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Sample records for temporomandibular joints tmj

  1. Orthodontics for treating temporomandibular joint (TMJ) disorders.

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    Luther, Friedy; Layton, Stephen; McDonald, Fraser

    2010-07-07

    Temporomandibular disorders (TMD) relate to discomfort of the temporomandibular joint (TMJ). The disorder is multifactorial with a degree of psychogenic influence varying throughout an individual's life with phases of symptoms affecting the quality of life. In an attempt to treat this complex group of disorders many treatment modalities have been identified some of which are also considered in other Cochrane reviews. The disorder also has a normal cycle of events appearing to spontaneously improve without treatment. To establish the effectiveness of orthodontic intervention in reducing symptoms in patients with TMD (compared with any control group receiving no treatment, placebo treatment or reassurance) and to establish if active orthodontic intervention leads to TMD. The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Handsearching of orthodontic journals and other related journals was undertaken in keeping with the Cochrane Collaboration handsearching programme. No language restrictions were applied. Authors of any studies were identified, as were experts offering legal advice, and contacted to identify unpublished trials. Most recent search: 13th April 2010. All randomised controlled trials (RCTs) including quasi-randomised trials assessing orthodontic treatment for TMD were included. Studies with adults aged equal to or above 18 years old with clinically diagnosed TMD were included. There were no age restrictions for prevention trials provided the follow-up period extended into adulthood. The inclusion criteria required reports to state their diagnostic criteria for TMD at the start of treatment and for participants to exhibit two or more of the signs and/or symptoms. The treatment group included treatment with appliances that could induce stable orthodontic tooth movement. Patients receiving splints for 8 to 12 weeks and studies involving surgical intervention (direct exploration/surgery of the joint and

  2. Temporomandibular joint (TMJ) disc position in patients with TMJ pain assessed by coronal MRI.

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    Eberhard, L; Giannakopoulos, N N; Rohde, S; Schmitter, M

    2013-01-01

    To assess the position of the temporomandibular joint (TMJ) disc in patients with TMJ pain and compare it with equivalent published data of asymptomatic volunteers. The oblique coronal closed- and open-jaw MR images from 66 patients with TMJ pain were evaluated. Clinical examination followed the research diagnostic criteria for temporomandibular disorders. In all coronal images, the transverse condylar axis and the medial and lateral edges of the disc were determined using special software. Inter-rater agreement was calculated [two raters; inter-rater correlation coefficient (ICC)]. The presence of osteoarthrosis (OA) was determined by two independent raters. The influence of OA was estimated in patients (generalized estimation equation model). The results were compared with those of healthy volunteers (t-test). Differences between closed and open jaw in patients were analysed with the Wilcoxon matched-pair test. The ICC was good for the transverse condylar axis (0.987) and the medial edge of the disc (0.799) and fair for the lateral edge (0.355). On average, the disc projected 5.5% to the medial side; laterally, the condyle was partially uncovered by the disc (-16.6%). In the open-jaw position, both the medial and the lateral edges shifted medially (to 17.6% vs -23.6%, Wilcoxon matched-pair test, p pain, the disc seems to be smaller and located less medially than in healthy volunteers. The extent of the medial shift on opening was similar.

  3. Spectrum of Magnetic Resonance Imaging Appearances of Juvenile Temporomandibular Joints (TMJ) in Non-Rheumatic Children

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    Tzaribachev, N. (Dept. of Hematology, Oncology, and General Pediatrics, Univ. Children' s Hospital, Eberhard-Karls-Univ., Tuebingen (Germany)). e-mail. tzari@o2online.de; Fritz, J. (Russell H. Morgan Dept. of Radiology and Radiological Science, Johns Hopkins Univ. School of Medicine, Baltimore, MD (United States)); Horger, M. (Dept. of Diagnostic Radiology, Eberhard-Karls-Univ., Tuebingen (Germany))

    2009-12-15

    Background: Temporomandibular joints (TMJ) are frequently involved in children with juvenile idiopathic arthritis (JIA), and gadolinium-enhanced magnetic resonance imaging (MRI) is the only modality for an early diagnosis. However, only very few data exist on the appearance of contrast-enhanced MRI of normal juvenile TMJ. Purpose: To define the spectrum of normal MRI findings of juvenile TMJ, and to assess a possible overlap with findings typical for active synovitis in JIA. Material and Methods: 96 children (192 TMJ), 51 boys and 45 girls with a median age of 7.8 years (range 3-13 years), underwent a head MRI. The presence of autoimmune disease, including JIA, was excluded via chart history, available laboratory findings, and the absence of known typical pathological MRI changes (degree of synovial enhancement, hyperintense signal on T2-weighted images in the synovia or bone marrow, and morphologic changes of the mandibular condyle) of the TMJ affected by JIA. Results: In 90 (94%) children, the TMJ showed no MRI abnormalities compatible with arthritis. In three children (3%), the only abnormal MRI finding was a small bilateral joint effusion. A further three children (3%) had a mild synovial enhancement seen on both axial and coronal MR planes in one child and only in the axial plane in the other two children. Signal hyperintensity on T2-weighted images and other corresponding characteristics of TMJ inflammation were lacking in all these six patients. Conclusion: The vast majority of juvenile TMJ in non-rheumatic children shows no MRI abnormalities. Exceptions, including a discrete enhancement of the synovial membrane (3%) or small joint effusions (3%), can occur in a minority of patients, but none of them are accompanied by other signs of inflammation or morphological changes of the TMJ

  4. Simultaneous treatment of temporomandibular joint ankylosis with severe mandibular deficiency by standard TMJ prosthesis.

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    Hu, YiHui; Zhang, LuZhu; He, DongMei; Yang, Chi; Chen, MinJie; Zhang, ShanYong; Li, Hui; Ellis Iii, Edward

    2017-03-24

    Temporomandibular joint (TMJ) ankylosis is a refractory disease that is difficult to predictably treat. This study evaluated the prognosis of using standard alloplastic TMJ prostheses for the treatment of TMJ ankylosis in Chinese patients with severe mandibular deficiency. Patients treated from 2013 to 2015 were reviewed. The computer-aided design and manufacture (CAD/CAM) technique was used to guide bony mass removal and locate the TMJ prosthesis (Biomet, USA). Eleven patients were included in this study. All prostheses were successfully installed and stabilized intraoperatively. In 4 patients with severe mandibular deficiency, their mandibular ramus was elongated by the TMJ prosthesis and 2 patients were combined with Le Fort I osteotomy guided by digital templates. Their mean chin advancement was 10.19 mm. Their SNB and ramus heights were also significantly improved after operation (P TMJ reconstruction with standard alloplastic prosthesis is a reliable treatment for ankylosis, especially in recurrent cases. By CAD/CAM technique, it can correct jaw deformities simultaneously and produce stable results.

  5. Diagnosis of retrodiscal tissue in painful temporomandibular joint (TMJ) by fluid-attenuated inversion recovery (FLAIR) signal intensity.

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    Kuroda, Migiwa; Otonari-Yamamoto, Mika; Sano, Tsukasa; Fujikura, Mamiko; Wakoh, Mamoru

    2015-10-01

    The purpose of the present study is to analyze the fluid-attenuated inversion recovery (FLAIR) signal intensity of the retrodiscal tissue in a painful temporomandibular joint (TMJ), and to develop a diagnostic system based on FLAIR data. The study was based on 33 joints of 17 patients referred for MR imaging of the TMJ. Regions of interest were placed over retrodiscal tissue and gray matter (GM) on FLAIR images. Using signal intensities of GM as reference points, signal intensity ratios (SIR) of retrodiscal tissue were calculated. SIRs in painful TMJ were compared with those in painless TMJ. Wilcoxon's Rank Sum Test was used to analyze the difference in SIRs between the painful and painless groups (Ppainful joints than in painless joints. FLAIR sequences provide a high signal in patients having painful TMJ, and it suggests that retrodiscal tissue in painful TMJ contains elements such as protein.

  6. Temporomandibular joint (TMJ) arthroscopic lysis and lavage: Outcomes and rate of progression to open surgery.

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    Breik, Omar; Devrukhkar, Vishakha; Dimitroulis, George

    2016-12-01

    Arthroscopic lysis and lavage has been shown to be effective in the management of a variety of TMJ (Temporomandibular joint) diseases. The purpose of this study was to evaluate the medium to long-term outcomes of TMJ arthroscopic lysis and lavage and determine factors associated with progression to open surgery. A retrospective cohort study of a single operator series was performed over a 6-year period from 2006 to 2012. The variables of gender, age and category (Dimitroulis classification) were compared to evaluate factors associated with success of arthroscopy and progression to open surgery. The data were analysed via Kaplan Meier method for time-to event analyses and Chi-squared tests for trend analyses. Pre-operative and post-operative Visual analogue scores and maximum inter-incisal opening results were analysed with the Student's t-test. A total of 167 patients and 216 joints underwent arthroscopy with a mean follow up of 6.9 years. Overall 77.7% of joints had a successful result and required no further surgery. There was no gender difference with respect to progression to surgery. Males underwent open surgery after a mean of 6.2 months from arthroscopy and Females after a mean of 15.6 months from arthroscopy (p disease progressing to open surgery (p TMJ is a reliable and effective operation for patients with early stage (i.e., Categories 1, 2 and 3) disorders of the TMJ. Patients with more advanced joint disease (i.e., Categories 4 & 5) gained only temporary relief from TMJ arthroscopy and often progress to open TMJ surgery. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. Temporomandibular joint (TMJ) pain revisited with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI).

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    Tasali, N; Cubuk, R; Aricak, M; Ozarar, M; Saydam, B; Nur, H; Tuncbilek, N

    2012-03-01

    We aimed to assess the contrast enhancement patterns of the retrodiscal tissue with dynamic contrast-enhanced MR imaging (DCE-MRI) with respect to different temporomandibular joint disc pathologies. Additionally, we questioned the relationship between the temporomandibular joint (TMJ) pain and the contrast enhancement pattern of the retrodiscal tissue regardless of the TMJ disc position. 52 joints of 26 patients (4 males and 22 females) who have pain in at least at one of their TMJ were included in this study. For the qualitative analysis, the joints were divided into four groups in terms of their disc positions: normal (1), partially displaced with or without reduction (2), totally dislocated with reduction (3) and totally dislocated without reduction (4). Besides, two different joint groups were constituted, namely the painful group and painless group according to the clinical findings without taking the TMJ disc positions into account. Quantitative analyses were made by means of measuring signal intensity ratios (SI) ratio at the retrodiscal tissue (from internal side and external side of the each joint) using DCE-MRI and these measurements were analyzed with paired samples t test to define the difference between the measurements. At the second stage, the time-dependent arithmetical mean values of the SI ratios were calculated for each joint group and significant differences between the groups were questioned using analysis of variance (ANOVA) test. Besides, painful and painless groups which were classified on the basis of the clinical data were compared according to the mean SI ratios found for each joint and the significant differences between these two groups were assessed by means of Student's T test. The results were assessed in 95% confidence interval where the significance level was pjoints with partial displacement. Another significant difference was found between the average time versus SI ratio curves of the four groups. In consequence of the

  8. Association of bone marrow edema with temporomandibular joint (TMJ) osteoarthritis and internal derangements.

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    Wahaj, Aiyesha; Hafeez, Kashif; Zafar, Muhammad Sohail

    2017-01-01

    This study reviewed the dental literature in order to determine the association of bone marrow edema with osteoarthritis and temporomandibular joint (TMJ) internal derangement disorders. A literature search was performed using electronic databases PubMed/Medline (National Library of Medicine, Bethesda, Maryland) and Cochrane for articles published during the last 15 years (January 2000-December 2014). A predetermined inclusion and exclusion criteria were used for filtering the scientific papers. Research articles fulfilling the basic inclusion criteria were included in the review. The reviewed studies showed that bone marrow edema is found in painful joints with osteoarthritis in a majority of cases. A few cases with no pain or significant degenerative changes are reported to have a bone marrow edema pattern as well. Bone marrow edema, increased fluid level, and pain are associated with osteoarthritis in the majority of patients reporting TMJ arthritis. Degenerative and disc displacement conditions are multifactorial and require further investigations. Magnetic resonance imaging can be employed to detect bone marrow edema even in the absence of pain and clinical symptoms in the patients of internal derangements.

  9. Evaluation of meniscus displacement of the temporomandibular joint by MR imaging. Correlation with clinical symptoms of TMJ disorders

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    Toyoda, Nagataka; Asada, Koichi; Naohara, Hiroaki; Jibiki, Masato; Ishibashi, Katsunori; Kobayashi, Kaoru [Tsurumi Univ., Yokohama (Japan). School of Dental Medicine

    1996-04-01

    MR imaging is useful in the diagnosis of bilateral internal derangement of the temporomandibular joint. This study was performed to investigate the correlation between clinical symptoms and displacement of the bilateral articular disk in patients with temporomandibular joint disorders (TMJD). A series of 170 patients who had signs and symptoms of TMJDs (TMJ pain, TMJ sound, trismus) were examined bilaterally by MR imaging. One hundred twenty-six patients had only unilateral symptoms, but 55 (44%) of them showed bilateral disk displacement. Among 93 patients with unilateral TMJ pain, 89% showed disk displacement (22 TMJs with reduction, 61 TMJs without reduction) on the symptomatic side, and 44% showed disk displacement on the asymptomatic side. Among 53 patients with unilateral TMJ sound, 96% showed disk displacement (28 TMJs with reduction, 23 TMJs without reduction) on the symptomatic side, and 53% showed disk displacement on the asymptomatic side. In patients with severe trismus (interincisal opening distance <39 mm), unilateral or bilateral disk displacement without reduction was frequently found. The results indicate that examinations by MR imaging are important for the diagnosis of internal derangement of the temporomandibular joint. (author).

  10. One-year prospective outcome analysis and complications following total replacement of the temporomandibular joint with the TMJ Concepts system.

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    Sidebottom, A J; Gruber, E

    2013-10-01

    Total replacement of the temporomandibular joint (TMJ) is increasingly accepted as the gold standard for reconstruction of irreparably damaged or ankylosed joints. The TMJ Concepts system (TMJ Concepts, Ventura, USA) has the longest follow-up of the 2 systems used in the UK. A total of 74 patients had placement of TMJ Concepts prostheses. The primary diagnoses were degenerative disease, multiple previous operations, injury, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ankylosis. Of these, 12 were revisions of previous replacements (3 after multiple operations). Over the year there was a significant mean (SD) reduction in pain score (10 cm visual analogue scale) from 72 (2.5) to 8 (1.7) (pJoints in 2 patients failed because of biofilm infections. Two patients required blood transfusion and one required ligation of the external carotid artery. Five had perioperative dislocation, which responded to elastic intermaxillary fixation for one week. A total of 31 patients had partial, and 2 had total weakness of the facial nerve. All resolved fully except weakness of the temporal branch in one patient, which required brow lift. Total TMJ replacement gives good early improvements in function and pain with few complications. Of the 74 patients, 71 were very pleased to have had the procedure. One was dissatisfied despite complete pain relief and improvement in mouth opening from 3 to 30 mm, and 2 were ambivalent (one had infection, revision, and permanent weakness of the temporal branch of the facial nerve). Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. A prospective, single-centre study on patient outcomes following temporomandibular joint replacement using a custom-made Biomet TMJ prosthesis

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    Aagaard, Esben; Thygesen, T.

    2014-01-01

    This study describes the clinical variables in 61 patients following total alloplastic temporomandibular joint reconstruction (TJR) in which the Biomet Microfixation Patient-Patient-Matched TMJ Implant was used. All patients were classified using the Wilkes classification. The visual analogue sca...

  12. Identification of inflammatory processes in temporomandibular joint (TMJ) by {sup 99m}Tc-HMPAO in animal model; Identificacao de processos inflamatorios na articulacao temporomandibular por {sup 99m}Tc-HMPAO em modelo animal

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    Brasileiro, Claudia Borges; Cardoso, Valbert Nascimento; Lima, Carla Flavia de; Campos, Tarcisio Passos Ribeiro de [Minas Gerais Univ., Belo Horizonte, MG (Brazil). Programa de Pos-graduacao em Ciencias e Tecnicas Nucleares]. E-mail: campos@nuclear.ufmg.br

    2005-07-01

    Temporomandibular joint (TMJ) is a synovial joint that represents the junction of mandible with skull. TMJ and mastication muscles are affected by temporomandibular disorders (TMDs). During the last two decades the advances in imaging diagnostic of TMJ have greatly contributed to the assessment of the TMJ disorders. Labelled leukocytes with technetium- 99m hexamethyl propylene amine oxime ({sup 99m}Tc-HMPAO) represent an efficient method that generates images based in physiological and/or biochemical changes related to inflammation. The aim of this study was to investigate the potential usefulness of technetium-99m labelled leukocytes scintigraphy in the diagnosis of TMJ inflammatory process applying a rabbit TMJ arthritis model. Arthritis was induced unilaterally with an intra-articular injection of ovalbumin in left ATM. On the contra-lateral side, the same dose of saline was injected. After five days, leukocytes were labeled with HMPAO and {sup 99m}Tc-HMPAO TMJ scintigraphic images were made. After twelve days a computed tomography was realized. Scintigraphic images obtained five days after induction of TMJ inflammation showed the localization of inflammatory process. The results were expressed as cpm of activity found in left ATM and contra-lateral side. Significant differences of activity were found between inflamed articulation and contra-lateral side (P = 0,0073). In conclusion, the method of leukocytes labeled with {sup 99m}Tc showed to be sensitive in detection of inflammatory disorders of TMJ and can be of great value in early diagnostic of these disorders. (author)

  13. Pseudomonas Infection of the Temporomandibular Joint (TMJ Health and Public Health Issues

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    Malachovsky I.

    2017-04-01

    Full Text Available The authors describe a case of a rare infectious disease of intra-articular tissues of the temporomandibular joint caused mainly by Pseudomonas aeruginosa. In scientific literature, under the heading invasive (malignant external otitis, we can find cases of an infectious disease of the external acoustic meatus caused by a microbial agent of Pseudomonas aeruginosa which can subsequently penetrate into structures. However, a primary affliction of the abovementioned structures has not been described. Localisation and severity of the infection requires long-term and massive treatment with antibiotics.

  14. Neoplastic lesions of the temporomandibular joint (TMJ): diagnosis, differential diagnosis and intervention; Neoplasien des Temporomandibulargelenks (TMG). Diagnostik, Differenzialdiagnostik und Intervention

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    Vogl, T.J.; Abolmaali, N.; Schedel, H.; Bergh, B. [Frankfurt Univ. (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Maeurer, J. [Radiologische Praxis am Prinzregentenplatz, Muenchen (Germany)

    2001-09-01

    Purpose. To evaluate the effectiveness of diagnostic and interventional radiological techniques for neoplastic lesions of the temporomandibular joint (TMJ). Material and methods. Modern diagnosis of the TMJ is based on the clinical use of conventional X-ray techniques, computed tomography (CT), magnetic resonance imaging (MRI) and interventional techniques like biopsies, vascular occlusion and ablation. Results. Conventional X-ray still forms the basic diagnostic procedure applied in open and closed mouth position. CT improves the diagnostic information and serves as the standard diagnostical instrument for cartaliganeous or osseous neoplastic lesions. MRI evaluates soft tissue infiltration in multiplanar techniques and high spatial resolution. Interventional vascular and ablative techniques improve the treatment of neoplastic disorders. (orig.) [German] Zielsetzung. Vorstellung der Wertigkeit bildgebender Verfahren fuer die diagnostische und interventionelle Radiologie des Temporomandibulargelenks (TMG). Material und Methodik. Die moderne Radiologie des TMG basiert auf dem Einsatz der konventionellen Roentgendiagnostik, der Computertomographie (CT) und der Magnetresonanztomographie (MRT), sowie interventioneller Verfahren wie der Biopsie, vaskulaerer Embolisationsverfahren und tumorablativer Verfahren. Ergebnisse. Als Basisdiagnostik dient die konventionelle Diagnostik in offener und geschlossener Mundposition der Erfassung von Funktionsstoerungen sowie ossaerer Destruktionen. Die CT erweitert das diagnostische Spektrum und verbessert die Differenzialdiagnostik fuer ossifizierende Prozesse. Der Einsatz der MRT erlaubt die Erfassung der Weichteilinfiltration sowie der Gelenkstrukturen. Vaskulaere interventionelle Verfahren dienen der praetherapeutischen Okklusion bzw. der palliativen Tumortherapie in Form der okklusiven Embolisation, der Chemoembolisation, oder auch der Tumorablation. (orig.)

  15. Temporomandibular joint: conservative care of TMJ dysfunction in a competitive swimmer.

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    Yuill, Erik; Howitt, Scott D

    2009-08-01

    To detail the progress of a patient with TMJ dysfunction and headaches due to swimming, who underwent a conservative treatment plan featuring soft tissue therapy, spinal manipulative therapy, and rehabilitation. The most important features were initial bilateral temporal headaches and persistent left sided TMJ pain brought about by bilateral breathing while swimming. Conventional treatment aimed at decreasing hypertonic muscles, increasing hyoid mobility, improving TMJ mobility, resolving cervical restrictions, and improving digastric facilitation. The conservative treatment approach utilized in this case involved soft tissue therapy, hyoid mobility treatment, TMJ mobilization, spinal manipulative therapy, and digastric facilitation. Outcome measures included subjective pain ratings, range of motion, and motion palpation of the cervical spine. A patient with bilateral temporal headaches and TMJ pain due to bilateral breathing while swimming appeared to be relieved of his pain after three treatments of soft tissue therapy, hyoid mobility treatment, spinal manipulative therapy, and digastric facilitation.

  16. Functional states of mandibular movements and synovial pumps of the temporomandibular joint. Is it possible to provide a biomechanically correct replacement for the TMJ?

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    Kubein-Meesenburg, D; Nägerl, H; Fialka-Fricke, J; Hahn, W; Weber, S; Hönig, J; Hansen, C; Fanghänel, J; Thieme, K M; Ihlow, D

    2012-03-20

    Due to its complexity, there is currently an incomplete understanding of temporomandibular joint (TMJ) function, especially in relation to the morphological interplay of the condyle and the disc as well as the disc, the Os temporale and the lateral pterygoid muscle. This also holds true for synovial flow and synovial pumps, the existence of which we postulate and for which we present a theory of their mechanism. In view of the complexity of mandibular movements and the morphology and function of the TMJ, we need to know how precisely a reconstruction of the TMJ, if necessary, must be adapted to nature. An analysis of the morphology of the functional states of the mandible, as well as the synovial pump system, should at least provide a basis for moulding reconstructions. Copyright © 2011 Elsevier GmbH. All rights reserved.

  17. The relationship between dental occlusion/temporomandibular joint status and general body health: part 1. Dental occlusion and TMJ status exert an influence on general body health.

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    Moon, Hyung-Joo; Lee, Yong-Keun

    2011-11-01

    There have been varied studies that have suggested a relationship between dental occlusion/temporomandibular joint (TMJ) status and general body health. Therefore, it is important to elucidate the systematic relationships and corresponding action mechanisms between them. The purpose of this part of study was to review the relationships between dental occlusion/TMJ status and systemic body health based on the published literature. This study, based mostly on peer-reviewed specialist articles, has determined that dental occlusion/TMJ status exerts an influence on (1) synchronization of head and jaw muscles with the muscles from other body sites for proper body posture; (2) body stability such as body equilibrium (balance), center of gravity fluctuation, and gaze stability; and (3) physical performance along with physical fitness. Therefore, these relationships should be further investigated and extended to the whole body, and the action mechanisms should be elucidated. © Mary Ann Liebert, Inc.

  18. Maresin 1 Inhibits TRPV1 in Temporomandibular Joint-Related Trigeminal Nociceptive Neurons and TMJ Inflammation-Induced Synaptic Plasticity in the Trigeminal Nucleus

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    Chul-Kyu Park

    2015-01-01

    Full Text Available In the trigeminal system, disruption of acute resolution processing may lead to uncontrolled inflammation and chronic pain associated with the temporomandibular joint (TMJ. Currently, there are no effective treatments for TMJ pain. Recently, it has been recognized that maresin 1, a newly identified macrophage-derived mediator of inflammation resolution, is a potent analgesic for somatic inflammatory pain without noticeable side effects in mice and a potent endogenous inhibitor of transient receptor potential vanilloid 1 (TRPV1 in the somatic system. However, the molecular mechanisms underlying the analgesic actions of maresin 1 on TMJ pain are unclear in the trigeminal system. Here, by performing TMJ injection of a retrograde labeling tracer DiI (a fluorescent dye, I showed that maresin 1 potently inhibits capsaicin-induced TRPV1 currents and neuronal activity via Gαi-coupled G-protein coupled receptors in DiI-labeled trigeminal nociceptive neurons. Further, maresin 1 blocked TRPV1 agonist-evoked increases in spontaneous excitatory postsynaptic current frequency and abolished TMJ inflammation-induced synaptic plasticity in the trigeminal nucleus. These results demonstrate the potent actions of maresin 1 in regulating TRPV1 in the trigeminal system. Thus, maresin 1 may serve as a novel endogenous inhibitor for treating TMJ-inflammatory pain in the orofacial region.

  19. The relationship between dental occlusion/temporomandibular joint status and general body health: part 2. Fascial connection of TMJ with other parts of the body.

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    Moon, Hyung-Joo; Lee, Yong-Keun

    2011-12-01

    In part 1 of this study, it was discussed that dental occlusion/temporomandibular joint (TMJ) status is functionally connected to general body health. The purpose of this part of the study was to attempt to formulate a conceptual account, the "fascial connection theory for TMJ and other parts of the body," to explain the functional connection between TMJ and other parts of the body. The first hypothesis that was studied is that TMJ and other parts of body are connected through the fascia as asserted by the myofascial-release schools, and the second one is that they are connected through the meridian system constituted of fascia (connective tissue). The fascial connection theory proposed here can explain the functional connection between dental occlusion/TMJ and other parts of the body based on either myofascial release or the qi and meridian system, or a combination of the two. Therefore, dental occlusion should be built up and maintained in a normal natural condition, and causes of deterioration of TMJ status should be treated in an effort to restore the natural condition. Other possible mechanisms that can account for these connections require elucidation, and additional experimental investigation should be undertaken.

  20. Temporomandibular joint examination reviewed

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    L. Guarda Nardini

    2011-01-01

    The temporo-mandibular joint (TMJ) it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont inv...

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

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

    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...

  2. TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND TEMPOROMANDIBULAR-JOINT HYPERMOBILITY

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    DIJKSTRA, PU; DEBONT, LGM; DELEEUW, R; STEGENGA, B; BOERING, G

    1993-01-01

    For studying the relationship between condylar hypermobility of the temporomandibular joint (TMJ) and osteoarthrosis (OA), 13 patients with bilateral condylar hypermobility were evaluated clinically and radiographically, 30 years after non-surgical treatment. The evaluation included range of motion,

  3. Determination of the spatial movement of the temporomandibular joints (tmj joint heads in patients with muscle and joint dysfunction according to computed tomography (ct

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    Аркадий Максимович Боян

    2015-11-01

    Full Text Available Computed tomography (CT is the one of most objective diagnostic methods of TMJ MJD it allows define amplitudes of joint heads movement in sagittal projections to detect an asymmetry of TMJ elements location.Aim of research. Assessment of location of mandibular joint heads and determination of its spatial position in patients with TMJ MJD before treatment and after it using CT.Materials and methods. 50 patients 28-62 years old, 37 women and 13 men who underwent computed tomography (CT of TMJ were under observation.The results of observation were analyzed in details.The studies were carried out using cone-radial computed tomographic scanner «Vatech Pax uni 3d». CT of TMJ was carried out in habitual occlusion before the start of treatment and after removal of TMJ MJD symptoms and complaints. At the study there were measured the width of joint fissure in front, upper and back segments according to N.A. Rabuhina methodology in N.E. Androsova and so-authors modification. Statistical analysis of the data received was carried out using «Statistics» (Statsoft, Inc program.Results. The results of TMJ CT in patients before the start of treatment demonstrated that the sizes of TMJ joint fissure were different. The width of the upper segment of TMJ joint fissure in patients before the start of treatment was reliably less (≤0,001 comparing with an analogous parameter in the group of patients after treatment that indicates the upper location of mandibular head in TMJ with reducing the height of the lower segment of face.So the data of study of the joint fissure width received using TMJ CT demonstrate formation of specific outlines of joint fissure at displacement of mandible and consequently joint head. Information about the joint fissure parameters allows rationally plan and realize orthopedic treatment and the necessary rehabilitation measures in patients with TMJ MJD.Conclusions. The studies demonstrated that the displacements of mandibular joint

  4. Temporomandibular Joint Imaging.

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    Tamimi, Dania; Jalali, Elnaz; Hatcher, David

    2018-01-01

    The temporomandibular joint (TMJ) is an anatomically and biomechanically complex structure. Understanding how this structure grows and functions is essential to accurate radiographic evaluation. This article discusses the anatomy, function, and growth and development of the TMJ and how growth changes can affect the morphology of the craniofacial structures. Accordingly, the radiographic appearance of the entities that may alter the TMJ are discussed, including developmental, degenerative, inflammatory, and traumatic changes. Both osseous imaging and soft tissue imaging are shown. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Imaging the temporomandibular joint

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    Katzberg, R.W.; Manzione, J.V.; Westesson, P.L.

    1988-01-01

    This book encompasses all imaging modalities as they apply to the Temporomandibular Joint and its disorders. The volume employs correlative line drawings to elaborate on diagnostic images. It helps teach methods of TMJ imaging and describes findings identified by different imaging modalities to both radiologists and dental clinicians.

  6. Reconstrucción de la articulación temporomandibular (ATM: prótesis aloplástica Reconstruction of the temporomandibular joint (TMJ: alloplastic prostheses

    Directory of Open Access Journals (Sweden)

    C. Goizueta Adame

    2005-02-01

    Full Text Available La incapacidad de desarrollar sistemas inertes eficaces para la sustitución completa de la articulación temporo-mandibular durante décadas ha generado una variedad de soluciones biológicas para un problema biomecánico. Los injertos autólogos no ofrecen garantías en funcionalidad, simetría, o estabilidad oclusal; resultan técnicamente más complejos y tienen mayor potencial morbilidad. El paciente candidato a reconstrucción completa de la ATM debe contar con la posibilidad de una prótesis si otras opciones fracasan. La reconstrucción aloplástica garantiza estabilidad oclusal, técnica sencilla y reproducible, estancia hospitalaria predecible y baja tasa de complicaciones con los sistemas protésicos actuales. Siempre van a existir pacientes en los que ésta sea la única opción, por lo tanto es primordial la medición de la magnitud de las fuerzas implicadas en la mecánica de la ATM para poder diseñar prótesis en base a modelos fiables como en otras articulaciones en las que ya han resuelto el problema.Incapabability to develop effective inert systems to total temporomandibular joint substitution during decades has genered several biologic solutions for a biomecanic question. Autologous grafts don´t offer security in functioning, simmetry, or oclusal estability; its have more coplex technique and more potencial morbility. Alloplastic reconstruction guarantees oclusal stability, single and reproducible technique, predictable time in hospital, and low morbility with actual prosthetic systems. Patients whos prostheses is only one option are going to exist always, so that it is primordial measures of magnitude of implicated strenghts in TMJ mecanic to can design prosthesis based on reliable models like others articulations which have just resolved the question.

  7. Temporomandibular Joint Anatomy and Derangements

    Directory of Open Access Journals (Sweden)

    Bahadır Odabaş

    2008-01-01

    Full Text Available Temporomandibular joint (TMJ is a diartrodial joint which is located just before the outer ear way and between the mandibular fossa and mandibular condyle. TMJ has rotation and translation movements. Approximately the 30-50 percent of the population has joint click. Most of the patients which have TMJ click may suffer from disc displacement. By the presence of disharmony between TMJ and occlusion and masticatory muscles, natural balance disappears. Therefore the function of the craniomandibular system and the factors that affects dysfunction must be considered when treatment planning is built.

  8. Temporomandibular joint arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyung Sik; Lee, Kyung Soo; Kim, Myoung Joon; Jun, Young Hwan; Chang, Duk Soo; Jung, Don Young; Jung, In Won [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1988-04-15

    The stress and occlusion disturbance are very important etiologic factors in the temporomandibular joint (TMJ) pain dysfunction syndromes. Authors performed TMJ arthrograms in the patients with TMJ problem such as pain, click sound, limited motion and locking, etc. The following results noted: 1. The arthrographic findings of 22 TMJ were analyzed. a) Normal: 6 cases b) Anterior disc displacement with rediction: 6 cases {center_dot} Early reduction: 2 cases {center_dot} Intermediate reduction: 3 cases {center_dot} Late reduction: 1 case c) Anterior disc displacement without reduction: 6 cases {center_dot} Two cases had adhesion between the posterior portion of disc and the posterior surfaces of the articular eminence. 2. Among 22 cases, the clinical findings of 16 cases (73%) were compatible with arthrographic findings. 6 cases showed disparity between them.

  9. Analysis by computed tomography of bone changes in the mandibular head and mandibular fossa in relation to clinical findings in patients with temporomandibular joint (TMJ) disorders

    Energy Technology Data Exchange (ETDEWEB)

    Hamamoto, Yoshioki; Nakajima, Tamio; Hayashi, Takafumi [Niigata Univ. (Japan). School of Dentistry

    1994-12-01

    Bone changes in the mandibular head and mandibular fossa in 33 patients with temporomandibular joint (TMJ) disorders were studied with axial computed tomography in relation to clinical findings to clarify possible factors leading to bone changes in this phenomenon. Bone changes of the mandibular head were observed in 45 (68%) of the 66 TMJs. The mandibular head was juxtaposed to the mandibular fossa in 13 (29%) of the 45 joints in centric occlusion and in 29 joints (64%) in the anterior position on CT, whereas the mandibular head with no pathological bone change was juxtaposed to the mandibular fossa in none of the 21 joints in centric occlusion and in only 1 joint (5%) in the anterior position. In the two groups of patients with and without juxtaposition of the mandibular head and mandibular fossa with bone changes, the incidence of the initial symptoms such as pain, crepitus, and difficulty in opening the mouth was increased compared with the symptoms at presentation. However, the former group had severer symptoms than the latter group. These findings suggest that bony degeneration of the TMJ is accelerated by juxtaposition of the head and fossa. (author).

  10. Growth factors, genes, bone proteins and apoptosis in the temporomandibular joint (TMJ) of children with ankylosis and during disease recurrence.

    Science.gov (United States)

    Pilmane, Mara; Skagers, Andrejs

    2011-01-01

    AIM OF STUDY was complex detection of appearance and distribution of growth factors, facial bone growth stimulating genes, ground substance proteins and apoptosis in bone of ankylotic TMJ in primary and repeatedly operated children. Ankylotic tissue was obtained during the arthroplastic surgery from two 6 years old children (boy and girl) with osseous type of disease. The girl underwent the repeated surgery in TMJ due to the same diagnosis in age of 12 years. Ankylotic tissue was proceeded for detection of BMP2/4, TGFβ, Msx2, osteopontin, osteocalcin immunohistochemically, and apoptosis. RESULTS demonstrated massive bone formation intermixed by neochondrogenesis the lack of BMP 2/4, but abundant number of TGFβ-containing cells in bone of all tested cases. Despite rich osteopontin positive structures in bone obtained from both - primary and repeated surgery, osteocalcin demonstrated variable appearance in 6 years aged children, but was abundant in joint 5 years later during disease recurrence. Expression of Msx2 varied widely before, but with tendency to decrease stabilized until few positive cells in bone of 12 years old girl. Apoptosis practically was not detected in primarily operated TMJ, but massively affected the supportive tissue in girl with recurrent ankylosis. The lack of BMP2/4 expression in ankylotic bone proves the disorders in cellular differentiation with simultaneous compensatory intensification of cellular proliferation and/or growth by rich expression of TGFβ leading to the remodelling of TMJ. Mainly rich distribution of osteocalcin and osteopontin indicate the intensive mineralization processes of ankylotic bone. Persistent Msx2 expression is characteristic for the supportive tissue of recurrent ankylosis of TMJ and indicates the persistent stimulation of bone growth compensatory limitated by massive increase of programmed cell death.

  11. Diagnostic index of three-dimensional osteoarthritic changes in temporomandibular joint condylar morphology

    National Research Council Canada - National Science Library

    Gomes, Liliane R; Gomes, Marcelo; Jung, Bryan; Paniagua, Beatriz; Ruellas, Antonio C; Gonçalves, João Roberto; Styner, Martin A; Wolford, Larry; Cevidanes, Lucia

    2015-01-01

    ...) osteoarthritic morphological variations among 169 temporomandibular joint (TMJ) condyles. Cone-beam computed tomography scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA...

  12. PATHOLOGY OF TEMPOROMANDIBULAR-JOINT INTERNAL DERANGEMENT AND OSTEOARTHROSIS

    NARCIS (Netherlands)

    DEBONT, LGM; STEGENGA, B

    Temporomandibular joint (TMJ) osteoarthrosis and disk displacement seem to be strongly related, but they may also represent mutually independent temporomandibular disorders. This paper presents relevant aspects of normal physiology and degeneration of synovial joints, aspects of normal

  13. Unfavourable results in temporomandibular joint ankylosis surgery

    Science.gov (United States)

    Jagannathan, Mukund; Munoli, Amarnath V.

    2013-01-01

    Temporomandibular joint (TMJ) ankylosis is a debilitating condition usually afflicting children and young adults. Treatment is surgical, i.e., release of the ankylosed joint/s with or without interposition arthroplasty and correction of secondary deformities (mandibular retrusion and asymmetry) This article deals with identifying potential setbacks in TMJ ankylosis surgery and preventing them. PMID:24501459

  14. Temporomandibular joint examination reviewed

    Directory of Open Access Journals (Sweden)

    L. Guarda Nardini

    2011-09-01

    Full Text Available The temporo-mandibular joint (TMJ it’s a joint closely related to the skull base, the spine, and the jaws; all these anatomical structures must be taken in consideration when evaluating pain involving the tmj. In order to detect patients affected by pathology or dysfunctions of the tmj, physical examination is of great value in orienting the diagnosis. Inspection must consider the symmetry of the body, the dental status and the type of occlusion. Palpation is a way to assess contractiont involving the muscles of the masticatory system and of the neck. Auscultation, based on articular noise provides means to determine whether we are dealing with degeneration of the joint or a dislocation of the intrarticular disc. In order to confirm the diagnosis obtained with the clinical evaluation, it’s useful to perform imaging techniques as opt, tomography and TC of the tmj and electromyokineosiography – index of the mandibular functionality and of the muscles status. MRI and dynamic MRI are among the non invasive exams which give the greatest amount of information, regarding the disc position and the joint degeneration. Arthroscopy is an invasive technique that allows early diagnosis of degeneration and is helpful to reveal early inflammatory processes of the joint.

