieve, resulting in a cross bite and difficulties in post-operative orthodontic treatment-especially in older patients. Morphologically, the mandibular angle region of the operative side is flat, and the angle of the mouth remains elevated. We performed mandibular-driven simultaneous maxillo-mandibular distraction while the occlusion was maintained using intermaxillary anchorage. However, mandibular-driven distraction tended to elongate the face because the mandible only elongated downwards and the mandibular ramus did not reach the glenoid. Furthermore, external distraction devices produce significant distress for patients until removal of the device and cause scars on the face. We developed a new internal distraction device with a variable angle and performed maxillary-driven simultaneous maxillo-mandibular distraction using this device. The result was morphologically satisfactory and solved the above problems. Because the patient was in the growth period, careful follow-up and induction to normal growth were important while the inferior growth of the affected side was monitored. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Radiologic study of mandibular third molar of Korean youths

International Nuclear Information System (INIS)

Ahn, Hyung Kyu

1982-01-01

The author has made a study on the classification of the mandibular 3rd molars of Korean youths through dental radiography by means of Pell and Gregory's classification and on the prevalence of the dental caries of distal surface of the mandibular 2nd molar adjacent to the mandibular 3rd molars turned anteriorly. The results are as follow; 1. It was found that the largest case number was class I (272 cases, 52.9%) in the relation of the tooth to the ramus of the mandible and 2nd molar. 2. The mesio-angular position was the largest number (239 cases, 46.5%) in the relation of the long axis of the impacted mandibular 3rd molar to the long axis of the 2nd molar. 3. The mesio-angular position of class I was the largest number (140 cases, 27.2%) in the relation of the tooth to the ramus of the mandible and 2nd molar and the long axis of the impacted mandibular 3rd moral to the long axis of the 2nd molar. 4. The average angle of the long axis of mandibular 3rd molar in mesioangular position or horizontal position to the occlusal plane was 143 W 5. Mandibular 3rd molar with lesion such as dental cries or pericoronitis was 73 cases (14.2). 6. The caries incidence rate of the distal surface of the 2nd molar was about 3.1%.

Surgical repair of propagating condylar fractures of the third metacarpal/metatarsal bones with cortical screws placed in lag fashion in 26 racehorses (2007-2015).

Science.gov (United States)

Moulin, N; François, I; Coté, N; Alford, C; Cleary, O; Desjardins, M R

2018-01-19

Despite the recommendation of plate fixation for propagating condylar fractures of the third metacarpal (McIII) or third metatarsal bone (MtIII), lag screw fixation can be a viable surgical option. To evaluate short-term outcome and long-term racing performance of horses that underwent lag screw fixation of long condylar fractures of the McIII/MtIII. Retrospective case series. Medical records, post-surgical racing performance and outcome of 26 horses with propagating fractures of the medial and/or lateral condyle of McIII/MtIII were reviewed. Medical information included were age, breed, sex, physical examination at admission, circumstances of fracture, radiographic evaluation, anaesthesia and recovery records, surgical and post-operative management, as well as complications. Outcome included racing data and information from telephone interviews. Twenty-six horses (9 Standardbreds and 17 Thoroughbreds) were admitted with a long condylar fracture of the McIII/MtIII. Fore- and hindlimbs were equally represented with the left hindlimb being more frequently involved. Most of the fractures had a spiralling component (76%) and four (15%) were comminuted. Fifteen (58%) horses raced post-surgery including nine Standardbreds (100%) and six Thoroughbreds (35%). Twelve of them were placed in at least one race and 11 won at least once. One horse sustained a severe complication in recovery. No significant difference was observed in the racing performances before and after surgery. Follow-up method and duration were not standardised and there is a low number of cases with six surgeons. Long condylar fractures can be repaired using lag fashion technique combined with a half-limb or full-limb tight cast for recovery as a good surgical alternative. Similar results to plate fixation can be expected, with a return to racing of more than 50%, and the prognosis being even better for pacers. © 2018 EVJ Ltd.

Fixation of zygomatic and mandibular fractures with biodegradable plates

OpenAIRE

Degala, Saikrishna; Shetty, Sujeeth; Ramya, S

2013-01-01

Context: In this prospective study, 13 randomly selected patients underwent treatment for zygomatic?complex fractures (2 site fractures) and mandibular fractures using 1.5 / 2 / 2.5-mm INION CPS biodegradable plates and screws. Aims: To assess the fixation of zygomatic-complex and mandibular fractures with biodegradable copolymer osteosynthesis system. Materials and Methods: In randomly selected 13 patients, zygomatic-complex and mandibular fractures were plated using resorbable plates and sc...

Algorithm of imaging modalities in cases of mandibular fractures

International Nuclear Information System (INIS)

Mihailova, H.

2009-01-01

Mandibular fracture is the most common bone fracture of maxillo-facial trauma. Up to now the main method for examination of the mandible is radiography. The aim of the issue is to present an algorithm of imaging modalities for investigation of patients in cases of mandibular trauma. It consists of series of X ray techniques and views of the facial skull named mandibulo-facial. This standardizes mandibulo-facial series includes exactly determined four projections done by conventional X ray techniques: posterior-anterior view of skull (PA or AP), oblique view of the left mandible; oblique view of the right mandible; occipito-mental view. Using these four planned radiograms is obligatory for each mandibular trauma. Panoramic X-ray is obligatory in cases of apparatus availability; this abolish only oblique views (left and right). Occipito-mental view of the skull gives anatomically better the coronoid process of the mandible, the zygoma complex, the orbital edges and maxillar sinus than Waters projection. So mandibulo-facial series of four planned radiograms is not only for diagnostic of mandibular fractures, but as a screening of mandibulo-facial trauma too. Thus using algorithm of imaging modalities in cases of mandibular fracture leads to optimization of diagnostic process in patients with mandibular trauma. (author)

Radiographic study of bone changes on TMJ arthrosis

International Nuclear Information System (INIS)

You, Dong Soo

1982-01-01

The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthrosis was eburnation of cortical bone (35.64%) of total cases. Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed state, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relationships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movement in 332 cases (28.55%), bone on bone relationships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). Bone on bone relationships in 248 cases (21.32%) and downward positioning of

Radiographic study of bone changes on TMJ arthrosis

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You, Dong Soo [Dept. of Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1982-11-15

The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthrosis was eburnation of cortical bone (35.64%) of total cases. Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed state, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relationships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movement in 332 cases (28.55%), bone on bone relationships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). Bone on bone relationships in 248 cases (21.32%) and downward positioning of

Effect of irradiation on the dental pulp tissues in streptozotocin-induced diabetic rats

International Nuclear Information System (INIS)

Kang, Ho Duk; Hwang, Eui Hwan; Lee, Sang Rae

2005-01-01

To observe the histological changes in the pulp tissues of mandibular molars in streptozotocin-induced diabetic rats after irradiation. The male Sprague-Dawley rats weighing approximately 250 gm were divided into four groups : control, diabetes, irradiation, and diabetes-irradiation groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in control and irradiation groups were injected with citrate buffer only. After 5 days, the head and neck region of the rats in irradiation and diabetes-irradiation groups were irradiated with a single absorbed dose of 10 Gy. All the rats were sacrificed at 3, 7, 14, 21, and 28 days after irradiation. The specimen including the mandibular molars were sectioned and observed using a histopathological method. In the diabetes group, capillary dilatation was observed. However, there was no obvious morphologic alteration of the odontoblasts. In the irradiation group, generalized necrosis of the dental pulp tissues was observed. Vacuolation of the odontoblasts and dilatation of the capillaries were noted in the early experimental phases. In the diabetes-irradiation group, generalized degeneration of the dental pulp tissues was observed. Vacuolation of the dental pulp cells and the odontoblasts was noted in the late experimental phases. This experiment suggest that dilatation of the capillaries in the dental pulp tissue is induced by diabetic state, and generalized degeneration of the dental pulp tissues is induced by irradiation of the diabetic group.

Chincup treatment modifies the mandibular shape in children with prognathism.