  15. Nonsurgical Management of Pediatric Temporomandibular Joint Dysfunction.

    Science.gov (United States)

    Scrivani, Steven John; Khawaja, Shehryar Nasir; Bavia, Paula Furlan

    2018-02-01

    Temporomandibular disorders (TMD) are a subgroup of craniofacial pain problems involving the temporomandibular joint (TMJ), masticatory muscles, and associated head and neck musculoskeletal structures. These disorders are subclassified into TMJ articular disorders and masticatory muscle disorders. Patients with TMD most commonly present with pain, restricted or asymmetric mandibular motion, and TMJ sounds during mandibular movements. The prevalence tends to increase with age. Management of TMJ articular disorders consists of a combination of patient education, home-care plan, biobehavioral therapy, physical therapy, orthotic jaw appliance therapy, pharmacotherapy, and/or surgery. The goal is to increase function, reduce pain, and improve quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Andrew M. Felstead

    2011-01-01

    Full Text Available Relatively few patients develop such severe degenerative temporomandibular joint (TMJ disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic. Ankylosis of the temporomandibular joint (TMJ secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  18. Temporomandibular joint disorder (review).

    Science.gov (United States)

    Dugashvili, G; Menabde, G; Janelidze, M; Chichua, Z; Amiranashvili, I

    2013-02-01

    Etiopathogenesis and clinical management of TMJD integrates a number of medical disciplines. In particular, dentistry, oral - facial surgery, neurology, rheumatology and so on. Nowadays there is no unified strategy for the management of this disease. Most cases of temporomandibular disorder (TMD) respond to simple treatment and the prognosis is good. Symptoms usually remit with simple care. In cases of secondary involvement of temporomandibular joint (TMJ), the prognosis depends on the primary disease. A comprehensive, chronological history and physical and examination of the patient, including dental history and examination, is essential to diagnose the specific condition to decide further investigations, if any, and to provide specific treatment. in severe cases, a joint consultation of a dentist, neurologist and rheumatologist is needed.

  19. [Temporomandibular joint disc surgery].

    Science.gov (United States)

    Potier, J; Maes, J-M; Nicot, R; Dumousseau, T; Cotelle, M; Ferri, J

    2016-09-01

    Temporomandibular joint (TMJ) disorders are a common disease and may be responsible for major functional and painful repercussions. Treatment is not consensual. The literature highlights the role of conservative treatments (physiotherapy, analgesics, splints) in a first attempt. Minimally invasive surgical techniques (arthroscopy, arthrocentesis) have developed rapidly in recent decades. They have proven effective and reliable, especially in patients suffering from irreducible or reducible anterior disc dislocation or presenting with arthopathies. The goal of our work was to make an update about disk surgery. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  20. Temporomandibular Joint Septic Arthritis

    Directory of Open Access Journals (Sweden)

    Gianfranco Frojo, MD

    2018-01-01

    Full Text Available Summary:. Infection of the temporomandibular joint (TMJ is a rare pediatric condition resulting from the introduction of pathogens into the joint by hematogenous seeding, local extension, or trauma. Early recognition of the typical signs and symptoms including fever, trismus, preauricular swelling, and TMJ region tenderness are critical in order to initiate further evaluation and prevent feared complications of fibrosis, ankylosis, abnormal facial structure, or persistence of symptoms. Contrast-enhanced computed tomography with ancillary laboratory analysis including erythrocyte sedimentation rate, C-reactive protein, and white blood cell count are beneficial in confirming the suspected diagnosis and monitoring response to therapy. Initial intervention should include empiric parenteral antibiotics, early mandibular mobilization, and joint decompression to provide synovial fluid for analysis including cultures. This report describes a case of TMJ bacterial arthritis in a healthy 6-year-old male who was promptly treated nonsurgically with intravenous antibiotics and localized needle joint decompression with return to normal function after completion of oral antibiotics and physical therapy.

  1. A prospective, single-centre study on patient outcomes following temporomandibular joint replacement using a custom-made Biomet TMJ prosthesis.

    Science.gov (United States)

    Aagaard, E; Thygesen, T

    2014-10-01

    This study describes the clinical variables in 61 patients following total alloplastic temporomandibular joint reconstruction (TJR) in which the Biomet Microfixation Patient-Patient-Matched TMJ Implant was used. All patients were classified using the Wilkes classification. The visual analogue scale score for jaw pain intensity, the maximum inter-incisal opening (MIO), and the frequency of adverse events were recorded during follow-up; the mean follow-up was 14.2±8.6 months. Significant improvements were found in the MIO (Pdisease. Our patients gained an almost normal range of mouth opening and experienced a significant reduction in pain. Our results are promising, however TJR is associated with some side effects. TJR should be considered when less invasive procedures fail and a comprehensive presurgical work-up has been performed. Ongoing prospective studies are needed to consolidate the possible significant treatment outcomes. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. CT Images of a Severe TMJ Osteoarthritis and Differential Diagnosis with Other Joint Disorders

    OpenAIRE

    K. L. Ferrazzo; L. B. Osório; Ferrazzo, V. A.

    2013-01-01

    Osteoarthritis (OA) is the most common arthritis which affects the human body and can affect the temporomandibular joint (TMJ). The diagnosis of TMJ OA is essentially based on clinical examination. However, laboratory tests and radiographic exams are also useful to exclude other diseases. The diagnosis of OA may be difficult because of other TMJ pathologies that can have similar clinical and radiographic aspects. The purpose of this study was to describe an unusual case of bilateral TMJ OA in...

  3. Rheumatoid arthritis affecting temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Amandeep Sodhi

    2015-01-01

    Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

  4. Temporomandibular joint dislocation in an epileptic and mentally ...

    African Journals Online (AJOL)

    Temporomandibular joint (TMJ) dislocation is defined as an excessive forward movement of the condyle beyond the articular eminence with complete separation of articular surfaces and fixation in that position.' Theories regarding the pathogenesis of TMJ dislocation propose laxity of TMJ ligaments or capsule, excessive ...

  5. Groningen temporomandibular joint prosthesis. Development and first clinical application

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Stegenga, B; Spijkervet, FKL; Verkerke, GJ

    Patients with a severely degenerated temporomandibular joint (TMJ) may benefit from an alloplastic TMJ replacement. The aim of the study was to develop a safe and properly functioning TMJ prosthesis. The design was based on imitation of anterior condylar translation by an inferiorly located centre

  6. An Overall Look for Temporomandibular Joint Pathologies and Imaging

    Directory of Open Access Journals (Sweden)

    Hakan Eren

    2015-10-01

    Full Text Available Temporomandibular joint (TMJ complex is one of the most complex joint which connects the mandible to the skull. This kind of joint system has ability to perform complex and bilateral movements. Because, TMJ has a complicated anatomy, there is a need for a thorough investigation to find the correct cause of TMJ disorders, as well as knowing the TMJ anatomy. Anatomical structures of TMJ contain hard tissues and soft tissues. Soft tissues consist of joint capsule, ligaments, articular disc, muscles and tendons. A healthy joint is connected to proper and compatible function of all these anatomical structures. Temporomandibular disorder (TMD is a term used for any problems that affecting the temporomandibular joint. Possible causes for TMD are injury to the TMJ or related anatomical structures, clenching the teeth or bruxism, dislocation of the disc, presence of osteoarthritis or rheumatoid arthritis in the TMJ, emotional stress, aging, etc. The most common TMJ disorders are pain dysfunction syndrome, internal derangement, arthritis, and traumas. Radiographic imaging is an important element in the correct diagnosis. Because of the anatomic complexity of the temporomandibular joint and its proximity to the temporal bone, mastoid air cells, and auditory structures, imaging of the joint structures should also be investigated. Therefore, careful clinical and radiological examinations are essential in the evaluation of TMJ. In this review, TMJ anatomy, Imaging methods, the classification of various pathologies and radiological techniques, are discussed.

  7. Atypical temporomandibular joint pain: a case report.

    Science.gov (United States)

    Widmer, Charles G; Wold, Courtney C; Stoll, Ethan M; Dolwick, M Franklin

    2014-12-01

    Atypical temporomandibular joint (TMJ) pain can consist of an unusual intensity, location or set of pain descriptors that do not match what is traditionally observed for TMJ capsular pain, disc displacements or arthritic conditions. Presented in this case report is an atypical pain report regarding a unilateral TMJ pain as the chief complaint. An overview of typical vs atypical TMJ pain is also reviewed to highlight unusual signs and symptoms so that the clinician can identify these atypical presentations and pursue further diagnostic approaches. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. [Temporo-mandibular joints and orthognathic surgery].

    Science.gov (United States)

    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.

  9. Temporomandibular joint: disorders, treatments, and biomechanics.

    Science.gov (United States)

    Ingawalé, Shirish; Goswami, Tarun

    2009-05-01

    Temporomandibular joint (TMJ) is a complex, sensitive, and highly mobile joint. Millions of people suffer from temporomandibular disorders (TMD) in USA alone. The TMD treatment options need to be looked at more fully to assess possible improvement of the available options and introduction of novel techniques. As reconstruction with either partial or total joint prosthesis is the potential treatment option in certain TMD conditions, it is essential to study outcomes of the FDA approved TMJ implants in a controlled comparative manner. Evaluating the kinetics and kinematics of the TMJ enables the understanding of structure and function of normal and diseased TMJ to predict changes due to alterations, and to propose more efficient methods of treatment. Although many researchers have conducted biomechanical analysis of the TMJ, many of the methods have certain limitations. Therefore, a more comprehensive analysis is necessary for better understanding of different movements and resulting forces and stresses in the joint components. This article provides the results of a state-of-the-art investigation of the TMJ anatomy, TMD, treatment options, a review of the FDA approved TMJ prosthetic devices, and the TMJ biomechanics.

  10. Nomenclature and classification of temporomandibular joint disorders

    NARCIS (Netherlands)

    Stegenga, B.

    2010-01-01

    P>Currently, there are basically two approaches to classification, one based on structural and one on positional changes occurring within the joint. Despite the increase in knowledge of pathologic changes occurring within the temporomandibular joint (TMJ), the disc still seems to be a central issue

  11. Temporomandibular joint dislocation in an 18-month-old child

    Directory of Open Access Journals (Sweden)

    Jaeson Mohanan Painatt

    2017-01-01

    Full Text Available Temporomandibular joint (TMJ dislocation in children is extremely rare. In our case, an 18-month-old child presented with a history of inability to close her mouth. To confirm the clinical diagnosis, a computed tomogram was taken. Clinical examination and X-ray of the TMJ revealed bilateral TMJ dislocation. Bilateral TMJ reduction was achieved manually after giving analgesia and procedural sedation. This is one of the few case reports of an acute dislocation in a toddler.

  12. Isolated Arthritis of the Temporomandibular Joint as the Initial Manifestation of Juvenile Idiopathic Arthritis

    DEFF Research Database (Denmark)

    Hügle, Boris; Spiegel, Lynn; Hotte, Julia

    2017-01-01

    OBJECTIVE: To describe characteristics of patients with juvenile idiopathic arthritis (JIA) presenting with isolated arthritis of the temporomandibular joints (TMJ). METHODS: Patients with JIA with isolated TMJ arthritis from 4 large tertiary pediatric rheumatology centers were included. Demograp...

  13. Temporomandibular joint in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Syrjaenen, S.M.

    The temporomandibular joint (TMJ) was investigated clinically and by orthopantomography in 110 patients with rheumatoid arthritis (RA) and in 73 control subjects. Clinical symptoms in the TMJ were established in 34% of the RA patients and in 18% of the controls. Radiographic abnormalities were found in 60% of the RA patients compared with 15% in the controls. No single radiographic abnormality was characteristic of joint involvement by RA. The most common radiologic features in RA patients were changes in the morphology of the condylar head and articular eminentia, marginal irregularities, reduced mobility, and an anterior position of the condylar head. No abnormalities were encountered in the early stage of the disease, which at least in part could be attributed to the inherent limitations of orthopantomography. The incidence of joint lesions increased with duration of the RA. (orig.).

  14. Ultrastructural characteristics of the synovial membrane in osteoarthritic temporomandibular joints

    NARCIS (Netherlands)

    Dijkgraaf, LC; Liem, RSB; deBont, LGM

    1997-01-01

    Purpose: This study analyzed the ultrastructural characteristics of the synovial membrane in various stages of osteoarthritis (OA) of the temporomandibular joint (TMJ), and developed a classification of this involvement based on these morphologic characteristics. Patients and Methods: Synovial

  15. Oral splint for temporomandibular joint disorders with revolutionary fluid system

    National Research Council Canada - National Science Library

    Srivastava, Rahul; Jyoti, Bhuvan; Devi, Parvathi

    2013-01-01

    Temporomandibular joint (TMJ) diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal...

  16. Tuberculosis of the temporomandibular joint.

    Science.gov (United States)

    Assouan, C; Anzouan, K; Nguessan, N D; Millogo, M; Horo, K; Konan, E; Zwetyenga, N

    2014-04-01

    Extrapulmonary and extra-spinal tuberculosis (TB) is rare, even in countries where the disease is endemic. Ten percent of these localizations are cervico-facial. Involvement of the temporomandibular joint (TMJ) is very unusual. We present the features of such a case. We looked for patients managed for TMJ TB in 2 Maxillofacial Surgery departments and in 1 Pneumology & Phthisiology Department since 1992. The second part of the study was a literature review. One case was found in our departments and 15 other cases were found in published data. Most patients were women with mean age of 39.9 years (5 to 68). Pre-auricular swelling was the predominant functional sign, often without fever or change in the health status. The biological and radiological abnormalities were non-specific (osteolysis, joint pinching, etc.). No lung involvement was observed. The joint recovered its normal function after appropriate management. Tuberculosis of the TMJ is difficult to diagnose given its rarity and the non-specific nature of clinical and paraclinical signs. It must be considered in the differential diagnosis for common diseases of the TMJ whether TB is endemic or not. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  17. Temporomandibular joint diagnostics using CBCT

    Science.gov (United States)

    Abrahamsson, A-K; Kristensen, M; Arvidsson, L Z

    2015-01-01

    The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost- and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome. PMID:25369205

  18. Temporomandibular joint involvement in psoriatic arthritis | Okkesim ...

    African Journals Online (AJOL)

    Psoriasis is a chronic, papulosquamous, and an inflammatory skin disease. It has been found that between 5% and 24% of patients develop psoriatic arthritis (PA) at the same time after or even prior to skin findings. The involvement of temporomandibular joint (TMJ) is a rare condition. In this report, a-46-year-old male ...

  19. Anterior bilateral temporomandibular joint dislocation: an ...

    African Journals Online (AJOL)

    Anterior dislocation of the temporomandibular joint (TMJ) though an infrequent presentation at the emergency department; often demands an immediate reduction to relieve discomfort and prevent adverse long-term sequelae. A simple and effective technique to reduce the dislocation is successfully demonstrated by putting ...

  20. TMJ Disorders

    Science.gov (United States)

    ... jaw Pain in one or both of the temporomandibular joints Aching pain in and around your ear Difficulty chewing or ... doctor Seek medical attention if you have persistent pain or tenderness in ... temporomandibular joint (TMJ) combines a hinge action with sliding motions. ...

  1. Mouse genetic models for temporomandibular joint development and disorders.

    Science.gov (United States)

    Suzuki, A; Iwata, J

    2016-01-01

    The temporomandibular joint (TMJ) is a synovial joint essential for hinge and sliding movements of the mammalian jaw. Temporomandibular joint disorders (TMD) are dysregulations of the muscles or the TMJ in structure, function, and physiology, and result in pain, limited mandibular mobility, and TMJ noise and clicking. Although approximately 40-70% adults in the USA have at least one sign of TMD, the etiology of TMD remains largely unknown. Here, we highlight recent advances in our understanding of TMD in mouse models. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Gnathological splint therapy in temporomandibular joint disorder

    Directory of Open Access Journals (Sweden)

    K Gnanashanmugham

    2015-01-01

    Full Text Available Temporomandibular joint (TMJ forms an integral functional part of stomatognathic system. Position, shape, structure and function of teeth have an influence on the proper functioning and health of TMJ. But a problem associated with TMJ is often neglected, and treatment for it is mostly restricted to palliative therapy. A proper understanding of the underlying cause of temporomandibular joint disorder (TMD is necessary to device a proper treatment plan. Etiology of TMDs varies from idiopathic reasons to systemic disorders. The option of Gnathological splint is a conservative, safe and an effective mode of therapy for TMDs caused by occlusal discrepancies (fulcrum/interferences. This article presents a case report of a patient with TMD caused by occlusal discrepancy

  3. Engineering Alloplastic Temporomandibular Joint Replacements

    Science.gov (United States)

    Sinno, Hani; Tahiri, Youssef; Gilardino, Mirko; Bobyn, Dennis

    2011-01-01

    Temporomandibular disorders (TMD) are part of a heterogeneous group of pathologies that manifest with a constellation of signs and symptoms. They are the most frequent cause of chronic orofacial pain and are prevalent in 12% of the general population. Despite the debilitating nature of these disorders, there is no standardization for treatment of the diseased temporomandibular joint (TMJ). In this review, we present an overview of the functional anatomy of the TMJ and the engineering concepts that must be understood to better understand the indications for surgical management, the types of available treatments and the requirements for reconstruction. A comparison is made of the clinical outcomes with autogenous versus alloplastic reconstruction, including a history of alloplastic materials and the design features of currently available implants. Emphasis is made on material selection, modulus, stiffness, notch sensitivity and modularity. For the treatment of TMD, engineered TMJ alloplastic replacements have had considerable promise with additional room for improvement using new materials and recent design concepts. PMID:22363183

  4. [Temporomandibular joint, occlusion and bruxism].

    Science.gov (United States)

    Orthlieb, J D; Ré, J P; Jeany, M; Giraudeau, A

    2016-09-01

    Temporomandibular joint and dental occlusion are joined for better and worse. TMJ has its own weaknesses, sometimes indicated by bad functional habits and occlusal disorders. Occlusal analysis needs to be addressed simply and clearly. The term "malocclusion" is not reliable to build epidemiological studies, etiologic mechanisms or therapeutic advice on this "diagnosis". Understanding the impact of pathogenic malocclusion is not just about occlusal relationships that are more or less defective, it requires to locate them within the skeletal framework, the articular and behavioural context of the patient, and above all to assess their impact on the functions of the masticatory system. The TMJ-occlusion couple is often symbiotic, developing together in relation to its environment, compensating for its own shortcomings. However, a third partner may alter this relationship, such as bruxism, or more generally oral parafunctions, trauma or an interventionist practitioner. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Inflammatory and degenerative disease in the temporomandibular joint

    OpenAIRE

    Gynther, Göran W.

    1996-01-01

    Temporomandibular joint (TMJ) arthroscopy is an established technique withhigh diagnostic accuracy regarding synovitis and degenerative changes of the articularfibrocartilage and disk. However, so far no studies have been done to correlate themacroscopic and histologic findings with each arthroscopic criterion. Thereforepatients with TMJ internal derangement (ID) were investigated by arthroscopy andarthrotomy (with biopsy) and the findings were compared with observations usinglight microscopy...

  6. TMJ online: Investigating temporomandibular disorders as "TMJ" on YouTube.

    Science.gov (United States)

    Basch, C H; Yin, J; Walker, N D; de Leon, A J; Fung, I C-H

    2018-01-01

    As the understanding of temporomandibular disorders' (TMDs) aetiologies and treatments develops from non-evidence-based to evidence-based approaches, the availability of sound information will likewise grow and need to be disseminated. The purpose of this study is to describe the content most commonly viewed in YouTube videos related to TMDs or "TMJ" and see whether videos from different sources have different content. Video information was gathered by searching YouTube for the term "TMJ," and data were recorded related to descriptive information as well as content. Statistical analyses included Kruskal-Wallis H Test, Spearman's Rho and univariate logistic regression. The sources of upload were Consumer (n = 62), Professional (n = 29) and News (n = 9). There were almost no statistically significant differences in content distribution among video sources. Videos garnered a total of 4 749 360 views, with an overall median of 7014.5 views. About two-thirds of the videos (68/100) explained what "TMJ" is, with a surprising third of Professional videos (9/29) not covering the subject. Roughly half of the videos mentioned at least one reason "TMJ" occurs (55/100), and seven in ten mentioned some kind of treatment (70/100). Video names mentioned a cure or treatment in 64 cases, while the other 36 referred to TMJ anatomy or "TMJ" aetiology. Future research should focus on ways to popularise professional videos with reliable information for those who are searching on YouTube for advice related to "TMJ." © 2017 John Wiley & Sons Ltd.

  7. Bilateral synovial chondromatosis of the temporomandibular joint.

    Science.gov (United States)

    Guijarro-Martínez, Raquel; Puche Torres, Miguel; Marqués Mateo, Mariano; Solís García, Ignacio; Miragall Alba, Luis; Iglesias Gimilio, María Eugenia; Pérez-Herrezuelo Hermosa, Gonzalo; Pascual Gil, José Vicente

    2011-06-01

    To report an exceptional case of bilateral synovial chondromatosis (SC) of the temporomandibular joint (TMJ) and discuss diagnostic approaches, treatment options and follow-up data. A 38-year-old woman presented with left preauricular swelling. Initial imaging studies revealed TMJ effusion only. Six years later, synovial calcifications were detected in the left TMJ; the right TMJ space was widened and presented incipient calcium deposits. Open arthrotomy of the left TMJ was performed, with removal of multiple cartilaginous loose bodies and complete synovectomy. Periodic controls proved the asynchronic development of intra-articular bodies in the right TMJ. SC is a metaplastic arthropathy that is uncommon in the TMJ. Bilaterality is exceptional. Diagnosis is often delayed due to the non-specific symptoms, progressive developmental stages and clinicians' lack of awareness of the condition. Magnetic resonance imaging (MRI) is particularly helpful in defining disease extension, excluding a possible tumour and detecting internal derangement. Definitive diagnosis requires arthroscopic or open examination and histopathological analysis. Recurrences are infrequent after arthrotomy, removal of loose bodies and complete synovectomy. SC is an uncommon condition in the TMJ. Bilateral involvement is extremely rare. MRI is effective for diagnosis and postoperative follow-up. Complete synovectomy usually yields an excellent prognosis. Copyright © 2010 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Loading of a unilateral temporomandibular joint prosthesis : A three-dimensional mathematical study

    NARCIS (Netherlands)

    van Loon, JP; Falkenstrom, CH; de Bont, LGM; Verkerke, GJ

    1998-01-01

    The load on the prosthetic side and the influence of the design on the remaining natural contralateral TMJ must be known before a unilateral temporomandibular joint (TMJ) prosthesis can be developed. The aim of the present study was to determine the maximum loading of the TMJ prosthetic side and the

  9. A short-term study in sheep with the Groningen temporomandibular joint prosthesis

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Spijkervet, FKL; Verkerke, GJ; Liem, RSB

    2000-01-01

    As part of the pre-clinical testing process of a newly developed temporomandibular joint (TMJ) prosthesis, animal experiments were performed. In 14 sheep, the right TMJ was replaced by the developed TMJ prosthesis. The prosthesis consisted of a skull part, a mandibular part and an intervening

  10. Stem Cells for Temporomandibular Joint Repair and Regeneration.

    Science.gov (United States)

    Zhang, Shipin; Yap, Adrian U J; Toh, Wei Seong

    2015-10-01

    Temporomandibular Disorders (TMD) represent a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles and/or associated structures. They are a major cause of non-dental orofacial pain. As a group, they are often multi-factorial in nature and have no common etiology or biological explanations. TMD can be broadly divided into masticatory muscle and TMJ disorders. TMJ disorders are characterized by intra-articular positional and/or structural abnormalities. The most common type of TMJ disorders involves displacement of the TMJ articular disc that precedes progressive degenerative changes of the joint leading to osteoarthritis (OA). In the past decade, progress made in the development of stem cell-based therapies and tissue engineering have provided alternative methods to attenuate the disease symptoms and even replace the diseased tissue in the treatment of TMJ disorders. Resident mesenchymal stem cells (MSCs) have been isolated from the synovia of TMJ, suggesting an important role in the repair and regeneration of TMJ. The seminal discovery of pluripotent stem cells including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have provided promising cell sources for drug discovery, transplantation as well as for tissue engineering of TMJ condylar cartilage and disc. This review discusses the most recent advances in development of stem cell-based treatments for TMJ disorders through innovative approaches of cell-based therapeutics, tissue engineering and drug discovery.

  11. Temporomandibular joint replacement: a New Zealand perspective.

    Science.gov (United States)

    Murdoch, B; Buchanan, J; Cliff, J

    2014-05-01

    Alloplastic total temporomandibular joint replacement (TMJ TJR) has been performed in New Zealand utilizing the TMJ Concepts patient-fitted system since 2000. The data analysed in this study were collected retrospectively from questionnaires sent to all maxillofacial surgeons in New Zealand who had implanted TMJ Concepts devices between 2000 and 2011. A total of 63 devices were implanted in 42 patients (13 males, 29 females) during this 12-year period. The primary indication for TMJ TJR was end-stage joint disease resulting from ankylosis and arthritis. The mean age of the patients was 47 years (range 7-80 years). The most common complication reported was transient facial nerve impairment in 4.8% of the patients. Objective results, measured as the maximal incisional opening, improved by a mean of 17.3mm (PTMJ TJR using the TMJ Concepts prosthesis is a reliable treatment option for the management of end-stage TMJ disease. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Ankylosis of temporomandibular joint in children

    Directory of Open Access Journals (Sweden)

    Das U

    2009-06-01

    Full Text Available Background: Temporomandibular joint (TMJ ankylosis or hypomobility involves fusion of the mandibular condyle to the base of the skull. It is a major clinical problem that affects many patients suffering from facial trauma, infection, or systemic disease. The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence. Case Report: This report describes a case of a 4-year-old boy with inability to open mouth, diagnosed with unilateral right bony TMJ ankylosis. The surgical approach consisted of gap arthroplasty followed by vigorous physiotherapy. Conclusion: A detailed history, clinical and functional examination, radiographic examination facilitating correct diagnosis followed by immediate surgical intervention, and physiotherapy can help us to restore physical, psychological, and emotional health of the child patient.

  13. Deficient cytokine control modulates temporomandibular joint pain in rheumatoid arthritis.

    Science.gov (United States)

    Ahmed, Neveen; Catrina, Anca I; Alyamani, Ahmed O; Mustafa, Hamid; Alstergren, Per

    2015-08-01

    The aim was to investigate how endogenous cytokine control of tumor necrosis factor (TNF) influences temporomandibular joint (TMJ) pain in relation to the role of anti-citrullinated peptide antibodies (ACPA) in patients with rheumatoid arthritis (RA). Twenty-six consecutive patients with TMJ RA were included. Temporomandibular joint pain intensity was assessed at rest, on maximum mouth opening, on chewing, and on palpation. Mandibular movement capacity and degree of anterior open bite (a clinical sign of structural destruction of TMJ tissues) were also assessed. Systemic inflammatory activity was assessed using the Disease Activity Score in 28 joints (DAS28) for rheumatoid arthritis. Samples of TMJ synovial fluid and blood were obtained and analyzed for TNF, its soluble receptor, soluble TNF receptor II (TNFsRII), and ACPA. A high concentration of TNF in relation to the concentration of TNFsRII in TMJ synovial fluid was associated with TMJ pain on posterior palpation on maximum mouth opening. The ACPA concentration correlated significantly to the TNF concentration, but not to the TNFsRII concentration, indicating that increased inflammatory activity is mainly caused by an insufficient increase in anti-inflammatory mediators. This study indicates that TMJ pain on palpation in patients with RA is related to a deficiency in local cytokine control that contributes to increased inflammatory activity, including sensitization to mechanical stimuli over the TMJ. © 2015 Eur J Oral Sci.

  14. Temporomandibular joint loads in subjects with and without disc displacement

    Directory of Open Access Journals (Sweden)

    Laura Rei Iwasaki

    2009-12-01

    Full Text Available The likelihood of development of degenerative joint disease (DJD of the temporomandibular joint (TMJ is related to the integrity of the TMJ disc. Predilection for mechanical failure of the TMJ disc may reflect inter-individual differences in TMJ loads. Nine females and eight males in each of normal TMJ disc position and bilateral disc displacement diagnostic groups consented to participate in our study. Disc position was determined by bilateral magnetic resonance images of the joints. Three-dimensional (3D anatomical geometry of each subject was used in a validated computer-assisted numerical model to calculate ipsilateral and contralateral TMJ loads for a range of biting positions (incisor, canine, molar and angles (1-13. Each TMJ load was a resultant vector at the anterosuperior-most mediolateral midpoint on the condyle and characterized in terms of magnitude and 3D orientation. Analysis of variance (ANOVA was used to test for effects of biting position and angle on TMJ loads. Mean TMJ loads in subjects with disc displacement were 9.5-69% higher than in subjects with normal disc position. During canine biting, TMJ loads in subjects with disc displacement were 43% (ipsilateral condyle, p=0.029 and 49% (contralateral condyle, p=0.015 higher on average than in subjects with normal disc position. Biting angle effects showed that laterally directed forces on the dentition produced ipsilateral joint loads, which on average were 69% higher (p=0.002 compared to individuals with normal TMJ disc position. The data reported here describe large differences in TMJ loads between individuals with disc displacement and normal disc position. The results support future investigations of inter-individual differences in joint mechanics as a variable in the development of DJD of the TMJ.

  15. Current concepts in the pathogenesis of traumatic temporomandibular joint ankylosis

    Science.gov (United States)

    2014-01-01

    Traumatic temporomandibular joint (TMJ) ankylosis can be classified into fibrous, fibro-osseous and bony ankylosis. It is still a huge challenge for oral and maxillofacial surgeons due to the technical difficulty and high incidence of recurrence. The poor outcome of disease may be partially attributed to the limited understanding of its pathogenesis. The purpose of this article was to comprehensively review the literature and summarise results from both human and animal studies related to the genesis of TMJ ankylosis. PMID:25189735

  16. Juvenile idiopathic arthritis overview and involvement of the temporomandibular joint: prevalence, systemic therapy.

    Science.gov (United States)

    Carrasco, Ruy

    2015-02-01

    The temporomandibular joint (TMJ) is one of the many joints involved in the inflammatory arthritides. As imaging of joints has developed, so have the data regarding extent and prevalence of TMJ involvement in these diseases. TMJ disease is especially prevalent in juvenile arthritis. The adult and pediatric inflammatory arthritides share common pathophysiology but are still markedly different. The preponderance of TMJ arthritis research exists in juvenile arthritis. This article discusses classification, treatment, and TMJ involvement in juvenile idiopathic arthritis. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

    OpenAIRE

    Song, Ji-Young; Kim, Seong-Gon; Choi, Hang-Moon; Kim, Hyun Jung

    2015-01-01

    Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ w...

  18. Towards Establishing a Standardized Magnetic Resonance Imaging Scoring System for Temporomandibular Joints in Juvenile Idiopathic Arthritis

    DEFF Research Database (Denmark)

    Tolend, Mirkamal A; Twilt, Marinka; Cron, Randy Q

    2017-01-01

    OBJECTIVES: The temporomandibular joints (TMJs) are frequently affected in children with juvenile idiopathic arthritis (JIA). Early detection is challenging, as major variation is present in scoring TMJ pathology on Magnetic Resonance Imaging (MRI). Consensus-driven development and validation...

  19. Involvement of temporomandibular joint in systemic joint disorders: A clinical and radiological study

    Directory of Open Access Journals (Sweden)

    D B Gandhi Babu

    2009-01-01

    Full Text Available There are many reports on the involvement of temporomandibular joint in certain specific joint diseases, in medical and dental literature. However, not many comprehensive studies have been undertaken to study the involvement of TMJ in systemic joint disorders to establish the cause and effect relationship between the two. This report aims to study the involvement of TMJ in patients affected with systemic joint diseases. A total of 106 patients have been examined; 55 suffering from rheumatoid arthritis (R.A and the rest suffering from related arthropathies. The results are significant and useful in the diagnosis and management of TMJ. in patients suffering from various arthropathies.

  20. Severe bony ankylosis of the temporomandibular joint on one side and contralateral adhesion: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Song, Ji Young [Dept. of Oral and Maxillofacial Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Seong Gon; Choi, Hang Moon [School of Dentistry, Gangneung-Wonju National University, Gangneung (Korea, Republic of); Kim, Hyun Jung [Dept. of Anesthesiology and Pain Medicine, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2015-06-15

    Bony fusion between the mandibular condyle and skull base involves temporomandibular joint (TMJ) bony ankylosis. This condition might originate from trauma, infection, or systemic disease. TMJ adhesion can develop after synovial damage. Both TMJ ankylosis and adhesion lead to functional impairment and pain. Here, we present a case of a 50-year-old female who had bony ankylosis of the right TMJ and adhesion of the left TMJ. She had otitis media in the right ear. A large mass in the right TMJ was observed on computed tomograph. Magnetic resonance image showed a large fused bone mass with normal bone marrow in the right TMJ and flattening of the condyle with a thin disk in the left TMJ. Gap arthroplasty with temporal fascia was performed on the right TMJ, and discectomy, high condylectomy, and coronoidectomy were performed on the left TMJ. During a 2-year follow-up after surgery, the patient had no recurrence.

  1. TMJ pain and cryoanalgesia

    OpenAIRE

    Sidebottom, Andrew J

    2013-01-01

    Temporomandibular (TMJ) joint pain is a complex issue involving several factors in a spectrum including myofascial pain, internal derangement and degenerative disease, all of which are reciprocally affected by psychological factors.

  2. Association of Temporomandibular Joint Pain According to Magnetic Resonance Imaging Findings in Temporomandibular Disorder Patients.

    Science.gov (United States)

    Takahara, Namiaki; Nakagawa, Satoshi; Sumikura, Kanako; Kabasawa, Yuji; Sakamoto, Ichiro; Harada, Hiroyuki

    2017-09-01

    This study investigated the associations between magnetic resonance imaging (MRI) findings and pain in the temporomandibular joint (TMJ). The study included 646 TMJs of 323 consecutive patients with temporomandibular disorders; of these, 222 (34.4%) had TMJ pain whereas 424 (65.6%) had no TMJ pain. MRIs were used to evaluate disc position, osteoarthritis, joint fluid, and bone marrow edema. Internal derangement was classified as normal, anterior disc displacement with reduction, and anterior disc displacement without reduction (ADDWOR); condylar morphology was classified as normal, moderate bony change, and severe bony change. The odds ratio (OR) for each MRI variable for nonpainful versus painful TMJs was computed using logistic regression analysis. Compared with joints with normal disc position, the OR of those with ADDWOR was 2.74 (P pain. Similarly, compared with joints with normal condylar morphology, the OR of those with severe bony change was 4.62 (P = .02) for TMJ pain. In addition, the risk of TMJ pain increased by 2.37 in joints with joint fluid (P joints with bone marrow edema (P = .006). The risk of TMJ pain increased significantly with ADDWOR in combination with severe bony change, joint fluid, and bone marrow edema. These results suggest an association between TMJ pain and ADDWOR, severe bony change, joint fluid, and bone marrow edema. Thus, combining various MRI variables may improve the diagnostic accuracy of TMJ pain. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. THE RELATIONSHIP BETWEEN TEMPOROMANDIBULAR-JOINT MOBILITY AND PERIPHERAL JOINT MOBILITY RECONSIDERED

    NARCIS (Netherlands)

    Dijkstra, P.U.; DEBONT, L.G.M.; VANDERWEELE, L.T.; Boering, G.

    The purpose of this paper was to study the relationship between temporomandibular joint (TMJ) mobility and mobility of joints and to study the general character of joint mobility in 83 subjects, 55 females and 28 males (mean age 26.7, range 13-46 years). The subjects were recruited from the

  4. Temporomandibular joint fibrocartilage degeneration from unilateral dental splints.

    Science.gov (United States)

    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.

  5. Radiographic study on temporomandibular joint Arthrosis

    Energy Technology Data Exchange (ETDEWEB)

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

    1980-11-15

    The author analysed the routine radiographic changes and clinical symptoms of 205 cases of temporomandibular joint arthrosis. The clinical symptoms of the patients were classified and the morphological changes of condylar head, articular eminence, and articular fossa were analyzed and discussed from radiographic view point. The positional change of condylar head and articular fossa relation in TMJ arthrosis were observed. The frequencies of coincidence between the site of complaints and the site of the abnormal images which could be detected were examined. The results were obtained as follows; 1. Bone erosion, deformity, marginal proliferation and sclerosis were selected from many abnormal images as the radiographic diagnostic criteria of TMJ arthritic lesions. 2. Abnormal radiographic findings were revealed in 150 cases (73.9%) of 205 total TMJ arthrosis cases and site with abnormal findings coincided with the site of complaints in 105 cases (70.7%) of 150 cases and coincidence rates were higher above fourth decades than below third decades. 3. Sclerosis of the abnormal radiographic findings could be found more often below third decades than above fourth decades. 4. The positional changes of condylar head were revealed in 176 cases (85.9%) of 205 total cases. 5. Pain complaints were revealed in 170 cases(82.9%) and clicking sounds were revealed in 120 cases (58.6%) of clinical symptoms of TMJ arthrosis. 6. No tendency was found so far the differential diagnosis between pain dysfunction syndrome and osteoarthrosis of TMJ.

  6. The theoretical optimal center of rotation for a temporomandibular joint prosthesis : A three-dimensional kinematic study

    NARCIS (Netherlands)

    van Loon, JP; Falkenstrom, CH; de Bont, LGM; Verkerke, GJ; Stegenga, B

    A unilateral temporomandibular joint (TMJ) prosthesis may cause dysfunction of the contralateral, natural TMJ because of lack of translatorial movements of the prosthetic side. The natural translatorial capacity of the mandible can be restored in part by a TMJ prosthesis with a fixed center of

  7. EVALUATION OF TEMPOROMANDIBULAR-JOINT PROSTHESES - REVIEW OF THE LITERATURE FROM 1946 TO 1994 AND IMPLICATIONS FOR FUTURE PROSTHESIS DESIGNS

    NARCIS (Netherlands)

    VANLOON, JP; DEBONT, LGM; BOERING, G

    Purpose: This article describes the useful elements of applied temporomandibular joint (TMJ) prostheses and discusses the factors necessary to be addressed in an appropriate TMJ prosthesis design. Materials and Methods: Information about TMJ prostheses was gathered by a literature search, Only

  8. Temporomandibular joint dislocation in Nairobi | Sang | East African ...

    African Journals Online (AJOL)

    Background: Despite the diverse conservative and surgical modalities for the management of temporomandibular joint (TMJ) dislocation and the controversy that surrounds them, very little has been done within the East-African setup in terms of highlighting and provoking greater interest in the epidemiology and ...