Science.gov (United States)

Alarcón, José Antonio; Bastir, Markus; Rosas, Antonio; Molero, Julia

2011-07-01

Although chincups are the preferred treatment for growing children with mandibular prognathism, the mechanism by which chincups improve this condition remains unclear. The aim of this study was to use geometric morphometrics to evaluate changes in the shape of the mandible of prognathic children treated with a chincup. Geometric morphometrics were used to evaluate the short-term mandibular shape changes in 50 prognathic children treated with chincups compared with 40 untreated matched controls. Twenty-one 2-dimensional mandibular landmarks from cephalograms taken before and after 36 months of treatment or observation were analyzed by Procrustes superimposition and thin plate spline. Permutation tests of the treated patients showed highly significant differences in the mandibular shapes before and after treatment, and compared with the control group after the observation period. The thin plate spline grid deformations indicated more rectangular mandibular configuration, forward condyle orientation, condyle neck compression, gonial area compression, and symphysis narrowing. Early chincup treatment widely modifies the mandibular shape of prognathic children to improve Class III malocclusion. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Augmented mandibular bone structurally adapts to functional loading

NARCIS (Netherlands)

Verhoeven, J. W.; Ruijter, J. M.; Koole, R.; de Putter, C.; Terlou, M.; Cune, M. S.

2013-01-01

Long-term changes in trabecular bone structure during the 10 years following onlay grafting with simultaneous mandibular implant placement were studied. Extraoral radiographs of both mandibular sides in eight patients were taken regularly. Bone structure was analysed using a custom-written image

Open treatment of unilateral mandibular condyle fractures in adults : A systematic review

NARCIS (Netherlands)

Rozeboom, A.; Dubois, L.; Bos, R.; Spijker, R.; de Lange, J.

2017-01-01

Since the introduction of rigid internal fixation devices, more and more surgeons favour an open approach to treating condylar fractures of the mandible in adult patients. Different indications for open treatment have been published. Open treatment is associated with surgical complications because

Autotransplantation of Mandibular Third Molar: A Case Report

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Pabbati Ravi kumar

2012-01-01

Full Text Available Autogenous transplantation is a feasible, fast, and economical option for the treatment of nonsalvageable teeth when a suitable donor tooth is available. This paper presents successful autotransplantation of a mature mandibular left third molar (38 without anatomical variances is used to replace a mandibular left second molar (37. The mandibular second molar was nonrestorable due to extensive root caries and resorption of distal root. After extraction of mandibular second and third molars, root canal therapy was done for the third molar extraorally, and the tooth was reimplanted into the extracted socket of second molar site. After one year, clinical and radiographic examination revealed satisfactory outcome with no signs or symptoms suggestive of pathology. In selected cases, autogenous tooth transplantation, even after complete root formation of the donor tooth, may be considered as a practical treatment alternative to conventional prosthetic rehabilitation or implant treatment.

Intermittent Hypoxia Influences Alveolar Bone Proper Microstructure via Hypoxia-Inducible Factor and VEGF Expression in Periodontal Ligaments of Growing Rats

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Shuji Oishi

2016-09-01

Full Text Available Intermittent hypoxia (IH recapitulates morphological changes in the maxillofacial bones in children with obstructive sleep apnea (OSA. Recently, we found that IH increased bone mineral density (BMD in the inter-radicular alveolar bone (reflecting enhanced osteogenesis in the mandibular first molar (M1 region in the growing rats, but the underlying mechanism remains unknown. In this study, we focused on the hypoxia-inducible factor (HIF pathway to assess the effect of IH by testing the null hypothesis of no significant differences in the mRNA-expression levels of relevant factors associated with the HIF pathway, between control rats and growing rats with IH. To test the null hypothesis, we investigated how IH enhances mandibular osteogenesis in the alveolar bone proper with respect to HIF-1α and vascular endothelial growth factor (VEGF in periodontal ligament (PDL tissues. Seven-week-old male Sprague–Dawley rats were exposed to IH for 3 weeks. The microstructure and BMD in the alveolar bone proper of the distal root of the mandibular M1 were evaluated using micro-computed tomography (micro-CT. Expression of HIF-1α and VEGF mRNA in PDL tissues were measured, whereas osteogenesis was evaluated by measuring mRNA levels for alkaline phosphatase (ALP and bone morphogenetic protein-2 (BMP-2. The null hypothesis was rejected: we found an increase in the expression of all of these markers after IH exposure. The results provided the first indication that IH enhanced osteogenesis of the mandibular M1 region in association with PDL angiogenesis during growth via HIF-1α in an animal model.

Ovariectomy delays alveolar wound healing after molar extractions in rats.

Science.gov (United States)

Pereira, Michele Conceição; Zecchin, Karina Gottardello; Campagnoli, Eduardo Bauml; Jorge, Jacks

2007-11-01

This study was conducted to investigate the morphological effects of the absence of estrogen on alveolar wound healing of young female rats after tooth extraction. A total of 60 4- to 6-week-old female rats underwent bilateral ovariectomy (OVX) or sham operations. Three weeks later, the first mandibular molars were extracted. Subsequently, the animals were killed by cervical dislocation 3, 5, 7, 14, 21, or 28 days after tooth extraction. The mandibles were removed, and serial transversal sections of mesial alveolus of the first mandibular molars were obtained for histometric analysis. OVX sockets showed significant increases in fibroblasts and collagen content 3 and 5 days after the extractions, followed by significant decreases in these parameters in the subsequent periods. In accordance with the decreased collagen content in the latest period of healing, new bone formation was significantly reduced in the OVX animals. These findings suggest that the initial molecular changes observed in the absence of estrogen lead to delayed alveolar wound healing.

Mandibular fracture cases in Pelotas, Rio Grande do Sul, Brazil

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Rafael Silva da Silva

2009-10-01

Full Text Available Objectives: To analyze the data in the literature, which show a high incidence of mandibular fractures. The aim of this research was to elucidate the context in which these fractures occur among patients attended at the first aid center of “Pronto Socorro Municipal de Pelotas”, Rio Grande do Sul, Brazil. Methods: From the records referring to the period of June, 2001 to August, 2007, there were 1 345 patients with facial fractures. Of this total, 116 patients with mandibular fracture were selected for this study and the items analysed were: age, gender, mandibular fracture site, etiology and period of the year. Results: It was found that 86.2% of the sample were men. The most prevalent age was 20 to 29 years old representing 36.2%, and the most affected mandibular sites were the body, with 29 cases (25%, and the condyle, with 26 cases (22.4%. The most common cause of fractures was the physical aggression representing 37.1%. The period of the year with the highest incidence of mandibular fractures was the summer, with 38 cases (32.8%. Conclusion: It was therefore observed that the patients with mandibular fracture assisted at Pronto-Socorro Municipal de Pelotas, Rio Grande do Sul, Brazil, were generally men, 20 to 29 years old with mandibular body fracture and they were victims of physical aggression.

Early Loaded Single Implant Reinforced Mandibular Overdenture

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K. Nischal

2016-01-01

Full Text Available Rehabilitating atrophied mandible with two-implant supported denture is a common treatment modality for implant retained removable overdenture in mandible. This paper aims to design a treatment modality where single implant reinforced overdenture is fabricated for a severely atrophied mandibular ridge with early loading protocol. Results of studies have shown that a single implant mandibular overdenture significantly increases the satisfaction and quality of life of patients with edentulism. Midline fracture of the prosthesis is the most common complication related to single implant and two-implant retained mandibular overdentures. To manage such complication, a thin metal mesh is used to reinforce the overdenture and also to make the prostheses lighter and cost effective as compared to conventional cast metal framework.

Intraoperative monitoring of marginal mandibular nerve during neck dissection.

Science.gov (United States)

Tirelli, Giancarlo; Bergamini, Pier Riccardo; Scardoni, Alessandro; Gatto, Annalisa; Boscolo Nata, Francesca; Marcuzzo, Alberto Vito

2018-05-01

The purpose of this study was to assess the efficacy of intraoperative nerve integrity monitoring (NIM) to prevent marginal mandibular nerve injuries during neck dissection. This prospective study compared 36 patients undergoing NIM-assisted neck dissection from July 2014 to March 2015 to a cohort of 35 patients subjected to neck dissection over an identical period of time before the technique was introduced. We also assessed possible correlations between marginal mandibular nerve injuries and other factors, such as anthropometric measurements, presence of clinical neck metastases, type of neck dissection, and site of primary tumor. The incidence of marginal mandibular nerve paralyses was significantly lower among the group of patients undergoing NIM-assisted neck dissection (P = .021). There was no significant difference in the duration of the procedure, and the technique resulted in a limited increase of cost. No other factor seemed to influence the onset of marginal mandibular nerve palsy. In our opinion, NIM is a valuable aid for preventing marginal mandibular nerve injuries during neck dissection. © 2018 Wiley Periodicals, Inc.

Dynamic compression plate (DCP) fixation of propagating medial condylar fractures of the third metacarpal/metatarsal bone in 30 racehorses: retrospective analysis (1990-2005).