  9. Impact of Temporomandibular Joint Pain in Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Neveen Ahmed

    2013-01-01

    Full Text Available To investigate the impact of temporomandibular joint (TMJ pain on daily activities and quality of life in relation to systemic inflammatory activity in patients with rheumatoid arthritis (RA, thirty-three consecutive outpatients with RA were included. TMJ pain intensity at rest, on maximum mouth opening, and on chewing was assessed on a 0–10 numerical rating scale. TMJ palpatory tenderness, degree of anterior open bite, the impact of TMJ pain on daily activities and quality of life were also assessed. The systemic inflammatory activity was estimated by the disease activity score 28 (DAS28, blood levels of inflammatory markers and number of painful musculoskeletal regions. TMJ pain at rest, on maximum mouth opening, and on chewing as well as DAS28 was correlated with the impact of the TMJ pain on daily activities and quality of life. Partial correlations showed a significant interaction between TMJ pain on movement and DAS28 that explained the TMJ pain impact on daily activities and quality of life to a significant degree. This study indicates that both current TMJ pain intensity and systemic inflammatory activity play roles in the impact of TMJ pain on daily living and quality of life in RA.

  10. Ear pain following temporomandibular surgery originating from the temporomandibular joint or the cranial nervous tissue? A case report.

    Science.gov (United States)

    Geerse, Wouter K; von Piekartz, Harry J M

    2015-02-01

    A patient presenting with local pain and limitation of movement in the temporomandibular region following surgery of the left temporomandibular joint (TMJ) is described. Manual techniques like distraction of the TMJ combined with motor control exercises to restore TMJ function were not sufficient to relieve the patient's symptoms and her orofacial functions. However, during manual assessment and treatment of cranial nervous tissue, in this case the auriculotemporal nerve and its interface, pain was relieved and orofacial functions improved. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Modified stethoscope for auscultation of temporomandibular joint sounds.

    Science.gov (United States)

    Dagar, Sanjiv Rajender Singh; Turakiya, Viral; Pakhan, Ashok J; Jaggi, Nitin; Kalra, Amit; Vaidya, Vidya

    2014-04-01

    Purpose of this study was to modify the stethoscope which can auscultate the temporomandibular joint (TMJ) sounds more precisely than conventional stethoscope, and fabrication of stethoscope compatible software which analyses the auscultated sound and gives documentary evidence of that analysis in the form of graph. The conventional stethoscope was modified by attaching a custom made soundscope with a recording device which can be placed in external auditory meatus (EAM) for auscultation of TMJ sounds. When this small and smooth end of custom made soundscope of modified stethoscope is placed in EAM & connected with specially developed software it records the TMJ sounds & analyzes them in form of graph. Fabrication of modified stethoscope with software records the auscultated sound as a sound wave in form of graph and analyses this sound wave graph to give graphic evidence of prominent intensity at prominent frequency as spectrum analysis graph, and duration of that sound as a sound length graph. The use of modified stethoscope with software increases the accuracy of auscultation of TMJ sounds without any patient's discomfort and helps in diagnosis of TMJ disorders. The modified stethoscope with software for auscultation of TMJ sounds results in more precise auscultation & analysis of TMJ for sounds even of low intensity & frequency. How to cite the article: Dagar SR, Turakiya V, Pakhan AJ, Jaggi N, Kalra A, Vaidya V. Modified stethoscope for auscultation of temporomandibular joint sounds. J Int Oral Health 2014;6(2):40-4.

  12. Potential Indications for Tissue Engineering in Temporomandibular Joint Surgery.

    Science.gov (United States)

    Salash, Jean R; Hossameldin, Reem H; Almarza, Alejandro J; Chou, Joli C; McCain, Joseph P; Mercuri, Louis G; Wolford, Larry M; Detamore, Michael S

    2016-04-01

    Musculoskeletal tissue engineering has advanced to the stage where it has the capability to engineer temporomandibular joint (TMJ) anatomic components. Unfortunately, there is a paucity of literature identifying specific indications for the use of TMJ tissue engineering solutions. The objective of this study was to establish an initial set of indications and contraindications for the use of engineered tissues for replacement of TMJ anatomic components. There was consensus among the authors that the management of patients requiring TMJ reconstruction as the result of 1) irreparable condylar trauma, 2) developmental or acquired TMJ pathology in skeletally immature patients, 3) hyperplasia, and 4) documented metal hypersensitivities could be indications for bioengineered condyle and ramus TMJ components. There was consensus that Wilkes stage III internal derangement might be an indication for use of a bioengineered TMJ disc or possibly even a disc-like bioengineered "fossa liner." However, there was some controversy as to whether TMJ arthritic disease (e.g., osteoarthritis) and reconstruction after failed alloplastic devices should be indications. Further research is required to determine whether tissue-engineered TMJ components could be a viable option for such cases. Contraindications for the use of bioengineered TMJ components could include patients with TMJ disorders and multiple failed surgeries, parafunctional oral habits, persistent TMJ infection, TMJ rheumatoid arthritis, and ankylosis unless the underlying pathology can be resolved. Biomedical engineers must appreciate the specific indications that might warrant TMJ bioengineered structures, so that they avoid developing technologies in search of problems that might not exist for patients and clinicians. Instead, they should focus on identifying and understanding the problems that need resolution and then tailor technologies to address those specific situations. The aforementioned indications and

  13. Temporomandibular joint disorders' impact on pain, function, and disability.

    Science.gov (United States)

    Chantaracherd, P; John, M T; Hodges, J S; Schiffman, E L

    2015-03-01

    The aim of this study was to determine the association between more advanced stages of temporomandibular joint (TMJ) intra-articular disorders ("TMJ intra-articular status"), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability ("TMD impact"). This cross-sectional study included 614 cases from the RDC/TMD Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intra-articular status was determined by 3 blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject's most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of 1) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), 2) jaw function (Jaw Functional Limitation Scale), and 3) disability (Disability Points from GCPS). A structural equation model estimated the association of TMJ intra-articular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (n = 614) and in cases with a TMD pain diagnosis (n = 500). The correlations between TMJ intra-articular status and TMD impact were 0.05 (95% confidence interval [CI], -0.04 to 0.13) for all TMD cases and 0.07 (95% CI, -0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conceptualizing worsening of TMJ intra-articular disorders as 4 stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intra-articular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored. © International & American Associations for Dental Research.

  14. Temporomandibular Joint Disorders’ Impact on Pain, Function, and Disability

    Science.gov (United States)

    Chantaracherd, P.; John, M.T.; Hodges, J.S.; Schiffman, E.L.

    2015-01-01

    The aim of this study was to determine the association between more advanced stages of temporomandibular joint (TMJ) intra-articular disorders (“TMJ intra-articular status”), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability (“TMD impact”). This cross-sectional study included 614 cases from the RDC/TMD Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intra-articular status was determined by 3 blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject’s most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of 1) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), 2) jaw function (Jaw Functional Limitation Scale), and 3) disability (Disability Points from GCPS). A structural equation model estimated the association of TMJ intra-articular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (n = 614) and in cases with a TMD pain diagnosis (n = 500). The correlations between TMJ intra-articular status and TMD impact were 0.05 (95% confidence interval [CI], −0.04 to 0.13) for all TMD cases and 0.07 (95% CI, −0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conceptualizing worsening of TMJ intra-articular disorders as 4 stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intra-articular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored. PMID:25572112

  15. Rationale of arthroscopic surgery of the temporomandibular joint

    Science.gov (United States)

    Murakami, KenIchiro

    2013-01-01

    Arthroscopic surgery has been widely used for treatment of temporomandibular joint (TMJ) internal derangements and diseases for the last 40 years. Although 626 articles have been hit by Pubmed search in terms of “TMJ arthroscopic surgery”, this review article is described based on distinguished publishing works and on my experiences with TMJ arthroscopic surgery and related research with an aim to analyse the rationale of arthroscopic surgeries of the temporomandibular joint. With arthrocentesis emerging as an alternative, less invasive, treatment for internal derangement with closed lock, the primary indication of arthroscopic surgery seems to be somewhat limited. However, the value of endoscopic inspection and surgery has its position for both patient and physician with its long-term reliable results. PMID:25737901

  16. A study of temporomandibular joint osteoarthritis using computed tomographic imaging.

    Science.gov (United States)

    Massilla Mani, F; Sivasubramanian, S Satha

    2016-06-01

    This study aimed to determine the various bony changes in osteoarthritis (OA) of elderly patients who are suffering from temporomandibular joint dysfunction (TMD) and to find if all the changes manifesting in generalized OA were presented in temporomandibular joint (TMJ). Thirty TMJs of fifteen elderly patients who were diagnosed with TMD were selected for the study. Patient with TMD were subjected to computerized tomographic (CT) imaging, and the various bony changes in the TMJ were recorded. CT study of TMJ showed that there is a positive evidence of joint involvement in 80% of the cases. In this study, female patients were more commonly affected by OA than the males. The condylar changes (69.93%) are more common than the changes in the articular eminence (6.6%) and condylar fossa (10%). About 56.6% of TMJ in the study was affected by the early manifestations of the OA. CT study showed that there is a positive evidence of TMJ involvement in the elderly patients with TMD. The results show that condylar changes are more common than the changes in the articular eminence and condylar fossa. The study also shows that most of the patients are affected by early TMJ OA; hence, initiating treatment at early stages may prevent the disease progression. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

  17. ALLOPLASTIC RECONSTRUCTION OF THE TEMPOROMANDIBULAR JOINT

    Directory of Open Access Journals (Sweden)

    Rushil R. DANG

    2017-12-01

    Full Text Available Temporomandibular joint reconstruction (TMJR is often necessary for patients with severe and/or refractory TMJ disease who have failed conservative treatment. TMJR aids to improve masticatory function and is associated with improved quality of life outcomes. Currently, alloplastic reconstruction is considered as the treatment of choice in most severe TMJ disorders due to its many advantages inclusive but not limited to early mobilization, stable longterm results, and significant improvement in jaw function. Broadly speaking, two types of TMJR prostheses are available for reconstruction: 1 stock, and, 2 custommade prostheses. The purpose of this article is to provide the reader with a brief overview of the basic principles and fundamentals of TMJR while referencing pertinent existing literature.

  18. Long-term followup of temporomandibular joint involvement in juvenile idiopathic arthritis

    NARCIS (Netherlands)

    M. Twilt (Marinka); A.J.M. Schulten; F. Verschure (Femke); L. Wisse (Lauke); B. Prahl-Andersen (Birte); L.W.A. van Suijlekom-Smit (Lisette)

    2008-01-01

    textabstractObjective. Temporomandibular joint (TMJ) involvement is a frequent feature in cross-sectional prevalence studies among patients with juvenile idiopathic arthritis (JIA). In this followup study, patients were reviewed after 5 years to study the course of TMJ involvement in relation to

  19. Long-term followup of temporomandibular joint involvement in juvenile idiopathic arthritis

    NARCIS (Netherlands)

    Twilt, M.; Schulten, A.J.M.; Verschure, F.; Wisse, L.; Prahl-Andersen, B.; van Suijlekom-Smit, L.W.A.

    2008-01-01

    Objective. Temporomandibular joint (TMJ) involvement is a frequent feature in cross-sectional prevalence studies among patients with juvenile idiopathic arthritis (JIA). In this followup study, patients were reviewed after 5 years to study the course of TMJ involvement in relation to disease

  20. COMPUTED-TOMOGRAPHY IN DIFFERENTIAL-DIAGNOSIS OF TEMPOROMANDIBULAR-JOINT DISORDERS

    NARCIS (Netherlands)

    DEBONT, LGM; VANDERKUIJL, B; STEGENGA, B; VENCKEN, LM; BOERING, G

    Computed tomography (CT) has great potential for imaging intra- and extracapsular hard-tissue abnormality of the temporomandibular joint (TMJ). CT is not the best method of imaging disk position and form. For differential diagnosis of TMJ disorders, CT is especially successful in bony lesions. The

  1. Osteoarthritis of the temporomandibular joint organ and its relationship to disc displacement

    NARCIS (Netherlands)

    Stegenga, B

    2001-01-01

    To overcome disagreements with regard to the relationship between disc displacement and osteoarthritis of the temporomandibular joint (TMJ), the evidence for suggested disease mechanisms and clinical course of these disorders is reviewed. The TMJ behaves as a complex organ in which biochemical and

  2. Biofeedback and Relaxation Therapy for Chronic Temporomandibular Joint Pain: Predicting Successful Outcomes.

    Science.gov (United States)

    Funch, Donna P.; Gale, Elliot N.

    1984-01-01

    Randomly assigned 57 patients with chronic temporomandibular joint (TMJ) pain to receive either relaxation or biofeedback therapy. Successful patients in the relaxation condition tended to be younger and had experienced TMJ pain for a shorter period of time than the successful biofeedback patients. (BH)

  3. Jacob's disease associated with temporomandibular joint dysfunction: a case report.

    Science.gov (United States)

    Capote, Ana; Rodríguez, Francisco J; Blasco, Ana; Muñoz, Mario F

    2005-01-01

    Jacob's disease is regarded a rare condition in which a joint formation is established between an enlarged mandibular coronoid process and the inner aspect of the zygomatic body. Chronic temporomandibular joint (TMJ) disk displacement has been proposed as etiological factor of coronoid process enlargement. We present a 23-year-old woman with long-standing TMJ dysfunction and restricted interincisal opening, who developed a progressive zygomatic asymmetry. The patient underwent treatment by intraoral coronoidectomy and homolateral TMJ arthroscopy in the same surgery. The histopathological diagnosis of the coronoid sample was cartilage-capped exostoses with presence of articular fibrous cartilage. Although the low prevalence of this entity, it should be considered as a possible diagnosis in patients with progressive limitation of mouth opening, although a TMJ syndrome may be present as a cause of this entity.

  4. HLA II class alleles in juvenile idiopathic arthritis patients with and without temporomandibular joint arthritis

    OpenAIRE

    D?vidsone, Zane; Egl?te, Je?ena; Lazareva, Arina; Dzelz?te, Sarm?te; ?antere, Ruta; B?rzi?a, Dace; Sta??vi?a, Valda

    2016-01-01

    Background Temporomandibular joint (TMJ) arthritis is seen very often (38?87?%) in children with juvenile idiopathic arthritis (JIA). With contrast enhanced magnetic resonance imaging (MRI) we can detect more cases of TMJ arthritis than ever before. Previous studies show that HLA II class alleles may have protective or risk importance in JIA subtypes. Our objective is to identify HLA II class alleles of risk and protection in JIA patients with TMJ arthritis. Methods During the period from 201...

  5. Measuring persistent temporomandibular joint nociception in rats and two mice strains

    OpenAIRE

    Kramer, Phillip R.; Kerins, Carolyn A.; Schneiderman, Emet; Bellinger, Larry L.

    2010-01-01

    Temporomandibular joint (TMJ) pain has been reported to last for prolonged periods in humans. In rodents a variety of methods have been used to measure TMJ nociception, but for most of these methods the period of measurement has been minutes to a couple of hours. In addition, most measurement protocols required restraint or training of the animal. Previous studies from our laboratory demonstrated that feeding behavior, particularly meal duration, was an indicator of TMJ nociception in unrestr...

  6. Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder

    OpenAIRE

    Wagner Cesar Munhoz; Amélia Pasqual Marques; José Tadeu Tesseroli de Siqueira

    2004-01-01

    Although the etiopathophysiology of internal temporomandibular joint internal disorders (TMJ ID) is still unknown, it has been suggested that head and body posture could be related to its initial onset, development and perpetuation. The purpose of the present study was to observe the relationship between cervical spine X-ray abnormalities and TMJ ID. This investigation evaluated 30 subjects with internal TMJ disorder symptoms (test group) and 20 healthy subjects (control group). Subjects were...

  7. Lubricin protects the temporomandibular joint surfaces from degeneration.

    Science.gov (United States)

    Hill, Adele; Duran, Juanita; Purcell, Patricia

    2014-01-01

    The temporomandibular joint (TMJ) is a specialized synovial joint essential for the mobility and function of the mammalian jaw. The TMJ is composed of the mandibular condyle, the glenoid fossa of the temporal bone, and a fibrocartilagenous disc interposed between these bones. A fibrous capsule, lined on the luminal surface by the synovial membrane, links these bones and retains synovial fluid within the cavity. The major component of synovial fluid is lubricin, a glycoprotein encoded by the gene proteoglycan 4 (Prg4), which is synthesized by chondrocytes at the surface of the articular cartilage and by synovial lining cells. We previously showed that in the knee joint, Prg4 is crucial for maintenance of cartilage surfaces and for regulating proliferation of the intimal cells in the synovium. Consequently, the objective of this study was to determine the role of lubricin in the maintenance of the TMJ. We found that mice lacking lubricin have a normal TMJ at birth, but develop degeneration resembling TMJ osteoarthritis by 2 months, increasing in severity over time. Disease progression in Prg4-/- mice results in synovial hyperplasia, deterioration of cartilage in the condyle, disc and fossa with an increase in chondrocyte number and their redistribution in clusters with loss of superficial zone chondrocytes. All articular surfaces of the joint had a prominent layer of protein deposition. Compared to the knee joint, the osteoarthritis-like phenotype was more severe and manifested earlier in the TMJ. Taken together, the lack of lubricin in the TMJ causes osteoarthritis-like degeneration that affects the articular cartilage as well as the integrity of multiple joint tissues. Our results provide the first molecular evidence of the role of lubricin in the TMJ and suggest that Prg4-/- mice might provide a valuable new animal model for the study of the early events of TMJ osteoarthritis.

  8. Lubricin protects the temporomandibular joint surfaces from degeneration.

    Directory of Open Access Journals (Sweden)

    Adele Hill

    Full Text Available The temporomandibular joint (TMJ is a specialized synovial joint essential for the mobility and function of the mammalian jaw. The TMJ is composed of the mandibular condyle, the glenoid fossa of the temporal bone, and a fibrocartilagenous disc interposed between these bones. A fibrous capsule, lined on the luminal surface by the synovial membrane, links these bones and retains synovial fluid within the cavity. The major component of synovial fluid is lubricin, a glycoprotein encoded by the gene proteoglycan 4 (Prg4, which is synthesized by chondrocytes at the surface of the articular cartilage and by synovial lining cells. We previously showed that in the knee joint, Prg4 is crucial for maintenance of cartilage surfaces and for regulating proliferation of the intimal cells in the synovium. Consequently, the objective of this study was to determine the role of lubricin in the maintenance of the TMJ. We found that mice lacking lubricin have a normal TMJ at birth, but develop degeneration resembling TMJ osteoarthritis by 2 months, increasing in severity over time. Disease progression in Prg4-/- mice results in synovial hyperplasia, deterioration of cartilage in the condyle, disc and fossa with an increase in chondrocyte number and their redistribution in clusters with loss of superficial zone chondrocytes. All articular surfaces of the joint had a prominent layer of protein deposition. Compared to the knee joint, the osteoarthritis-like phenotype was more severe and manifested earlier in the TMJ. Taken together, the lack of lubricin in the TMJ causes osteoarthritis-like degeneration that affects the articular cartilage as well as the integrity of multiple joint tissues. Our results provide the first molecular evidence of the role of lubricin in the TMJ and suggest that Prg4-/- mice might provide a valuable new animal model for the study of the early events of TMJ osteoarthritis.

  9. A new surgical classification for temporomandibular joint disorders.

    Science.gov (United States)

    Dimitroulis, G

    2013-02-01

    The role of temporomandibular joint (TMJ) surgery is ill-defined, so a universal classification is needed to collate the evidence required to justify the surgical interventions undertaken to treat TMJ disorders. The aim of this article is to introduce a new classification that divides TMJ disorders into 5 categories of escalating degrees of joint disease that can be applied to TMJ surgery. Using a category scale from 1 to 5, with category 1 being normal, and category 5 referring to catastrophic changes to the joint, the new classification will provide the basis for enhanced quantitative and descriptive data collection that can be used in the field of TMJ surgery research and clinical practice. It is hoped that this new classification will form the basis of what will eventually become the universal standard surgical classification of TMJ disorders that will be adopted by both researchers and clinicians so that ultimately, the role of TMJ surgery will be based on evidence rather than conjecture. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Analysis of pain in the rabbit temporomandibular joint after unilateral splint placement.

    Science.gov (United States)

    Henderson, Sarah E; Tudares, Mauro A; Gold, Michael S; Almarza, Alejandro J

    2015-01-01

    To determine whether behavioral, anatomical, and physiologic endpoints widely used to infer the presence of pain in rodent models of temporomandibular disorders (TMD) were applicable to the rabbit model of TMD associated with altered joint loading. Unilateral molar dental splints were used to alter temporomandibular joint (TMJ) loading. Changes in nociceptive threshold were assessed with a mechanical probing of the TMJ region on nine splinted and three control rabbits. Fos-like immunoreacitivty in the trigeminal subnucleus caudalis was assessed with standard immunohistochemical techniques from three splinted and six control animals. Retrogradely labeled TMJ afferents were studied with patch-clamp electrophysiologic techniques from three splinted and three control animals. Remodeling of TMJ condyles was assessed by histologic investigations of three splinted and three control animals. A Student t test or a Mann-Whitney U test was used with significance set at P joint degeneration. These compensatory changes may reflect pain-adaption processes that many patients with TMJ disorders experience.

  11. Pseudodynamic MR imaging of temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Nakasato, Tatsuhiko; Ehara, Shigeru (Iwate Medical Coll., Morioka (Japan). School of Medicine)

    1992-09-01

    Magnetic resonance (MR) imaging of the temporomandibular joint (TMJ) has now been established as a procedure of choice in the evaluation of TMJ disorders. In this study, we evaluated the dynamics of TMJ motion on MR imaging, which resembles arthrography. Sixty-eight TMJs in 38 symptomatic patients and one healthy volunteer were examined using pseudodynamic images with gradient echo sequences using a 0.5 Tesla MR unit and 8 cm circular planar surface coil. For depiction of each compartment of the meniscus, the optimum sequence was 200/15/2 (TR/TE/excitations) with 50 deg or 60 deg flip angle in gradient refocused acquisition in steady-state (GRASS) sequences. Three contiguous slices on sagittal MR images were routinely obtained at 14-18 different phases of the opening cycle and displayed in closed-loop cine fashion. Internal derangement was observed in 57% of 68 joints. The most common type was anterior meniscal displacement without reduction. Sideway and rotational displacements, observed in 10% each, were noted on both sagittal multislice images and axial reference images. As a pseudodynamic MR technique, jaw movement specifically designed to check bite procedure to adjust splints is useful for detecting the exact time of meniscal redisplacement on the second click. After conservative therapy for arthrosis, pseudodynamic MR provided information on changes in the meniscus and condylar relationship. Pseudodynamic MR with multiple phases is suitable for evaluating subtle motion abnormality of the meniscus and for post-therapeutic monitoring. (author).

  12. Effusion in magnetic resonance imaging of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Pusan National University College of Medicine, Busan (Korea, Republic of)

    2003-03-15

    The purpose of this study was to investigate the distribution and frequency of temporomandibular joint (TMJ) effusion in magnetic resonance (MR) images of patients with disc displacements. On T2 weighted MR images of 148 TMJs taken from 74 patients presenting with TMJ pain and dysfunction, we assessed the cases showing TMJ effusion, defined as an amount of fluid that exceeded the maximum amount seen in a control group of asymptomatic volunteers. The amount of TMJ fluid was graded as: I (none or minimal), II (moderate), III (marked), and IV (extensive), according to a standard set by a reference. Disc displacement categories were also recorded. Of the 148 TMJs examined in this study, 52 joints (35.1%) presented with joint effusion, 24 (16.2%) showing bilateral joint effusion. 38 joints showed upper joint space effusion, and 3 showed lower joint space effusion, and 11 showed both upper and lower joint space effusion. 96 joints (64.9%) had grade I joint fluid, 27 (18.2%) grade II, 15 (10.1%) grade III, and 10 (6.8%) grade IV. 80.0% of the joints presenting with grade IV effusion showed disc displacement without reduction. Joint effusion was found not only in upper, but also in lower joint spaces. The higher the effusion grade, the greater the frequency of disc displacement without reduction.

  13. Asymmetric uptake of Tc-99m HDP on temporomandibular joints may predict prognosis of temporomandibular joint disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Mi; Lee, Won Woo; Yun, PiI Young; Kim, Young Kyun; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    There is no reliable predictor for therapeutic efficacy for temporomandibular joint (TMJ) disease. The aim of the present study was to evaluate the usefulness of Tc-99m HDP bone scan in the pre-therapeutic assessment of prognosis for TMJ disease. Between January 2005 and July 2007, 94 patients (M: F=18: 76; mean age, 33.4{+-}14.0 y) with TMJ disease who underwent pre-therapeutic bone scan were enrolled. Planar bone scan images were obtained at right and left lateral skull areas 3 hours post Tc-99m HDP injection (dose=1295 MBq). TMJ uptake of Tc-99m HDP was quantitated using 13X13 pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratio was calculated as; (TMJ background) / background. Asymmetric indices for involved TMJ uptake (Al{sub invovle}) were defined as; TMJ uptake ratio of involved/non-involved joint. Asymmetric indices for greater TMJ uptake regardless of disease involvement (AI{sub greater}) were defined as; TMJ uptake ratio of greater/smaller TMJ uptake. Splint therapy was applied to all patients with mean duration of 7 months (range; 3-34 months). Therapeutic efficacy was dichotomised as improved or non-improved in consideration of mandibular movement, TMJ noise, pain, and tenderness. Seventy-six patients experienced improvement, whereas 18 patients non-improvement. There was no significant difference between improved versus non-improved patients regarding TMJ uptake ratio of involved joint (2.92{+-}0.82 vs. 2.91{+-}0.66), and AI{sub invovle} (1.16{+-}0.22 vs. 1.10{+-}0.12) (p>0.05, t-test). However, AI{sub greater} was significantly higher in improved patients than non-improved patients (1.20{+-}0.19 vs. 1.13{+-}0.09, p<0.05, t-test). Regardless of disease involvement of TMJ disease, asymmetricities of Tc-99m HDP uptake were more frequently found in improved group after splint therapy. Tc-99m HDP bone scan can predict the efficacy of splint therapy in TMJ disease.

  14. Spontaneously developed osteoarthritis in the temporomandibular joint in STR/ort mice

    OpenAIRE

    Kumagai, Kenichi; Suzuki, Satsuki; KANRI, YORIAKI; Matsubara, Ryota; Fujii, Keisuke; WAKE, MASAHIRO; Suzuki, Ryuji; Hamada, Yoshiki

    2015-01-01

    Temporomandibular joint (TMJ) osteoarthritis is typically a slowly progressive asymmetric disease. Little is known regarding the natural destruction of TMJ articular tissues. The aim of the present study was to investigate morphological changes in the TMJ of STR/ort mice, known to be the model for spontaneous osteoarthritis in the knee joint, and to evaluate STR/ort mice as a suitable animal model for TMJ osteoarthritis. TMJs from 32 STR/ort mice euthanized at 30, 40, 50 or 60 weeks of age, a...

  15. STRATEGIES FOR COPING WITH PAIN AND PSYCHOLOGICAL DISTRESS ASSOCIATED WITH TEMPOROMANDIBULAR-JOINT OSTEOARTHROSIS AND INTERNAL DERANGEMENT

    NARCIS (Netherlands)

    JASPERS, JPC; HEUVEL, F; STEGENGA, B; DEBONT, LGM

    Objective: To analyse the relationship among a variety of emotional, cognitive, and behavioral coping strategies and pain/suffering and psychological distress in patients with temporomandibular joint (TMJ) pain. Design: Cross-sectional, correlational study. Setting: Department of Oral and

  16. Effects of Condylar Elastic Properties to Temporomandibular Joint Stress

    Directory of Open Access Journals (Sweden)

    Min Zhang

    2009-01-01

    Full Text Available Mandibular condyle plays an important role in the growth and reconstruction of the temporomandibular joint (TMJ. We aimed to obtain orthotropic elastic parameters of the condyle using a continuous-wave ultrasonic technique and to observe the effects of condylar elastic parameters on stress distribution of the TMJ using finite element analysis (FEA. Using the ultrasonic technique, all nine elastic parameters were obtained, which showed that the mandibular condyle was orthotropic. With the condyle defined as orthotropic, the occlusal stress was transferred fluently and uniformly from the mandible to the TMJ. The stress distribution in the isotropic model showed stepped variation among different anatomical structures with higher stress values in the cartilage and condyle than in the orthotropic model. We conclude that anisotropy has subtle yet significant effects on stress distribution of the TMJ and could improve the reality of simulations.

  17. Roentgenographic study of the temporomandibular joint in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

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

    1984-11-15

    For the study of the temporomandibular joint in rheumatoid arthritis 30 patients were selected who were diagnosis as rheumatoid arthritis through the clinical, radiographic examination and laboratory finding. Temporoman dibular joint involvement was evaluated through the clinical, radiographic examination. The results were as follows; 1. TMJ was involved in 15 patients of 30 patients with rheumatoid arthritis. (50% involvement). 2. Duration of rheumatoid arthritis was more longer in patients with TMJ involvement than in patients without TMJ involvement. 3. Osseous changes in TMJ were in order of frequency erosion, flattening, osteophyte, sclerosis, deformity, and most common involved site was mandibular condyle. 4. Most common positional change of condyle was forward position in centric occlusion, and restricted movement of condyle in 1 inch mouth opening. 5. TMJ involvement of rheumatoid arthritis was almost bilateral. 6. Main symptoms of TMJ were pain, stiffness, tenderness, limitation of mouth opening, crepitation. 7. There was not the case of ankylosis. 8. There was statistically insignificant correlation between mandibular deviation and TMJ involvement, but some cases showed severe deviation on mouth opening.

  18. Cytopathologic diagnosis on joint lavage fluid for patients with temporomandibular joint disorders.

    Science.gov (United States)

    Mikami, Toshinari; Kumagai, Akiko; Aomura, Tomoyuki; Javed, Fawad; Sugiyama, Yoshiki; Mizuki, Harumi; Takeda, Yasunori

    2014-01-01

    Temporomandibular joint (TMJ) disorders (TMD) are usually diagnosed based on the patient's clinical findings and the results of image investigations; however, understanding of the inflammatory process in TMJ is difficult. In addition, many of the TMJ disease types share common principal symptoms. Therefore, TMJ diseases in the early stage can be misdiagnosed with TMD. It is hypothesized that cytopathologic examination of the joint lavage fluids is useful in interpreting the TMD-associated inflammatory process from a cellular aspect. The aim of this study was to assess the TMJ lavage fluid cytopathologically in TMD patients. Thirty-nine patients, clinically diagnosed as TMD, were included in the present study. Clinical symptoms of the patients were recorded. Forty-four samples of TMJ lavage fluid were collected and paraffin-embedded cell sections were made by cell block tissue array method. Cytologic conditions in upper articular cavity of TMJ were cytopathologically diagnosed and were compared with the clinical symptoms of each patient. Cell components were detected in 22 of the 44 analyzed joint lavage fluids. There was a correlation between cytopathologic findings and clinical symptoms. Variety of cytopathology and inflammatory conditions in patients with similar clinical symptoms were also found. The results suggested that cytopathologic examination of the joint lavage fluids from TMD patients is helpful for gaining an understanding of the inner local conditions of TMJ at the cellular level. Copyright © 2013 Wiley Periodicals, Inc.

  19. MR findings of the temporomandibular joint with crepitus

    Energy Technology Data Exchange (ETDEWEB)

    Sano, Tsukasa; Yamamoto, Mika; Yamaga, Takayoshi; Takahashi, Koji; Masuda, Saeko; Tagaya, Atsuko; Michi, Ken-ichi; Okano, Tomohiro [Showa Univ., Tokyo (Japan). School of Dentistry

    1997-06-01

    Crepitus is an important sign for diagnosis of arthrosis of the temporomandibular joint (TMJ). The presence of crepitus can be evaluated by the listening test previously proposed by our group. However, TMJ can be diagnosed by MR imaging showing the disc position and related findings including bony changes and joint effusion. This study investigated the relationship between the presence of crepitus and pathology of the joint. Fourteen joints with crepitus diagnosed by the listening test were examined in this study. TMJ was categorized into four types based on findings on double spin echo MR images. The results were as follows: Of fourteen joints with crepitus, five (36%) were showed as normal superior disc position. The remaining 9 joints (64%) were diagnosed with disc displacement, of which, 6 showed reduction, one was without reduction and 2 without reduction were associated with arthrosis. Statistical analysis using the data obtained here and other data showed that the joints with crepitus tended to show disk displacement. There was no significant difference between the degree of certainty about the presence of the crepitus and the distribution of joint pathology. Joint effusion was observed only in the joints with displacement. These results indicated that TMJ with crepitus is associated with varied joint pathology. (author)

  20. Causes of persistent joint pain after arthrocentesis of temporomandibular joint.

    Science.gov (United States)

    Honda, Kosuke; Yasukawa, Yoko; Fujiwara, Masanori; Abe, Tetsuya; Urade, Masahiro

    2011-09-01

    The present study was undertaken to elucidate the factors responsible for the failure of arthrocentesis to cure persistent joint pain in patients with nonreducing articular disc displacement in the temporomandibular joint (TMJ). Thirty-six patients with internal derangement of the TMJ were selected. Magnetic resonance imaging was used to examine the configuration and position of the articular discs, cortical changes, and bone marrow abnormalities in the condyle and the presence of joint effusion. Arthrocentesis was then performed, and the patients were followed for 6 weeks. The results were then classified as poor or improved. The effects of arthrocentesis did not depend on the configuration of the disc, disc position and motion, or bone marrow abnormalities. Joints with no or minimal amounts of joint effusion achieved a good response to arthrocentesis. Joints with erosive cortical changes of the condyle were less responsive to arthrocentesis. Persistent joint pain after arthrocentesis is generally associated with extensive amounts of joint effusion or erosive cortical changes of the condyle. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. MR of 2270 TMJs: prevalence of radiographic presence of otomastoiditis in temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Orhan, Kaan [Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ankara University, 06500 Besevler, Ankara (Turkey)]. E-mail: call53@yahoo.com; Nishiyama, Hideyoshi [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Tadashi, Sasaki [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Shumei, Murakami [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan); Furukawa, Souhei [Department of Oral Maxillofacial Radiology, Graduate School of Dentistry, Osaka University, Osaka (Japan)

    2005-07-01

    Objective: : The purpose of this study is to determine the prevalence of radiographic presence of otomastoiditis while examining temporomandibular joint (TMJ) disorders in magnetic resonance images (MRI) in a series of 2270 temporomandibular joint magnetic resonance images and to examine the relationship between otomastoiditis and TMJ disorders. Materials and methods: : 2270 temporomandibular joint magnetic resonance images and patients' data were retrospectively investigated. Magnetic resonance images were obtained from the patients who referred to Osaka University Dental Hospital Outpatient Clinic with TMJ complaints for the last four years (from January 1998 to January 2003). The patients, who were diagnosed as otomastoiditis based on their temporomandibular joint magnetic resonance images, were sent to Osaka University Hospital Department of Otolaryngology for a medical consultation in order to have their pathologies certified following their MR process. Age and sex were recorded for all patients and for otomastoiditis cases; location of the disease, symptoms of patients and TMJ findings were noted as well. Results: : Seven patients were diagnosed as acute otomastoiditis and one patient diagnosed as chronic active otitis media with cholesteatoma in the series of 2270 MR, which were representing a prevalence of 0.39%. Neurilemoma diagnosed in left mastoid process in one patient. The final diagnoses of all patients were made after medical consultation. Conclusion: : While examining temporomandibular joint magnetic resonance images; it is not only important to examine just the TMJ structures, but also to look at the nearby anatomical features to check evidence for inflammatory disease.

  2. A study of the temporomandibular joint during bruxism.

    Science.gov (United States)

    Commisso, María S; Martínez-Reina, Javier; Mayo, Juana

    2014-06-01

    A finite element model of the temporomandibular joint (TMJ) and the human mandible was fabricated to study the effect of abnormal loading, such as awake and asleep bruxism, on the articular disc. A quasilinear viscoelastic model was used to simulate the behaviour of the disc. The viscoelastic nature of this tissue is shown to be an important factor when sustained (awake bruxism) or cyclic loading (sleep bruxism) is simulated. From the comparison of the two types of bruxism, it was seen that sustained clenching is the most detrimental activity for the TMJ disc, producing an overload that could lead to severe damage of this tissue.

  3. Women with more severe degrees of temporomandibular disorder exhibit an increase in temperature over the temporomandibular joint

    OpenAIRE

    Dibai-Filho, Almir Vieira; Costa, Ana Cláudia de Souza; Packer, Amanda Carine; de Castro, Ester Moreira; Rodrigues-Bigaton, Delaine

    2014-01-01

    Aim: The purpose of the present study was to correlate the degree of temporomandibular disorder (TMD) severity and skin temperatures over the temporomandibular joint (TMJ) and masseter and anterior temporalis muscles. Materials and methods: This blind cross-sectional study involved 60 women aged 18–40 years. The volunteers were allocated to groups based on Fonseca anamnestic index (FAI) score: no TMD, mild TMD, moderate TMD, and severe TMD (n = 15 each). All volunteers underwent infrared t...