Science.gov (United States)

Goodrich, L R; Nixon, A J; Conway, J D; Morley, P S; Bladon, B M; Hogan, P M

2014-11-01

An in-depth review of dynamic compression plate (DCP) fixation of propagating medial condyle fractures of the third metacarpus or metatarsus has not been previously reported. To describe the technique, evaluate short-term outcome and long-term race performance of racehorses that underwent DCP fixation for repair of propagating or spiralling medial condylar fractures of the third metacarpal (McIII) or metatarsal (MtIII) bone. Retrospective case series. The surgical case records of 30 horses with propagating fractures of the medial condyle of McIII or MtIII were reviewed. Medical information included: age, breed, sex, presentation, how injury occurred (racing or training), surgical treatment and post operative complications. Racing information included: starts, top 3 placing and career earnings. Long propagating fractures of the medial condyle of Mc/tIII were identified in 23 Thoroughbred (TB) and 7 Standardbred (STB) racehorses. The fracture spiralled proximally in 22 of 30 cases (73%). Standardbreds had a higher propensity for hindlimb involvement (71%), whereas TBs tended to have more front limb involvement (61%). Twelve of 30 (40%) horses raced post surgery. Career earnings were significantly lower for TB horses with medial condylar fractures; $34,916 when compared with the national average of $60,841 (P≤0.03). Overall, horses having DCP fixation for medial condylar fractures had less starts post surgery (3.1 TBs and 5.8 STBs) compared with the national average (7 TBs and 17.3 STBs) and decreased lifetime starts 13.4 (TBs) compared with 17.3 nationally. Propagating medial condyle fractures can be repaired with plate fixation to potentially lessen the risk of catastrophic fracture destabilisation and return to racing can be expected in 40% of horses. Further prospective studies are warranted comparing lag screw fixation with DCP fixation for repair of severe medial condylar fractures of the metacarpus/metatarsus. © 2013 The Authors. Equine Veterinary Journal

Radiographic Localization of the Mental Foramen and Mandibular Canal

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Farzaneh Afkhami

2013-01-01

Full Text Available Objective: Accurately localizing the mental foramen and mandibular canal is important when administering local anesthesia and performing surgery; therefore, knowing the normal range of the possible locations is essential. Our purpose was to assess the location of the mental foramen and mandibular canal in an Iranian population using panoramic radiography.Materials and Methods: Standard panoramic radiographies were performed. The positions of 100 mental foramens were evaluated. The distances from the center of the mental foramen to the superior and inferior borders of the mandible and to the apexes of the first and second premolar were measured. The distance of the mental foramens from the mandibular midline and the diameter of the mandibular canal in the mental foramen connection were also measured.Results: Among 100 mental foramens, 6% were positioned under the first premolar, 24% were between the first and second premolars, 67% were under the second premolar, and the remaining 3% were behind the second premolar. The mean distance from the mental foramen to the mandibular midline was 27.77±3.20 mm. The mean diameter of the mandibular canal in the mental foramen connection was 3.09±0.69mm.Conclusion: The mental foramen was near the second premolar and the inferior border of the mandible. This information can be used to perform safer mental nerve blocks in surgical interventions.

21 CFR 874.3695 - Mandibular implant facial prosthesis.

Science.gov (United States)

2010-04-01

... made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based alloy... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular implant facial prosthesis. 874.3695... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant...

Penetration of flomoxef into human maxillary and mandibular bones.

Science.gov (United States)

Igawa, H H; Sugihara, T; Yoshida, T; Kawashima, K; Ohura, T

1995-09-01

Penetration of flomoxef into the maxillary and mandibular bones was assayed clinically to provide data about its usefulness for the prevention of postoperative infection after maxillofacial surgery. Twenty-one patients undergoing maxillofacial surgery at our department were given flomoxef 2 g dissolved in 20 ml of physiological saline intravenously over 3 minutes during operation, and the serum, maxillary and mandibular concentrations were measured 1, 3, and 6 hours after injection by the band culture method using Escherichia coli 7437 as the indicator strain. The mean concentrations were 53.4, 16.1, and 2.6 micrograms/ml, respectively, in the serum, 17.6, 7.8, and 1.0 micrograms/g in maxillary bone, and 16.4, 4.2, and 0.9 micrograms/g in mandibular bone. The mean bone:serum ratios at 1, 3, and 6 hours were 33.0%, 48.2%, and 36.8%, respectively, for maxillary bone, and 30.7%, 26.2%, and 35.7% for mandibular bone. When compared with previously reported data on the bone:serum ratios in jaw of various other intravenous antibiotics, our results show that penetration of flomoxef into maxillary and mandibular bone is extremely high. As all the intramaxillary and intramandibular concentrations exceed its MIC80 values against clinical isolates of bacteria frequently isolated in cases of infection in the oral and maxillofacial region, it is apparent that one intravenous shot of flomoxef 2 g allows penetration of the drug into the maxillary and mandibular bones at effective concentrations. Flomoxef is therefore potentially useful for the prevention and treatment of infections in the oral and maxillofacial region, as it has excellent penetration into the maxillary and mandibular bones.

Intermaxillary Fixation Screw Morbidity in Treatment of Mandibular Fractures

DEFF Research Database (Denmark)

Florescu, Vlad-Andrei; Kofod, Thomas; Pinholt, Else Marie

2016-01-01

Purpose The aim of the present retrospective study was to investigate the morbidity of screws used for intermaxillary fixation (IMF) in the treatment of mandibular fractures. A review of the published data was also performed for a comparison of outcomes. Our hypothesis was that the use of screws...... for IMF of mandibular fractures would result in minimal morbidity. Materials and Methods Patients treated for mandibular fractures from 2007 to 2013, using screws for IMF, using the international diagnosis code for mandibular fracture, DS026, were anonymously selected (Department of Oral and Maxillofacial...... Surgery, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark). The fracture type, radiographic findings, treatment modality, screw type and number, and root damage were recorded. For the outcome comparison, a review of the published data regarding iatrogenic dental root damage caused...

[A toddler with a mandibular fracture].

Science.gov (United States)

van der Linden, E L; Bun, R J; van Os, E

2017-01-01

Mandibular fractures are rare in children. Symptoms of these fractures include preauricular pain and swelling, trismus and pain when opening the mouth, and they are often preceded by a fall on the chin. If the diagnosis is missed they may have serious consequences for the growth and development of the jaw. A 3-year-old boy was referred with a swelling in his left cheek, fever and vomiting. Two days earlier he had fallen on his chin. At physical examination he had severe preauricular pain on palpation and a trismus. The patient was admitted because of suspicion of a viral parotitis and the threat of dehydration. After discharge, he went to the dentist for examination of a molar that was painful to the touch. The dentist performed an orthopantomogram and discovered a fracture of the left mandibular collum. Any child with trauma to the chin should be observed for symptoms of a mandibular fracture, and if it seems necessary non-invasive radiographic examination should be performed.

Coronal views of the paediatric mandibular condyle on ...

African Journals Online (AJOL)

This article highlights the importance of routinely reviewing the mandibular condyle on computerised tomography brain studies in a trauma setting, that often extends to involve the mandibular condyles in the scan parameters. We discuss 4 cases seen over the last 18 months at our institution, and review the relevant ...

Congenital external auditory canal atresia and stenosis: temporal bone CT findings

Energy Technology Data Exchange (ETDEWEB)

Lee, Dong Hoon; Kim, Bum Soo; Jung, So Lyung; Kim, Young Joo; Chun, Ho Jong; Choi, Kyu Ho; Park, Shi Nae [College of Medicine, Catholic Univ. of Korea, Seoul (Korea, Republic of)

2002-04-01

To determine the computed tomographic (CT) findings of atresia and stenosis of the external auditory canal (EAC), and to describe associated abnormalities in surrounding structures. We retrospectively reviewed the axial and coronal CT images of the temporal bone in 15 patients (M:F=8:7;mean age, 15.8 years) with 16 cases of EAC atresia (unilateral n=11, bilateral n=1) and EAC stenosis (unilateral n=3). Associated abnormalities of the EAC, tympanic cavity, ossicles, mastoid air cells, eustachian tube, facial nerve course, mandibular condyle and condylar fossa, sigmoid sinus and jugular bulb, and the base of the middle cranial fossa were evaluated. Thirteen cases of bony EAC atresia (one bilateral), with an atretic bony plate, were noted, and one case of unilateral membranous atresia, in which a soft tissue the EAC. A unilateral lesion occurred more frequently on the right temporal bone (n=8, 73%). Associated abnormalities included a small tympanic cavity (n=8, 62%), decreased mastoid pneumatization (n=8, 62%), displacement of the mandibular condyle and the posterior wall of the condylar fossa (n=7, 54%), dilatation of the Eustachian tube (n=7, 54%), and inferior displacement of the temporal fossa base (n=8, 62%). Abnormalities of ossicles were noted in the malleolus (n=12, 92%), incus (n=10, 77%) and stapes (n=6, 46%). The course of the facial nerve was abnormal in four cases, and abnormality of the auditory canal was noted in one. Among three cases of EAC stenosis, ossicular aplasia was observed in one, and in another the location of the mandibular condyle and condylar fossa was abnormal. In the remaining case there was no associated abnormality. Atresia of the EAC is frequently accompanied by abnormalities of the middle ear cavity, ossicles, and adjacent structures other than the inner ear. For patients with atresia and stenosis of this canal, CT of the temporal bone is essentially helpful in evaluating these associated abnormalities.