  4. Does Unilateral Temporomandibular Total Joint Reconstruction Result in Contralateral Joint Pain and Dysfunction?

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    Perez, Daniel E; Wolford, Larry M; Schneiderman, Emet; Movahed, Reza; Bourland, Campbell; Gutierrez, Enrique Perez

    2016-08-01

    The purpose of this study was to evaluate patients requiring unilateral total temporomandibular joint (TMJ) reconstruction and the risk for development of postsurgical contralateral TMJ pain and dysfunction over time requiring subsequent contralateral total joint reconstruction. Long-term subjective and objective outcomes of unilateral TMJ reconstruction also were evaluated. Seventy patients underwent unilateral total joint reconstruction using a patient-fitted total joint prosthesis from a single private practice from 1990 through 2012. The inclusion criteria were 1) unilateral TMJ reconstruction with TMJ Concepts or Techmedica patient-fitted total joint prosthesis; 2) operation performed by 1 surgeon (L.M.W.); 3) minimum 12-month follow-up; and 4) adequate records. There were no specific exclusion criteria. The primary outcome variable was to evaluate the effects of unilateral TMJ reconstruction with a total joint prosthesis on the contralateral TMJ relative to development of pain and dysfunction requiring subsequent contralateral reconstruction with a total joint prosthesis. Secondary outcome variables for all patients included TMJ pain, facial pain, headaches, diet, disability, quality of life, maximum incisal opening (MIO), and lateral excursion movements after unilateral TMJ reconstruction with the patient-fitted total joint prosthesis. Student t test and Wilcoxon test were used for statistical analyses, with a P value less than .01 for statistical significance. Sixty-one of 70 patients (87%) met the inclusion criteria (47 women [77%] and 14 men [23%]; average age, 38 yr; age range, 11 to 69 yr; average follow-up, 44 months; range, 12 to 215 months). Eight of 61 patients (13%) subsequently required contralateral TMJ reconstruction with a total joint prosthesis related to contralateral pain, dysfunction, and arthritis, but all 8 (8 of 27 [29.6%]) had previous contralateral TMJ disc repositioning surgery. For the secondary outcomes, TMJ pain decreased 63

  5. Outcomes of temporomandibular joint arthroscopy in patients with painful but otherwise normal joints.

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    Dimitroulis, George

    2015-07-01

    The aim of this retrospective clinical study was to assess the clinical outcomes of temporomandibular joint (TMJ) arthroscopy in patients who presented with category 1 normal joints. The null hypothesis being tested was that patients with normal joints do not respond to TMJ arthroscopy. The clinical records of 116 patients who had undergone TMJ arthroscopy by the author from 2010 to 2013 were retrieved and individually analysed for inclusion in this retrospective, cohort clinical study. The inclusion criteria used to select patients for this study were those who had arthroscopically proven category 1 normal joints, free of intra-articular pathology. Of the 14 patients who were found to have normal joints, only 10 could be contacted for a follow-up survey. Despite the fact that all patients were informed that no joint pathology was found, six out of the 10 patients reported improvement in their temporomandibular disorder (TMD) symptoms that lasted for more than 6 months following TMJ arthroscopy. The results of this investigation indicate that we can reject the null hypothesis, and that patients with normal TMJs do indeed respond to TMJ arthroscopy. What this limited study has highlighted is the pervasive effects of the placebo that all surgeons need to keep in mind when formulating treatment plans for patients with TMD. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  6. Characterization of Degenerative Changes in the Temporomandibular Joint of the Bengal Tiger (Panthera tigris tigris) and Siberian Tiger (Panthera tigris altaica)

    OpenAIRE

    Murphy, M. K.; Arzi, B.; Vapniarsky-Arzi, N.; Athanasiou, K. A.

    2013-01-01

    The articulation of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally and a fibrous articular disc. The TMJ disc plays an essential role in distributing load between the two articular surfaces. Degeneration of the disc in the presence of joint pathology has been shown in man; however, TMJ pathology has not been documented previously in tigers ( Panthera tigris). The mandibular condyle and TMJ disc of a Bengal tiger ( P. tigris tigris...

  7. Clinical evaluation of double-contrast computed tomography of the temporomandibular joint

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    Ohnishi, Masatoshi; Nakayama, Eiji; Ohtuki, Kayoko

    1989-01-01

    Soft tissue pathology should be appreciated in diagnosing temporomandibular joint (TMJ) disease. For this purpose, contrast arthrography is useful and we also have introduced double-contrast arthrotomography of the TMJ. X-ray computed tomography (CT), on the other hand, is well suited to the diagnosis of TMJ disease, because it can clearly delineate both hard and soft tissues. We thus introduce direct sagittal CT of the head with the enhancement of the articular space of the TMJ using negative and positivse contrast media and confirmed that this method is very useful for the diagnosis of TMJ disease. In this paper we principally investigate the suitability of this double-contrast computed tomography of the TMJ. We conclude that double-contrast CT technique is equally or more useful in some cases than single-contrast CT technique in the diagnosis of TMJ disease.

  8. Risk factors for temporomandibular joint arthritis in children with juvenile idiopathic arthritis.

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    Stoll, Matthew L; Sharpe, Tyler; Beukelman, Timothy; Good, Jennifer; Young, Daniel; Cron, Randy Q

    2012-09-01

    To determine the prevalence and features of temporomandibular joint (TMJ) arthritis by magnetic resonance imaging (MRI) among children with juvenile idiopathic arthritis (JIA), and to identify risk factors for TMJ arthritis. A retrospective chart review was performed on 187 patients with JIA who underwent a TMJ MRI at Children's Hospital of Alabama between September 2007 and June 2010. Demographic and clinical information was abstracted from the charts. Univariate and multivariate analyses were performed to identify risk factors for TMJ arthritis identified by MRI. MRI evidence of TMJ arthritis was detected in 43% of patients, with no significant difference among JIA categories. The number of joints with active arthritis (exclusive of the TMJ) and the use of systemic immunomodulatory therapies were not associated with TMJ arthritis. Multivariable analysis revealed a strong association between mouth-opening deviation and TMJ arthritis (OR 6.21, 95% CI 2.87-13.4). A smaller maximal incisal opening and shorter disease duration were also associated with an increased risk of TMJ arthritis. TMJ arthritis was identified in a substantial proportion of children with JIA (43%) and affects all JIA categories. TMJ arthritis was present in some patients despite limited or otherwise quiescent disease and in the presence of concurrent systemic immunomodulatory therapy. Routine evaluation for TMJ arthritis by MRI is warranted for all children with JIA.

  9. Temporomandibular joint synovitis in patients with Crohn's disease : a case report

    OpenAIRE

    金澤, 香; 柴田, 考典; 櫻井, 博理; 吉澤, 信夫; カナザワ, カオル; シバタ, タカノリ; サクライ, ヒロマサ; ヨシザワ, ノブオ; Kaoru, KANAZAWA; Takanori, SHIBATA; Hiromasa, SAKURAI; Nobuo,YOSHIZAWA

    2004-01-01

    We report a case of bilateral temporomandibular joint (TMJ) synovitis in a patient with Crohn's disease. The patient was an eighteen year old male, who had been diagnosed with Crohn's disease in February 1992 at Yamagata University Medical Hospital. The patient complained of jaw opening pain of the bilateral TMJ, and was referred to the Department of Oral and Maxillofacial Surgery of the Hospital. The magnetic resonance images demonstrated severe joint effusion in the upper and lower compartm...

  10. Temporomandibular Joint, Closed

    Science.gov (United States)

    ... NIDCR Home Oral Health Diseases and Conditions Gum Disease TMJ Disorders Oral Cancer Dry Mouth Burning Mouth Tooth Decay See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/ ...

  11. Temporomandibular Joint, Open

    Science.gov (United States)

    ... NIDCR Home Oral Health Diseases and Conditions Gum Disease TMJ Disorders Oral Cancer Dry Mouth Burning Mouth Tooth Decay See All Oral Complications of Systemic Diseases Cancer Treatment Developmental Disabilities Diabetes Heart Disease HIV/ ...

  12. A rat model of temporomandibular joint pain with histopathologic modifications.

    Science.gov (United States)

    Nicoll, Steven B; Hee, Christopher K; Davis, Martin B; Winkelstein, Beth A

    2010-01-01

    To develop a rat model of temporomandibular joint (TMJ) pain and to characterize in it the development and temporal response of behavioral hypersensitivity as well as to evaluate if and to what extent a loading protocol is associated with histological changes in the TMJ consistent with osteoarthritic pathology. A novel rat model of TMJ pain was developed using a noninvasive, mechanical loading protocol. Rats were exposed to steady mouth-opening for 7 days (2 N force, 1 hour/day), and mechanical hyperalgesia (increased pain response) was measured during the loading period and for 14 days thereafter. Histological modifications in the joint cartilage were also evaluated. Outcomes for the mouth-opening exposure were compared to age-matched controls. Thresholds for evoking responses were compared using a ranked ANOVA with repeated measures. Increased mechanical hypersensitivity in the temporomandibular region developed during daily loading and persisted even after the termination of the loading protocol. Histologic characterization revealed thinning of the cartilaginous structures of the joint and irregular zonal cellular arrangements in the condylar cartilage of rats subjected to the daily loading protocol. The injury model presented here is the first to demonstrate mechanically-induced behavioral hypersensitivity accompanied by osteoarthritic pathology in the TMJ.

  13. Diclofenac sodium as an alternative treatment of temporomandibular joint pain.

    Science.gov (United States)

    Ekberg, E C; Kopp, S; Akerman, S

    1996-06-01

    In a double-blind study, diclofenac sodium (Voltaren), 50 mg two or three times a day, was compared with placebo in 32 patients with pain localized to the temporomandibular joint (TMJ). The patients were allocated into two equally large groups. A visual analog scale was used to estimate the pretreatment degree of pain. The treatment effect was assessed as the frequency of joint and muscle pain and by the patients' own evaluation of improvement. The change in the clinical condition was assessed by tenderness to palpation of the TMJ and masticatory muscles and by mandibular mobility. The frequency of TMJ pain showed a greater reduction in the diclofenac group than in the placebo group, and there was a significant reduction of daily TMJ pain in the diclofenac group. The diclofenac group also showed a significant decrease in tenderness to palpation of the masticatory muscles in comparison with the placebo group. The patients with short duration of pain showed the best response to diclofenac. There was no evidence in this study to prove that diclofenac should be used as a primary treatment of TMJ pain, but it could be used as a complement to other treatments of acute TMJ pain.

  14. Magnetic resonance imaging and ultrasonography in the diagnosis of temporomandibular joint internal derangements: A comparative study

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    Altaf Hussain Chalkoo

    2015-01-01

    Full Text Available Objective: The purpose of the study was to compare high-resolution ultrasonography (HR-USG with magnetic resonance imaging (MRI in the diagnosis of temporomandibular joint (TMJ internal derangements. Materials and Methods: The study was conducted on 11 subjects with a chief complaint of TMJ discomfort, who were diagnosed as having TMJ internal derangement according to clinical diagnostic criteria (CDC for temporomandibular disorders (TMD. A control group of eight subjects who had no sign of TMJ internal derangement were also examined. Imaging modalities (MRI and HR-USG were performed on all the subjects (cases and controls. Results: Strong agreement was found between MRI and HR-USG in the diagnosis of TMJ internal derangements (k = 0.918, P < 0.001. Conclusion: MRI and HR-USG can be used to define the disc and its displacement.

  15. Temporomandibular joint involvement in Juvenile Idiopathic Arthritis: reliability and validity of a screening protocol for the rheumatologist.

    NARCIS (Netherlands)

    Steenks, M.H.; Giancane, G.; Leeuw, R.R. de; Bronkhorst, E.M.; Es, R.J. van; Koole, R.A.; Bruggen, H.W. van; Wulffraat, N.M.

    2015-01-01

    BACKGROUND: In Juvenile Idiopathic Arthritis (JIA) the temporomandibular joint (TMJ) can be involved leading to pain, dysfunction and growth disturbances of the mandible and associated structures. There may be value to a three minute screening protocol allowing the rheumatologist to detect TMJ

  16. Temporomandibular joint involvement in Juvenile Idiopathic Arthritis : reliability and validity of a screening protocol for the rheumatologist

    NARCIS (Netherlands)

    Steenks, Michel H.; Giancane, G; de Leeuw, Rob R. J.; Bronkhorst, Ewald M.; van Es, Robert J. J.; Koole, Ron; van Bruggen, H. Willemijn; Wulffraat, NM

    2015-01-01

    Background: In Juvenile Idiopathic Arthritis (JIA) the temporomandibular joint (TMJ) can be involved leading to pain, dysfunction and growth disturbances of the mandible and associated structures. There may be value to a three minute screening protocol allowing the rheumatologist to detect TMJ

  17. Facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint involvement

    DEFF Research Database (Denmark)

    Hsieh, Yuh-Jia; Darvann, Tron Andre; Hermann, Nuno V.

    2016-01-01

    Introduction: The aims of this study were to (1) assess lateral facial morphology in children and adolescents with juvenile idiopathic arthritis and moderate to severe temporomandibular joint (TMJ) involvement, (2) compare the lateral facial morphology of these subjects with and without TMJ invol...

  18. The Effects of Unilateral Alloplastic Temporomandibular Joint Replacement on the Opposite-Side Natural Joint: A Finite-Element Analysis.

    Science.gov (United States)

    Bekcioglu, Burak; Bulut, Emel; Bas, Burcu

    2017-11-01

    The purpose of this study was to evaluate the stress distribution on the temporomandibular joint (TMJ) prosthesis and contralateral natural TMJ with finite-element analysis. A TMJ implant was used to create a 3-dimensional model with a computer. This model was integrated with a mandible model created with a computer by use of computed tomography images, similar to a real TMJ replacement procedure. Masticatory loads were applied to the model. The loads transmitted to the TMJ prosthesis and contralateral healthy joint were evaluated by means of finite-element analysis. In the model without the TMJ prosthesis, maximum von Mises stress was 252.697 N/mm(2) at the condyle and 5.418 N/mm(2) at the disc. In the model with the unilateral TMJ prosthesis, maximum stress at the joint prosthesis was 792.681 N/mm(2). In the contralateral natural joint, maximum stress was 268.908 N/mm(2) at the condyle and 8.357 N/mm(2) at the disc. In the TMJ model with the unilateral total TMJ prosthesis, increased stress values were observed at the disc and condyle of the contralateral natural TMJ. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Temporomandibular joint dysfunction in Moebius syndrome.

    Science.gov (United States)

    Di Blasio, A; Cassi, D; Di Blasio, C; Gandolfini, M

    2013-12-01

    Moebius syndrome is a rare condition characterised by bilateral facial and abducens nerve paralysis. In the present study, it was investigated the effect of the long term facial muscles hypoactivity on temporomandibular joint movements development. Accordingly with Terzis classification (Terzis, 2003), a wide sample of A type and B type Moebius patients was investigated for mandibular range of movements. Moebius patients were compared with a sample of healthy subjects. Both type A and type B Moebius patients develop a severe articular movement reduction, especially during mouth opening. A highly significant difference was found between Moebius patients and the healthy group. No difference was found between A and B Moebius sub-samples. The authors stress the importance of an early adequate rehabilitation of Moebius patients, in order to avoid the limitation of TMJ movement range.

  20. Psychoneuroimmunological disorders and temporomandibular joint pain: A review

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    Ranjani Shetty

    2014-01-01

    Full Text Available Psychoneuroimmunology characterizes a disease entity that combines psychological components, central nervous system regulation, and immunology, to explain the etiological complexity of a disease. Temporomandibular disorders (TMDs include a heterogeneous group of painful conditions that involve the temporomandibular joint (TMJ, muscles of mastication, and the adjacent anatomic structures. This review focuses on the psychoneuroimmunological diseases and disorders that mimic the symptoms of TMDs. The differentiation of these disorders is of great significance to the oral physician - differentiating and diagnosing the cause of TMJ pain and treating it effectively to benefit the patient.The literature for this review was taken from Medline/PubMed, other indexed journals, standard text books, and online material.

  1. [Physical therapy for temporomandibular joint anterior disc displacement without reduction].

    Science.gov (United States)

    Cai, B

    2017-03-09

    Temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDwoR) is a common type of temporomandibular joint disorders. Most patients experience limited mouth opening and joint pain at the same time. The standpoint of physical therapy is the function of the joint instead of the displaced disc. The treatment aims to make symptoms disappeared and joint function regained through 3M techniques, including modality, manual and movement. For ADDwoR patients with limited mouth opening within 2 month, manual therapy may reposition disc and the following splint and movement therapy can maintain disc-condyle relationship. Even so, restoring anatomical relationship is not the end of physical therapy. Enhanced health education and multidisciplinary cooperation are important for successful management of the ADDwoR patients.

  2. Does Hypoxia-Reperfusion Injury Occur in Osteoarthritis of the Temporomandibular Joint?

    NARCIS (Netherlands)

    Vos, Lukas M.; Slater, James J. R. Huddleston; Leijsma, Martha K.; Stegenga, Boudewijn

    2012-01-01

    Aims: To determine the available evidence in the literature for whether hypoxia-reperfusion injury plays a role in the pathogenesis of joint diseases in general and of osteoarthritis (OA) of the temporomandibular joint (TMJ) in particular. Methods: The electronic databases CENTRAL, PubMed, and

  3. Arthroscopic cauterization of retrodiscal tissue as a successful minimal invasive therapy in habitual temporomandibular joint luxation

    NARCIS (Netherlands)

    Ybema, A.; De Bont, L. G. M.; Spijkervet, F. K. L.

    Habitual temporomandibular joint (TMJ) luxation is a serious condition for the patient, and is often managed by extensive open joint surgery. Arthroscopic eminoplasty is an alternative, but this technique could also cause concomitant damage to the articular surface. The aim of this study was to

  4. Temporomandibular joint ankylosis in child: A case report

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    Rahul J Hegde

    2015-01-01

    Full Text Available Background: Ankylosis of the temporomandibular joint (TMJ is an intracapsular union of the disc-condyle complex to the temporal articular surface that restricts mandibular movements, including the fibrous adhesions or bony fusion between condyle, disc, glenoid fossa, and eminence. It is a serious and disabling condition that may cause problems in mastication, digestion, speech, appearance, and hygiene. Case Report: This report describes a case of a 12-year-old girl with inability to open her mouth, diagnosed with unilateral right bony TMJ ankylosis. The surgical approach consisted of gap arthroplasty with interpositional temporalis muscle flap followed by vigorous physiotherapy. Conclusion: The treatment of TMJ ankylosis poses a significant challenge because of technical difficulties and a high incidence of recurrence. Its treatment includes the orthodontist, oral and maxillofacial surgeon, pediatric dentist, and psychologist and physical therapist as part of the healthcare team.

  5. Dual joint space arthrography in temporomandibular joint disorders: Comparison with single inferior joint space arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hyung Sik; Chang, Duk Soo; Lee, Kyung Soo; Kim, Woo Sun; Sung, Jung Ho; Jun, Young Hwan [Capital Armed Forces General Hospital, Seoul (Korea, Republic of)

    1989-02-15

    The temporomandibular joint(TMJ) is really a complex of two synovial space separated by fibrocartilaginous disc. Single inferior joint space arthrography is commonly performed for evaluation of TMJ disorders, which is known to be superior in demonstrating joint dynamics. But it reveals only the inferior surface of the disc. Therefore, dual space arthrography is superior to demonstrate the soft tissue anatomic feature of the joint such as disc position and shape. Authors performed 83 TMJ arthrograms in TMJ problems. Initially, the inferior joint space was done and then the superior space was sequentially contrasted. The follow results were noted: 1. In all cases, dual space arthrography revealed accurate disc shape and positions. 2. Concordant findings between the two techniques: 68 cases (82%). Discordance between the two techniques: 15 cases (18%) 3. Possible causes of discordance between inferior and dual space arthrography. a) Normal varians of anterior recess: 3 cases b) Posterior disc displacement: 4 cases c) Influence of the patient's head position change :4 cases d) False perforation: 2 cases e) Reduction change: 2 cases 4. In 5 cases with anterior displacement, dual space arthrography gave additional findings such as adhesion within the superior space, which could not be evaluated by single inferior space.

  6. Sustained Inflammation Induces Degeneration of the Temporomandibular Joint

    Science.gov (United States)

    Wang, X.D.; Kou, X.X.; Mao, J.J.; Gan, Y.H.; Zhou, Y.H.

    2012-01-01

    The temporomandibular joint (TMJ) undergoes degenerative changes among patients who suffer from arthritis, and yet the pathogenesis of TMJ osteoarthritis and rheumatoid arthritis is poorly understood. We hypothesized that sustained inflammation in the TMJ induces structural abnormalities, and accordingly characterized the disc and synovium in a novel model with double injections of complete Freund’s adjuvant (CFA), using behavioral, morphological, cellular, and molecular assessments. Thirty-five days following double CFA injections in seven-week-old female Sprague-Dawley rats, the disc in the CFA-induced inflammation group demonstrated multiple degenerative changes, including marked thickening, opacity, and deformation. The discs in the CFA group further showed significantly greater wet and net weights, and elevated collagen, aggrecan, and total glycosaminoglycan contents. The synovium in the CFA-induced inflammation group showed marked infiltration of mononucleated cells and accumulated sub-synovial adipose tissue. Both the disc and synovium had significantly higher iNOS and IL-1β mRNA expression than controls (saline injections). These findings are consistent with our hypothesis that sustained TMJ inflammation, even within the presently observed 35 days, may be a predisposing factor for structural abnormalities. Insight into TMJ inflammation and degeneration is anticipated to improve our understanding of the pathogenesis of TMJ arthritis and help design clinically relevant strategies for tissue engineering. PMID:22427270

  7. Critical assessment of temporomandibular joint clicking in diagnosing anterior disc displacement.

    Science.gov (United States)

    Kobs, Giedre; Bernhardt, Olaf; Kocher, Thomas; Meyer, Georg

    2005-01-01

    The objective of this study was to compare temporomandibular joint (TMJ) findings from clinical examination and magnetic resonance imaging (MRI) for diagnosing anterior disc displacement. 114 subjects with at least one sign of temporomandibular disorders (tenderness/pain on palpation of the joints or muscles, TMJ sounds, pain or deviation during maximum mouth opening (active/passive)) and 193 controls underwent MRI after proper history taking and assessment of clinical symptoms. 464 joints with no disk displacement (NDD), 114 joints with reducible displaced disk (RDD), and 36 joints with permanently displaced disk (PDD) were confirmed on magnetic resonance imaging (MRI). The results suggest that anterior disc displacement of the TMJ can not be diagnosed with considerable accuracy through the use of clinical examination only.

  8. Post-traumatic changes of the temporo-mandibular joint by bone scintigraphy

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    Harris, S.A.; Rood, J.P.; Testa, H.J.

    1988-01-01

    13 patients who sustained mandibular trauma were investigated with radiographs and scintiscans. The scintiscans showed abnormal uptake of radiopharmaceutical in the temporomandibular joint (TMJ). In patients with a long history of traumatic arthrosis, there was more positive correlation between the scintiscans, and clinical symptoms and histology than between radiographs, and symptoms and histology. In patients with mandibular body fractures and no TMJ symptoms, the scans showed abnormal uptake in the TMJ in 7/8 joints, in the absence of radiographic abnormality. The significance of the abnormal uptake and the value of scintigraphy is discussed.

  9. A comparison of clinical symptoms and magnetic resonance images in temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yong Suk; Hwang, Eui Hwan; Lee, Sang Rae [Kyunghee University College of Medicine, Seoul (Korea, Republic of)

    2003-06-15

    To determine the relationship between clinical symptoms and magnetic resonance (MR) images in patients presenting with temporomandibular joint (TMJ) disorders. This study was based on 172 joints in 86 patients presenting with TMJ disorders. Joint pain and sound during jaw opening and closing movements were recorded, and the possible relationship between disc positions and bony changes of the condylar head and the articular fossa in MR images in the oblique sagittal planes were examined. Data were analyzed by Chi-square test. There was no statistically significant relationship between clinical symptoms and MR images in the patients with TMJ disorders. In the patient with TMJ disorders, joint pain and sound could not be specific clinical symptoms that are related with MR image findings, and asymptomatic joint did not necessarily imply that the joints are normal according to MR image findings.

  10. Dietary correlates of temporomandibular joint morphology in the great apes.

    Science.gov (United States)

    Terhune, Claire E

    2013-02-01

    Behavioral observations of great apes have consistently identified differences in feeding behavior among species, and these differences have been linked to variation in masticatory form. As the point at which the mandible and cranium articulate, the temporomandibular joint (TMJ) is an important component of the masticatory apparatus. Forces are transmitted between the mandible and cranium via the TMJ, and this joint helps govern mandibular range of motion. This study examined the extent to which TMJ form covaries with feeding behavior in the great apes by testing a series of biomechanical hypotheses relating to specific components of joint shape using linear measurements extracted from three-dimensional coordinate data. Results of these analyses found that taxa differ significantly in TMJ shape, particularly in the mandibular fossa. Chimpanzees have relatively more anteroposteriorly elongated joint surfaces, whereas gorillas tend to have relatively anteroposteriorly compressed joints. Orangutans were most commonly intermediate in form between Pan and Gorilla, perhaps reflecting a trade-off between jaw gape and load resistance capabilities. Importantly, much of the observed variation among taxa reflects differences in morphologies that facilitate gape over force production. These data therefore continue to emphasize the unclear relationship between mandibular loading and bony morphology, but highlight the need for further data regarding food material properties, jaw gape, and ingestive/food processing behaviors. Copyright © 2012 Wiley Periodicals, Inc.

  11. Minimally invasive surgical treatment for temporomandibular joint in patients with various rheumatic diseases

    Directory of Open Access Journals (Sweden)

    A. Yu. Drobyshev

    2017-01-01

    Full Text Available Temporomandibular joint (TMJ involvement occurs in patients with different rheumatic diseases (RDs. Pain, limitation of mouth opening can lead to significant problems in both oral hygiene and when eating. Conservative treatments for TMJ lesions are not always effective. Objective: to evaluate the efficiency of minimally invasive surgical interventions (TMJ arthrocentesis and arthroscopy in patients with RDs. Patients and methods. The investigation enrolled 64 patients with different RDs (43 with rheumatoid arthritis, 11 with psoriatic arthritis, 8 with systemic lupus erythematosus, and 2 with ankylosing spondylitis who were divided into three groups in relation to the severity of TMJ involvement in accordance with the Wilkes classification. All the patients underwent TMJ magnetic resonance imaging at baseline and 6 months after treatment. Also at baseline, 14 days, and 1, 6, and 12 months after surgery, the investigators assessed TMJ pain intensity by visual analogue scale and the parameters of mandibular movements. Patients with Wilkes stages IV and V TMJ involvement underwent arthroscopic intervention into the TMJ and those with III stage received TMJ arthrocentesis with arthrolavage. Results and discussion. After surgical treatment, all the groups were noted to have a significant decrease in TMJ pain intensity compared with the baseline level; moreover, the severity of TMJ pain most significantly decreased on day 7 after surgery. Later on, positive changes remained within subsequent follow-up months. There were data similar in the higher degree of mouth opening. The results of surgical treatment in patients with Wilkes stage V TMJ involvement were worse than in those with stages III and IV. Conclusion. Minimally invasive TMJ surgery in patients with RDs is effective and associated with the low frequency of postoperative complications and exacerbations of RDs. The efficiency of minimally invasive TMJ surgery is higher in patients with the

  12. Periodontal Ligament Mesenchymal Stromal Cells Increase Proliferation and Glycosaminoglycans Formation of Temporomandibular Joint Derived Fibrochondrocytes

    OpenAIRE

    Jianli Zhang; Fujun Guo; Jianqiang Mi; Zhiye Zhang

    2014-01-01

    Objectives. Temporomandibular joint (TMJ) disorders are common disease in maxillofacial surgery. The aim of this study is to regenerate fibrocartilage with a mixture of TMJ fibrochondrocytes and periodontal ligament derived mesenchymal stem cells (PD-MSCs). Materials and Methods. Fibrochondrocytes and PD-MSC were cocultured (ratio 1 : 1) for 3 weeks. Histology and glycosaminoglycans (GAGs) assay were performed to examine the deposition of GAG. Green florescent protein (GFP) was used to track ...

  13. Effect of turban use on temporomandibular joint problems.

    Science.gov (United States)

    Uysal, S; Avcu, N

    2008-12-01

    The aim of this study was to evaluate the effects of daily turban wear on temporomandibular joint (TMJ) problems. This cross-sectional study was carried out on 249 female patients. Of these, 119 patients were using turban daily, while 130 patients did not use. Patients were asked questions to ascertain the signs of TMJ problems. Thereafter, the TMJ region was examined clinically. Cross-tabulations and Chi-square statistics were computed in accordance with Bonferroni correction for multiple comparisons. To investigate the association between continuous turban wear and temporomandibular disorder symptoms, logistic regression analysis was performed. Limited mouth opening, deviation, pain on TMJ palpation and mouth opening were not affected with turban usage. However, turban users more frequently demonstrated pain during palpation of the masticatory muscles than non-users (P = 0.001). Duration of the turban usage did not affect clinical examination findings except pain on masticatory muscles during palpation (P = 0.001). Complaint of pain on masticatory muscles are more frequently seen among the turban users.

  14. The role of custom-made prosthesis for temporomandibular joint replacement Papel de la prótesis hecha a medida para la sustitución de la articulación temporomandibular

    OpenAIRE

    Mercuri, Louis G.

    2013-01-01

    Alloplastic temporomandibular joint replacement (TMJ TJR) presents unique problems due to the integral and multifaceted roles this joint plays within the stomatognathic system to establish and maintain appropriate mandibular function and form. The TMJ not only acts as a secondary mandibular growth center pre-puberty, but is also crucial in maintaining proper mastication, speech, airway support and deglutition. Further, these essential life functions place the TMJ under more cyclical loading a...

  15. Preclinical Animal Models for Temporomandibular Joint Tissue Engineering.

    Science.gov (United States)

    Almarza, Alejandro J; Brown, Bryan N; Arzi, Boaz; Ângelo, David Faustino; Chung, William; Badylak, Stephen F; Detamore, Michael

    2018-01-02

    There is a paucity of in vivo studies that investigate the safety and efficacy of temporomandibular joint (TMJ) tissue regeneration approaches, in part due to the lack of established animal models. Review of disease models for study of TMJ is presented herein with an attempt to identify relevant preclinical animal models for TMJ tissue engineering, with emphasis on the disc and condyle. Although degenerative joint disease models have been mainly performed on mice, rats, and rabbits, preclinical regeneration approaches must employ larger animal species. There remains controversy regarding the preferred choice of larger animal models between the farm pig, minipig, goat, sheep, and dog. The advantages of the pig and minipig include their well characterized anatomy, physiology, and tissue properties. The advantages of the sheep and goat are their easier surgical access, low cost per animal, and its high tissue availability. The advantage of the dog is that the joint space is confined, so migration of interpositional devices should be less likely. However, each species has limitations as well. For example, the farm pig has continuous growth until about 18 months of age, and difficult surgical access due to the zygomatic arch covering the lateral aspect of joint. The minipig is not widely available and somewhat costly. The sheep and the goat are herbivores, and their TMJs mainly function in translation. The dog is a carnivore, and the TMJ is a hinge joint that can only rotate. Although no species provides the gold standard for all preclinical TMJ tissue engineering approaches, the goat and sheep have emerged as the leading options, with the minipig as the choice when cost is less of a limitation; and with the dog and farm pig serving as acceptable alternatives. Finally, naturally occurring TMJ disorders in domestic species may be harnessed on a preclinical trial basis as a clinically relevant platform for translation.

  16. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006-2011).

    Science.gov (United States)

    Arzi, Boaz; Cissell, Derek D; Verstraete, Frank J M; Kass, Philip H; DuRaine, Grayson D; Athanasiou, Kyriacos A

    2013-01-01

    To describe CT findings in dogs and cats with temporomandibular joint (TMJ) disorders. Retrospective case series. 41 dogs and 17 cats. Medical records and CT images of the skull were reviewed for dogs and cats that were examined at a dentistry and oral surgery specialty practice between 2006 and 2011. Of 142 dogs and 42 cats evaluated, 41 dogs and 17 cats had CT findings consistent with a TMJ disorder. In dogs, the most common TMJ disorder was osteoarthritis; however, in most cases, there were other TMJ disorders present in addition to osteoarthritis. Osteoarthritis was more frequently identified at the medial aspect rather than the lateral aspect of the TMJ, whereas the frequency of osteoarthritic involvement of the dorsal and ventral compartments did not differ significantly. In cats, fractures were the most common TMJ disorder, followed by osteoarthritis. Clinical signs were observed in all dogs and cats with TMJ fractures, dysplasia, ankylosis, luxation, and tumors; however, only 4 of 15 dogs and 2 of 4 cats with osteoarthritis alone had clinical signs. Results indicated that TMJ disorders were frequently present in combination. Osteoarthritis was the most common TMJ disorder in dogs and the second most common TMJ disorder in cats. Computed tomography should be considered as a tool for the diagnosis of TMJ disorders in dogs and cats with suspected orofacial disorders and signs of pain. (J Am Vet Med Assoc 2013;242:69-75).

  17. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006–2011)

    Science.gov (United States)

    Arzi, Boaz; Cissell, Derek D.; Verstraete, Frank J. M.; Kass, Philip H.; DuRaine, Grayson D.; Athanasiou, Kyriacos A.

    2013-01-01

    Objective To describe CT findings in dogs and cats with temporomandibular joint (TMJ) disorders. Design Retrospective case-series. Animals 41 dogs and 17 cats. Procedures Medical records and CT images of the skull were reviewed for dogs and cats that were examined at a dentistry and oral surgery specialty practice between 2006 and 2011. Results Of 142 dogs and 42 cats evaluated, 41 dogs and 17 cats had CT findings consistent with a TMJ disorder. In dogs, the most common TMJ disorder was osteoarthritis; however, in most cases, there were other TMJ disorders present in addition to osteoarthritis. Osteoarthritis was more frequently identified at the medial aspect rather than the lateral aspect of the TMJ, whereas the frequency of osteoarthritic involvement of the dorsal and ventral compartments did not differ significantly. In cats, fractures were the most common TMJ disorder, followed by osteoarthritis. Clinical signs were observed in all dogs and cats with TMJ fractures, dysplasia, ankylosis, luxation, and tumors; however, only 4 of 15 dogs and 2 of 4 cats with osteoarthritis alone had clinical signs. Conclusions and Clinical Relevance Results indicated that TMJ disorders are frequently present in combination. Osteoarthritis was the most common TMJ disorder in dogs and the second most common TMJ disorder in cats. Computed tomography should be considered as a tool for the diagnosis of TMJ disorders in dogs and cats with suspected orofacial disorders and pain. PMID:23234284

  18. MRI Slice Segmentation and 3D Modelling of Temporomandibular Joint Measured by Microscopic Coil

    Science.gov (United States)

    Smirg, O.; Liberda, O.; Smekal, Z.; Sprlakova-Pukova, A.

    2012-01-01

    The paper focuses on the segmentation of magnetic resonance imaging (MRI) slices and 3D modelling of the temporomandibular joint disc in order to help physicians diagnose patients with dysfunction of the temporomandibular joint (TMJ). The TMJ is one of the most complex joints in the human body. The most common joint dysfunction is due to the disc. The disc is a soft tissue, which in principle cannot be diagnosed by the CT method. Therefore, a 3D model is made from the MRI slices, which can image soft tissues. For the segmentation of the disc in individual slices a new method is developed based on spatial distribution and anatomical TMJ structure with automatic thresholding. The thresholding is controlled by a genetic algorithm. The 3D model is realized using the marching cube method.

  19. Nasal obstruction may alleviate bruxism related temporomandibular joint disorders.

    Science.gov (United States)

    Bektas, Devrim; Cankaya, Mustafa; Livaoglu, Murat

    2011-02-01

    Temporomandibular disorder (TMD) is a collective term used to identify a group of musculoskeletal conditions of the temporomandibular region. Bruxism is a non-functional activity characterized by repeated tooth clenching or grinding in an unconscious manner. Over the time bruxism may lead to TMD by the uploading it causes. Nasal obstruction is a common complaint that necessitates mouth breathing when severe. The treatment of bruxism is frequently performed by oral appliances, which induce occlusal disengagement and relax jaw musculature and therefore reduce the force on the temporomandibular joint (TMJ). We believe that nasal obstruction may indirectly have a preemptive and therapeutic effect on sleep bruxism related TMD by causing mouth breathing. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Ultrasonographic imaging of the temporomandibular joint in healthy cattle and pathological findings in one clinical case.

    Science.gov (United States)

    Borges, N C; Weissengruber, G E; Huber, J; Kofler, J

    2016-11-01

    To describe the normal ultrasonographic appearance of the temporomandibular joint (TMJ) in cattle, and to describe the ultrasonographic pathology of the TMJ as assessed in one cow with TMJ disease. The TMJ of 12 healthy Holstein-Friesian cows were examined using a portable ultrasonographic unit with a 7.5 MHz linear probe and a 6.0 MHz convex probe. Each TMJ was scanned in a rostrolateral, lateral and caudolateral plane. In addition, the TMJ of one 2-year-old cow with clinical signs of food retention in the mouth, head tilt, swelling and pain in the right TMJ region and an infected horn fracture was examined ultrasonographically. The bone surfaces of the temporal process, the zygomatic process and the temporal bone, the larger muscles of the TMJ region, the superficial temporal vein, and the parotid salivary gland could be imaged in all normal healthy cattle. Using the linear probe, the joint capsule was visible in 17/24 (71%) cases in the caudolateral plane, but the articular disc could not be visualised. With the convex probe, the joint capsule could be imaged in all cases in the caudolateral plane, and the articular disc in 13/24 (54%) cases in the caudolateral plane. It was never possible to see the synovial pouch in healthy cattle using either probe. By contrast, in the cow diagnosed with septic arthritis of the right TMJ, a marked anechoic and heterogeneous hypoechoic effusion of the TMJ with distension of the joint capsule was visualised. The results of this descriptive study serve to provide a reference for ultrasonography of pathological conditions of the TMJ region in cattle. As many veterinarians are equipped with ultrasound machines with 5-8 MHz linear rectal probes, the authors recommend using these probes for further investigation of clinical cases with swelling of the TMJ region and/or masticatory problems of unclear origin to exclude or diagnose TMJ disorders.

  1. Imaging diagnosis of temporomandibular disorders (TMD). MR imaging of the disk of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Sano, Tsukasa; Yamamoto, Mika; Sakuma, Katsuya [Showa Univ., Tokyo (Japan). School of Dentistry] [and others

    2001-03-01

    Since its introduction in the 1980s, magnetic resonance imaging has become the preferred method for diagnosing soft tissue abnormalities of temporomandibular joint (TMJ). MR imaging is non-invasive and more accurate than arthorography. In addition, it requires less operator skill and is well tolerated by patients. We are usually taking MR images of the TMJ with the fast spin echo technique that can simultaneously obtain both T2-weighted and proton density images. The purpose of this study was to determine the utility of T2-weighed and proton density images for diagnosing the disk status in TMJ, comparing the results with those obtained by T1-weighted images. We studied 104 TMJs in 52 patients with both T2-weighted and proton density images, and 80 TMJs in 40 patients with only T1-weighted images. The joints were evaluated by two oral radiologists who looked at three aspects of the joints-disk displacement, disk reduction and disk shape - giving ratings of good'' or ''fair'' in each category. Ratings of ''good'' were significant higher in all three categories in T2-weighted and proton density images than in T1-weighted images (p<0.01). Based on these results, we conclude that T2-weighted and proton density images taken with the fast spin echo technique are useful for diagnosing the disk status of the TMJ. (author)

  2. Nerve growth factor acts with the beta2-adrenoceptor to induce spontaneous nociceptive behavior during temporomandibular joint inflammatory hyperalgesia.

    Science.gov (United States)

    Pelegrini-da-Silva, Adriana; Oliveira, Maria Cláudia G; Parada, Carlos Amílcar; Tambeli, Cláudia Herrera

    2008-12-05

    The aim of this study was to investigate whether the injection of nerve growth factor induces spontaneous nociceptive behavior in the intact or sensitized temporomandibular joint (TMJ) of rats. NGF was injected into the TMJ 1 h after the TMJ injection of saline or carrageenan and the spontaneous nociceptive behavior was quantified. The mechanism involved in this phenomenon was investigated by the injection of NGF into the carrageenan-sensitized TMJ in the presence of indomethacin or of beta-adrenergic antagonists. NGF injected into the TMJ sensitized by a prior TMJ injection of carrageenan but not into the intact TMJ induced a significant nociceptive behavior. Co-injection of the non-specific Trk receptor antagonist k252A with NGF 1 h after the TMJ injection of carrageenan significantly reduced NGF-induced spontaneous nociception supporting the Trk receptor activation in this nociceptive effect. Blockade of prostaglandin synthesis by indomethacin before the TMJ injection of carrageenan did not reduce NGF-induced nociception. Co-administration of carrageenan with the beta2-adrenoceptor antagonist ICI 118.55 but not with the beta1-adrenoceptor antagonist atenolol significantly reduced NGF-induced nociception. The injection of NGF the TMJ sensitized by a previous TMJ injection of epinephrine also induced nociceptive behavior. Taken together, these results indicate that NGF can induce TMJ nociception during TMJ inflammation. Moreover, the expression of this nociceptive response seems to depend on the synergic activity of NGF and sympathetic amines released during TMJ inflammation acting on beta2-adrenergic receptors.

  3. Efficacy of Temporomandibular Joint Arthrocentesis with Sodium Hyaluronate in the Management of Temporomandibular Joint Disorders: A Prospective Randomized Control Trial.

    Science.gov (United States)

    Gorrela, Harsha; Prameela, J; Srinivas, G; Reddy, B Vijay Baskar; Sudhir, Mvs; Arakeri, Gururaj

    2017-12-01

    This study was designed to investigate the efficacy of the temporomandibular joint arthrocentesis with and without injection of sodium hyaluronate (SH) in the treatment of temporomandibular joint disorders. A total of sixty two TMJs in 34 males and 28 females aged 20-65 years comprised the study material. The patients' complaints were limited mouth opening, TMJ pain, and joint noises during function. Patients were randomly divided into 2 groups in which arthrocentesis plus intra-articular injection of sodium hyaluronate was performed in 1 group and only arthrocentesis was performed in the other group. Both groups contained patients with disc displacement with reduction and without reduction. Clinical evaluation of the patients was done before the procedure, immediately after the procedure, at 1 week and 1, 3 and 6 months postoperatively. Intensity of TMJ pain was assessed using visual analog scales. Maximal mouth opening and lateral jaw movements also were recorded at each follow-up visit. Both techniques increased maximal mouth opening, lateral movements, and function, while reducing TMJ pain and noise. Although patients benefitted from both techniques, arthrocentesis with injection of SH seemed to be superior to arthrocentesis alone.

  4. Recent Tissue Engineering Advances for the Treatment of Temporomandibular Joint Disorders.

    Science.gov (United States)

    Aryaei, Ashkan; Vapniarsky, Natalia; Hu, Jerry C; Athanasiou, Kyriacos A

    2016-12-01

    Temporomandibular disorders (TMDs) are among the most common maxillofacial complaints and a major cause of orofacial pain. Although current treatments provide short- and long-term relief, alternative tissue engineering solutions are in great demand. Particularly, the development of strategies, providing long-term resolution of TMD to help patients regain normal function, is a high priority. An absolute prerequisite of tissue engineering is to understand normal structure and function. The current knowledge of anatomical, mechanical, and biochemical characteristics of the temporomandibular joint (TMJ) and associated tissues will be discussed, followed by a brief description of current TMD treatments. The main focus is on recent tissue engineering developments for regenerating TMJ tissue components, with or without a scaffold. The expectation for effectively managing TMD is that tissue engineering will produce biomimetic TMJ tissues that recapitulate the normal structure and function of the TMJ.

  5. Osteophytes in temporomandibular joint, a spectrum of appearance in cone-beam computed tomography: Report of four cases

    Directory of Open Access Journals (Sweden)

    Jayachandran Sadaksharam

    2016-01-01

    Full Text Available Osteophyte is one of the hallmark radiographic feature of temporomandibular joint (TMJ degenerative joint disease that has been used to define the presence of disease. The development of osteophyte is an attempt to stabilize the overload caused by occlusal forces, representing areas of newly-formed cartilage. It can cause various clinical symptoms such as pain, decreased jaw movements, nerve compression, and subsequently compromise joint function. Here, we report four cases of patients with TMJ arthritis showing different appearance of osteophyte using cone-beam computed tomography. This paper also reports two cases of bridging osteophyte at the temporomandibular joint, which has not been reported previously in literature.

  6. Women with more severe degrees of temporomandibular disorder exhibit an increase in temperature over the temporomandibular joint.

    Science.gov (United States)

    Dibai-Filho, Almir Vieira; Costa, Ana Cláudia de Souza; Packer, Amanda Carine; de Castro, Ester Moreira; Rodrigues-Bigaton, Delaine

    2015-01-01

    The purpose of the present study was to correlate the degree of temporomandibular disorder (TMD) severity and skin temperatures over the temporomandibular joint (TMJ) and masseter and anterior temporalis muscles. This blind cross-sectional study involved 60 women aged 18-40 years. The volunteers were allocated to groups based on Fonseca anamnestic index (FAI) score: no TMD, mild TMD, moderate TMD, and severe TMD (n = 15 each). All volunteers underwent infrared thermography for the determination of skin temperatures over the TMJ, masseter and anterior temporalis muscles. The Shapiro-Wilk test was used to determine the normality of the data. The Kruskal-Wallis test, followed by Dunn's test, was used for comparisons among groups according to TMD severity. Spearman's correlation coefficients were calculated to determine the strength of associations among variables. Weak, positive, significant associations were found between FAI score and skin temperatures over the left TMJ (rs = 0.195, p = 0.009) and right TMJ (rs = 0.238, p = 0.001). Temperatures over the right and left TMJ were significantly higher in groups with more severe TMD (p < 0.05). FAI score was associated with skin temperature over the TMJ, as determined by infrared thermography, in this sample. Women with more severe TMD demonstrated a bilateral increase in skin temperature.

  7. A prospective study of 138 arthroscopies of the temporomandibular joint

    Directory of Open Access Journals (Sweden)

    Paulo Alexandre da Silva

    2015-08-01

    Full Text Available INTRODUCTION: Internal derangements (ID of the temporomandibular joint (TMJ have a multifactorial etiology and are most often treated conservatively by splints, physical therapy and medications. Only in 2-5% of cases are the treatment surgical, either by arthroscopy or arthrotomy.OBJECTIVE: To evaluate improvement of mouth opening, pain relief during function, position of the articular disk and complications following Arthroscopic Lyse and Lavage (ALL.METHODS: A prospective study of 78 patients (138 TMJs with TMJ ID, 5 males and 73 females, mean age 29.7 years, treated between January 2010 and April 2013, who were refractory to conservative treatment, had limited mouth opening and pain localized to the TMJ during function, and who were submitted to TMJ ALL and followed for a period of 12 months, with periodic reviews.RESULTS: ALL was effective in 93.6% of cases, with 85.3% experiencing improvement in mouth opening and 91.2% in pain reduction during function, 63% improvement in disk position and a rate of complications of 6.2%.CONCLUSION: In this study the ALL exhibited a high rate of success with low morbidity in internal derangements of the TMJ.

  8. Dynamic MR imaging of the temporomandibular joint by using a mouth opener

    Energy Technology Data Exchange (ETDEWEB)

    Niitsu, Mamoru; Anno, Izumi; Yoshioka, Hiroshi; Itai, Yuji; Onizawa, Koshiro; Hirohata, Hiromi; Nemoto, Kazuo (Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine)

    1991-08-01

    A mouth opener, an exercise device for the treatment of the disturbance of opening mouth, was utilized for a dynamic fast-scan magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). Thirteen patients suspected with internal derangements of the TMJ were examined with dynamic MRI and static spin echo imaging. Dynamic images clearly demonstrated anteriorly displaced disks and detailed features of its recapture. In the case of disk displacement without reduction, deformed disks resulting in restrictions of mouth opening were depicted. With the simple equipment available in the clinical use, the increased information from dynamic MR imaging warrants clinical application for the TMJ disease. (author).

  9. Ultrasound-Guided Temporomandibular Joint Injection for Chronic Posthemimandibulectomy Jaw Pain.

    Science.gov (United States)

    Chakraborty, Arunangshu; Datta, Taniya; Lingegowda, Dayananda; Khemka, Rakhi

    2016-11-15

    Temporomandibular joint (TMJ) pain can be difficult to diagnose and treat. We describe a patient with left jaw pain after right hemimandibulectomy. The patient was initially managed conservatively, which failed to reduce pain. He was then administered inferior alveolar nerve block and TMJ injection with steroid and local anesthetic. These injections provided temporary pain relief that lasted approximately 1 month and the pain recurred. Computed tomography scan showed lateral displacement of left mandibular condyle. He was then given ultrasound-guided TMJ injection of steroid and local anesthetic. This injection provided lasting pain relief.

  10. Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage

    OpenAIRE

    Tanaka, Eiji; Yamano, Eizo; Inubushi, Toshihiro; Kuroda, Shingo

    2012-01-01

    This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and t...

  11. Dislocation of temporo-mandibular joint - an uncommon circumstance of occurrence: vaginal delivery

    Directory of Open Access Journals (Sweden)

    Abderrahim El Bouazzaoui

    2010-06-01

    Full Text Available Dislocation of temporo-mandibular joint (TMJ is an infrequent disease but still almost spectacular. This disease consists of a permanent, to some extent complete disruption of the temporo-mandibular joint. These dislocations often occurs in a context of yawning, and less frequently after a burst of laughing or relatively mild facial trauma (slap, punch on the chin.We report a case of TMJ occurring in an uncommon circumstance : vaginal delivery. A young woman aged 24-years with no special past medical history; primipara was admitted in the Department of Maternity of the University Hospital Hassan II of Fez for an imminent delivery of a twin pregnancy. Obstetrical analgesia was not possible so the parturient cried in a strong manner during labour. Ten minutes after admission, the patient delivered vaginally with episiotomy. She gave birth to twins weighing 2800g and 2400g. During labour, and effort of crying, the patient presented a sudden and immediate loss of function of the temporo-mandibular joint, with difficulty of speaking, the mouth permanently opened, with the chin lowered and thrown forward. The examination found an emptiness of the glenoid fossa of the temporo-mandibular joint in both sides. The diagnosis of dislocation of the TMJ has established. Performance of special radiologic screening to study the TM was technically not possible. A CT scan of facial bones has been achieved so objectifying a bilateral dislocation of TMJ. The reduction of this dislocation was performed in the operating room under sedation

  12. Temporomandibular Joint Prosthesis - 3D-CT Reconstruction before and after Treatment

    Czech Academy of Sciences Publication Activity Database

    Feltlová, E.; Dostálová, T.; Kašparová, M.; Daněk, J.; Hliňáková, P.; Hubáček, M.; Nedoma, Jiří

    2010-01-01

    Roč. 6, č. 1 (2010), s. 15-19 ISSN 1801-5603 Institutional research plan: CEZ:AV0Z10300504 Keywords : dentistry * maxillofacial surgery * partial TMJ prosthesis * three-dimensional computed tomography * magnetic resonance imaging * temporomandibular joint Subject RIV: BA - General Mathematics http://www.ejbi.cz/articles/201012/50/1.html

  13. Cost effectiveness of arthrocentesis as initial treatment for temporomandibular joint arthralgia: A randomized controlled trial

    NARCIS (Netherlands)

    Vos, L.M.; Stant, A.D.; Quik, E.H.; Huddleston Slater, J.J.R.; Stegenga, B.

    2013-01-01

    Objective: To determine the cost effectiveness of arthrocentesis as initial treatment compared to care as usual (CAU) for temporomandibular joint (TMJ) arthralgia. Materials and methods: 80 patients were randomly allocated to arthrocentesis as initial treatment (n = 40) or CAU (n = 40).

  14. Chronic temporomandibular joint pain: two cases of osteoid osteoma and a review of the literature

    NARCIS (Netherlands)

    Deferm, J.T.; Steens, S.C.A.; Vriens, D.; Bekers, E.M.; Kalaykova, S.I.; Borstlap, W.A.

    2017-01-01

    Osteoid osteoma is a benign bone tumour with self-limiting growth potential occurring in any part of the body. Two rare cases of a pathologically proven osteoid osteoma invading the temporomandibular joint (TMJ) are reported herein. This article also reviews the cases of osteoid osteoma of the

  15. Bilateral TMJ Involvement in Rheumatoid Arthritis

    OpenAIRE

    Ruparelia, Pritesh B.; Shah, Deep S.; Kosha Ruparelia; Sutaria, Shreyansh P.; Deep Pathak

    2014-01-01

    Rheumatoid arthritis (RA) is a systemic inflammatory, slowly progressive disease that results in cartilage and bone destruction. Temporomandibular joint (TMJ) involvement is not uncommon in RA, and it is present in about more than 50% of patients; however, TMJ is usually among the last joints to be involved and is associated with many varied clinical signs and symptoms. Hence, RA of TMJ presents to the dentist with great diagnostic challenges. This report presents a case of RA with bilateral ...

  16. The temporomandibular joint of California sea lions (Zalophus californianus): part 1 - characterisation in health and disease.

    Science.gov (United States)

    Arzi, B; Murphy, M K; Leale, D M; Vapniarsky-Arzi, N; Verstraete, F J M

    2015-01-01

    This study aimed to characterise the histologic, biomechanical and biochemical properties of the temporomandibular joint (TMJ) of California sea lions. In addition, we sought to identify structure-function relationships and to characterise TMJ lesions found in this species. Temporomandibular joints from fresh cadaver heads (n=14) of California sea lions acquired from strandings were examined macroscopically and microscopically. The specimens were also evaluated for their mechanical and biochemical properties. Furthermore, if TMJ arthritic changes were present, joint characteristics were described and compared to healthy joints. Five male and 9 female specimens demonstrated macroscopically normal fibrocartilaginous articular surfaces and fibrous discs in the TMJ. Out of the 9 female specimens, 4 specimens had TMJ lesions were seen either in the articular surface or the disc. Histologically, these pathologic specimens demonstrated subchondral bone defects, cartilage irregularities and inflammatory cell infiltrates. The normal TMJ discs did not exhibit significant direction dependence in tensile stiffness or strength in the rostrocaudal direction compared with the mediolateral direction among normal discs or discs from affected joints. The TMJ discs were not found to be anisotropic in tensile properties. This feature was further supported by randomly oriented collagen fibres as seen by electron microscopy. Furthermore, no significant differences were detected in biochemical composition of the discs dependent upon population. The TMJ and its disc of the California sea lion exhibit similarities but also differences compared to other mammals with regards to structure-function relationships. A fibrous TMJ disc rich in collagen with minimal glycosaminoglycan content was characterised, and random fibre organisation was associated with isotropic mechanical properties in the central region of the disc. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. COMPUTED TOMOGRAPHIC APPEARANCE OF THE TEMPOROMANDIBULAR JOINT IN 1018 ASYMPTOMATIC HORSES: A MULTI-INSTITUTION STUDY.

    Science.gov (United States)

    Carmalt, James L; Kneissl, Sibylle; Rawlinson, Jennifer E; Zwick, Timo; Zekas, Lisa; Ohlerth, Stefanie; Bienert-Zeit, Astrid

    2016-05-01

    Published descriptions of nonseptic arthritis of the equine temporomandibular joint (TMJ) are rare and large studies investigating variations in the TMJ for asymptomatic horses are lacking. The objectives of this cross-sectional, retrospective, multi-institutional study were to describe anatomical variations in the TMJ detected using computed tomography (CT) in an equid population asymptomatic for TMJ disease and determine whether these variations were associated with patient signalment, reason for CT examination, or CT slice width. Medical records at eight hospitals were searched for horses that had head/neck CT scans and no clinical signs of TMJ disease. Age, breed, sex, clinical presentation, and CT slice width data were recorded. Alterations in CT contour and density of the mandibular condyles, mandibular fossae, and TMJ intra-articular discs were described for each horse. Generalized logistic regression was used to test associations between anatomical variations and horse age. A total of 1018 horses were sampled. Anatomical variations were found in TMJ CT images for 40% of horses and 29% of joints. These were dichotomous with regard to age. Horses TMJ anatomic variations were common in CT images of younger and older horses asymptomatic for TMJ disease. Future studies are needed to more definitively characterize these CT variations using gross pathology and histopathology. © 2016 American College of Veterinary Radiology.

  18. [Synovial chondromatosis in the temporomandibular joint: report of 2 cases].

    Science.gov (United States)

    Dai, Xin; Feng, Yuan-Yong; Bu, Ling-Xue; Song, Kai; Gao, Qian-Qian; Shang, Wei

    2016-10-01

    The clinical manifestations, radiographic findings, intraoperative view, histopathologic features of synovial chondromatosis(SC) in the temporomandibular joint (TMJ) were summarized in 2 cases. Preoperative symptoms included preauricular pain(2/2), swelling(2/2) and limitation of mouth opening (0/2). X-ray findings showed widened joint space. The articular surface destructed and irregular stippled calcifications were seen in the infratemporal fossa by CT scan in one case. MRI showed multiple small nodular formations in the articular cavity. There was no malocclusion and limitation of mouth opening after surgery. As a rare disease of the temporomandibular joint, SC often exists in superior spaces. The clinical manifestations lack specificity. Detection of calcified loose bodies on radiography was helpful to diagnosis, while final diagnosis was dependent on histopathologic examination with characteristic cartilaginous nodules in the synovial membrane.

  19. Oral splint for temporomandibular joint disorders with revolutionary fluid system

    Directory of Open Access Journals (Sweden)

    Rahul Srivastava

    2013-01-01

    Full Text Available Temporomandibular joint (TMJ diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal movements of speech, facial expression, eating, chewing, and swallowing. The conventional soft occlusal splint therapy is a much safer and effective mode of a conservative line of therapy in comparison to the surgical therapy for temporomandibular joint disorders (TMD. The purpose of this article is to review the Aqualizer TM , an hydrostatic oral splint, as accurate, effective treatment and differential diagnostic tool in TMD that allow treating the patient′s pain quickly and accurately saving valuable treatment time. The review article has been prepared doing a literature review from the world-wide web and pubmed/medline.

  20. The useful of the double-contrast arthrograpic CT-MPR of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Koichiro; Ando, Akira; Yamada, Hiroyuki [Fujieda Municipal General Hosital, Shizuoka (Japan)] [and others

    1998-08-01

    We performed 35 double-contrast arthrographic computed tomography multiplanar reconstruction (CT-MPR) of the temporomandibular joint (TMJ) and 35 double-contrast arthrotomography of the TMJ in 70 patients of disorder of the TMJ since June 1994 to February 1998. The comparison of double-contrast CT-MPR and double-contrast tomography were examined by 5 radiological technologists and 3 oral surgeons. Those imaging evaluation as 5 grades in the superior joint space, inferior joint space 3 parts of an articular disc were studied. Each scores of CT-MPR was statistically superior to that of tomography (p<0.05). These results suggest that CT-MPR is markedly useful for diagnosis of TMJ disorders. (author)

  1. [Treatment of temporomandibular joint disc perforation with injection of hyaluronic acid or disc repair].

    Science.gov (United States)

    Lu, Jinbiao; Long, Xing; Deng, Mohong; Cheng, Yong; Li, Bo

    2014-08-01

    To assess the efficacy of injection of sodium hyaluronate in the treatment of patients with disc perforation by using cone- beam computed tomography (CBCT) and temporomandibular joint (TMJ) function. Twenty- eight patients (38 joints) with disc perforation observed through arthrography who received injection of sodium hyaluronate and other 20 patients (29 joints) who received disc repair were included in this study. Pain (visual analog scale, scores 0 to 100), maximal mouth opening, modified Helkimo's clinical dysfunction index and TMJ examinations with CBCT were obtained before and 3, 9 months after treatment. A statistically significant increase (P joints) of patients after HA injection and 55% (16 of 29 joints) of patients appeared bone remodeling after disc repair. Both injection of hyaluronic acid and disc repair are effective for treatment of temporomandibular joint disc perforation.

  2. MR diagnosis of temporomandibular joint. A study of joint effusion

    Energy Technology Data Exchange (ETDEWEB)

    Kaneda, Takashi; Yamashiro, Mitsuaki; Ozawa, Kaoru; Suzuki, Hiromi; Okada, Hiroyuki; Yamamoto, Hirotsugu [Nihon Univ., Matsudo, Chiba (Japan). School of Dentistry

    1998-03-01

    The purposes of this study were to evaluate the relationship between correlation of MR joint effusion of the temporomandibular joint and disk position, to evaluate the relationship between joint effusion and aging, and to assess the frequency of MR joint effusion of bilateral temporomandibular joints. The temporomandibular joints of 192 patients with clinical symptoms of temporomandibular joint disorders were imaged bilaterally using high field, surface-coil MR imaging. Oblique sagittal and coronal proton density-weighted and T2-weighted images were obtained. Imaging findings of joint effusion were correlated with disk position, aging, and bilateral temporomandibular joints. MR showed effusion in 4% of the joints with normal superior disk position, 36% of the joints with disk displacement with reduction, and 45% of the joints with disk displacement without reduction. There were significant differences in the incidence of joint effusion between normal disk position and anterior disk displacement with or without reduction. Younger patients less than 40 years were significant higher the incidence of joint effusion than those of older patients. A significant association was seen between joint effusion and aging. MR showed effusion in 17% of the unilateral temporomandibular joint, 24% of the bilateral temporomandibular joints. There was no significant difference between unilateral and bilateral case. These results indicated that joint effusion using MR imaging was associated with varied temporomandibular joint pathologic states. (author)

  3. Application of the rapid prototyping technique to design a customized temporomandibular joint used to treat temporomandibular ankylosis

    Science.gov (United States)

    Chaware, Suresh M.; Bagaria, Vaibhav; Kuthe, Abhay

    2009-01-01

    Anthropometric variations in humans make it difficult to replace a temporomandibular joint (TMJ), successfully using a standard “one-size-fits-all” prosthesis. The case report presents a unique concept of total TMJ replacement with customized and modified TMJ prosthesis, which is cost-effective and provides the best fit for the patient. The process involved in designing and modifications over the existing prosthesis are also described. A 12-year- old female who presented for treatment of left unilateral TMJ ankylosis underwent the surgery for total TMJ replacement. A three-dimensional computed tomography (CT) scan suggested features of bony ankylosis of left TMJ. CT images were converted to a sterolithographic model using CAD software and a rapid prototyping machine. A process of rapid manufacturing was then used to manufacture the customized prosthesis. Postoperative recovery was uneventful, with an improvement in mouth opening of 3.5 cm and painless jaw movements. Three years postsurgery, the patient is pain-free, has a mouth opening of about 4.0 cm and enjoys a normal diet. The postoperative radiographs concur with the excellent clinical results. The use of CAD/CAM technique to design the custom-made prosthesis, using orthopaedically proven structural materials, significantly improves the predictability and success rates of TMJ replacement surgery. PMID:19881026

  4. Skeletal pattern in subjects with temporomandibular joint disorders.

    Science.gov (United States)

    Almăşan, Oana Cristina; Băciuţ, Mihaela; Almăşan, Horea Artimoniu; Bran, Simion; Lascu, Liana; Iancu, Mihaela; Băciuţ, Grigore

    2013-02-21

    To establish the skeletal pattern in subjects with malocclusions and temporomandibular disorders (TMD); to assess the relationship between craniofacial skeletal structures and TMD in subjects with malocclusions. Sixty-four subjects with malocclusions, over 18 years of age, were included in the study. Temporomandibular disorders were clinically assessed according to the Helkimo Anamnestic Index. Subjects underwent a lateral cephalogram. Subjects were grouped according to the sagittal skeletal pattern (ANB angle) into class I, II and III. Parametric Student tests with equal or unequal variations were used (variations were previously tested with Levene test). Twenty-four patients with TMD (experimental sample); 40 patients without TMD (control group); interincisal angle was higher in class I and II (p < 0.05) experimental subjects; overjet was larger in experimental subjects; midline shift and Wits appraisal were broader in the experimental group in all three classes. In class III subjects, the SNB angle was higher in the experimental group (p = 0.01). Joint noises followed by reduced mandible mobility, muscular pain and temporomandibular joint (TMJ) pain were the most frequent symptoms in subjects with TMD and malocclusions. Temporomandibular joint status is an important factor to consider when planning orthodontic treatment in patients with severe malocclusions; midline shift, large overjet and deep overbite have been associated with signs and symptoms of TMD.

  5. Treatment of tophaceous pseudogout with custom-fitted temporomandibular joint: a two-staged approach

    Directory of Open Access Journals (Sweden)

    Robert Pellecchia, DDS

    2015-12-01

    Full Text Available Tophaceous pseudogout, a variant of calcium pyrophosphate dihydrate deposition, is a relatively rare juxta-articular disease. It is a metabolic condition, in which patients develop pseudo-tumoral calcifications associated with peri-articular structures secondary to calcium pyrophosphate deposition into joints with fibrocartilage rather than hyaline cartilage. These lesions are reported in the knee, wrist, pubis, shoulder, and temporomandibular joint (TMJ and induce a histocytic foreign body giant cell reaction. We report a case of tophaceous pseudogout affecting the left TMJ with destruction of the condyle and glenoid and middle cranial fossa that was reconstructed with a TMJ Concepts (Ventura, CA custom-fitted prosthesis in a 2-staged surgical approach using a silicone spacer. The surgical management using a patient-specific TMJ is a viable option when the fossa or condylar component has been compromised due to breakdown of bone secondary to a pathologic process. Our case describes and identifies the lesion and its rare occurrence in the region of the temporomandibular region. The successful management of tophaceous pseudogout of the TMJ must include a thorough patient workup including the involvement of other joints as well as the modification of bone of the glenoid fossa and condylar relationship of the TMJ.

  6. The association between oral examination findings and computed tomographic appearance of the equine temporomandibular joint.

    Science.gov (United States)

    Carmalt, J L; Simhofer, H; Bienert-Zeit, A; Rawlinson, J E; Waldner, C L

    2017-11-01

    The temporomandibular joint (TMJ) forms the junction between the maxilla and mandible. Movement of the jaw and resulting masticatory forces have been extensively studied in the horse; however, less is known about the inter-relationship between this joint and oral and dental pathology. To determine the association between specific oral and dental pathologies and anatomical variations of the TMJ imaged with computed tomography (CT) in horses with asymptomatic TMJs. Retrospective cross-sectional study. Horses (n = 201) from three practices with a complete oral examination and skull or upper cervical CT study were reviewed. Age, breed, sex, clinical presentation, oral examination findings, slice width and practice were recorded. Alterations in contour and density of the mandibular condyle, mandibular fossa and intra-articular disc were also documented. Logistic regression, corrected for clustering by practice, was used to determine whether CT anatomical variations were significantly associated with the oral examination findings. Horses categorised as having abnormal TMJs were older than those with normal TMJ. Horses with periodontal disease were less likely to have abnormal TMJ findings compared with horses with no oral pathology. In contrast, horses with infundibular disease were more likely to have TMJ abnormalities. Due to the cross-sectional nature of the study, it was difficult to establish whether oral pathology preceded TMJ abnormalities. Despite examining over 200 horses of varying ages, the biological significance of the observed associations between oral, or dental disease and anatomically appreciable temporomandibular joint disorders remains uncertain. © 2017 EVJ Ltd.

  7. Lavage Therapy Versus Nonsurgical Therapy for the Treatment of Arthralgia of the Temporomandibular Joint : A Systematic Review of Randomized Controlled Trials

    NARCIS (Netherlands)

    Vos, Lukas M.; Slater, James J. R. Huddleston; Stegenga, Boudewijn

    2013-01-01

    Aims: To carry out a systematic review of randomized controlled trials (RCTs) to investigate in patients with arthralgia of the temporomandibular joint (TMJ) the effectiveness of TMJ lavage compared to nonsurgical treatment with regard to pain intensity and mandibular range of motion. Methods: The

  8. Evaluation of temporomandibular joint disc displacement as a risk factor for osteoarthrosis.

    Science.gov (United States)

    Dias, I M; Cordeiro, P C de F; Devito, K L; Tavares, M L F; Leite, I C G; Tesch, R de S

    2016-03-01

    Temporomandibular joint (TMJ) disc displacement is a clinical sign often found in patients with temporomandibular disorders (TMDs) and associated with TMJ osteoarthrosis. Osteoarthrosis is a degenerative joint disease that may be associated with pain and functional disability. The aim of this study was to evaluate the odds ratio (OR) of joints with disc displacement presenting osteoarthrosis via magnetic resonance imaging (MRI) analysis. In total, 224 TMJ images from patients with signs and symptoms of a TMD were evaluated. The OR, a measure of association, was used to calculate the likelihood of TMJ disc displacement (with or without reduction) with osteoarthrosis. Joints with anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) were 2.73- and 8.25-times, respectively, more likely to have osteoarthrosis. A nine-times greater likelihood of osteophyte occurrence was observed in cases of ADDwoR, whereas a lower OR for their occurrence (OR 2.96) was observed in cases of ADDwR. The significant OR of joints with disc displacement presenting osteoarthrosis, particularly in cases of ADDwoR, emphasizes the importance of accurate assessment of changes in disc position, which may be associated with other painful and functional disorders of the TMJ. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Temporomandibular Joint Disorders and Orofacial Pain.

    Science.gov (United States)

    Ahmad, Mansur; Schiffman, Eric L

    2016-01-01

    Temporomandibular disorders (TMD) affect 5% to 12% of the United States population. This article discusses common conditions related to temporomandibular joints, including disc displacements, inflammatory disturbances, loose joint bodies, traumatic disturbances, and developmental conditions. Also addressed are the appropriate imaging modalities and diagnostic criteria for TMD. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

    Science.gov (United States)

    Cömert Kiliç, S; Kiliç, N; Sümbüllü, M A

    2015-10-01

    The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Diagnostic group differences in temporomandibular joint energy densities.

    Science.gov (United States)

    Gallo, L M; Iwasaki, L R; Gonzalez, Y M; Liu, H; Marx, D B; Nickel, J C

    2015-04-01

    Cartilage fatigue, due to mechanical work, may account for precocious development of degenerative joint disease in the temporomandibular joint (TMJ). This study compared energy densities (mJ/mm³) in TMJs of three diagnostic groups. Sixty-eight subjects (44 women, 24 men) gave informed consent. Diagnostic criteria for temporomandibular disorders (DC/TMD) and imaging were used to group subjects according to presence of jaw muscle or joint pain (+P) and bilateral disk displacement (+DD). Subjects (+P+DD, n=16; -P+DD, n=16; and -P-DD, n=36) provided cone-beam computed tomography and magnetic resonance images, and jaw-tracking data. Numerical modeling was used to determine TMJ loads (Fnormal). Dynamic stereometry was used to characterize individual-specific data of stress-field dynamics during 10 symmetrical jaw-closing cycles. These data were used to estimate tractional forces (Ftraction). Energy densities were then calculated as W/Q (W=work done or mechanical energy input=tractional force×distance of stress-field translation, Q=volume of cartilage). anova and Tukey-Kramer post hoc analyses tested for intergroup differences. Mean±standard error energy density for the +P+DD group was 12.7±1.5 mJ/mm³ and significantly greater (all adjusted ppain and disk displacement. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. 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.

  13. Outcomes of office-based temporomandibular joint arthroscopy: a 5-year retrospective study.

    Science.gov (United States)

    Hossameldin, R H; McCain, J P

    2018-01-01

    Temporomandibular joint (TMJ) arthroscopy is a minimally invasive surgical approach for intra-articular TMJ diseases. Office-based arthroscopy using the smallest TMJ scope allows for good visualization, as well as the ability to lavage the joint in an office setting. This study aimed to assess the efficacy of an office-based TMJ arthroscopic technique. A retrospective evaluation of 363 patients with a TMJ disorder was performed. These patients underwent office-based arthroscopy using the OnPoint 1.2mm Scope System (Biomet Microfixation, Jacksonville, FL, USA) in Florida, USA, from July 2007. The following outcomes of the procedure were assessed: improvement in painless range of mandibular motion, pain on loading, and functional jaw pain; these were evaluated using a visual analog scale (VAS) over an average follow-up period of 263.81±142.1 days. The statistical analysis was performed using IBM SPSS Statistics version 20. Statistically significant improvements in TMJ pain and function, and other variables (P=0.001) were shown following TMJ arthroscopic lysis and lavage. Office-based arthroscopy using the OnPoint System was demonstrated to be a safe and efficient procedure for the treatment of patients with TMJ disorders as the first level of the algorithm of care. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Microvascular temporomandibular joint and mandibular ramus reconstruction in hemifacial microsomia.

    Science.gov (United States)

    Vilkki, S K; Hukki, J; Nietosvaara, Y; Hurmerinta, K; Suominen, E

    2002-11-01

    Microvascular temporomandibular joint (TMJ) and mandibular ramus reconstruction was performed in a 4-year-old hemifacial microsomia patient with multiple craniofacial and extracranial anomalies (Goldenhar syndrome). Her major craniofacial anomalies included bilateral cleft lip and palate, left macrostomia, left microtia, and complete absence of the left vertical mandibular ramus and TMJ. Most of her other anomalies had been corrected surgically before TMJ and vertical mandibular ramus reconstruction, which was accomplished with a metatarsophalangeal (MTP) joint transplantation. The MTP joint was placed in hyperextended position in the skull base inserting the proximal phalanx under the remnants of the zygomatic arch and replacing the vertical mandibular ramus with the metatarsal bone. Straight mouth opening, correction of the midline, and normalized lateral movements of the mandible were accomplished. The graft includes two epiphyseal plates, which should maintain growth of the transplant. During the follow-up period (16 months) the achieved results have been maintained without adverse effects. The present technique appears to be a promising alternative in the treatment of children with Pruzansky type 3 hemifacial microsomia.

  15. Magnetic resonance evidence of joint effusion in patients with temporomandibular joint disorders

    Energy Technology Data Exchange (ETDEWEB)

    Ko, Jee Young; Kim, Kee Deog; Park, Chang Seo [Yonsei Univ. College of Dentistry, Seoul (Korea, Republic of)

    2001-06-15

    The purpose of this study was to find the relationship among the joint status, pain and effusion in patients with temporomandibular joint disorders. Materials included 406 patients (812 joints) with clinical records and bilateral TMJ MRIs in TMJ clinic, Yongdong Severance Hospital. All joints were classified in 4 groups in MR images according to the disc status of joint; normal disc position, disc displacement with reduction (DDsR), and also 2 groups according to the bony status of joint; normal bony structure and osteoarthrosis. MR evidence of joint effusion was categorized in 4 groups according to its amount. To determine the relationship between joint pain and joint effusion, 289 patients with unilateral TMJ symptoms were selected from total materials. Joint effusion was found 8.0% in normal disc position, 32.6% in DDcR, and 59.2% in DDsR (83.1% in early state and 23.1% in late stage). Joint effusion was found 39.7% in osteoarthrosis and 35.0% in normal bony structure. Joint effusion was more found in the painful joints (49.8%) than in the painless joints (22.4%) (p<0.001). Joint effusion in the early stage of DDsR only was more found significantly in painful joints (91.9%) than in painless joints (62.1%) (p<0.001). MR evidence of joint effusion might be related to disc displacement regardless of the presence of osteoarthrosis, and the early stage of DDsR was found more frequently combined with joint effusion and joint pain.

  16. Dynamic 3 T MRI of temporomandibular joint in diagnosing a stuck disk

    Directory of Open Access Journals (Sweden)

    J Sureka

    2012-01-01

    Full Text Available Magnetic resonance imaging (MRI is the imaging modality of choice in the evaluation of internal derangement of the temporomandibular joint (TMJ. Dynamic MRI including the open and close mouth views in sagittal plane determine the exact position of articular disk and thus help to evaluate the joint for internal derangement. We also highlight the role of dynamic MRI of TMJ in diagnosis of stuck disk in a 17-year-old male who presented with symptoms of pain and difficulty in opening the mouth.