Orthodontic Extraction of High-Risk Impacted Mandibular Third Molars in Close Proximity to the Mandibular Canal: A Systematic Review.

Science.gov (United States)

Kalantar Motamedi, Mahmood Reza; Heidarpour, Majid; Siadat, Sara; Kalantar Motamedi, Alimohammad; Bahreman, Ali Akbar

2015-09-01

Extraction of mandibular third molars (M3s) in close proximity to the mandibular canal has some inherent risks to adjacent structures, such as neurologic damage to teeth, bone defects distal to the mandibular second molar (M2), or pathologic fractures in association with enlarged dentigerous cysts. The procedure for extrusion and subsequent extraction of high-risk M3s is called orthodontic extraction. This is a systematic review of the available approaches for orthodontic extraction of impacted mandibular M3s in close proximity to the mandibular canal and their outcomes. The PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), DOAJ, Google Scholar, OpenGrey, Iranian Science Information Database (SID), Iranmedex, and Irandoc databases were searched using specific keywords up to June 2, 2014. Studies were evaluated based on predetermined eligibility criteria, treatment approaches, and their outcomes. Thirteen articles met the inclusion criteria. A total of 123 impacted teeth were extracted by orthodontic extraction and 2 cases were complicated by transient paresthesia. Three types of biomechanical approaches were used: 1) using the posterior maxillary region as the anchor for orthodontic extrusion of lower M3s, 2) simple cantilever springs attached to the M3 buttonhole, and 3) cantilever springs tied to a bonded orthodontic bracket on the M3 plus multiple-loop spring wire for distal movement of the M3. Osteo-periodontal status of M2s also improved uneventfully. Despite the drawbacks of orthodontic extraction, removal of deeply impacted M3s using the described techniques is safe with regard to mandibular nerve injury and neurologic damage. Orthodontic extraction is recommended for extraction of impacted M3s that present a high risk of postoperative osteo-periodontal defects on the distal surface of the adjacent M2 and those associated with dentigerous cysts. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by

Experimental occlusal interferences. Part V. Mandibular rotations versus hemimandibular translations.

Science.gov (United States)

Christensen, L V; Rassouli, N M

1995-12-01

Frontal plane mandibular rotations and corresponding hemimandibular translations were studied in vitro by using direct observations of a human cadaver mandible and in vivo by using the indirect observations of rotational electrognathography. A comparison between the two methods showed that rotational electrognathography erred in measuring the clinically relevant hemimandibular translations resulting from mandibular rotations having a unilateral molar point (simulated occlusal interference) as the pivot of frontal plane torque. In vitro frontal plane rotations about a unilateral mandibular molar tooth (simulated occlusal interference) suggested that the resulting hemimandibular upward translations of the lateral portion of the mandibular condyle, contralateral to the molar tooth, would cause considerable compressive loading of the temporomandibular joint disc.

Radiographic study on the anterior portion of the neck of the condylar process. Aged-related developmental changes based on Hellman's dental stage

Energy Technology Data Exchange (ETDEWEB)

Inoue, Hiroshi; Yamato, Rieko; Tada, Miwako [Meikai Univ., Sakado, Saitama (Japan). School of Dentistry] [and others

2003-02-01

The condylar process is directly and indirectly influenced by the masticatory muscles and the temporomandibular joint, which functions to regulate jaw movement. Age-related changes in the condylar process were found in both external and internal structures. Observation of X-ray profiles afforded identification of areas of interest in the anterior portion of the neck of condylar process. This portion anatomically includes the pterygoid fovea; moreover, the process serves as a terminal for the lateral pterygoid muscle. Rather than directly analyzing bone structure, we made distinct measurements in regions of interest by X-ray image analysis. Subsequently, changes in occlusion during each developmental stage were evaluated. In addition, bone mineral density measurements were performed. Greater growth was recognized in the long axis of the condylar process in comparison to the short axis. The long axis indicated a 2.7-fold increase in ODL (length along the major axis) from the IA period to the VA period; additionally, the total absolute length increased by 3.1-fold. The short axis demonstrated a 2.3-fold increase in ODS (length along the minor axis) from the IA period to the VA period; furthermore, the total average length revealed a 1.9-fold increase. Bone mineral density was highest in the anterior portion (region of interest) and was higher in the posterior portion (cortical bone); than in the middle portion (central bone). Among these 3 areas, density differences became larger as the developmental stage of occlusion progressed. Detailed measurements in the region of interest demonstrated significant increases from the IIC period to the IIIA (B) period, and distinct peak times of increases were observed in bone mineral density: the center bone structure, as well as the posterior cortical bone, showed significant increases between the IIIC period and the IVA period. The anterior border displayed to constant increase with an exception for the period between stages

Effect of digital template in the assistant of a giant condylar osteochondroma resection.

Science.gov (United States)

Bai, Guo; He, Dongmei; Yang, Chi; Lu, Chuan; Huang, Dong; Chen, Minjie; Yuan, Jianbing

2014-05-01

Exostosis osteochondroma is usually resected with the whole condyle even part of it is not involved. This study was to report the effect of using digital template in the assistant of resection while protecting the uninvolved condyle. We used computer-aided design technique in the assistant of making preoperative plan of a patient with giant condylar osteochondroma of exogenous type, including determining the boundary between the tumor and the articular surface of condyle, and designing the virtual tumor resection plane, surgical approach, and remove-out path of the tumor. The digital osteotomy template was made by rapid prototyping technique based on the preoperative plan. Postoperative CT scan was performed and merged with the preoperative CT by the Proplan 1.3 system to evaluate the accuracy of surgical resection with the guide of digital template. The osteotomy template was attached to the lateral surface of condyle accurately, and the tumor was removed totally by the guide of the template without injuries to adjacent nerves and vessels. Postoperative CT showed that the osteochondroma was removed completely and the unaffected articular surface of condyle was preserved well. The merging of postoperative and preoperative CT by Proplan 1.3 system showed the outcome of the operation matched with the preoperative planning quite well with an error of 0.92 mm. There was no sign of recurrence after 6 months of follow-up. The application of digital template could improve the accuracy of the giant condylar tumor resection and help to preserve the uninvolved condyle. The use of digital template could reduce injuries to the nerves and vessels as well as save time for the operation.

Predicting pathology in impacted mandibular third molars

Directory of Open Access Journals (Sweden)

Aveek Mukherji

2017-01-01

Full Text Available Introduction: The rising incidence of the impacted mandibular third molars and their association with pathologies is now considered a public health problem. Aims and Objectives: The objective of this study was to assess the position of impacted mandibular third molars that are prone to developing pathologies and to determine the frequency and type of pathological conditions associated with these impacted teeth to facilitate planning for their prophylactic removal. Materials and Methods: Consecutive panoramic radiographs and clinical examination of 300 patients with impacted mandibular third molars were collected. They were segregated according to Pell and Gregory’s classification, Winter’s classification, and according to their state of eruption. These were correlated with associated pathologies based on clinical and radiological criteria. Statistical Analysis Used: Descriptive statistics included computation of percentages, mean, and standard deviations. The statistical test applied for the analysis was Pearson’s Chi-square test (χ2. For this test, confidence interval and P value were set at 93% and ≤0.03, respectively. Results: The pathology most commonly associated with impacted third molars was pericoronitis, which had the highest frequency of occurrence in partially erupted, distoangular, and IA positioned (as per Pell and Gregory classification impacted teeth. Impacted mandibular third molars, which were in IA position, placed mesially, and partially erupted, were prone to develop pathologies such as dental caries and periodontitis. Conclusion: The clinical and radiographical features of impacted third molar may be correlated to the development of their pathological complications. The partially impacted mandibular third molars with mesioangularly aligned in IA position have the highest potential to cause pathological complications.

Pediatric mandibular fractures: a free hand technique.