  17. Groningen temporomandibular total joint prosthesis: an 8-year longitudinal follow-up on function and pain.

    Science.gov (United States)

    Schuurhuis, Jennifer M; Dijkstra, Pieter U; Stegenga, Boudewijn; de Bont, Lambert G M; Spijkervet, Fred K L

    2012-12-01

    Total temporomandibular joint replacement is a surgical procedure for patients with severe temporomandibular joint afflictions affecting quality of life, which have not responded beneficially to previous conventional surgery. The aim of this study was to assess the long-term outcome of the Groningen temporomandibular joint (TMJ) prosthesis in patients with chronic pain and mutilated temporomandibular joints following multiple surgical procedures, with respect to prosthesis failure, the patient's postoperative level of satisfaction and longitudinal changes in maximum mouth opening, functional mandibular impairment and pain. Eight female patients were studied in whom Groningen TMJ prostheses were inserted, two unilaterally and six bilaterally. The Groningen TMJ prosthesis was mechanically successful during 8 years of follow-up in seven out of eight patients with a disc dislocation being seen in one patient (7%). Patients were satisfied, despite the limited improvement of the maximum mouth opening, and pain scores. Although the decline of MFIQ scores during 8 years of follow-up was significant compared to baseline (p=0.027), the effects of the prosthesis on maximum mouth opening, function and pain were limited. This may be due to persistent chronic pain and the adverse effects of multiple previous surgical procedures. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  18. Therapeutic outcome assessment in permanent temporomandibular joint disc displacement

    NARCIS (Netherlands)

    Kropmans, TJB; Dijkstra, PU; Stegenga, B; De Bont, LGM

    In permanent temporomandibular disc displacement (TMJ-DD) outcome studies many authors claim positive effects of arthroscopic surgery, arthrocentesis and physical therapy. This literature review was undertaken to analyse whether the claimed effects are based on acceptable methodology. The recorded

  19. Dynamic MR imaging of internal derangements of the temporomandibular joint: correlation with clinical signs and symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Young Ah; Chun, Eun Ju; Kim, Yoo Kyung; Yoo, Jeong Hyun; Choi, Hae Young; Kim, Hyun Jin [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of); Chung, Eun Chul [Sungkyunkwan Univ. College of Medicine, Seoul (Korea, Republic of)

    1999-01-01

    To evaluate the correlation between findings of dynamic magnetic resonance (MR) imaging of the temporomandibular joint (TMJ) and clinical findings in patients with internal derangement of the TMJ. Dynamic MR images of 130 joints of 65 patients (17 men and 48 women aged 14 to 74; mean age, 34) with internal derangement of the TMJ were obtained using a 1.5-T MR imaging system. MR findings of anterior displacement, disc deformity and degenerative change were correlated with clinical findings including joint pain, clicking sound, crepitation and maximal mouth opening (MMO). Among 62 joints with TMJ pain, 32 showed anterior displacement without reduction, 15 showed disc deformity and 19 showed degenerative change. Among 49 joints in which there was a clicking sound, 24, 8 and 12 joints, respectively, showed the above-mentioned findings, while in seven with crepitation, these same findings were evident in five, six and four joints, respectively. Bilateral and unilateral joint disorders were observed in 17 and five patients, respectively, among 22 with MMO less than 30mm and in 11 and 18 of 42 patients with MMO between 30mm and 60mm. On MR imaging, patients with MMO less than 30mm usually showed bilateral joint disorders and those with crepitation showed chronic change. This indicates that there is high association between clinical findings of internal derangement of TMJ and MR findings.

  20. Congenital Temporomandibular Joint Ankylosis: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Ryan Chin Taw Cheong

    2016-01-01

    Full Text Available Congenital temporomandibular joint (TMJ ankylosis is an uncommon condition that presents itself at or soon after birth in the absence of acquired factors that could have contributed to the ankylosis such as infection and trauma. The experience of managing one such case is reported in light of a review of the literature on this condition. Key management principles include adequate removal of the ankylotic mass, costochondral grafting, and post-op physiotherapy. Most patients reported in the literature with the condition experienced relapse. This echoes our own experience where there was recurrence of the ankylosis. However, after removal of the ankylotic mass, the patient maintains a satisfactory maximal incisal opening (MIO till the present day. The additional challenges faced in the congenital form in addition to the already complex management of acquired paediatric temporomandibular joint ankylosis are (1 much earlier insult to the TMJ, (2 reduced opportunity for neuromuscular development of the muscles of mastication, and (3 reduced compliance with postoperative physiotherapy programmes due to the younger age of these patients.

  1. Osseous osteoarthritic-like changes and joint mobility of the temporomandibular joints and upper cervical spine: is there a relation?

    Science.gov (United States)

    Sonnesen, Liselotte; Petersson, Arne; Wiese, Mie; Jensen, Karl Erik; Svanholt, Palle; Bakke, Merete

    2017-02-01

    To compare 1) temporomandibular joint (TMJ) mobility between patients with and without reduced upper cervical spine (UCS) mobility and with and without TMJ osseous osteoarthritic-like changes, and 2) UCS osseous changes between patients with and without TMJ osseous osteoarthritic-like changes and with and without reduced UCS mobility. The study comprised 39 patients without pain from TMJ or UCS and with obstructive sleep apnea, 15 women (age range 26-72 years, mean 56.0) and 24 men (age range 27-71 years, mean 49.8). The range of motion (ROM) of the mandible and UCS was assessed clinically. Osseous changes of the TMJ and UCS were assessed by cone beam computed tomography. Differences were tested and adjusted for age and gender by multiple linear and logistic regression analyses. The mandibular ROM was within normal range (45-64 mm) but the UCS ROM was reduced in 15 patients. Osseous TMJ and UCS changes were both found in 38.5% of the patients. Osseous UCS changes were found more frequently in patients with than without TMJ changes (P = .0003; odds ratio 21.9). No other significant results were found. The present findings of comorbid osseous changes in patients with obstructive sleep apnea support a possible biomechanical relationship between the TMJ and the UCS. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. IL-1β Inhibits TGFβ in the Temporomandibular Joint

    Science.gov (United States)

    Lim, W.H.; Toothman, J.; Miller, J.H.; Tallents, R.H.; Brouxhon, S.M.; Olschowka, M.E.; Kyrkanides, S.

    2009-01-01

    Similarly to humans, healthy, wild-type mice develop osteoarthritis, including of the temporomandibular joint (TMJ), as a result of aging. Pro-inflammatory cytokines, such as IL-1β, IL-6, and TNFα, are known to contribute to the development of osteoarthritis, whereas TGFβ has been associated with articular regeneration. We hypothesized that a balance between IL-1β and TGFβ underlies the development of TMJ osteoarthritis, whereby IL-1β signaling down-regulates TGFβ expression as part of disease pathology. Our studies in wild-type mice, as well as the Col1-IL1βXAT mouse model of osteoarthritis, demonstrated an inverse correlation between IL-1β and TGFβ expression in the TMJ. IL-1β etiologically correlated with joint pathology, whereas TGFβ expression associated with IL-1β down-regulation and improvement of articular pathology. Better understanding of the underlying inflammatory processes during disease will potentially enable us to harness inflammation for orofacial tissue regeneration. PMID:19587162

  3. A Young Patient with Temporomandibular Joint Osteoarthritis: Case Report

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    Iva Alajbeg

    2017-01-01

    Full Text Available This paper describes a case of a young patient who sought help because of pain in the right temporomandibular joint (TMJ. She also reported increasing of pain during chewing. Clinical examination revealed limited mouth opening with uncorrected deviation to the ipsilateral side. Palpation of the lateral pole of the right condyle discovered crepitus, and maximum assisted opening elicited a report of “familiar pain”. The diagnosis of osteoarthritis of the TMJ (RDC / TMD criteria, Axis I, Group III was confirmed by CBCT of TMJ. There is no “gold standard” for the management of TMD, but the need for TMD treatment has to be based on precise indications related to the presence of pain, limitation in function of the lower jaw and signs of degenerative joint disease. Conservative, reversible therapeutic procedures are considered as the first choice for TMD treatment and their task is to improve the function of the entire masticatory system. In this case patient was treated with the combination of physical therapy and stabilization splint, in order to reduce the pain and restore the normal function of the lower jaw. At 6 months’ follow-up symptoms have almost completely disappeared, while 3 years later, the patient still has no significant subjective symptoms. In the present case non-invasive therapy was sufficient to bring, otherwise recurrent nature of osteoarthritis, in complete remission and keep it like that for years.

  4. Magnetic resonance imaging-based temporomandibular joint space evaluation in temporomandibular disorders

    Energy Technology Data Exchange (ETDEWEB)

    Nah, Kyung Soo [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2007-03-15

    Disc and condylar position were observed on MRIs of temporomandibular joint disorder patients and condylar position agreement between MRI and tranascranal radiography was evaluated. MRI and transcranial radiographs of both TM joints from 67 patients with temporomandibular disorder were used. On MRI, the position and shape of disc and condylar position as anterior, middle, posterior was evaluated at medial, center, and lateral views. On transcranial radiographs, condylar position was evaluated using the shortest distance from condyle to fossa in anterior, superior, and posterior directions. 1. On MRI, 96 joints (71.6%) of 134 had anterior disc dispalcement with reduction and 38 joints (28.4%) without reduction. 2. Fourteen (14.6%) of 96 reducible joints showed anterior condylar position. 19 (19.8%) showed central position, 63 joints (65.6%) showed posterior position. Two joints (5.3%) of 38 non-reducible joints showed anterior condylar position, while 9 (23.7%) showed central position, and 27 (71.1%)-posterior position. 3. In 85 joints (63.4%) of 134, the transcranial condylar position agreed with that of the central MRI view, 10 joints (7.5%) with that of medial, 16 joints (11.6%) with that of lateral, and 23 joints (17.2%) disagreed with that of MRI. On MRI, most of the reducible and non-reducible joints showed posterior condylar position. Transcranial radiographs taken with machine designed for TMJ had better agreement of condylar position with that of MRI. Extremely narrow joint spaces or very posterior condylar positions observed on transcranial radiographs had a little more than fifty percent agreement with those of MRIs.

  5. Effect of temporal bone resection on temporomandibular joint function: a quality of life study.

    Science.gov (United States)

    de Casso, Carmen; Kwhaja, Sadie; Davies, Stephen; Al-Ani, Ziad; Saeed, Shakeel R; Homer, Jarrod J

    2010-01-01

    Temporal bone resection for carcinoma may affect quality of life (QOL) and result in temporomandibular joint (TMJ) disorders. The aims of this study were to 1) assess TMJ function after temporal bone resection, and 2) assess the impact of TMJ dysfunction on QOL. Chart and patient review and QOL study. Tertiary referral center (Manchester Royal Infirmary). Thirty patients who had undergone temporal bone resection were identified. Thirteen patients were alive and were included in the study. All patients were submitted to a clinical examination to identify TMJ disorders and determine facial nerve function, and they all answered the University of Washington QOL (UW-QOL) questionnaire (version 4). Eight patients had TMJ disorders with reduced mobility in either direction and/or significant pain. Main factors affecting QOL were pain (P = 0.001), appearance (P = 0.001), and anxiety (P = 0.000). Neither facial nerve palsy nor TMJ disorders affected QOL. The responses to the UW-QOL questionnaire showed that 69 percent of our patients had a good QOL. A total of 61.53 percent of our patients had TMJ dysfunction presenting as restriction of jaw mobility with or without pain. TMJ dysfunction is present in a significant number of patients after temporal bone resection, resulting in longstanding problems, which should be addressed accordingly. Poor QOL results from ongoing pain and psycho-social disturbance.

  6. Benign Temporomandibular Joint Lesions Presenting as Masses in the External Auditory Canal.

    Science.gov (United States)

    Williams, Ryan A; Jackler, Robert K; Corrales, C Eduardo

    2017-04-01

    Describe benign lesions arising from the temporomandibular joint (TMJ) that presented as masses in the external auditory canal (EAC). Retrospective case series of two academic medical centers. Six patients with lesions emanating from the TMJ that presented as EAC masses. Lesions included pigmented villonodular synovitis (PVNS), nodular fasciitis, foramen of Huschke herniation with salivary fistula, fibroepithelial polyp, superficial angiomyxoma, and giant cell tumor (GCT). Surgical resection. Tumor control, TMJ function, and hearing. All patients presented with hearing loss, TMJ pain, and otalgia. Three patients with EAC occluding masses developed entrapment cholesteatoma between the mass and tympanic membrane. Following surgical resection, four patients were free of disease. The patient with PVNS has a stable remnant at 3 years follow up and the patient with giant cell tumor is under active surveillance. Hearing improved in three patients, remained stable in one patient, and worsened in two patients. All had resolution of their TMJ and ear pain. EAC masses of uncertain origin should be imaged preoperatively to exclude lesions best not biopsied (e.g., encephalocele, facial nerve schwannoma, paraganglioma). In the differential of EAC masses, lesions emanating from the TMJ need to be considered, especially for those based anteriorly. Understanding the extent of TMJ involvement is crucial for surgical planning which optimizes outcome. Goals for therapy are to control the underlying disease process, restore patency of the EAC, improve hearing, and preserve function of TMJ.

  7. Pain profiling of patients with temporomandibular joint arthralgia and osteoarthritis diagnosed with different imaging techniques.

    Science.gov (United States)

    Kothari, Simple Futarmal; Baad-Hansen, Lene; Hansen, Lars Bolvig; Bang, Niels; Sørensen, Leif Hovgaard; Eskildsen, Helle Wulf; Svensson, Peter

    2016-12-01

    Clinical differentiation between pain mechanisms of temporomandibular joint (TMJ) arthralgia and osteoarthritis (OA) is challenging. The aims were to compare somatosensory function at the TMJs and conditioned pain modulation (CPM) effects between TMJ arthralgia and OA patients diagnosed clinically and based on different imaging techniques and age- and gender-matched healthy controls (n = 41). Patients (n = 58) underwent standard clinical examination and three different TMJ imaging modalities. After each examination, they were classified into arthralgia or OA based on the findings. TMJ region somatosensory testing was performed in all participants. Z-scores were calculated for patients based on healthy reference data. CPM was tested by comparing pressure pain thresholds (PPTs) at TMJ and thenar (control) before, during and after the application of painful and nonpainful cold stimuli. Data were analyzed using analyses of variance. Somatosensory abnormalities were commonly detected in both patient groups. Assessment of somatosensory function at the TMJ revealed that arthralgia patients were less sensitive to warmth, cold and tactile stimuli than OA patients (P painful cold application in all groups (P Pain profiles including somatosensory function differed between TMJ arthralgia and OA patients although CPM effects were similar in patients and controls. Thus, different TMJ pain conditions may share common pain mechanisms but the present study for the first time also indicated that differential pain mechanisms could be involved.

  8. Analysis of MRI findings in minimum invasive treatment for habitual temporomandibular joint dislocation by autologous blood injection around the temporomandibular joint capsule.

    Science.gov (United States)

    Oshiro, Nobuyoshi; Yoshida, Hiroaki; Uemura, Mamoru; Suwa, Fumihiko; Morita, Shosuke

    2014-10-01

    The aim of this study was to investigate magnetic resonance imaging (MRI) findings following autologous blood injection (ABI) for habitual temporomandibular joint (TMJ) dislocation. MRI was performed one hour and four and twelve weeks after ABI, revealing three types of significant findings. The first type was similar to hematoma and/or joint effusion in the articular capsule of the TMJ (type I). The second showed sporadic and diffuse T2 emphasis around the TMJ capsule (type II). The third involved a decreased range of condyle movement compared to before ABI (type III). Furthermore, we analyzed the three types of significant MRI findings. At one hour after ABI, type I was Grade 0 in 0 of 14 patients, Grade 1 in 8, Grade 2 in 2, and Grade 3 in 4. Type II was seen in 9 of the 14 cases and type III in 8. After twelve weeks, all cases of type I were Grade 0, no type II cases were evident, and type III was seen in 11 cases. Injecting autologous blood into surrounding TMJ tissues is an important factor in ABI. Minimally invasive treatment for habitual TMJ dislocation using ABI around the TMJ capsule appears to represent a very effective and safe treatment. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. [Metastases in the temporomandibular joint: a review from 1954 to 2013. Rare causes for temporomandibular disorders].

    Science.gov (United States)

    Pretzl, Christine; Lübbers, Heinz-Theo; Grätz, Klaus W; Kruse, Astrid L

    2014-01-01

    Metastatic lesions make up approximately 1% of all oral cancers.A comparatively rare location is the temporomandibular joint.Leading symptoms can be misdirecting, especially in the beginning,because they are frequently similar or even identical to those occurring in temporomandibular disorders. Therefore it can be quite difficult to confirm the diagnosis of a TMJ metastasis.delayed initiation of therapy and thus a poor prognosis are often the results. A review of the literature from 1954 to 2013 was realized and the published cases between 1954 and January 2013 were evaluated.The results were analyzed according to gender distribution, age,first symptoms, location of the primary tumor, as well as to the occurrence of malignancies in the patients' medical history. The research identified sixty-six patients. Tumors of the lung and breast were the main starting points of the metastatic spread. The histopathological workup showed above all the diagnosis of an adenocarcinoma. In all of the cases, unspecific symptoms led to the diagnosis of a metastatic disease. In the case of nonspecific TMJ affection, diagnostics should consider less-frequent diagnoses, such as the presence of metastasis.A clinical differentiation by additional symptoms like swelling, unexplained weight loss and night sweats, as well as a tumor disease in the past or failure of conservative treatment can provide additional indications. If there is reasonable suspicion,extended medical imaging and diagnostic measures must be performed to allow early treatment initiation and a better prognosis.

  10. Bilateral TMJ Involvement in Rheumatoid Arthritis

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    Pritesh B. Ruparelia

    2014-01-01

    Full Text Available Rheumatoid arthritis (RA is a systemic inflammatory, slowly progressive disease that results in cartilage and bone destruction. Temporomandibular joint (TMJ involvement is not uncommon in RA, and it is present in about more than 50% of patients; however, TMJ is usually among the last joints to be involved and is associated with many varied clinical signs and symptoms. Hence, RA of TMJ presents to the dentist with great diagnostic challenges. This report presents a case of RA with bilateral TMJ involvement with its classical radiographic findings and review literature.

  11. Chondrosarcoma of the temporomandibular joint: a case report and review of the literature.

    Science.gov (United States)

    Oh, Kyu-Young; Yoon, Hye-Jung; Lee, Jae-Il; Hong, Sam-Pyo; Hong, Seong-Doo

    2016-07-01

    Chondrosarcoma is the second most common sarcoma arising in the bone, but it rarely involves the temporomandibular joint (TMJ). To date, 30 cases of TMJ chondrosarcoma have been reported in the English literature, and the authors report an additional case arising from a cystic lesion in a 60-year-old female patient. The clinical and radiological diagnosis of the lesion was initially synovial cyst, and periodic check-ups were done after aspiration of the lesion. After three years, the patient perceived swelling of the lesion, and surgical excision was performed. The final diagnosis was grade I chondrosarcoma. When clinicians detect a cystic lesion in the radiographic imaging of the TMJ, chondrosarcoma should be included in the differential diagnosis. In addition, computed tomography (CT) as well as magnetic resonance imaging (MRI) is recommended for the accurate diagnosis and proper preoperative planning in TMJ chondrosarcoma.

  12. Incidentally found and unexpected tumors discovered by MRI examination for temporomandibular joint arthrosis

    Energy Technology Data Exchange (ETDEWEB)

    Yanagi, Yoshinobu; Asaumi, Jun-ichi E-mail: asaumi@md.okayama-u.ac.jp; Maki, Yuu; Murakami, Jun; Hisatomi, Miki; Matsuzaki, Hidenobu; Konouchi, Hironobu; Honda, Yosutoshi; Kishi, Kanji

    2003-07-01

    We examined the frequency of incidentally found or unexpected tumors discovered at the time of magnetic resonance imaging (MRI) examinations in the temporomandibular joint (TMJ) region for patients with suspicion of TMJ arthrosis. Five MR images (T1-weighted transverse scout image and proton density and T2-weighted oblique sagittal images at the open and closed mouth) were acquired. In 2776 MRI examinations of TMJ arthrosis, two tumors were discovered. They consisted of an adenoid cystic carcinoma in the deep portion of the parotid gland, and a malignant tumor extending from the infratemporal fossa to the parapharyngeal space. The rate of incidentally founded or unexpected tumors in TMJ examinations was low (0.072%), but the two tumors found were malignant tumors, and therefore, scout image should be carefully examined, not only used for positing the slice.

  13. Ganglion and Synovial Cyst of the Temporomandibular Joint: A Case Report and Literature Review.

    Science.gov (United States)

    Steen, M Willemijn; Hofstede, Diederik J

    2015-09-01

    Ganglion and synovial cysts of the temporomandibular joint (TMJ) are rare. Although histopathological findings differ, clinical presentation is comparable. This study adds a case report of a ganglion of the TMJ to existing literature and a review of all available case reports on ganglion and synovial cysts of the TMJ. Including our own case report, we reviewed 49 cases of ganglion and synovial cysts of the TMJ. They occurred in a female:male ratio of 3:1, at an median age of 46 years (range, 11-64 years). Patients mainly presented with preauricular swelling and pain. After imaging, the ganglion or synovial cyst was most commonly excised under general anesthesia. No recurrences were described.

  14. Osteoarthrosis of Temporomandibular Joint Related to the Defects of Posterior Dentition: A Retrospective Study.

    Science.gov (United States)

    Levorová, Jitka; Machoň, Vladimír; Guha, Anasuya; Foltán, René

    Osteoarthrosis (OA) of temporomandibular joint (TMJ) is a progressive degenerative disease, gradually affecting cartilage, synovial membrane and bone structures. OA of TMJ clinically manifests with joint noises, pain and restricted mouth opening. In late stages, it results in severe damage of TMJ structures and development of ankylosis. Osteoarthrosis is a multifactorial disease; the occurrence is associated with TMJ overloading. The cohort included 619 patients [538 women (87%) and 81 men (13%), with average age 40.6 years (age range 8-89 years)] with TMJ disorder, who were examined in the year 2014 in Department of Dental Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic. The aim of this retrospective study was to analyse, if the lack of posterior teeth (supporting teeth zones) is the main etiologic factor of osteoarthrosis of TMJ. Diagnosis of OA was established on the clinical signs and the panoramic X-ray signs. Simultaneously other etiologic factors of OA were assessed. The presence of OA changes on X-ray had 171 patients (i.e. 27.6% of the total number of 619). 17.5% from these patients with OA had defect in posterior dentition. Other aetiological factors (stress, skeletal or vertebrogenous disorders) showed higher incidence of OA changes on X-ray. Defect of posterior dentition is not negligible, but it is not the main aetiological factor for osteoarthrosis of TMJ.

  15. Osteoarthrosis of Temporomandibular Joint Related to the Defects of Posterior Dentition: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Jitka Levorová

    2016-01-01

    Full Text Available Osteoarthrosis (OA of temporomandibular joint (TMJ is a progressive degenerative disease, gradually affecting cartilage, synovial membrane and bone structures. OA of TMJ clinically manifests with joint noises, pain and restricted mouth opening. In late stages, it results in severe damage of TMJ structures and development of ankylosis. Osteoarthrosis is a multifactorial disease; the occurrence is associated with TMJ overloading. The cohort included 619 patients [538 women (87% and 81 men (13%, with average age 40.6 years (age range 8–89 years] with TMJ disorder, who were examined in the year 2014 in Department of Dental Medicine, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic. The aim of this retrospective study was to analyse, if the lack of posterior teeth (supporting teeth zones is the main etiologic factor of osteoarthrosis of TMJ. Diagnosis of OA was established on the clinical signs and the panoramic X-ray signs. Simultaneously other etiologic factors of OA were assessed. The presence of OA changes on X-ray had 171 patients (i.e. 27.6% of the total number of 619. 17.5% from these patients with OA had defect in posterior dentition. Other aetiological factors (stress, skeletal or vertebrogenous disorders showed higher incidence of OA changes on X-ray. Defect of posterior dentition is not negligible, but it is not the main aetiological factor for osteoarthrosis of TMJ.

  16. Assessment of the Temporomandibular Joint Function in Young Adults without Complaints from the Masticatory System.

    Science.gov (United States)

    Kondrat, Wojciech; Sierpińska, Teresa; Radke, John

    2018-01-01

    Objective of the study was to evaluate the clinical status of the masticatory system in young adults with full permanent dentition and no stomatognathic system complaints. The study involved 186 randomly selected people with full dental arches with normal occlusal conditions corresponding to Angle's Class I aged 18 - 21 years with an average age of 19 years. Subjects were clinically examined and temporomandibular joint (TMJ) vibrations were recorded during open-wide and close movements using BioJVA. Then, patients were categorized into groups according to Piper's classification system. The TMJs of the subjects were categorized according to the values of the vibration energy and the Piper protocol. This detected 33.4% of the joints with loosened ligaments, subluxation in 8.28%, initial signs of disc dysfunction in 5.08% and disc displacement without locking in 1.6 %. Median frequency differed significantly (p < 0.05) between the group of subjects with initial signs of TMJ dysfunction and other groups. Peak Frequency differed significantly (p < 0.05) between the healthy joints and those with TMJ subluxation. In this group of young healthy people, the majority of study joints generated small vibrations. However, a subset of people manifested higher vibrations that may indicate an early stage of TMJ dysfunction. Median Frequency was an important parameter for detecting initial symptoms of TMJ dysfunction. Peak Frequency was an important characteristic parameter for detecting TMJ subluxation.

  17. Management of temporomandibular joint ankylosis with combination of gap arthroplasty surgery and physiotherapy

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    Nurul Ramadhanty

    2017-08-01

    Full Text Available Background. Temporomandibular joint (TMJ ankylosis is a union of the articular surface of the temporal bone to the disc-condyle complex that restricts mandibular movements due to either a fibrous or bony union between the head of the condyle and the glenoid fossa. Common etiological factors are trauma, infection, and pathology in the joint or systemic diseases. The diagnosis of TMJ ankylosis is established through physical and clinical evaluation, and imaging examination. Currently, the surgical techniques used to treat TMJ ankylosis are gap arthroplasty, interpositional arthroplasty, joint reconstruction, and distraction osteogenesis. Purpose. To provide overview about management of temporomandibular joint ankylosis with gap arthroplasty combined with physiotherapy post surgery. Case. A 12-year-old female patient came to Department of Oral and Maxillofacial Surgery with complaint of opening mouth restriction, which occured since one year prior to admission. After complete physical and radiographic examination, patient then was diagnosed with TMJ ankylosis due to neglected odontogenic infection. The treatment was performed with gap arthroplasty under general anesthesia. Patient then underwent physiotherapy after the surgery, including application of heat on the affected region and exercises to open and close mouth. Discussion. Ankylosis of TMJ is an uncommon case that results in chronic and severe limited mouth opening. The critical factor of successful treatment of TMJ ankylosis is early detection, correct surgery approach, implementation of an intensive physiotherapy program, and a good post-operative conduct. Therefore on this patient, gap arthroplasty was the chosen surgery approach followed by intensive physiotherapy. Conclusion.Management goal in TMJ ankylosis is  to increase the patient’s mandibular function, correct associated facial deformity, decrease pain, and prevent reankylosis. Careful surgical technique and subsequent atten

  18. Intra-articular injections with corticosteroids and sodium hyaluronate for treating temporomandibular joint disorders: a systematic review

    OpenAIRE

    Eduardo Machado; Daniel Bonotto; Paulo Afonso Cunali

    2013-01-01

    INTRODUCTION: In some cases, conservative treatment of internal derangements of the Temporomandibular Joint (TMJ) is considered little responsive. Thus, it is necessary to accomplish treatments that aim at reducing pain and improve patients' functions who present arthrogenic temporomandibular disorders. OBJECTIVE: This study, by means of a systematic review of the literature, aimed to analyze the effectiveness of intra-articular injections with corticosteroids and sodium hyaluronate for treat...

  19. A Joint Less Ordinary: Intriguing Roles for Hedgehog Signalling in the Development of the Temporomandibular Synovial Joint

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    Malgorzata Kubiak

    2016-08-01

    Full Text Available This review highlights the essential role of Hedgehog (Hh signalling in the developmental steps of temporomandibular joint (TMJ formation. We review evidence for intra- and potentially inter-tissue Hh signaling as well as Glioma-Associated Oncogene Homolog (GLI dependent and independent functions. Morphogenesis and maturation of the TMJ’s individual components and the general landscape of Hh signalling is also covered. Comparison of the appendicular knee and axial TMJ also reveals interesting differences and similarities in their mechanisms of development, chondrogenesis and reliance on Hh signalling.

  20. The Temporomandibular Joint Pain Dysfunction Syndrome

    OpenAIRE

    Speck, John E.

    1988-01-01

    When a patient complains of headache, neckache, or earache and these are associated with noisy temporomandibular joint function, restricted opening or increased pain when chewing, a temporomandibular joint or masticatory muscle disorder should be considered in the differential diagnosis, because signs and symptoms of these disorders are common in all age groups. This article indicates the more common etiological contributions, that is, microtrauma, repeated microtrauma, muscle hyperactivity, ...

  1. Ex vivo thickness measurement of cartilage covering the temporomandibular joint.

    Science.gov (United States)

    Mirahmadi, Fereshteh; Koolstra, Jan Harm; Lobbezoo, Frank; van Lenthe, G Harry; Everts, Vincent

    2017-02-08

    Articular cartilage covers the temporomandibular joint (TMJ) and provides smooth and nearly frictionless articulation while distributing mechanical loads to the subchondral bone. The thickness of the cartilage is considered to be an indicator of the stage of development, maturation, aging, loading history, and disease. The aim of our study was to develop a method for ex vivo assessment of the thickness of the cartilage that covers the TMJ and to compare that with two other existing methods. Eight porcine TMJ condyles were used to measure cartilage thickness. Three different methods were employed: needle penetration, micro-computed tomography (micro-CT), and histology; the latter was considered the gold standard. Histology and micro-CT scanning results showed no significant differences between thicknesses throughout the condyle. Needle penetration produced significantly higher values than histology, in the lateral and anterior regions. All three methods showed the anterior region to be thinner than the other regions. We concluded that overestimated thickness by the needle penetration is caused by the penetration of the needle through the first layer of subchondral bone, in which mineralization is less than in deeper layers. Micro-CT scanning method was found to be a valid method to quantify the thickness of the cartilage, and has the advantage of being non-destructive. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Clinical treatment of a ruptured temporomandibular joint disc: morphological changes at 5-year follow-up.

    Science.gov (United States)

    Cardinal, Lucas; Porto, Felipe; Agarwal, Sachin; Grossman, Eduardo

    2014-01-01

    Osteoarthrosis is a disease that affects the temporomandibular joint (TMJ). This case report chronicles the diagnosis and treatment of a patient for whom this pathological condition was accompanied by a rupture of the articular disc. The patient presented with loud sounds in the left TMJ and an irregular mandibular occlusal plane due to condylar intrusion in the glenoid fossa on the ipsilateral side. A noninvasive treatment was selected. A 4-month follow-up revealed remission of the articular sounds, and tissue regeneration was noted. These improvements remained visible at 5-year follow-up.

  3. Targeted assessment of the temporomandibular joint in patients with rheumatoid arthritis.

    Science.gov (United States)

    Bessa-Nogueira, Ricardo V; Vasconcelos, Belmiro Cavalcanti do Egito; Duarte, Angela P; Góes, Paulo S A; Bezerra, Tácio P

    2008-09-01

    This observational study was done to identify the signs and symptoms of temporomandibular joint (TMJ) involvement in patients with rheumatoid arthritis (RA) and to assess the association between these and quantitative measurements for the evaluation of rheumatologic disease. The sample comprised 61 patients suffering from RA whose signs and symptoms of TMJ were recorded by means of a questionnaire (scale of limited mandibular function) and clinical measurements (pain during jaw movement, limitation of maximal mouth opening, joint sounds, tenderness on TMJ palpation, tenderness on masticatory muscle palpation). These findings were correlated with the quantitative measurements for evaluating RA: duration of the disease, positivity for rheumatoid factor, Health Assessment Questionnaire (HAQ) score, number of edematous and painful joints, and overall assessment of functional status. In terms of overall figures, 70.5% of the patients presented with at least 1 sign or symptom, 49.2% had at least 1 symptom, and 54.1% had at least 1 sign. The variable pain on movement was associated with the number of painful joints and the overall assessment findings (P palpation of the masticatory muscles was associated with the number of painful joints (P = .0023). Pain on palpation of the TMJ was statistically significantly associated with the HAQ score (P = .0344) and with the number of painful joints (P = .0006). A significant percentage of the patients with RA have signs and symptoms of TMJ involvement, and the scale of limited mandibular function proved to be an important measurement tool.

  4. On surgical intervention in the temporomandibular joint.

    Science.gov (United States)

    Widmark, G

    1997-01-01

    The aim of this thesis was to evaluate the indications for and the results of temporomandibular joint (TMJ) surgery in patients with long-standing severe orofacial pain and dysfunction as well as in patients with fractures of the condylar neck. The patients with long-standing pain and dysfunction had had symptoms for a mean time of 4 years, had been treated conservatively for a mean time of 2.5 years, and had undergone numerous conservative treatment methods without improvement except for a minor increase in mouth opening capacity. The indications for surgery were strict; only 1% or less of all the patients referred to the departments with a diagnosis of temporomandibular disorder (TMD) were prescribed surgery, which was considered to be the only remaining option. The TMJ surgery reduced pain, sleeping problems, and analgesic consumption and improved mouth opening capacity. The procedure showed low morbidity except for a facial nerve disturbance in three patients. Postoperatively, the bite force was observed to be normalised, and the radiographic examination showed moderate to severe osteoarthrotic changes. These changes, though extensive, were considered to be the normal outcome of diskectomy and without clinical significance, even though they resembled degenerative joint disease. In study V, surgery was performed on patients with a clear diagnosis of anterior disk displacement (ADD) with or without reduction. The preoperative pain and mouth opening capacity were markedly improved as well as other subjective symptoms. Although surgical morbidity was low, some radiographic changes were clearly detectable. In agreement with earlier reports, patients with a distinct diagnosis of ADD with or without reduction were clearly helped by diskectomy. In cases of ADD with or without reduction, it can be concluded that unsuccessful conservative treatment should not exceed 3-6 months but be discontinued in favour of the documented advantages of surgery in these cases. Patients

  5. Evaluation of skin dose in tomographic radiographs of temporomandibular joint; Avaliacao da dose pele em radiografias tomograficas da articulacao tempromandibular

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    Oliveira, S.B.; Chaves, F.C.; Rocha, F.E.F.C. [Pernambuco Univ., Recife, PE (Brazil). Dept. de Clinica e Odontologia Preventiva; Khoury, H.J. [Pernambuco Univ., Recife, PE (Brazil). Dept. de Energia Nuclear]. E-mail: khoury@elogica.com.br

    2001-07-01

    The aim of this study was to evaluate the skin entrance dose, in patients with temporomandibular joint (TMJ) dysfunctions submitted to computerized tomography. For this purpose, in a private medical establishment, in the city of Recife-Pe/Br, 40 patients were evaluated, in according to radiation doses received in eyes, thyroid and TMJ regions. The value found for eye region range from 0.004 to 0.125 mGy, for thyroid range from 0.002 to 0.113 mGy and for TMJ range from 0.112 to 0.541 mGy.

  6. Spontaneous temporomandibular joint herniation into the external auditory canal through a patent foramen of Huschke: A case report

    Directory of Open Access Journals (Sweden)

    Kyeong Hwa Ryu, M.D.

    2017-06-01

    Full Text Available Temporomandibular joint herniation (TMJ can be caused by inflammation, trauma, tumor, or otologic procedures. However, spontaneous TMJ herniation can also occur as a result of a congenital bony defect in the external auditory canal (EAC, known as the patent foramen of Huschke (PFH, and occurs in 0.4% of the population. Herein, the authors present a case of spontaneous TMJ herniation through the PFH with clicking tinnitus. The patient underwent the surgical repair of bony defect in the EAC with placement of titanium mesh, and the symptom disappeared after surgery. They also review the relevant literature regarding this disease and discuss its embryologic development and clinical significance.

  7. Is There an Association Between Temporomandibular Joint Effusion and Arthralgia?

    Science.gov (United States)

    Khawaja, Shehryar N; Crow, Heidi; Mahmoud, Ruba F G; Kartha, Krishnan; Gonzalez, Yoly

    2017-02-01

    The literature on joint effusion (JE) and its association with clinical and radiologic variables in patients with temporomandibular disorders (TMDs) is inconsistent and is characterized by multiple methodologic limitations. The primary aim of this investigation was to evaluate the association between magnetic resonance imaging (MRI) identified JE and temporomandibular joint (TMJ) arthralgia. The secondary aim of this investigation was to determine the association between JE and other clinical and MRI-identified soft tissue characteristics. A retrospective cohort study was conducted. Clinical and soft tissue imaging assessments were carried out according to the Diagnostic Criteria for Temporomandibular Disorders guidelines. The dependent variable was JE and the primary independent variable was arthralgia. The secondary independent variables were TMJ pain-associated characteristics and MRI-identified variables. When applicable, Pearson χ2 or t test was used to determine the statistical associations between JE and clinical characteristics and between JE and MRI-identified variables. Furthermore, generalized estimating equation (GEE) modeling was conducted to determine which of the independent clinical and MRI-identified variables were associated with JE. Data for 158 participants, representing 312 joints, were extracted. The mean age of the female sample (59.4%) was 31 ± 11.1 years and that of the male sample (40.6%) was 29.8 ± 9.7 years. No association was found between JE and arthralgia. However, statistically significant associations were found between JE and lateral disc rotation (P = .001) and between JE and disc position in the coronal and sagittal planes (P = .001). The GEE model suggested that disc displacement with reduction (odds ratio = 2.5) was a statistically relevant contributing factor for JE in the absence of degenerative joint disease. Results associated JE with the position of the disc in the sagittal plane. No association was found between

  8. Temporomandibular Joint Pain: Clinical Presentations and Response to Conservative Treatments in a Nigerian Tertiary Hospital.

    Science.gov (United States)

    Oyetola, Elijah Olufemi; Adesina, Olufunlola Motunrayo; Oluwadaisi, Adeniyi; Adewale, Adedotun; Adewole, Opeyemi; Anizoba, E

    2017-01-01

    The aims of this study are to determine the prevalence, pattern of presentation, and response to conservative (medical) interventions among patients who presented with temporomandibular joint (TMJ) pain in a Nigerian teaching hospital. Consecutive patients who presented in Oral Medicine and Periodontology Clinic of Obafemi Awolowo University Teaching Hospitals' Complex on account of TMJ pain from January 2015 to December 2015 were recruited for the study. They were all interviewed and examined. The severity of pain was recorded using visual analog scale (VAS). Patients were treated with medications and physiotherapy. They were reviewed at 2, 4, and 6 weeks. Those who could not make the appointment were contacted through phone. The findings were recorded and analyzed using STATA version 11. A total of 401 participants were seen, 55 presented on account of TMJ pain. The mean age of patients with TMJ pain was 54 ± 16.9 with 60% being female. Pain was present in all participants; other signs include clicking joint sound (85%), jaw deviation (64%), attrition (24%), and reduced mouth opening (23%). The left joint was more frequently affected (75%). Following 6 weeks of conservative treatments, none of the respondents had VAS score of more than 3. The prevalence of TMJ pain was 13%. TMJ was found to be more common in participants above 50 years with female predilection. Pain was most common symptom seen, and response to conservative treatments as assessed using VAS following 6-week of treatment showed complete remission of the pain.