Science.gov (United States)

Davison, S P; Clifton, M S; Davison, M N; Hedrick, M; Sotereanos, G

2001-01-01

The treatment of pediatric mandibular fractures is rare, controversial, and complicated by mixed dentition. To determine if open mandibular fracture repair with intraoral and extraoral rigid plate placement, after free hand occlusal and bone reduction, without intermaxillary fixation (IMF), is appropriate and to discuss postoperative advantages, namely, maximal early return of function and minimal oral hygiene issues. A group of 29 pediatric patients with a mandibular fracture were examined. Twenty pediatric patients (13 males and 7 females) with a mean age of 9 years (age range, 1-17 years) were treated using IMF. All patients were treated by the same surgeon (G.S.). Surgical time for plating was reduced by 1 hour, the average time to place patients in IMF. The patients who underwent open reduction internal fixation without IMF ate a soft mechanical diet by postoperative day 3 compared with postoperative day 16 for those who underwent IMF. Complication rates related to fixation technique were comparable at 20% for those who did not undergo IMF and 33% for those who did. We believe that free hand reduction is a valuable technique to reduce operative time for pediatric mandibular fractures. It maximizes return to function while minimizing the oral hygiene issues and hardware removal of intermaxillary function.

Forced extrusion for removal of impacted third molars close to the mandibular canal Extrusión forzada para extraer los terceros molares impactados cerca del canal mandibular

Directory of Open Access Journals (Sweden)

Dennis Flanagan DDS

2012-03-01

Full Text Available Impacted mandibular third molars can be located in close proximity to the mandibular canal. This creates a risk for the nerve or artery injury. These are contained in the canal. However, the impacted third molar can be moved coronally by orthodontic means, after removal of overlying bone, and safely extracted. The orthodontic intervention slowly moves the tooth apex away from the mandibular canal and reduces the potential for a neural injury. This method may be useful for older patients with root apices that approximate or are actually located in the mandibular canal. This technique needs further study. There is a theoretical potential for neural or arterial injury from physical contact of the tooth apex as it moves by or through the mandibular canal.Los terceros molares inferiores impactados pueden localizarse muy cerca del canal mandibular. Esto constituye un riesgo de lesión del nervio o la arteria, que se localizan dentro del canal. No obstante, el tercer molar impactado puede desplazarse en dirección coronal con ortodoncia, tras ostectomía del hueso suprayacente, y extraerse sin riesgos. La intervención ortodóncica desplaza lentamente el ápice del diente fuera del canal mandibular y reduce la posibilidad de lesión neural. Este método puede ser útil para pacientes de edad avanzada con ápices dentales que se aproximan o en realidad se localizan en el canal mandibular. La técnica necesita un estudio adicional. Hay la posibilidad teórica de lesión neural o arterial a partir del contacto físico del ápice del diente a medida que se desplaza a través del canal mandibular.

Assessing joint space and condylar position in the people with normal function of temporomandibular joint with cone-beam computed tomography

Directory of Open Access Journals (Sweden)

Zahra Dalili

2012-01-01

Conclusion: The assessment of joint spaces in right and left sides should be done independently. Overall, the measured joint spaces except Sjs are not different in two sexes. The data from this study could be a useful and comparable reference for the clinical assessment of condylar position in patients with normal functional joints.

Radiographic evaluation of the course and visibility of the mandibular canal

International Nuclear Information System (INIS)

Jung, Yun Hoa; Cho, Bong Hae

2014-01-01

This study was performed to investigate the course of the mandibular canal on panoramic radiography and the visibility of this canal on both panoramic radiography and cone-beam computed tomography (CBCT). The study consisted of panoramic radiographs and CBCT images from 262 patients. The course of the mandibular canal, as seen in panoramic radiographs, was classified into four types: linear, elliptical, spoon-shaped, and turning curves. The visibility of this canal from the first to the third molar region was evaluated by visually determining whether the mandibular canal was clearly visible, probably visible, or invisible. The visibility of the canal on panoramic radiographs was compared with that on CBCT images. Elliptical curves were most frequently observed along the course of the mandibular canal. The percentage of clearly visible mandibular canals was the highest among the spoon-shaped curves and the lowest among the linear curves. On panoramic radiographs, invisible mandibular canals were found in 22.7% of the examined sites in the first molar region, 11.8% in the second molar region, and 1.3% in the third molar region. On CBCT cross-sectional images, the mandibular canal was invisible in 8.2% of the examined sites in the first molar region, 5.7% in the second molar region, and 0.2% in the third molar region. The visibility of this canal was lower in the first molar region than in the third molar region. The mandibular canal presented better visibility on CBCT images than on panoramic radiographs.

Mandibular ramus fractures: a rarity.

Science.gov (United States)

Kale, Tejraj Pundalik; Kotrashetti, S M; Louis, Archana; Lingaraj, J B; Sarvesh, B U

2013-01-01

To determine the incidence of mandibular ramus fractures in KLE's PK Hospital and to analyze the outcome of open reduction and internal fixation of these fractures. Using a retrospective study design, records of all trauma patients who reported to the Department of Oral and Maxillofacial Surgery, KLE's PK Hospital Belgaum, between the years January 2006 to October 2011 was obtained from the medical records office. The data variables that were analyzed were the name, age, sex, cause of injury, pretreatment occlusion, treatment given, period of MMF and post-treatment occlusion. Total number of mandibular fracture cases was 298. Ramus fractures were 10 in number which accounted for 3.3% of fractures. The age range of these 10 patients was seen to be between 20 to 80 years with the average age being 35.6 years. Of these 10 patients, 9 were male and 1 was female and 7 patients were treated by open reduction and internal fixation and the remaining 3 by closed reduction. The average period of MMF was 3 days for the patients who underwent open reduction and internal fixation. There was improvement in occlusion in all 10 patients post-treatment and there was no complication reported in any of the cases. Ramus fractures accounted for 3.3% of all mandibular fractures. Open reduction and internal fixation of ramus fractures ensures adequate functional and anatomic reduction. This study makes an attempt to throw a light on the increasing incidence of ramus fractures and a successful management of these fractures by open reduction and internal fixation. How to cite this article: Kale TP, Kotrashetti SM, Louis A, Lingaraj JB, Sarvesh BU. Mandibular Ramus Fractures: A Rarity. J Contemp Dent Pract 2013;14(1):39-42. Source of support: Nil Conflict of interest: None declared.

Cerebro-costo-mandibular syndrome: Report of two cases.

Science.gov (United States)

Abdalla, Wael; Panigrahy, Ashok; Bartoletti, Stefano C

2011-01-01

Cerebro-costo-mandibular syndrome (CCMS) is a rare syndrome that includes a constellation of mandibular hypoplasia and posterior rib defects as its basic features. Additional features can include hearing loss, tracheal cartilage abnormalities, scoliosis, elbow hypoplasia, and spina bifida. Here we report two cases of CCMS and discuss the reported long-term outcome of the disease.

Treatment of medial condylar fractures of the third metatarsus in three horses with fibreglass casts under standing neuroleptanalgesia.

Science.gov (United States)

Lloyd, D; Johanson, C; Phillips, T J

2008-05-03

Minimally displaced condylar fractures propagating into the third metatarsal diaphysis were treated conservatively in one thoroughbred and two Arabian racehorses. In each case a neuroleptanalgesic protocol provided adequate pain relief for a rigid fibreglass cast to be applied in a weight-bearing position. The fractures healed completely and the three horses recovered uneventfully. Two of them returned successfully to racing and the third was used for breeding.

[Imaging analysis of temporomandibular joint anatomy changes after intraoral condylectomy combined with orthognathic surgery].

Science.gov (United States)

Luo, N J; Li, Z L; Yi, B; Liang, C; Wang, X; Wang, X X

2016-06-01

To quantitatively analyze the changes of facial symmetry and temporomandibular joint structure at different periods after intraoral condylectomy combined with orthognathic surgery, and to evaluate the long-term stability after the operation. Spiral CT data of 10 cases treated by intraoral condylectomy combined with orthognathic surgery were collected, and then reconstructed by ProPlan software. Mark points were drawn on the 3D-images reconstructed immediately after the operation, and 6 months and 12 months after the operation. The measurements parameters included condylar axis angle in three dimensions, condylar-glenoid relative position and condylar facial morphology related indicators. The results were statistically analyzed by the consistency test and the variance of repeated measurement data. The facial asymmetry of the patients was corrected after operation, the height of the affected mandibular ascending ramus(T1: [67.81±6.95]mm, T2: [64.49±6.24]mm, T3: [63.05±7.07]mm)as well as the degree of pogonion deviation decreased(T1: [2.79±4.93]mm, T2: [0.37±4.20]mm, T3: [0.33 ± 3.97]mm)(P0.05). The post-operative 3D changes of the position and shape of the resected and its contralateral condylar showed that the bilateral condylar axis angle in the horizontal plane gradually grew after operation(affected condyle: 71.95° ± 7.47°, 74.73°±8.44°, 76.56°±5.22°; control condyle: 72.60°±5.56°, 76.00°±5.30°, 77.19°±6.20° and had significant difference between all the post-operative periods)(P0.05). The intraoral condylectomy combined with orthognathic surgery can eliminate condylar lesions effectively and correct the facial asymmetry caused by condylar benign tumor and hyperplasia. The facial symmetry can be maintained well after the operation, and the post-operative condylar morphology changes tended to be stable six months after the operation.

A clinico-radiographic study to compare and co-relate sagittal condylar guidance determined by intraoral gothic arch tracing method and panoramic radiograph in completely edentulous patients

Directory of Open Access Journals (Sweden)

Sanath Shetty

2018-01-01

Conclusion: Within the limitations of this study, it was concluded that the protrusive condylar guidance angles obtained by panoramic radiograph may be used for programming semi-adjustable articulators.

Pearls of mandibular trauma management.

Science.gov (United States)

Koshy, John C; Feldman, Evan M; Chike-Obi, Chuma J; Bullocks, Jamal M

2010-11-01

Mandibular trauma is a common problem seen by plastic surgeons. When fractures occur, they have the ability to affect the patient's occlusion significantly, cause infection, and lead to considerable pain. Interventions to prevent these sequelae require either closed or open forms of reduction and fixation. Physicians determining how to manage these injuries should take into consideration the nature of the injury, background information regarding the patient's health, and the patient's comorbidities. Whereas general principles guide the management of the majority of injuries, special consideration must be paid to the edentulous patient, complex and comminuted fractures, and pediatric patients. These topics are discussed in this article, with a special emphasis on pearls of mandibular trauma management.

Experimental occlusal interferences. Part III. Mandibular rotations induced by a rigid interference.

Science.gov (United States)

Rassouli, N M; Christensen, L V

1995-10-01

A rigid intercuspal interference (minimum mean height of 0.24 mm) was placed on either the right or left mandibular second premolar and first molar of 12 subjects. During brisk and forceful biting on the interference, rotational electrognathography measured maximum torque of the right and left mandibular condyles in the frontal and horizontal planes of orientation. All subjects showed frontal plan upward rotation (mean of 0.7 degrees) of the mandibular condyle contralateral to the interference. In 33% of the subjects there was no horizontal plane backward rotation. In 58% of the subjects there was horizontal plane backward rotation (mean of 0.5 degrees) of the mandibular condyle ipsilateral to the interference, and in one subject (8%) there was backward horizontal plane rotation (0.1 degree) of the mandibular condyle contralateral to the interference. It was inferred that the masseter muscle, ipsilateral to the interference, generated negative work in order to decelerate frontal plane 'unseating' of the mandibular condyle ipsilateral to the interference. It was inferred that the masseter muscle, contralateral to the interference, produced positive work in order to accelerate frontal plane 'seating' of the mandibular condyle contralateral to the interference. Finally, it was speculated that the impact forces of frontal plane 'seating' of the mandibular condyle, contralateral to the interference, might lead to 'vacuum sticking' of the temporomandibular joint disc because of the formation of negative hydrostatic pressures.

Maxillary advancement for mandibular prognathism: indications and rationale.

Science.gov (United States)

Rosen, H M

1991-05-01

The surgical correction of mandibular prognathism has traditionally involved posterior repositioning of the mandibular body. This treatment approach corrects the skeletal disproportion at the expense of reducing facial skeletal volume and can unpredictably result in inadequately supported soft tissues with loss of skeletal definition. In an effort to avoid these sequelae of mandibular reduction, 18 patients diagnosed as having mandibular prognathism were treated with maxillary advancement surgery at the Le Fort I level. Mean patient SNB angle was 85.2 degrees, as compared with a normal 79 +/- 3 degrees. Maxillae were documented to be in normal position relative to both cranial base and Frankfort horizontal. The mean maxillary advancement was 6.9 mm, with a range of 4.5 to 8.8 mm. All patients required genioplasty to reduce vertical chin height and/or to laterally shift the chin. At the time of follow-up (mean 16.2 months), all patients retained cephalometric data suggestive of enlarged mandibles and excessive anterior facial divergence. However, maxillomandibular harmony and facial convexity had been restored without sacrificing skeletal volume. Treatment results demonstrated these faces to be skeletally well proportioned despite lower face protrusion that was beyond "normal." Postoperative appearances were characterized by a well-supported soft-tissue envelope and a highlighted skeletal foundation, creating angular, well-defined lower faces. These findings support the credibility of maxillary advancement as the procedure of choice in selected individuals with mandibular prognathism. Indications and an aesthetic rationale for this surgical approach are presented.

Mandibular pseudocarcinomatous hyperplasia.

Science.gov (United States)

Warter, A; Walter, P; Meyer, C; Barrière, P; Galatir, L; Wilk, A

2000-08-01

Three unusual cases of pseudocarcinomatous (pseudoepitheliomatous) hyperplasia (PH) affecting chronic osteomyelitic mandibular sequestra are reported to highlight the differences with the various squamous neoplasms which occur in that site. In two patients carrying a mandibular graft following the excision of an ameloblastoma, mucosal ulcers resulted in chronic osteomyelitis. In a third patient, an apical dental infection was associated with fistulated osteomyelitis. Histology of the three sequestra showed an intraosseous squamous proliferation. It was characterized by a peripheral involvement of medullary spaces, the more mature epithelial layer covering the bone trabeculae without intervening stroma, and the basal type epithelial layer surrounding a central fibrovascular core. There were no histological or cytological signs of malignancy. PH shows an inverted pattern when compared with the centro-medullary tumoural islands seen in the various oral or odontogenic squamous neoplasms which occur in the jaws. The lack of signs of malignancy distinguish PH from common squamous cell carcinomas. A short clinical course is an important feature in the distinction of PH from the well differentiated squamous cell carcinomas which may develop in fistulated chronic osteomyelitis.

Distracción mandibular y articulación temporomandibular Mandibular distraction and the temporomandibular joint

Directory of Open Access Journals (Sweden)

F. Monje Gil

2004-08-01

Full Text Available Los pacientes con deformidades craneofaciales requieren generalmente multiples y, a veces, complejos procedimientos quirurgicos para reconstruir tejidos blandos y duros alterados. Un avance importante en cirugía reconstructiva es el alargamiento de la mandibula por distracción que tiene la ventaja de una cirugía menos agresiva que determinados tipos de osteotomías. Con esta técnica una osteotomía bicortical se hace en distintas zonas de la mandibula colocandose el distractor hasta alcanzar los efectos deseados. Aunque las fuerzas aplicadas se han mostrado eficaces para alargar la mandíbula, sus efectos en segmentos proximales y distales, incluyendo la articulación temporomandibular no han sido analizados sistemáticamente. En este artículo se repasa trabajos experimentales y clínicos en los que se detalla la relación entre distracción mandibular y articulación temporomandibular.Abstract: Patients with severe craniofacial abnormalities often require multiple and complex surgical procedures to reconstruct maldeveloped hard and soft tissues of the maxillofacial complex. An important advance in reconstructive surgery is mandibular lengthening by gradual distraction, which takes advantage to be less agressive surgery than some osteotomies. With this technique, a bicortical osteotomy is made at the angle of the deficient mandible, and an expansion appliance is placed across the osteotomy line. Although the applied forces have been shown to lengthen the mandible effectively in the region of the application, their effects on the proximal and distal mandibular segments, including the temporomandibular joint region, have not been analyzed systematically. In this article, we study several experimental and clinical papers where it describes the relationship between mandibular distraction and temporomandibular joint.

Treatment of Lateral Tibial Condylar Fractures Using Bioactive, Bioresorbable Forged Composites of Raw Particulate Unsintered Hydroxyapatite/Poly-L-Lactide Screws.