  9. BMPRIA mediated signaling is essential for temporomandibular joint development in mice.

    Directory of Open Access Journals (Sweden)

    Shuping Gu

    Full Text Available The central importance of BMP signaling in the development and homeostasis of synovial joint of appendicular skeleton has been well documented, but its role in the development of temporomandibular joint (TMJ, also classified as a synovial joint, remains completely unknown. In this study, we investigated the function of BMPRIA mediated signaling in TMJ development in mice by transgenic loss-of- and gain-of-function approaches. We found that BMPRIA is expressed in the cranial neural crest (CNC-derived developing condyle and glenoid fossa, major components of TMJ, as well as the interzone mesenchymal cells. Wnt1-Cre mediated tissue specific inactivation of BmprIa in CNC lineage led to defective TMJ development, including failure of articular disc separation from a hypoplastic condyle, persistence of interzone cells, and failed formation of a functional fibrocartilage layer on the articular surface of the glenoid fossa and condyle, which could be at least partially attributed to the down-regulation of Ihh in the developing condyle and inhibition of apoptosis in the interzone. On the other hand, augmented BMPRIA signaling by Wnt1-Cre driven expression of a constitutively active form of BmprIa (caBmprIa inhibited osteogenesis of the glenoid fossa and converted the condylar primordium from secondary cartilage to primary cartilage associated with ectopic activation of Smad-dependent pathway but inhibition of JNK pathway, leading to TMJ agenesis. Our results present unambiguous evidence for an essential role of finely tuned BMPRIA mediated signaling in TMJ development.

  10. Value of cone-beam computed tomography in the process of diagnosis and management of disorders of the temporomandibular joint

    NARCIS (Netherlands)

    de Boer, E. W. J.; Dijkstra, P. U.; Stegenga, B.; de Bont, L. G. M.; Spijkervet, F. K. L.

    The objective of this study was to assess the value of cone-beam computed tomographic (CT) images in the primary diagnosis and management of 128 outpatients with disorders of the temporomandibular joint (TMJ). Before a diagnosis was made and treatment planned, the history was taken, physical

  11. A radiographic study on temporomandibular joint trouble

    Energy Technology Data Exchange (ETDEWEB)

    Choe, Byoung Woon; Ahn, Hyung Kyu [Dept. of Dental Radiology, Graduate School, Seoul National University, Seoul (Korea, Republic of)

    1979-11-15

    The purpose of this study was to investigate the radiographic images of Temporomandibular joint trouble patients. This study included 186 patients with the chief complaints of TMJ pain and dysfunction. Their age ranged from 17 to 68 years. All patients were identified in the department of Dental Radiology at the Infirmary of College of Dentistry, Seoul National University, during the period from Apr. 1978 to Jun. 1979. The author has observed the radiographic variations of two positions of condylar head taken by modified transcranial oblique-lateral projection, which are one in centric occlusion and the other in 1 inch(2.54 cm) mouth open. The results were obtained as follows; 1. In centric occlusion, the distances and positional relationship between the summit of condylar head and the deepest point of articular fossa revealed more or less large variations; Normal range is of 37.9%, anterior displacement of 37.3% and posterior displacement of 22.6%. 2. In the horizontal movement of condylar heads when on 1 inch mouth open, it was revealed that normal range was of 46.5%, anterior displacement of 12.3%, posterior displacement of 41.1%. 3. In the positional interrelationship of both condylar heads when on 1 inch mouth open, it was revealed that symmetry(71.5%) occurred approximately 2.5 times as many as asymmetry. 4. In both centric and 1 inch mouth open, it was showed that almost all estimated figures were greater in male than in female, and in the horizontal movement of condylar head when on 1 inch open, it was showed that hypermobility was dominant in male and hypomobility in female.

  12. Crosslinking of fibrinogen and fibronectin by free radicals : A possible initial step in adhesion formation in osteoarthritis of the temporomandibular joint

    NARCIS (Netherlands)

    Dijkgraaf, LC; Zardeneta, G; Cordewener, FW; Liem, RSB; Schmitz, JP; de Bont, LGM; Milam, SB

    Purpose: Adhesion formation in osteoarthritis (OA) of the temporomandibular joint (TMJ) typically results in a sustained limitation of joint movement. We propose the hypothesis that free-radical-mediated crosslinking of proteins underlies this adhesion formation in affected joints. Free radicals may

  13. Clinical view of the temporomandibular joint disorder.

    Science.gov (United States)

    Badel, Tomislav; Ćimić, Samir; Munitić, Mirna; Zadravec, Dijana; Kes, Vanja Bašić; Šimunković, Sonja Kraljević

    2014-12-01

    Temporomandibular pain has a musculoskeletal origin because it occurs as a consequence of masticatory muscle function disorder and temporomandibular joint disorder. Most common diagnoses of disorders are disc displacement and osteoarthritis, but their comorbidity can also occur. Pain is the most common symptom, where chronic temporomandibular pain may con- tribute to the occurrence of psychological disorders in the patient population. Splint is the most widespread dental method of treatment but other, noninvasive methods of musculoskeletal pain treatment are also recommended. Electronic axiography is used for visualization of mandibular movements, in particular pathologic sounds in the joints. Mental health, although not so obvious in dental practice, can influence the need of a multidisciplinary approach to the patient with disorder of the temporomandibular joint.

  14. Orofacial symptoms related to temporomandibular joint arthritis in juvenile idiopathic arthritis: smallest detectable difference in self-reported pain intensity.

    Science.gov (United States)

    Stoustrup, Peter; Kristensen, Kasper D; Verna, Carlalberta; Küseler, Annelise; Herlin, Troels; Pedersen, Thomas K

    2012-12-01

    Temporomandibular joint (TMJ) inflammation in patients with juvenile idiopathic arthritis (JIA) may lead to mandibular growth disturbances and interfere with optimal joint and muscle function. Orofacial symptoms are common clinical findings in relation to TMJ arthritis in adolescence. Knowledge about their clinical manifestation is important for TMJ arthritis diagnosis, treatment choice, and outcome evaluation. The aim of our prospective observational study was to evaluate and describe the frequency, the main complaints, and the localization of TMJ arthritis-related orofacial symptoms. The smallest detectable differences (SDD) for minimal, average, and maximal pain were estimated. Thirty-three patients with JIA and arthritis-related orofacial symptoms in relation to 55 affected TMJ were included in our questionnaire study (mean age 14.11 yrs). Calculation of the SDD was based on a duplicate assessment 45 min after the first questionnaire was completed. The majority of the patients had common orofacial symptoms during mastication and maximal mouth opening procedures. Persistent orofacial symptoms were rare. The TMJ area in combination with the masseter muscle region was the orofacial region where symptoms were most common. The SDD for minimal, average, and maximal pain were between 10 and 14 mm on a visual analog scale. Our study offers new knowledge about TMJ arthritis-related orofacial symptoms that may aid diagnosis and clinical decision-making. We suggest that TMJ arthritis-related orofacial symptoms could be understood as products of the primary TMJ inflammation in combination with secondary myogenic and functional issues.

  15. Two-year prospective study of outcomes following total temporomandibular joint replacement.

    Science.gov (United States)

    Gonzalez-Perez, L M; Fakih-Gomez, N; Gonzalez-Perez-Somarriba, B; Centeno, G; Montes-Carmona, J F

    2016-01-01

    The purpose of this 2-year prospective study was to investigate outcomes achieved with a stock temporomandibular joint (TMJ) replacement system in the management of end-stage TMJ disorders. Fifty-two patients requiring reconstruction (36 unilateral/16 bilateral) were operated on during the period 2006-2012; 68 total prostheses were implanted (Biomet Microfixation TMJ Replacement System). The mean age at surgery was 52.6±11.5 years. Changes in the values of inclusion diagnostic criteria at entry were assessed. These included persistent and significant TMJ pain, functional impairment after failure of other surgical therapies, and imaging evidence consistent with advanced TMJ disease of more than 1-year duration. Subjects were excluded if they presented insufficient quantity/quality of bone to support the TMJ replacement, severe hyperfunctional habits, active infectious disease, or an inability to follow postoperative instructions. Over the 2 years of postoperative follow-up, mean pain intensity was reduced from 6.4±1.4 to 1.6±1.2 (PTMJ replacements fitted. The results of this study support the view that the surgical placement of stock TMJ prostheses provides significant long-term improvements in pain and function, with few complications. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Management of temporomandibular joint arthritis in adult rheumatology practices: a survey of adult rheumatologists

    Directory of Open Access Journals (Sweden)

    Ringold Sarah

    2012-08-01

    Full Text Available Abstract Background The temporomandibular (TMJ is frequently involved in juvenile idiopathic arthritis (JIA, however little is known about management of this joint once a patient transitions from pediatric to adult care and about how rheumatologists approach TMJ involvement in rheumatoid arthritis (RA. The objective of this project was to describe adult rheumatologists’ approaches to the diagnosis and treatment of TMJ arthritis in adults with JIA or RA. Findings One hundred and eighteen rheumatologists responded to an online survey of adult rheumatologists in the United States and Canada. Respondents estimated that 1-25% of their patients with RA or JIA had TMJ arthritis. Respondents reported lower rates of MRI use (19% and higher rates of use of splinting/functional devices (50% than anticipated. Approximately 80% of respondents reported that their practice had a standardized approach to the evaluation of patients with TMJ arthritis. The most commonly used medical therapies were non-steroid anti-inflammatory drugs, anti-tumor necrosis factor alpha medications, and methotrexate. Conclusions Despite the majority of respondents stating that their practices had a standardized approach to the diagnosis and treatment of TMJ disease, there nevertheless appeared to be a range of practices reported. Standardizing the evaluation and treatment of TMJ arthritis across practices may benefit both adult and pediatric patients.

  17. Clinical comparative study of microcurrent electrical stimulation to mid-laser and placebo treatment in degenerative joint disease of the temporomandibular joint.

    Science.gov (United States)

    Bertolucci, L E; Grey, T

    1995-04-01

    Mid-laser and microcurrent stimulation (MENS) have been found to be effective in the reduction of painful temporomandibular joints (TMJ) with internal derangement. There was significant improvement in mobility with the reduction of pain. Mid-laser was superior to MENS in its application and effect, and both were significantly better than the placebo treatment.

  18. Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series

    OpenAIRE

    Joe Iwanaga; Yoshiaki Nakamura; Jingo Kusukawa; R. Shane Tubbs

    2016-01-01

    Eminectomy which is one of the popular and most effective treatments for habitual temporomandibular joint luxation was first described by Myrhaug in 1951. There are few reports which described eminectomy being performed under local anesthesia and conscious sedation. We present a case series of habitual luxation of the TMJ treated by eminectomy performed under local anesthesia and conscious sedation and general anesthesia. Five patients were examined and found to have recurrent luxation of the...

  19. Aspergillosis of the temporomandibular joint following irradiation of the parotid region: a case report.

    Science.gov (United States)

    Lo, W L; Chang, R C S; Yang, A H; Kao, S Y

    2003-10-01

    We report a case of aspergillosis in the right temporomandibular joint (TMJ) with a history of parotid carcinoma and post-irradiation otitis. Previous treatment attempts with surgery and antibiotics were unsuccessful. Radical debridement of the glenoid fossae, supplemented with amphotericin B and adjunct hyperbaric oxygen (HBO) therapy, was provided to resolve the symptoms. This case report highlights the need to be aware of the possibility of invasive mycosis in immunocompromised patients.

  20. Selective Role of Discoidin Domain Receptor 2 in Murine Temporomandibular Joint Development and Aging.

    Science.gov (United States)

    Ge, C; Mohamed, F; Binrayes, A; Kapila, S; Franceschi, R T

    2017-10-01

    Temporomandibular joint (TMJ) disorders are often associated with development of osteoarthritis-like changes in the mandibular condyle. Discoidin domain receptor 2 (DDR2), a collagen receptor preferentially activated by type I and III collagen found in the TMJ and other fibrocartilages, has been associated with TMJ degeneration, but its role in normal joint development has not been previously examined. Using Ddr2 LacZ-tagged mice and immunohistochemistry, we found that DDR2 is preferentially expressed and activated in the articular zone of TMJs but not knee joints. To assess the requirement for Ddr2 in TMJ development, studies were undertaken to compare wild-type and smallie ( slie) mice, which contain a spontaneous deletion in Ddr2 to produce an effective null allele. Analysis of TMJs from newborn Ddr2slie/slie mice revealed a developmental delay in condyle mineralization, as measured by micro-computed tomography and histologic analysis. In marked contrast, knee joints of Ddr2slie/slie mice were normal. Analysis of older Ddr2slie/slie mice (3 and 10 mo) revealed that the early developmental delay led to a dramatic and progressive loss of TMJ articular integrity and osteoarthritis-like changes. Mutant condyles had a rough and flattened bone surface, accompanied by a dramatic loss of bone mineral density. Mankin scores showed significantly greater degenerative changes in the TMJs of 3- and 10-mo-old Ddr2slie/slie mice as compared with wild-type controls. No DDR2-dependent degenerative changes were seen in knees. Analysis of primary cultures of TMJ articular chondrocytes from wild-type and Ddr2slie/slie mice showed defects in chondrocyte maturation and mineralization in the absence of Ddr2. These studies demonstrate that DDR2 is necessary for normal TMJ condyle development and homeostasis and that these DDR2 functions are restricted to TMJ fibrocartilage and not seen in the hyaline cartilage of the knee.

  1. Comorbidity of internal derangement of the temporomandibular joint and silent dysfunction of the cervical spine.

    Science.gov (United States)

    Stiesch-Scholz, M; Fink, M; Tschernitschek, H

    2003-04-01

    The aim of this evaluation was to examine correlations between internal derangement of the temporomandibular joint (TMJ) and cervical spine disorder (CSD). A prospective controlled clinical study was carried out. Thirty patients with signs and symptoms of internal derangement but without any subjective neck problems and 30 age- and gender-matched control subjects without signs and symptoms of internal derangement were examined. The investigation of the temporomandibular system was carried out using a 'Craniomandibular Index'. Afterwards an examiner-blinded manual medical investigation of the craniocervical system was performed. This included muscle palpation of the cervical spine and shoulder girdle as well as passive movement tests of the cervical spine, to detect restrictions in the range of movement as well as segmental intervertebral dysfunction. The internal derangement of the TMJ was significantly associated with 'silent' CSD (t-test, P muscle tenderness of the temporomandibular system exhibited significantly more often pain on pressure of the neck muscles than patients without muscle tenderness of the temporomandibular system (t-test, P TMJ an additional examination of the craniocervical system should be recommended.

  2. Management of the Temporomandibular Joint after Ablative Surgery

    OpenAIRE

    Bredell, Marius; Grätz, Klaus; Obwegeser, Joachim; Gujer, Astrid Kruse

    2014-01-01

    Management of the temporomandibular joint in ablative head and neck surgery is controversial with no standardized approach. The aim of the study was to establish risk-based guidelines for the management of the temporomandibular joint after ablative surgery.

  3. Temporomandibular Joint Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies

    Science.gov (United States)

    Murphy, Meghan K.; MacBarb, Regina F.; Wong, Mark E.; Athanasiou, Kyriacos A.

    2015-01-01

    Epidemiology reports state temporomandibular joint disorders (TMD) affect up to 25% of the population, yet their etiology and progression are poorly understood. As a result, treatment options are limited and fail to meet the long-term demands of the relatively young patient population. TMD are a class of degenerative musculoskeletal conditions associated with morphological and functional deformities. In up to 70% of cases, TMD are accompanied by malpositioning of the TMJ disc, termed “internal derangement.” Though onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Due to the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient’s disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches capable of restoring joint functionality while responding to changes in the joint have become a necessity. Capable of integration and adaptation in the TMJ, one such approach, tissue engineering, carries significant potential in the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. Preceding the current trends in tissue engineering is an analysis of native tissue characterization, toward identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ. PMID:24278954

  4. The effect of intra-articular injection of ultracain in the temporomandibular joint in patients with preauricular pain - A randomized prospective double-blind placebo-controlled crossover study

    NARCIS (Netherlands)

    Tjakkes, Geerten-Has E.; TenVergert, Elisabeth M.; de Bont, Lambert G. M.; Stegenga, Boudewijn

    2007-01-01

    Objectives: To evaluate the distinguishing ability of intraarticular anesthesia from placebo in orofacial pain patients with pain located in the temporomandibular joint (TMJ) region, aiming at a validation of intra-articular anesthesia injection as a diagnostic test of pain in the TMJ region.

  5. Loose bodies of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Q.N.; Katzberg, R.W.

    1984-01-01

    We report a series of four patients presenting with symptoms of temporomandibular joint pain and dysfunction, and manifesting calcified loose bodies within the temporomandibular joint. Tomographic and arthrotomographic findings are described. Surgical confirmation was obtained in two patients and the histopathology in one demonstrated that the loose body was calcified cartilage surrounded by synovial tissue. The synovial tissue of the joint space was normal in all four cases by arthrotomography and at surgery in two patients. The findings suggest that these cases may be examples of osteochondrosis dissecans.

  6. Randomized Trial on the Effectiveness of Dexamethasone in TMJ Arthrocentesis

    NARCIS (Netherlands)

    Huddleston-Slater, J.J.R.; Vos, L.M.; Stroy, L.P.P.; Stegenga, B.

    The aim of this study was to compare the effectiveness of dexamethasone administration following arthrocentesis of the temporomandibular joint (TMJ) with a placebo (saline). Twenty-eight participants with TMJ arthralgia were randomly assigned to two groups of a parallel double-blind RCT. In both

  7. Synovial sarcoma of the temporomandibular joint and infratemporal fossa.

    Science.gov (United States)

    Nomura, Fuminori; Kishimoto, Seiji

    2014-12-01

    Synovial sarcoma in the head and neck region is rare, and is difficult to resect with adequate safety margins because of its anatomical complexity. We herein report our experiences with synovial sarcoma in this region, and review the literature regarding the management of such cases. We retrospectively examined four cases of synovial sarcoma arising from the temporomandibular joint (TMJ) area and infratemporal fossa. Only one patient remains alive without disease, while the other three patients have died. The local control of these tumors has improved because of the progress in the surgical operation methods, while it is expected that there is still a high rate of deaths due to distant metastasis increase. The development of strong chemotherapy is needed for the use after the initial treatment and surgery. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Experimental Model of Zymosan-Induced Arthritis in the Rat Temporomandibular Joint: Role of Nitric Oxide and Neutrophils

    Directory of Open Access Journals (Sweden)

    Hellíada Vasconcelos Chaves

    2011-01-01

    Full Text Available Aims. To establish a new model of zymosan-induced temporomandibular joint (TMJ arthritis in the rat and to investigate the role of nitric oxide. Methods. Inflammation was induced by an intra-articular injection of zymosan into the left TMJ. Mechanical hypernociception, cell influx, vascular permeability, myeloperoxidase activity, nitrite levels, and histological changes were measured in TMJ lavages or tissues at selected time points. These parameters were also evaluated after treatment with the nitric oxide synthase (NOS inhibitors L-NAME or 1400 W. Results. Zymosan-induced TMJ arthritis caused a time-dependent leucocyte migration, plasma extravasation, mechanical hypernociception, and neutrophil accumulation between 4 and 24 h. TMJ immunohistochemical analyses showed increased inducible NOS expression. Treatment with L-NAME or 1400 W inhibited these parameters. Conclusion. Zymosan-induced TMJ arthritis is a reproducible model that may be used to assess both the mechanisms underlying TMJ inflammation and the potential tools for therapies. Nitric oxide may participate in the inflammatory temporomandibular dysfunction mechanisms.

  9. Temporomandibular Joint Disorders in Patients With Different Facial Morphology. A Systematic Review of the Literature.

    Science.gov (United States)

    Manfredini, Daniele; Segù, Marzia; Arveda, Niki; Lombardo, Luca; Siciliani, Giuseppe; Alessandro Rossi; Guarda-Nardini, Luca

    2016-01-01

    The present article aimed to review systematically the literature on the relation between facial skeletal structures and temporomandibular joint (TMJ) disorders. A systematic search in the dental and medical literature was performed to identify all studies of humans assessing the relation between TMJ disorders and facial morphology. Articles were included based on study design, irrespective of TMJ disorder (eg, disc displacement, osteoarthrosis, or unspecified), skeletal features, diagnostic strategies (e.g., imaging techniques or clinical assessment), and population (eg, demographic features of participants) under investigation. The selected articles were assessed according to a format based on patients, problem, and population, intervention, comparison, and outcome and quality was evaluated based on the Newcastle-Ottawa Scale. Thirty-four articles were included in the review, 27 of which concerned adult samples and 7 concerned adolescent samples. Quality was generally moderate. The articles dealt with the relation between facial morphology and the following TMJ disorders, assessed clinically or by magnetic resonance (MR): disc displacement (n = 20), osteoarthritis or osteoarthrosis (n = 8), and temporomandibular disorder signs and symptoms (n = 6). The different approaches featuring the various investigations and the presence of some potential methodologic biases complicated a summary of the findings. Most studies reported that some features related to the vertical dimension of the face might help distinguish patients with potential TMJ disc displacement or MR-detected signs of osteoarthrosis from those without TMJ disorders. The quality of the available literature is not adequate to provide an evidence base on the topic. Despite the heterogeneity of design and findings of the reviewed articles, it seems reasonable to suggest that skeletal Class II profiles and hyperdivergent growth patterns are likely associated with an increased frequency of TMJ disc

  10. Intra-articular vs. systemic administration of etanercept in antigen-induced arthritis in the temporomandibular joint. Part II: mandibular growth

    OpenAIRE

    Gelineck John; Pedersen Thomas K; Küseler Annelise; Kristensen Kasper D; Stoustrup Peter; Herlin Troels

    2009-01-01

    Abstract Background Temporomandibular joint (TMJ) arthritis in children causes alterations in the craniomandibular growth. Resultant abnormalities include; condylar erosions, a posterior mandibular rotation pattern, micrognathia, malocclusion with an anterior open bite, altered joint and muscular function occasionally associated with pain. These alterations may be prevented by early aggressive anti-inflammatory intervention. Previously, we have shown that intra-articular (IA) corticosteroid r...

  11. Personality traits are potentially associated with the presence of chronic temporomandibular joint pain in patients without effusion as determined by T-2 weighted magnetic resonance.

    Science.gov (United States)

    Manfredini, Daniele; Cerea, Silvia; Pavan, Chiara; Guarda-Nardini, Luca

    2017-03-20

    The study aimed at investigating personality traits in chronic temporomandibular joints (TMJ) pain patients with and without joint effusion. Two groups of chronic TMJ pain patients were recruited. The TMJ pain control group was composed of patients showing magnetic resonance imaging (MRI) signs of TMJ effusion, while the TMJ pain test group included patients with chronic TMJ pain seemingly not justified, due to the absence of MRI-detected disorders. A third set of pain free individuals was selected as a comparison group. All patients completed a personality assessment with the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) instrument, and the between-group differences were assessed for significance by performing an analysis of variance test. Patients of the TMJ pain test group had higher scores than subjects belonging to the TMJ pain and pain-free control groups in almost all of the MMPI-2 clinical scales. A significant difference was shown for the scales related to concerns about physical health (Scale 1-Hs; F = 7.74; p = .001) and physical symptoms (Scale 3-Hy; F = 8.43; p = .001). Chronic TMJ pain patients without MRI-detected TMJ effusion have a different personality profile than patients with TMJ effusion and pain-free individuals, regarding high levels of concerns about physical health and physical symptoms. This study has important clinical implications for temporomandibular disorders practitioners, providing suggestions that symptoms in the TMJ area are not only related to a physical disorder. The possible existence of a psychologically modulated condition in patients who refer pain in the TMJ area without signs of effusion should be carefully taken into consideration.

  12. MRI of the temporomandibular joint using flip back spin echo technique

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ha; Kim, Yun Ju; Kim, Chang Soo; Chung, Chun Phil; Kim, Yang Sook [Maryknoll Hospital, Pusan (Korea, Republic of)

    1993-07-15

    The authors introduced flip back spin echo (FBSE) technique for MR imaging of the temporomandibular joint (TMI) instead of conventional spin echo (SE) technique, and evaluated whether FBSE technique in MRI of TMJ is adequate for the diagnosis of the disorders or not. FBSE T1 parasagital images in closed mouth state and sequential opening and closing mouth states using patient's own finger(s) were obtained, and then FBSE T1 paracoronal images in closed mouth state and STAGE (short tip angle gradient echo) parasagital T2WI were followed. All 30 images of the symptomatic TMJs using FBSE technique were excellent in the visualization of articular discs and their displacement, and we could easily diagnosis the internal derangement. FBSE technique was adequate for the diagnosis of internal derangement of the TMJ, and the modified cine display from images using FBSE technique was advantageous in the diagnosis of the disorders by visualization of the dynamic motion of the TMJ.

  13. Comparison of MRI findings with clinical symptoms in temporomandibular joint internal derangement

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Ki Jeong [Chonbuk National University College of Medicine, Gwangju (Korea, Republic of)

    2005-06-15

    To determine the clinical correlation of magnetic resonance imaging (MRI) findings of temporomandibular joint internal derangements. The MR images of 150 TMJs in 75 patients were analyzed. The clinical symptoms were pain in the pre auricular area and masticatory muscles and TMJ sounds. There was a statistically significant relationship between the MRI diagnoses of different types of disc displacements and clinical findings of pain, clicking, and crepitus. The risk of TMJ pain was increased when the disc displacement without reduction occurred at the same time in combination with the osteoarthrosis and effusion. Regardless of the results, the data indicate that each of these MR imaging variables may not be regarded as the unique and dominant factor in defining TMJ pain occurrence.

  14. Successful Function-Preserving Therapy for Chondroblastoma of the Temporal Bone Involving the Temporomandibular Joint

    Directory of Open Access Journals (Sweden)

    Junkichi Yokoyama

    2011-02-01

    Full Text Available We present a case involving a late diagnosis of chondroblastoma of the temporal skull base involving the temporomandibular joint (TMJ. Following an initial misdiagnosis and unsuccessful treatment over a period of 5 years, the patient was referred to our department for further evaluation and possible surgical intervention for occlusal abnormalities, trismus, clicking of the TMJ, and hearing impairment. Based on preoperative immunochemical studies showing positive reaction of multinucleated giant cells for S-100 protein, the final diagnosis was chondroblastoma. The surgical approach – postauricular incision and total parotidectomy, with complete removal of the temporal bone, including the TMJ via the extended middle fossa – was successful in preserving facial nerves and diminishing clinical manifestations. This study highlights a misdiagnosed case in an effort to underline the importance of medical examinations and accurate differential diagnosis in cases involving any tumor mass in the temporal bone.

  15. A Study on Magnetic Resonance Imaging of the Temporomandibular Joint

    Energy Technology Data Exchange (ETDEWEB)

    Kim, HYung Sick; Kim, Jae Duck [Dept. of Oral Radiology, College of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1990-08-15

    Examinations of the temporomandibular joints were performed on a 1.5 Tesla magnetic resonance (MR) system. An MR surface receiver coil 3 inch in diameter was placed on plastic frame, the patient's head being placed in the frame so that the coil was pressed against the temporal region. In taking advantage of the magnetic resonance imaging that has been studied briskly till now, author obtained the images of parasagittal and paracoronal planes about the temporomandibular joint by using MPGR (Multi-Planar Gradient Recalled), GRASS (Gradient Recalled Acquisition in the Steady State), and CSMEMP (Contiguous Slice Multiple Echo, Multi-Planar), that differ from the Spin Echo pulse sequence which the previous author used. Five subjects with no symptoms of temporomandibular joint pain and dysfunction were studied. The plane images obtained by these methods were compared with those by Spin Echo pulse sequence. The results were as follows: 1. The optimal repetition times (TR) and echo times (TE) for T.M.J. image were; a. 400 msec and 18 msec in PMGR pulse sequence. b. 40 msec and 12 msec in GRASS pulse sequence. c. 700 msec and 30 msec in CSMEMP pulse sequence. d. 500 msec and 20 msec in Spin Echo pulse sequence. 2. When the MPGR pulse sequence was using, T2-weighted image was obtained in very short time. 3. On the image of the paracoronal plane by GRASS pulse sequence, meniscus showed the moderate signal intensity, and the meniscus and its anteromedial, posterolateral attachments were observed definitely with gray color. 4. The signal intensity of Spin Echo pulse sequence was equal to of CSMEMP pulse sequence, but the image by CSMEMP pulse sequence showed relatively lower level in its resolution.

  16. Periodontal Ligament Mesenchymal Stromal Cells Increase Proliferation and Glycosaminoglycans Formation of Temporomandibular Joint Derived Fibrochondrocytes

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    Jianli Zhang

    2014-01-01

    Full Text Available Objectives. Temporomandibular joint (TMJ disorders are common disease in maxillofacial surgery. The aim of this study is to regenerate fibrocartilage with a mixture of TMJ fibrochondrocytes and periodontal ligament derived mesenchymal stem cells (PD-MSCs. Materials and Methods. Fibrochondrocytes and PD-MSC were cocultured (ratio 1 : 1 for 3 weeks. Histology and glycosaminoglycans (GAGs assay were performed to examine the deposition of GAG. Green florescent protein (GFP was used to track PD-MSC. Conditioned medium of PD-MSCs was collected to study the soluble factors. Gene expression of fibrochondrocytes cultured in conditioned medium was tested by quantitative PCR (qPCR. Results. Increased proliferation of TMJ-CH was observed in coculture pellets when compared to monoculture. Enhanced GAG production in cocultures was shown by histology and GAG quantification. Tracing of GFP revealed the fact that PD-MSC disappears after coculture with TMJ-CH for 3 weeks. In addition, conditioned medium of PD-MSC was also shown to increase the proliferation and GAG deposition of TMJ-CH. Meanwhile, results of qPCR demonstrated that conditioned medium enhanced the expression levels of matrix-related genes in TMJ-CH. Conclusions. Results from this study support the mechanism of MSC-chondrocyte interaction, in which MSCs act as secretor of soluble factors that stimulate proliferation and extracellular matrix deposition of chondrocytes.

  17. Periodontal ligament mesenchymal stromal cells increase proliferation and glycosaminoglycans formation of temporomandibular joint derived fibrochondrocytes.

    Science.gov (United States)

    Zhang, Jianli; Guo, Fujun; Mi, Jianqiang; Zhang, Zhiye

    2014-01-01

    Temporomandibular joint (TMJ) disorders are common disease in maxillofacial surgery. The aim of this study is to regenerate fibrocartilage with a mixture of TMJ fibrochondrocytes and periodontal ligament derived mesenchymal stem cells (PD-MSCs). Fibrochondrocytes and PD-MSC were cocultured (ratio 1 : 1) for 3 weeks. Histology and glycosaminoglycans (GAGs) assay were performed to examine the deposition of GAG. Green florescent protein (GFP) was used to track PD-MSC. Conditioned medium of PD-MSCs was collected to study the soluble factors. Gene expression of fibrochondrocytes cultured in conditioned medium was tested by quantitative PCR (qPCR). Increased proliferation of TMJ-CH was observed in coculture pellets when compared to monoculture. Enhanced GAG production in cocultures was shown by histology and GAG quantification. Tracing of GFP revealed the fact that PD-MSC disappears after coculture with TMJ-CH for 3 weeks. In addition, conditioned medium of PD-MSC was also shown to increase the proliferation and GAG deposition of TMJ-CH. Meanwhile, results of qPCR demonstrated that conditioned medium enhanced the expression levels of matrix-related genes in TMJ-CH. Results from this study support the mechanism of MSC-chondrocyte interaction, in which MSCs act as secretor of soluble factors that stimulate proliferation and extracellular matrix deposition of chondrocytes.

  18. Temporomandibular joint involvement in juvenile idiopathic arthritis: treatment with an orthodontic appliance

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    M. Gattinara

    2011-09-01

    Full Text Available Introduction and purpose: About 65% of children suffering from juvenile idiopathic arthritis (JIA shows a more or less marked involvement of temporo-mandibular joint (TMJ with altered mandibular growth, resorption of the condyles, occlusary instability, reduced chewing ability and facial dysmorphia. The purpose of our study is to prevent and to treat the progressive evolution of JIA on craniofacial growth and morphology with a functional appliance; surgery should be considered only in so far as the adequacy of TMJ movement is concemed. Methods: From 1992 until now 72 children with proved JIA and TMJ involvement have been treated (50 females, 22 males, aged 6 to 16 years old. TMJ involvement was bilateral in 61% and unilateral in 39% of patients. A diagnostic workup was carried out involving tomograms of TMJ and cephalometric radiograph and analysis. The authors used a bimaxillary activator in the attempt to modify the unfavourable growth pattern and provide a gradual ante-rotation of the jaw. Results: Almost all JIA patients showed satisfactory long term results, easing of pain, reduced skeletal discrepancy, increased function and good facial profile. Conclusions: The long term results of this study indicate that orthopaedic therapy might control the vicious circle of the malocclusion in children with JIA, preventing exacerbation of mandibular clockwise rotation. Surgical intervention for the improvement of TMJ function should be considered only if a severe restricted state is imminent.

  19. Overexpression of Shox2 Leads to Congenital Dysplasia of the Temporomandibular Joint in Mice

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    Xihai Li

    2014-07-01

    Full Text Available Our previous study reported that inactivation of Shox2 led to dysplasia and ankylosis of the temporomandibular joint (TMJ, and that replacing Shox2 with human Shox partially rescued the phenotype with a prematurely worn out articular disc. However, the mechanisms of Shox2 activity in TMJ development remain to be elucidated. In this study, we investigated the molecular and cellular basis for the congenital dysplasia of TMJ in Wnt1-Cre; pMes-stop Shox2 mice. We found that condyle and glenoid fossa dysplasia occurs primarily in the second week after the birth. The dysplastic TMJ of Wnt1-Cre; pMes-stop Shox2 mice exhibits a loss of Collagen type I, Collagen type II, Ihh and Gli2. In situ zymography and immunohistochemistry further demonstrate an up-regulation of matrix metalloproteinases (MMPs, MMP9 and MMP13, accompanied by a significantly increased cell apoptosis. In addition, the cell proliferation and expressions of Sox9, Runx2 and Ihh are no different in the embryonic TMJ between the wild type and mutant mice. Our results show that overexpression of Shox2 leads to the loss of extracellular matrix and the increase of cell apoptosis in TMJ dysplasia by up-regulating MMPs and down-regulating the Ihh signaling pathway.

  20. Antioxidant capacity of synovial fluid in the temporomandibular joint correlated with radiological morphology of temporomandibular disorders.

    Science.gov (United States)

    Ishimaru, Kyoko; Ohba, Seigo; Yoshimura, Hitoshi; Matsuda, Shinpei; Ishimaru, Jun-Ichi; Sano, Kazuo

    2015-02-01

    We investigated the correlation between the antioxidant capacity of synovial fluid and radiological findings of intra-articular structures in patients with disorders of the temporomandibular joint (TMJ). We recruited 21 patients (9 men and 12 women, aged 18-84 years of age) with such disorders, excluding myofascial pain and dysfunction syndrome, or other muscular disorders. The clinical variables recorded included age, sex, interincisal distance, and visual analogue pain scores (VAS). Radiological findings were obtained from diagnostic arthrogram and cone-beam computed tomography (CT). The antioxidant capacity of the synovial fluid was measured by chemiluminescence. Eleven patients were radiologically diagnosed with closed lock, and the remaining 10 with no closed lock. An anchored intra-articular disc was most often seen on cone-beam CT (n=19) followed by perforated disc (n=7), osteoarthrosis (n=7), and anterior disc displacement without reduction (n=5). Although there were no significant differences between antioxidant capacity and age, sex, VAS, or any findings on cone-beam CT, antioxidant capacity was significantly decreased in the patients with closed lock compared with those who did not have closed lock (p=0.02). The results suggest an association between the oxidative stress of the synovial fluid and closed-lock in disorders of the TMJ. Copyright © 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Temporomandibular joint ankylosis in ankylosing spondylitis: A case report and review of literature

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    Nishtha Gupta

    2016-01-01

    Full Text Available Ankylosing spondylitis (AS is a chronic systemic inflammatory disorder. It primarily affects the axial skeleton through involvement of the peripheral joint scan occurs. Temporomandibular joint (TMJ involvement in AS varies from 4% to 35%. Here, we present a case of a 35-year-old male, follow-up of AS from last 8 years on nonsteroidal anti-inflammatory drugs, presented with fresh complaints of painfully restricted movements of jaw during swallowing. Computer tomography of patient demonstrates articular cartilage changes with disc and joint abnormalities.