Science.gov (United States)

Kuroyanagi, Gen; Yoshihara, Hiroyuki; Yamamoto, Naohiro; Suzuki, Hiroyuki; Yamada, Kunio; Yoshida, Yukio; Otsuka, Takanobu; Takada, Naoya

2018-05-01

Forged composites of raw particulate unsintered hydroxyapatite/poly-L-lactide (F-u-HA/PLLA) devices possess high mechanical strength, bioactivity, and radio-opacity. The aim of this study was to assess the efficacy of F-u-HA/PLLA screws in the treatment of lateral tibial condylar fractures. From January 2005 to December 2010, a total of 7 patients with displaced closed lateral tibial condylar fractures (Schatzker type II) were treated using F-u-HA/PLLA screws. Open reduction and internal fixation was performed using 2 or 3 F-u-HA/PLLA screws. After surgery, weight bearing was not allowed for 6 weeks. Range of motion exercise was initiated after removal of the plaster splint. Radiographs were evaluated for fracture healing, joint depression, and the radioopacity of F-u-HA/PLLA screws. Clinical outcomes and postoperative complications were also assessed. Average follow-up was 44 months. All fractures were successfully healed. Average values for joint depression were 4.7 mm (range, 2-9 mm) preoperatively, 0.4 mm (range, 0-1 mm) postoperatively, and 0.4 mm (range, 0-1 mm) at final follow-up. Whole shadows of F-u-HA/PLLA screws were observed during the follow-up period. Breakage of screws, osteolysis, and a radiolucent zone around the screws were not observed at final follow-up. Average knee flexion and extension were 134° (range, 110° to 150°) and -1° (range, -10° to 0°), respectively. No patient had wound infection, late aseptic tissue response, or foreign body reaction postoperatively. None of the patients reported pain at final follow-up. These results suggest that F-u-HA/PLLA screws could be an alternative option for the treatment of lateral tibial condylar fractures. [Orthopedics. 2018; 41(3):e365-e368.]. Copyright 2018, SLACK Incorporated.

Effect of irradiation on the periodontal tissues in streptozotocin-induced diabetic rats

International Nuclear Information System (INIS)

Park, Dong Sin; Hwang, Eui Hwan; Lee, Sang Rae

2005-01-01

To observe the histopathological changes in the periodontal tissues of mandibular molars in streptozotocin-induced diabetic rats after irradiation. The male Sprague-Dawley rats weighing approximately 250 gm were divided into four groups; control, diabetes, irradiation, and diabetes - irradiation groups. Diabetes mellitus was induced in the rats by injecting streptozotocin. Rats in the control and irradiation groups were injected with citrate buffer only. After 5 days, the head and neck region of the rats in irradiation and diabetes - irradiation groups were irradiated with a single absorbed dose of 10 Gy. All the rats were sacrificed at 3, 7, 14, 21, and 28 days after irradiation. The specimen including the mandibular molars were sectioned and observed using a histopathological method. In the diabetes group, osteoclastic activity was observed in the alveolar bone and the root throughout the period of experiment. Also, osteoblastic and fibroblastic activities were markedly decreased. In the irradiation group, the osteoclasts were observed in the alveolar bone and the dilated capillaries were increased in the early experimental phases. However, vigorous osteoblastic activity was noted in the late experimental phases. In the diabetes- irradiation group, osteoblastic activity in the alveolar bone and the root was observed in the early experimental phases. However, there were no resorption and osteoblastic activity in the alveolar bone and the root in the late experimental phases, and obvious atrophic change of fibrous tissues was noted. This experiment suggests that osteoblastic activity was caused by irradiation in the late experimental phases, but atrophic change of the periodontal ligament tissues was induced after irradiation in diabetic state.

Mandibular marginal contouring in oriental aesthetic surgery: refined surgical concept and operative procedure.

Science.gov (United States)

Satoh, Kaneshige; Mitsukawa, Nobuyuki

2014-05-01

In aesthetic mandibular contouring surgery, which is often conducted in Asians, the operative procedure is thought to deliver a more aesthetic mandibular shape by means of contouring conducted as a whole from the ramus to the symphysis. The authors describe the refined concept and operative procedures of mandibular marginal contouring. For the 7-year period from 2004 to 2011, mandibular marginal contouring has been used in 57 consecutive series of Japanese subjects. Patient ages ranged from 18 to 33 years, and the subjects included 15 men and 42 women. The surgery was carried out by cutting off the protruding deformed mandibular margin from the ramus to the symphysis. In 53 of 57 cases, the focus was on angle contouring. Concomitant genioplasty by horizontal osteotomy of the chin was conducted in 42 of 57 cases (recession, advancement, shortening, elongation, and correction of the shift variously). In 22 materials exhibiting bulk around the mandibular, the ramus to the body was excised sagittally and thinned. In all the patients, mandibular marginal contouring from the ramus to the symphysis was completed. Partial masseter muscle resection was conducted in 11 of 57 cases. Mandibular contouring effectively achieved a highly satisfactory result in all cases. The upper portion of the peripheral branch of the trunk of the mental nerve was dissected by an electric scalpel in 1 case but sutured immediately using an 8-0 nylon stitch. Transient palsy of the mental nerve was noticed in a few cases but subsided in 1 to 2 months. No particular complications were encountered. No secondary revision was required in this series. In mandibular angle plasty, mandibular marginal contouring from the ramus to the symphysis should be carried out by cutting off the angle keeping in mind the entire mandibular shape. This concept and the procedure can deliver greater patient satisfaction.

Thin-plate spline graphical analysis of the mandible in mandibular prognathism.

Science.gov (United States)

Chang, Hsin-Fu; Chang, Hong-Po; Liu, Pao-Hsin; Chang, Chih-Han

2002-11-01

The chin cup has been used to treat skeletal mandibular prognathism in growing patients for 200 years. The pull on the orthopedic-force chin cup is oriented along a line from the mandibular symphysis to the mandibular condyle. Various levels of success have been reported with this restraining device. The vertical chin cup produces strong vertical compression stress on the maxillary molar regions when the direction of traction is 20 degrees more vertical than the chin-condyle line. This treatment strategy may prevent relapse due to counter-clockwise rotation of the mandible. In this report, we describe a new strategy for using chin-cup therapy involving thin-plate spline (TPS) analysis of lateral cephalometric roentgenograms to visualize transformation of the mandible. The actual sites of mandibular skeletal change are not detectable with conventional cephalometric analysis. A case of mandibular prognathism treated with a chin cup and a case of dental Class III malocclusion without orthodontic treatment are described. The case analysis illustrates that specific patterns of mandibular transformation are associated with Class III malocclusion with or without orthopedic therapy, and that visualization of these deformations is feasible using TPS graphical analysis.

Surgical-prosthetic treatment of large mandibular cysts

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Džambas Ljubiša D.

2003-01-01

Full Text Available This paper presents a combined surgical-prosthetic procedure of reconstructing mandibular bone defect in a 53 year old patient, following enucleation of a mandibular cyst (Cystectomy Partsch II. After a thorough diagnostic evaluation, a surgical procedure was planned with the particular attention to the nature of the disease, patient’s condition, size and extension of the cyst, tissue loss, and the possibilities of prosthetic management of a mandibular bone defect with partial postresection dental prosthesis. It is of great importance to point to the significance of teamwork of a maxillofacial surgeon and a specialist in prosthodontics. This kind of cooperation provided very effective and less risky soft tissue, as well as bone tissue regeneration (osteogenesis. The patient’s recovery was fast, and he could return to his daily activities and work without significant changes regarding quality of life after surgery and prosthetic treatment.

Prospective audit of mandibular fractures at the Charlotte Maxeke ...

African Journals Online (AJOL)

Objective. This study was a prospective cross-sectional clinical audit of patients with mandibular fractures at the Charlotte Maxeke Johannesburg Academic Hospital. Methods. Between 1 March and 31 August 2004, patients with mandibular fractures seen by one clinician had their details recorded. Results. The female:male ...

Combined surgical management of mandibular angle prominence and microgenia

International Nuclear Information System (INIS)

Portelles Masso, Ayelen Maria; Berger Kohn, Carlos

2010-01-01

Chin play a very important role in facial aesthetics. Different deformities of volume and of position may occur at this level and it is the microgenia one of the more frequent. Treatment options include the use of silicone, alloplasty materials and autologous bone graft. Authors report the use of the bone removed from mandibular angle to increase the chin. This is the case of a white female patient aged 18 seen by the Orthognathics Multidisciplinary Staff of 'V. I. Lenin' Hospital due to its uncommon face width. The corresponding physical examination as well as the complementary ones diagnosed a bilateral prominence of mandibular angle associated with a microgenia. Surgery carried out was of remodeling type of both mandibular angles and genioplasty of height increase and a discrete advancement using the bone removed from the gonion. There were satisfactory aesthetic results without evidence of bone reabsorption. We conclude that use of autologous graft of mandibular angle is an effective treatment alternative for correction of microgenia. (author)

Biomechanical and biochemical characteristics of the mandibular condylar cartilage

NARCIS (Netherlands)

Kuroda, S.; Tanimoto, K.; Izawa, T.; Fujihara, S.; Koolstra, J.H.; Tanaka, E.

2009-01-01

The human masticatory system consists of a mandible which is able to move with respect to the skull at its bilateral temporomandibular joint (TMJ) through contractions of the masticatory muscles. Like other synovial joints, the TMJ is loaded mechanically during function. The articular surface of the

Variant Root Morphology of Third Mandibular Molar in Normal and ...

African Journals Online (AJOL)

isaac kipyator

2017-11-12

Nov 12, 2017 ... ABSTRACT. The mandibular third molar poses a challenge to dental surgeons due to it's unpredictable morphology ... treatment in the School of Dental Sciences since 2010. ... mandibular third molar include presence of three.

Quiste óseo aneurismático mandibular

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Denia Morales Navarro

Full Text Available El quiste óseo aneurismático es definido como una lesión osteolítica expansiva que consiste en espacios llenos de sangre y canales divididos por tabiques de tejido conectivo, los cuales contienen tejido osteoide y células gigantes multinucleadas. El objetivo es presentar un caso clínico poco común de un quiste óseo aneurismático de la región del cuerpo mandibular. Se trata de una paciente femenina de 39 años de edad que acudió a consulta externa del Servicio de Cirugía Maxilofacial del Hospital Universitario "General Calixto García" por aumento de volumen en región mandibular derecha y dolor intenso de 1 mes de evolución. Radiográficamente se detectó un área radiolúcida unilocular de bordes bien definidos; se realizó curetaje de la cavidad, y estudio histopatológico de la lesión que informó la presencia de un quiste óseo aneurismático. Se concluye que el quiste óseo aneurismático es más común en los huesos largos y en la región del ángulo mandibular en el esqueleto facial, por lo que la presentación de este en el cuerpo mandibular resulta de interés.

Radiographic analysis of odontogenic cysts showing displacement of the mandibular canal

International Nuclear Information System (INIS)

Cho, Bong Hae

2003-01-01

To assess the radiographic findings of odontogenic cysts showing displacement of the mandibular canal using computed tomographic (CT) and panoramic images. CT and panoramic images of 63 odontogenic cysts (27 dentigerous, 16 odontogenic keratocysts, and 20 radicular cysts) were analyzed to evaluate the following parameters: the dimension and shape of the cysts, and the effect of the cysts on the mandibular canal and cortical plates. Of the 63 cysts examined in the study, 35 (55.6%) showed inferior displacement of the mandibular canal and 46 (73.0%) showed perforation of the canal. There were statistically significant differenced between CT and panoramic images in depicting displacement and perforation of the mandibular canal. Cortical expansion was seen in 46 cases (73.0%) and cortical perforation in 23 cases (36.5%). The radicular cysts showed cortical expansion and perforation less frequently than the other cyst groups. Large cysts of mandible should be evaluated by multiplanar CT images in order to detect the mandibular canal and cortical bone involvement.

Deoxycholic Acid and the Marginal Mandibular Nerve: A Cadaver Study.

Science.gov (United States)

Blandford, Alexander D; Ansari, Waseem; Young, Jason M; Maley, Bruce; Plesec, Thomas P; Hwang, Catherine J; Perry, Julian D

2018-06-04

One of the rare but serious complications observed with deoxycholic acid administration is damage to the marginal mandibular nerve. In this study, we evaluated if deoxycholic acid directly induces histologic damage to fresh cadaveric marginal mandibular nerve. A segment of marginal mandibular nerve was harvested from 12 hemifaces of 6 fresh cadavers. The nerve specimen was exposed to either 0.9% sterile saline for 24 h, deoxycholic acid (10 mg/ml) for 20 min, or deoxycholic acid (10 mg/ml) for 24 h. The nerve specimens were then fixed in glutaraldehyde for a minimum of 24 h. Toluidine blue stained sections were evaluated for stain intensity using light microscopy and color deconvolution image analysis. Supraplatysmal fat was harvested as a positive control and exposed to the same treatments as the marginal mandibular nerve specimens, then evaluated using transmission electron microscopy. Toluidine blue staining was less in the marginal mandibular nerve exposed to deoxycholic acid when compared to saline. The specimen exposed to deoxycholic acid for 24 h showed less toluidine blue staining than that of the nerve exposed to deoxycholic acid for 20 min. Transmission electron microscopy of submental fat exposed to deoxycholic acid revealed disruption of adipocyte cell membrane integrity and loss of cellular organelles when compared to specimens only exposed to saline. Deoxycholic acid (10 mg/ml) damages the marginal mandibular nerve myelin sheath in fresh human cadaver specimens. Direct deoxycholic acid neurotoxicity may cause marginal mandibular nerve injury clinically. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Congenitally missing mandibular second premolars: clinical options.

Science.gov (United States)

Kokich, Vincent G; Kokich, Vincent O

2006-10-01

Congenital absence of mandibular second premolars affects many orthodontic patients. The orthodontist must make the proper decision at the appropriate time regarding management of the edentulous space. These spaces can be closed or left open. If the space will be left open for an eventual restoration, the keys during orthodontic treatment are to create the correct amount of space and to leave the alveolar ridge in an ideal condition for a future restoration. If the space will be closed, the clinician must avoid any detrimental alterations to the occlusion and the facial profile. Some early decisions that the orthodontist makes for a patient whose mandibular second premolars are congenitally missing will affect his or her dental health for a lifetime. Therefore, the correct decision must be made at the appropriate time. In this article, we present and discuss various treatment alternatives for managing orthodontic patients with at least 1 congenitally missing mandibular second premolar.

The Psychological Status of Patients with Acute Mandibular Injury

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A. N. Pudov

2012-01-01

Full Text Available Objective: to define the specific features of the psychological status of patients with acute mandibular injury, to compare a psychological reaction to injury in different age groups and in persons with signs of alcohol addiction. Subjects and methods. The study enrolled 37 patients of both sexes over 15 years of age. The patients were distributed by age and chronic alcohol intoxication. Psychological parameters were determined using personality questionnaires: Spielberg-Hanin, Zung, GHQ-28, and Wein ones. Results. The patients with mandibular injury were found to have higher levels of situational and personality anxiety. A state of depression as a response to acute mandibular injury of reactive genesis was found in 29.8% of cases. Autonomic dysfunction occurred in 62.2% of the patients with mandibular fractures. Occult pathopsychological states were detected in 35.1% of the study group patients. Conclusion. The main found peculiarities of the psychological status of the patients with acute mandibular injury were high anxiety and the considerable incidence of autonomic dysfunction syndrome. There were no great age differences in psychological status and the direction of reactions. The patients with chronic alcohol intoxication more frequently developed a depressive state, but the autonomic dysfunction syndrome was just less often encountered and pathopsychological states were less frequently found. Key words: acute low anxiety depression alcohol abuse, psychological status.

Bone changes of mandibular condyle using cone beam computed tomography

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Lee, Ji Un; Kim, Hyung Seop; Song, Ju Seop; Kim, Kyoung A; Koh, Kwang Joon [Chonbuk National Univ., Chonju (Korea, Republic of)

2007-09-15

To assess bone changes of mandibular condyle using cone beam computed tomography (CBCT) in temporomandibualr disorder (TMD) patients. 314 temporomandibular joints (TMJs) images of 163 TMD patients were examined at the Department of Oral and Maxillofacial Radiology, Chonbuk National University. The images were obtained by PSR9000N (Asahi Roentgen Co., Japan) and reconstructed by using Asahivision software (Asahi Roentgen Co., Japan). The CBCT images were examined three times with four weeks interval by three radiologists. Bone changes of mandibular condyle such as flattening, sclerosis, erosion and osteophyte formation were observed in sagittal, axial, coronal and 3 dimensional images of the mandibular condyle. The statistical analysis was performed using SPSS 12.0. Intra-and interobserver agreement were performed by 3 radiologists without the knowledge of clinical information. Osteopathy (2.9%) was found more frequently on anterior surface of the mandibular condyle. Erosion (31.8%) was found more frequently on anterior surface of the mandibular condyle. The intraobserver agreement was good to excellent (k=0.78{sub 0}.84), but interobserver agreement was fair (k=0.45). CBCT can provide high qualified images of bone changes of the TMJ with axial, coronal and 3 dimensional images.

Bone changes of mandibular condyle using cone beam computed tomography

International Nuclear Information System (INIS)

Lee, Ji Un; Kim, Hyung Seop; Song, Ju Seop; Kim, Kyoung A; Koh, Kwang Joon