  2. CT imaging in the surgical treatment of one-sided extraarticular temporomandibular joint ankylosis; Uso da tomografia computadorizada no planejamento cirurgico da anquilose temporomandibular extra-articular unilateral

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    Villamizar, Lenin A.; Ghirelli, Carolina de Oliveira; Baroni, Carina Outi; Ferro, Daniel; Pinto, Ana Carolina Brandao de Campos Fonseca, E-mail: carinaouti@yahoo.com.br [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina Veterinaria e Zootecnia. Dept. de Cirurgia

    2012-07-01

    Temporomandibular joint (TMJ) ankylosis is characterized by difficulty to open the mouth. The ankylosis may be articular when TJM is involved and extra-articular when other factors lead to a restriction of chewing movements without TJM involvement. Case report of one patient with unilateral ankylosis and his surgical planning through the tomography imaging. CT imaging helps preoperative planning because it can locate the exact point of injury and can make the difference between the true and false ankylosis of the TJM. (author)

  3. Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

    Science.gov (United States)

    O’Connor, Rory C; Fawthrop, Fiona; Salha, Rami; Sidebottom, Andrew J

    2017-01-01

    Many conditions may affect the temporomandibular joint (TMJ), but its incidence in individual joint diseases is low. However, inflammatory arthropathies, particularly rheumatoid and psoriatic arthritis and ankylosing spondylitis, appear to have a propensity for affecting the joint. Symptoms include pain, restriction in mouth opening, locking, and noises, which together can lead to significant impairment. Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients. Symptom deterioration does not necessarily follow disease progression, but when it does, TMJ arthroscopy and arthrocentesis can help modulate pain, increase mouth opening, and relieve locking. These minimally invasive procedures have few complications and can be repeated. Operations to repair or remove a damaged intra-articular disc or to refine joint anatomy are used in select cases. Total TMJ replacement is reserved for patients where joint collapse or fusion has occurred or in whom other treatments have failed to provide adequate symptomatic control. It yields excellent outcomes and is approved by the National Institute of Health and Care Excellence (NICE), UK. Knowledge of the assessment and treatment of the TMJ, which differs from other joints affected by inflammatory arthritis due to its unique anatomy and function, is not widespread outside of the field of oral and maxillofacial surgery. The aim of this article is to highlight the peculiarities of TMJ disease secondary to rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis and how to best manage these ailments, which should help guide when referral to a specialist TMJ surgeon is appropriate. PMID:28638693

  4. Management of pain secondary to temporomandibular joint syndrome with peripheral nerve stimulation.

    Science.gov (United States)

    Rodriguez-Lopez, Manuel J; Fernandez-Baena, Mariano; Aldaya-Valverde, Carlos

    2015-01-01

    Temporomandibular joint syndrome, or Costen syndrome, is a clinically diagnosed disorder whose most common symptoms include joint pain and clicking, difficulty opening the mouth, and temporomandibular joint discomfort. The temporomandibular joint (TMJ) is supplied by the auriculotemporal nerve, a collateral branch of the mandibular nerve (the V3 branch of the trigeminal nerve). The aim of this study is to assess the effectiveness and safety of permanent peripheral nerve stimulation to relieve TMJ pain. This case series is a prospective study. Pain Unit of a regional universitary hospital. The study included 6 female patients with temporomandibular pain lasting from 2 to 8 years that did not respond to intraarticular local anesthetic and corticoid injections. After a positive diagnostic block test, the patients were implanted with quadripolar or octapolar leads in the affected preauricular region for a 2-week stimulation test phase, after which the leads were connected to a permanent implanted pulse generator. Results of the visual analog scale, SF-12 Health Survey, Brief Pain Inventory, and drug intake were recorded at baseline and at 4, 12, and 24 weeks after the permanent implant. Five out of 6 patients experienced pain relief exceeding 80% (average 72%) and received a permanent implant. The SF-12 Health Survey results were very positive for all specific questions, especially items concerning the physical component. Patients reported returning to normal physical activity and rest at night. Four patients discontinued their analgesic medication and 1 patient reduced their gabapentin dose by 50%. Sample size; impossibility of placebo control. Patients affected with TMJ syndrome who do not respond to conservative treatments may find a solution in peripheral nerve stimulation, a simple technique with a relatively low level of complications.

  5. Laterality of proprioception in the orofacial muscles and temporomandibular joint.

    Science.gov (United States)

    Frayne, Ellie; Coulson, Susan; Adams, Roger; Croxson, Glen; Waddington, Gordon

    2016-12-02

    Laterality of function in the orofacial musculature suggests there may be side-to-side asymmetry of proprioceptive acuity in lip movement compared to the temporomandibular joint (TMJ). In the present work, 14 young adults were tested for acuity of lip and TMJ closure movements onto plugs varying from 5 to 8mm without visual feedback. Testing was conducted on both left and right sides, using the same psychophysical task and stimuli. Results showed superior proprioceptive acuity at the lips, with no significant side effect. However, there was side-to-side asymmetry in the correlations between proprioceptive performance for the two anatomical structures, with performance on the right side strongly correlated but not on the left. This is consistent with the need for coordination between structures during chewing. When acuity at different points in the stimulus range was examined, the right side lips were better with small stimuli. Overall, results support enhanced use-specific proprioception. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Occlusal effects on longitudinal bone alterations of the temporomandibular joint.

    Science.gov (United States)

    Zhang, J; Jiao, K; Zhang, M; Zhou, T; Liu, X-D; Yu, S-B; Lu, L; Jing, L; Yang, T; Zhang, Y; Chen, D; Wang, M-Q

    2013-03-01

    The pathological changes of subchondral bone during osteoarthritis (OA) development in the temporomandibular joint (TMJ) are poorly understood. In the present study, we investigated the longitudinal alterations of subchondral bone using a rat TMJ-OA model developed in our laboratory. Changes in bone mass were examined by micro-CT, and changes in osteoblast and osteoclast activities were analyzed by real-time PCR, immunohistochemistry, and TRAP staining. Subchondral bone loss was detected from 8 weeks after dental occlusion alteration and reached the maximum at 12 weeks, followed by a repair phase until 32 weeks. Although bone mass increased at late stages, poor mechanical structure and lower bone mineral density (BMD) were found in these rats. The numbers of TRAP-positive cells were increased at 12 weeks, while the numbers of osteocalcin-expressing cells were increased at both 12 and 32 weeks. Levels of mRNA expression of TRAP and cathepsin K were increased at 12 weeks, while levels of ALP and osteocalcin were increased at both 12 and 32 weeks. These findings demonstrated that there is an active bone remodeling in subchondral bone in TMJs in response to alteration in occlusion, although new bone was formed with lower BMD and poor mechanical properties.

  7. Decreased Temporomandibular Joint Range of Motion in a Model of Early Osteoarthritis in the Rabbit.

    Science.gov (United States)

    Henderson, Sarah E; Tudares, Mauro A; Tashman, Scott; Almarza, Alejandro J

    2015-09-01

    Analysis of mandibular biomechanics could help with understanding the mechanisms of temporomandibular joint (TMJ) disorders (TMJDs), such as osteoarthritis (TMJ-OA), by investigating the effects of injury or disease on TMJ movement. The objective of the present study was to determine the functional kinematic implications of mild TMJ-OA degeneration caused by altered occlusion from unilateral splints in the rabbit. Altered occlusion of the TMJ was mechanically induced in rabbits by way of a unilateral molar dental splint (n = 3). TMJ motion was assessed using 3-dimensional (3D) skeletal kinematics twice, once before and once after 6 weeks of splint placement with the splints removed, after allowing 3 days of recovery. The relative motion of the condyle to the fossa and the distance between the incisors were tracked. An overall decrease in the range of joint movement was observed at the incisors and in the joint space between the condyle and fossa. The incisor movement decreased from 7.0 ± 0.5 mm to 6.2 ± 0.5 mm right to left, from 5.5 ± 2.2 mm to 4.6 ± 0.8 mm anterior to posterior, and from 13.3 ± 1.8 mm to 11.6 ± 1.4 mm superior to inferior (P TMJ-OA and determining when the symptoms become a chronic, irreversible problem. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Clinical and radiologic findings of synovial chondromatosis affecting the temporomandibular joint.

    Science.gov (United States)

    Meng, Juanhong; Guo, Chuanbin; Yi, Biao; Zhao, Yanping; Luo, Haiyan; Ma, Xuchen

    2010-03-01

    Our aim was to study the clinical and radiologic findings of synovial chondromatosis (SC) affecting the temporomandibular joint (TMJ) and provide references for diagnosis and treatment. Twenty patients confirmed as SC histopathologically were included in the investigation. Nineteen cases were treated with arthrotomy and 1 case with arthroscopy. The clinical manifestations, radiographic findings, histopathologic features, surgical treatment, and differential diagnosis were combined to study this disease. The SC features of TMJ on magnetic resonance (MR) images were summarized on proton density-weighted (PD) and T2-weighted images. Synovial chondromatosis of TMJ occurred more often in women and on the right. Symptoms included preauricular pain, swelling, limitation of mouth opening, crepitations, and deviation on opening. The detection rate of calcified loose bodies was 30% on conventional radiographs and 53.3% on computerized tomography. Multiple small ring-like or tubular signals could be seen on PD and T2-weighted MR images. SC mainly affected the superior joint space; it could involve the inferior space when a perforated or deformed disc was present. SC could extend into intracranial fossa, infratemporal fossa, and lateral pytergoid muscle. The characteristic ring-like signals could be found on MR images of the patients with SC of TMJ. This lesion should be differentially diagnosed with TMJ disorders and preauricular masses. Considering its recurrence and the different behavior of SC in different patients, various treatment strategies should be considered. Copyright 2010 Mosby, Inc. All rights reserved.

  9. Magnetic resonance imaging features of the temporomandibular joint in normal dogs.

    Science.gov (United States)

    Macready, Dawn M; Hecht, Silke; Craig, Linden E; Conklin, Gordon A

    2010-01-01

    Evaluation of the canine temporomandibular joint (TMJ) is important in the clinical diagnosis of animals presenting with dysphagia, malocclusion and jaw pain. In humans, magnetic resonance imaging (MRI) is the modality of choice for evaluation of the TMJ. The objectives of this study were to establish a technical protocol for performing MRI of the canine TMJ and describe the MRI anatomy and appearance of the normal canine TMJ. Ten dogs (one fresh cadaver and nine healthy live dogs) were imaged. MRIs were compared with cadaveric tissue sections. T1-weighted (T1-W) transverse closed-mouth, T1-W sagittal closed-mouth, T1-W sagittal open-mouth, and T2-W sagittal open-mouth sequences were obtained. The condylar process of the mandible and the mandibular fossa of the temporal bone were hyperintense to muscle and isointense to hypointense to fat on T1-W images, mildly hyperintense to muscle on T2-W images, and were frequently heterogeneous. The articular disc was visible in 14/20 (70%) TMJs on T1-W images and 13/20 (65%) TMJs on T2-W images. The articular disc was isointense to hyperintense to muscle on T1-W images and varied from hypointense to hyperintense to muscle on T2-W images. The lateral collateral ligament was not identified in any joint. MRI allows evaluation of the osseous and certain soft tissue structures of the TMJ in dogs.

  10. Arthrocentesis and Temporomandibular Joint Disorders: Clinical and Radiological Results of a Prospective Study

    Directory of Open Access Journals (Sweden)

    Giacomo De Riu

    2013-01-01

    Full Text Available Purpose. We evaluated the efficacy of arthrocentesis in the treatment of temporomandibular joint (TMJ disorders. Material and Methods. In this prospective clinical case series, 30 consecutive patients with TMJ disorders underwent arthrocentesis using saline and sodium hyaluronate injections. Outcome measures were TMJ pain, maximum mouth opening (MMO, joint noises, and anatomical changes in the TMJ architecture. Patients were evaluated using cone-beam computed tomography (CBCT and magnetic resonance imaging (MRI at the beginning of treatment and 60 days after the last arthrocentesis. Pretreatment and posttreatment clinical parameters were compared using paired and unpaired t-tests, and McNemar’s test was used to evaluate CBCT and MRI changes (. Results. At 1-year follow-up examinations, visual analogue scale scores indicated that pain was reduced significantly and mean postoperative MMO was increased significantly. CBCT findings showed no significant change, and MRI showed only slight reductions in inflammatory signs. Conclusions. Within the limitations of this study, we can conclude that arthrocentesis is a simple, minimally invasive procedure with a relatively low risk of complications and significant clinical benefits in patients with TMJ disorders. This trial is registered with NCT01903512.

  11. A tomographic study of positional and bony changes in the temporomandibular joint following orthognathic surgery

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    Song, Nam Kyu; Kim Min Suk; Koh, Kwang Joon [Dept. of Oral Radiology, College of Dentistry, Chonpook National University, Chonju (Korea, Republic of)

    1992-08-15

    The purpose of this study was to aid in the evaluation of prognosis of temporomandibular joint following orthognathic surgery. For this study, 20 patients (40 TMJ) who undergone orthognathic surgery were examined. Preoperative and postoperative tomograms of TMJ were taken. And the subjects were divided into 3 groups according to postoperative periods. The obtained results were as follows : 1. There were no significant differences between preoperative and postoperative changes in joint spaces in each group and between groups (P<0.05). 2. There were no significant differences between preoperative and postoperative ratio of joint spaces (P<0.05).3. There were no significant differences between preoperative and postoperative changes in the range of motion of condylar head (P<0.05). 4. The bony changes of condylar head were observed in 14 (35%) condyles (6 erosion, 2 flattening, 5 double contour, 1 osteophyte).

  12. Quantifying Temporomandibular Joint Synovitis in Children With Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Resnick, Cory M; Vakilian, Pouya M; Breen, Micheál; Zurakowski, David; Caruso, Paul; Henderson, Lauren; Nigrovic, Peter A; Kaban, Leonard B; Peacock, Zachary S

    2016-12-01

    Juvenile idiopathic arthritis (JIA) frequently affects the temporomandibular joints (TMJs) and is often undetected by history, examination, and plain imaging. Qualitative assessment of gadolinium-enhanced magnetic resonance images (MRIs) is currently the standard for diagnosis of TMJ synovitis associated with JIA. The purpose of this study is to apply a quantitative analysis of synovial enhancement to MRIs of patients with and without JIA to establish a disease threshold and sensitivity and specificity for the technique. This is a retrospective case-control study of children (age ≤16 years) who had MRIs with gadolinium including the TMJs. Subjects were divided into a JIA group and a control group. From a coronal T1-weighted image, a ratio (enhancement ratio [ER]) of the average pixel intensity within three 0.2-mm2 regions of interest (ROIs) in the TMJ synovium to that of a 50-mm2 ROI of the longus capitis muscle was calculated. Receiver operating characteristic curves were used to determine the sensitivity and specificity. The inter- and intraexaminer reliability was evaluated with Bland-Altman plots and 2-way mixed, absolute agreement intraclass correlation coefficients. There were 187 and 142 TMJs included in the JIA and control groups, respectively. An ER threshold of 1.55 had a sensitivity and specificity for detecting synovitis of 91% and 96%, respectively. The inter- and intraexaminer reliability was excellent. Calculating a ratio of pixel intensity between the TMJ synovium and the longus capitis muscle is a reliable way to quantify synovial enhancement. An ER of 1.55 differentiates normal TMJs from those affected by inflammatory arthritis. © 2016, American College of Rheumatology.

  13. Improved Temporomandibular Joint Position After 3-Dimensional Planned Mandibular Reconstruction.

    Science.gov (United States)

    Sawh-Martinez, Rajendra; Parsaei, Yassmin; Wu, Robin; Lin, Alexander; Metzler, Philipp; DeSesa, Christopher; Steinbacher, Derek M

    2017-01-01

    Virtual surgical planning (VSP) using computer-aided design and manufacturing (CAD-CAM) has been reported to aid in craniofacial reconstruction. The reported improvements have been related mainly to operative performance, with limited evaluations of the position and function of the temporomandibular joint (TMJ). This study analyzed the radiographic detail of postoperative outcomes related to the TMJ. Patients who underwent mandibular reconstruction with and without VSP were analyzed. All patients underwent preoperative computed tomography (CT) of their mandible. In the VSP group, CAD-CAM planning was performed preoperatively using CT Digital Imaging and Communications in Medicine (DICOM) data. Postoperative CT images from the 2 groups were quantitatively compared to evaluate the TMJ. CT images were digitized for 2- and 3-dimensional analysis using surgical planning software (Materialise, Leuven, Belgium). Anatomic landmarks and cephalometric relations were analyzed. Sixteen patients who underwent traditional planning or VSP for mandibular reconstruction were compared. Two groups (n = 8 each) were compared for positioning of the mandibular condyle in the glenoid fossa. Measurements of superior, anterior, and lateral movements were comparable in the pre- and postoperative groups for the traditional and VSP groups (P mandibular condyle position for traditional planning versus VSP noted decreased percentages of change in superior (22 vs 10%; P mandibular reconstructions (n = 8). Ipsilateral right mandibular reconstructions (n = 6) showed changes in superior (62 vs 15%; P mandibular reconstructions. Evaluation of condyle movements showed differences in the ipsilateral position in the pre- and postoperative groups. VSP resulted in decreased superior and lateral shifts of the ipsilateral condyle and decreased changes in the condylar and condylar neck angles. This work shows that VSP can lead to increased precision in reconstruction leading to preserved normative

  14. Temporomandibular joint involvement in Juvenile Idiopathic Arthritis: reliability and validity of a screening protocol for the rheumatologist.

    Science.gov (United States)

    Steenks, Michel H; Giancane, Gabriella; de Leeuw, Rob R J; Bronkhorst, Ewald M; van Es, Robert J J; Koole, Ron; van Bruggen, H Willemijn; Wulffraat, Nico M

    2015-05-07

    In Juvenile Idiopathic Arthritis (JIA) the temporomandibular joint (TMJ) can be involved leading to pain, dysfunction and growth disturbances of the mandible and associated structures. There may be value to a three minute screening protocol allowing the rheumatologist to detect TMJ involvement systematically. Reliability and validity of the TMJ protocol for detecting TMJ co-morbidity were determined in 74 consecutive JIA patients. The assessments of the rheumatologist and of a reference examiner (RE) were compared and validity of the TMJ protocol was established using the disease activity (JADAS-27) as an external reference. The internal consistency of the protocol was 0.73 (Cronbach's alpha). The inter-examiner agreement between the rheumatologist and the RE varied between 0.25 and 0.87 (Cohen's Kappa). Sensitivity and specificity, with the JADAS "3.8" indicating minimal disease activity, were 0.57 and 0.77 respectively. The area under the curve (AUC) was 0.70. A cut-off value of two positive items was found to be an optimal threshold to select the patients with likely TMJ involvement. The use of the protocol is feasible in everyday clinical practice. Reliability and validity aspects were satisfactory. The screening protocol for TMJ involvement provides the rheumatologist with systematic and focused TMJ information which relates to the JIA disease activity (JADAS-27).

  15. Juvenile idiopathic arthritis and the temporomandibular joint

    African Journals Online (AJOL)

    Yasser Mohammed

    e Pediatric Immunology Units, Ain Shams University hospitals, Faculty of Medicine, Ain Shams University, Cairo, Egypt. Received 1 October 2011; accepted 23 November 2011. Available online 1 February 2012. KEYWORDS. Juvenile idiopathic arthritis;. Temporomandibular joint;. Magnetic resonance imaging. Abstract ...

  16. Ankylosis of the Temporomandibular Joint and Reconstruction With a Costochondral Graft in a Patient With Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Felix, Valtuir Barbosa; Cabral, Dhayanna Rolemberg Gama; de Almeida, Alana Beatriz Wanderley; Soares, Elionai Dias; de Moraes Fernandes, Katharina Jucá

    2017-01-01

    Juvenile idiopathic arthritis (JIA), the most common inflammatory autoimmune rheumatic disease in children, consists of a heterogeneous group of diseases with 7 distinct subtypes. Involvement of the temporomandibular joint (TMJ) in JIA varies from 17% to 87%, and can alter craniofacial growth due to damage to the condylar growth center. This study was a literature review and clinical report of bilateral ankylosis of the TMJ in a 13-year-old patient with polyarticular JIA. Temporomandibular joint reconstruction with a costochondral graft was carried out. The surgery was uneventful and the patient developed a mouth opening of 40 mm during the postoperative period of 24 months. The authors concluded that treatment of TMJ ankylosis should be surgical with removal of the ankylotic mass, and when necessary, joint reconstruction in patients undergoing a growth phase. Costochondral graft is still the gold standard due to its biological similarity and growth potential in patients with JIA. Research and early diagnosis of TMJ diseases should be carried out, because the earlier the identification of the disease, the better the chances of reducing its devastating effects, thus avoiding the worst possible outcome: TMJ ankylosis.

  17. The temporomandibular joint of California sea lions (Zalophus californianus): part 2-osteoarthritic changes.

    Science.gov (United States)

    Arzi, B; Leale, D M; Sinai, N L; Kass, P H; Lin, A; Verstraete, F J M

    2015-01-01

    Following comprehensive characterization of the temporomandibular joint (TMJ) of the California sea lion, as well demonstrating that TMJ-osteoarthritis (OA) occurs in this species, the objective of this part of the investigation was to describe the macroscopic osteologic findings associated with TMJ-OA in a large museum collection of skull specimens. Museum skull specimens (n=497) of California sea lions were examined macroscopically according to defined criteria for the presence, severity, location and characteristics of TMJ-OA. The specimens, acquired from strandings, varied in age from young adults to mature adults. Overall 63.5% of the specimens had findings consistent with TMJ-OA. Of these, 56.2% were from females 43.8% were from males. Moreover, 71.2% specimens were from mature adults and 28.8% from young adults. However, there was no significant association between age and sex with the presence or severity of TMJ-OA. The most prominent TMJ-OA changes were the presence of subchondral bone defects and abnormal porosity. The majority of the OA present at the mandibular head affected the entire articular surface. In contrast, the OA present on the mandibular fossa of the temporal bone was located primarily on the medial aspect (PTMJ-OA in California sea lions is high and varies in severity. Although the significance of the high incidence of this disease in the California sea lion remains elusive, the occurrence and severity of TMJ-OA detected in this study may play an important role in the species' morbidity and mortality. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Parotid Lymphadenopathy Is Associated With Joint Effusion in Non-Neoplastic Temporomandibular Disorders.

    Science.gov (United States)

    Muraoka, Hirotaka; Kaneda, Takashi; Kawashima, Yusuke; Hirahara, Naohisa; Fukuda, Taiga; Muramatsu, Teruaki; Ito, Kotaro

    2017-03-01

    Lymphadenopathy often occurs in the setting of inflammation, with or without infection. We sought to elucidate any association of parotid lymphadenopathy with joint effusion in temporomandibular joint (TMJ) disorders. We performed a retrospective cohort study. We analyzed the magnetic resonance imaging studies of patients with suspected TMJ disorders performed from April 2006 to March 2007. The degree of joint effusion was graded on sagittal T2-weighted spin echo images according to a commonly used system. On axial short T1-weighted short inversion recovery images, the number and short-axis diameter of the parotid lymph nodes were recorded. We performed analyses of the cluster-correlated data using the Mann-Whitney U test and Spearman's correlation coefficients. P disorders were analyzed from 201 patients during the study period. The number and size of the parotid lymph nodes identified was significantly greater in the patients with TMJ effusion (P disorders. These findings indicate that lymphadenopathy should be considered as an inflammation condition commonly associated with joint effusion in TMJ disorders. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  19. The treatment of painful temporomandibular joint clicking with oral splints: a randomized clinical trial.

    Science.gov (United States)

    Conti, Paulo César Rodrigues; dos Santos, Carlos Neanes; Kogawa, Evelyn Mikaela; de Castro Ferreira Conti, Ana Claudia; de Araujo, Carlos dos Reis Pereira

    2006-08-01

    The authors compared the efficacy of bilateral balanced and canine guidance (occlusal) splints in the treatment of temporomandibular joint (TMJ) pain in subjects who experienced joint clicking with a nonoccluding splint in a double-blind, controlled randomized clinical trial. The authors randomly assigned 57 people with signs of disk displacement and TMJ pain into three groups according to the type of splint: bilateral balanced, canine guidance and nonoccluding. The authors followed the groups for six months using analysis of a visual analog scale (VAS), palpation of the TMJ and masticatory muscles, mandibular movements and joint sounds. They used repeated analysis of variance and a chi(2) test to test the hypothesis. The type of guidance used did not influence the pain reduction, yet both occlusal splints were superior to the nonoccluding splint, on the basis of the VAS. Despite similar outcomes in relation to opening, left lateral and protrusive movements, TMJ and muscle pain on palpation, subjects who used the occlusal splints had improved clinical outcomes. The frequency of joint noises decreased over time, with no significant differences among groups. Subjects in the groups using the occlusal splints reported more comfort. The type of lateral guidance did not influence the subjects' improvement. All of the subjects had a general improvement on the VAS, though subjects in the occlusal splint groups had better results that did subjects in the nonoccluding splint group.

  20. Local application of Aqua Titan improves symptoms of temporomandibular joint muscle disorder: a preliminary study.

    Science.gov (United States)

    Matsumoto, K; Tsukimura, N; Ishizuka, T; Kohinata, K; Yonehara, Y; Honda, K

    2015-04-01

    Aqua Titan (AT), comprising microscopic titanium particles dispersed in water, has been reported to have beneficial effects on muscle tissue. This study investigated the effects of local application of AT on symptoms in patients with muscle disorders of the temporomandibular joint (TMJ) compared to patients with joint disorders of the TMJ. Sixteen patients with unilateral masseter muscle pain during motion (muscle disorder group) and six patients with unilateral TMJ pain during motion (joint disorder group) applied an AT-permeated patch over the painful area every night for 2 weeks. Symptoms were evaluated clinically at the initial visit and 1 and 2 weeks later. Clinical symptoms in the joint disorder group showed no tendency towards improvement after 2 weeks. In contrast, mouth opening range with/without pain, visual analogue scale (VAS) scores for pain during mouth opening and eating, and activities of daily living (ADL) scores in the muscle disorder group were improved significantly after 2 weeks. Multiple comparison tests in the muscle disorder group showed significant improvements in the VAS for eating and ADL score after 1 week. These results suggest that the AT patch has a potential supplementary role in the treatment of patients with muscle disorders of the TMJ. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Development of a Rat Model of Mechanically Induced Tunable Pain and Associated Temporomandibular Joint Responses.

    Science.gov (United States)

    Kartha, Sonia; Zhou, Timothy; Granquist, Eric J; Winkelstein, Beth A

    2016-01-01

    Although mechanical overloading of the temporomandibular joint (TMJ) is implicated in TMJ osteoarthritis (OA) and orofacial pain, most experimental models of TMJ-OA induce only acute and resolving pain, which do not meaningfully simulate the pathomechanisms of TMJ-OA in patients with chronic pain. The aim of this study was to adapt an existing rat model of mechanically induced TMJ-OA, to induce persistent orofacial pain by altering only the jaw-opening force, and to measure the expression of common proxies of TMJ-OA, including degradation and inflammatory proteins, in the joint. TMJ-OA was mechanically induced in a randomized, prospective study using 2 magnitudes of opening loads in separate groups (ie.,. 2-N, 3.5-N and sham control [no load]). Steady mouth opening was imposed daily (60 minutes/day for 7 days) in female Holtzman rats, followed by 7 days of rest, and orofacial sensitivity was measured throughout the loading and rest periods. Joint structure and extent of degeneration were assessed at day 14 and expression of matrix metalloproteinase-13 (MMP-13), hypoxia-inducible factor-1α (HIF-1α), and tumor necrosis factor-α (TNF-α) in articular cartilage was evaluated by immunohistochemistry and quantitative densitometry methods at day 7 between the 2 loading and control groups. Statistical differences of orofacial sensitivity and chondrocyte expression between loading groups were computed and significance was set at a P value less than .05. Head-withdrawal thresholds for the 2 loading groups were significantly decreased during loading (P joints over those loaded by 2 N. Unlike a 2-N loading force, mechanical overloading of the TMJ using a 3.5-N loading force induced constant and nonresolving pain and the upregulation of inflammatory markers only in the 3.5-N group, suggesting that these markers could predict the maintenance of persistent orofacial pain. As such, the development of a tunable experimental TMJ-OA model that can separately induce acute or

  2. Characterization of degenerative changes in the temporomandibular joint of the bengal tiger (Panthera tigris tigris) and siberian tiger (Panthera tigris altaica).

    Science.gov (United States)

    Murphy, M K; Arzi, B; Vapniarsky-Arzi, N; Athanasiou, K A

    2013-11-01

    The articulation of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally and a fibrous articular disc. The TMJ disc plays an essential role in distributing load between the two articular surfaces. Degeneration of the disc in the presence of joint pathology has been shown in man; however, TMJ pathology has not been documented previously in tigers (Panthera tigris). The mandibular condyle and TMJ disc of a Bengal tiger (P. tigris tigris) and a Siberian tiger (P. tigris altaica) were evaluated grossly and the TMJ disc was characterized biochemically and mechanically. Characterization of the TMJ disc verified region- and direction-dependent biochemical and mechanical properties, reflective of the functional demands on the joint. Degenerative joint disease was observed in both cases and this was more severe in the Siberian tiger. Simultaneous evaluation of joint pathology, biochemical composition and mechanical properties of the TMJ disc revealed a loss in functional properties (tensile anisotropy) of the disc as joint pathology advanced from moderate to severe. TMJ degeneration may compromise the ability of the animal to eat and thrive and may be a factor contributing to the endangered status of these species. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Choosing sheep (Ovis aries) as animal model for temporomandibular joint research: Morphological, histological and biomechanical characterization of the joint disc.

    Science.gov (United States)

    Angelo, D F; Morouço, P; Alves, N; Viana, T; Santos, F; González, R; Monje, F; Macias, D; Carrapiço, B; Sousa, R; Cavaco-Gonçalves, S; Salvado, F; Peleteiro, C; Pinho, M

    2016-12-01

    Preclinical trials are essential to the development of scientific technologies. Remarkable molecular and cellular research has been done using small animal models. However, significant differences exist regarding the articular behavior between these models and humans. Thus, large animal models may be more appropriate to perform trials involving the temporomandibular joint (TMJ). The aim of this work was to make a morphological (anatomic dissection and white light 3D scanning system), histological (TMJ in bloc was removed for histologic analysis) and biomechanical characterization (tension and compression tests) of sheep TMJ comparing the obtained results with human data. Results showed that sheep processus condylaris and fossa mandibularis are anatomically similar to the same human structures. TMJ disc has an elliptical perimeter, thinner in the center than in periphery. Peripheral area acts as a ring structure supporting the central zone. The disc cells display both fibroblast and chondrocyte-like morphology. Marginal area is formed by loose connective tissue, with some chondrocyte-like cells and collagen fibers in diverse orientations. Discs obtained a tensile modulus of 3.97±0.73MPa and 9.39±1.67MPa, for anteroposterior and mediolateral assessment. The TMJ discs presented a compressive modulus (E) of 446.41±5.16MPa and their maximum stress value (σmax) was 18.87±1.33MPa. Obtained results suggest that these animals should be considered as a prime model for TMJ research and procedural training. Further investigations in the field of oromaxillofacial surgery involving TMJ should consider sheep as a good animal model due to its resemblance of the same joint in humans. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Application of the subtraction technique to the radiological diagnosis of temporomandibular joint disorders. On the fundamental studies

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    Sakurai, Tohru; Tanaka, Toshio; Imaizumi, Satoru; Imaizumi, Eiichi; Yoshihara, Junya; Ohtani, Masatoshi

    1985-02-01

    The oblique lateral transcranial projection (OLTP) of the temporomandibular joint (TMJ) is widely used for the diagnosis of TMJ disease. The OLTP is a simple and valuable technique for the lateral projection of the TMJ, but is sometimes reveals a complex radiographic findings due to the overlapping of the pars petrosa and the mastoid process to the TMJ. We have recently applied a photographic subtraction technique to the OLTP for reduction of the complex radiographic findings in the OLTP. The purpose of this study is to know the value of the photographic subtraction technique in the OLTP fundamentally. The results obtained are as follows: 1) The shape of the condyle was clearly demonstrated by the subtraction technique. 2) Diagnostic ability on disease of the condyle was increased by applying the subtraction technique. 3) Location of the condyle in the fossa was easily detected by the subtraction technique. (author).

  5. Characterization of The Temporomandibular Joint of Southern Sea Otters (Enhydra lutris nereis

    Directory of Open Access Journals (Sweden)

    Danielle eLieske

    2015-12-01

    Full Text Available The structure-function relationship of the temporomandibular joint (TMJ of southern sea otter has largely not been described. This study aims to describe the histological, biochemical, and biomechanical features of the TMJ disc in the southern sea otter. The TMJ discs from fresh cadaver heads of southern sea otter adult males (n=8 and females (n=8 acquired from strandings were examined. Following macroscopical evaluation, the TMJs were investigated for their histological, mechanical and biochemical properties. We found that the sea otter TMJ discs are, in general, similar to other carnivores. Macroscopically, the TMJ disc was highly congruent and the mandibular head was encased tightly by the mandibular fossa with a thin disc separating the joint into two compartments. Histologically the articular surfaces were lined with dense fibrous connective tissue that gradually transitioned into one to two cell thick layer of hyaline-like cartilage. The disc fibres were aligned primarily in the rostrocaudal direction and had occasional lacuna with chondrocyte-like cells. The disc was composed primarily of collagen type 1. Biochemical analysis indicates sulphated glycosaminoglycan (sGAG content lower than other mammals, but significantly higher in male sea otters than female sea otters. Finally, mechanical analysis demonstrated a disc that was stronger and stiffer in the rostrocaudal direction than the mediolateral direction, but also significantly stronger and stiffer in females than males. We conclude that the congruent design of the TMJ, thin disc, biochemical content, and mechanical properties all reflect a structure-function relationship within the TMJ disc that is likely designed for the sea otter’s hard diet and continuous food intake.

  6. Non-surgical treatment of sports-related temporomandibular joint disorders in basketball players.

    Science.gov (United States)

    Muhtaroğullari, Mehmet; Demiralp, Burak; Ertan, Atila

    2004-12-01

    In this study, 18 basketball players (11 female, seven male; age range 14-32 years) with temporomandibular joint (TMJ) problems who had a history of sport injuries related to head or jaw region were evaluated and the results of the treatment were presented. A standardized functional examination of the masticatory system was performed including measurement of maximal jaw movements, recording of joint sounds, pain on movement of the jaw as well as tenderness to palpation of the both TMJ or masticatory muscles. Patients were also evaluated periodontally. Diagnosis was made according the criteria, described by Okeson, and appropriate treatment was applied using different kind of splints. At the end of treatment only one patient continued with right TMJ reduction with slight pain. Except for that patient, none of the patients had pain after treatment. The maximum opening of the jaws and the maximal jaw movements were statistically increased after treatment. Patients with TMJ problems also showed periodontal problems, most likely due to inadequate oral hygiene because of the limited jaw movements and pain. Periodontal parameters including probing depth (PD), Plaque index (PI), and Sulcus Bleeding Index (SBI) improved after treatment. Sports-related TMJ injuries may result in complex problems such as pain, TMJ sounds, limitation in maximal jaw movements and maximum opening of the mouth, difficulty in chewing. With the appropriate diagnosis this could be treated non-surgically in 6-8 months. This study also showed that the TMJ disorders may cause periodontal problems, which may affect all teeth and also the general health of the athlete.

  7. Characterization of the Temporomandibular Joint of Southern Sea Otters (Enhydra lutris nereis).

    Science.gov (United States)

    Lieske, Danielle; Vapniarsky, Natalia; Verstraete, Frank J M; Leale, Dustin M; Young, Colleen; Arzi, Boaz

    2015-01-01

    The structure-function relationship of the temporomandibular joint (TMJ) of southern sea otter has largely not been described. This study aims to describe the histological, biochemical, and biomechanical features of the TMJ disk in the southern sea otter. The TMJ disks from fresh cadaver heads of southern sea otter adult males (n = 8) and females (n = 8) acquired from strandings were examined. Following macroscopical evaluation, the TMJs were investigated for their histological, mechanical, and biochemical properties. We found that the sea otter TMJ disks are, in general, similar to other carnivores. Macroscopically, the TMJ disk was highly congruent, and the mandibular head was encased tightly by the mandibular fossa with a thin disk separating the joint into two compartments. Histologically, the articular surfaces were lined with dense fibrous connective tissue that gradually transitioned into one to two cell thick layer of hyaline-like cartilage. The disk fibers were aligned primarily in the rostrocaudal direction and had occasional lacuna with chondrocyte-like cells. The disk was composed primarily of collagen type 1. Biochemical analysis indicates sulfated glycosaminoglycan content lower than other mammals, but significantly higher in male sea otters than female sea otters. Finally, mechanical analysis demonstrated a disk that was not only stronger and stiffer in the rostrocaudal direction than the mediolateral direction but also significantly stronger and stiffer in females than males. We conclude that the congruent design of the TMJ, thin disk, biochemical content, and mechanical properties all reflect a structure-function relationship within the TMJ disk that is likely designed for the sea otter's hard diet and continuous food intake.

  8. Symptom reporting in temporomandibular joint clicking; Some theoretical considerations.

    NARCIS (Netherlands)

    Spruijt, R.; Hoogstraten, J.

    1992-01-01

    Analysis of research on psychological aspects of temporomandibular disorders suggests that self-reports of symptoms do not constitute reliable instruments for the measurement of physiological processes. In TMJ clicking, the actual physiological signal can be measured and compared with self-reports

  9. Comprehensive treatment of temporomandibular joint disorders.

    Science.gov (United States)

    Navrátil, Leos; Navratil, Vaclav; Hajkova, Simona; Hlinakova, Petra; Dostalova, Tatjana; Vranová, Jana

    2014-01-01

    Changing lifestyles, decreasing physical activity, which is increasing the number of degenerative joint diseases of various etiology, and certain dental procedures are increasing the number of patients complaining of pain in their temporomandibular joints. The aim of the study was to assess the benefits of comprehensive physiotherapy sessions in order to decrease the number of temporomandibular joint problems, thereby improving the patient's quality of life. An examination by a dentist determined each patient's treatment plan, which consisted of a medical exam, physical therapy and education. Each form of treatment was applied 10 times at intervals of 7-14 days. The main goal of the therapeutic physical education was to redress the muscle imbalance in the mandibular joint. This was achieved by restoring balance between the masticatory muscles, along with releasing the spastic shrouds found in the masticatory muscles. The aim of education was to teach the patient exercises focused on the temporomandibular joint and masticatory muscles. The intensity of the exercises and their composition were individually adjusted and adapted to their current state. Physical therapy consisted of the application of pulsed magnetic therapy, laser therapy, and non-invasive positive thermotherapy. The above procedure was conducted on a therapeutic group of 24 patients (3 men and 20 women). In the course of therapy, there were no complications, and all patients adhered to the prescribed regime. None reported any side effects. The mean treatment duration was 123 +/- 66 days. The outcome of the therapy was evaluated as described in the methodology, the degree of pain affecting the joint, and the opening ability of the mouth. In both parameters, there was a significant decline in patient pain. In a study devoted to tactics of rehabilitation treatment for temporomandibular joint disorders, the need for comprehensive long-term therapy, involving education, and learning proper chewing habits

  10. Temporomandibular joint injury potential imposed by the low-velocity extension-flexion maneuver.

    Science.gov (United States)

    Howard, R P; Hatsell, C P; Guzman, H M

    1995-03-01

    It has been proposed that significant temporomandibular joint injury can occur as a result of rapid extension-flexion motion of the neck (whip-lash). This motion, which is experienced by passengers in vehicles that undergo rear-end collisions, has been described as causing rapid protrusion and opening of the mandible. It has been speculated that this relative motion between the mandible and the cranium produces forces at the temporomandibular joint (TMJ) that injure the articular elements. The objective of this study was to measure these forces by an experimental method. Accelerometer sensor and high-speed cinematographic data were obtained from the kinematic responses of live human test subjects positioned as occupants in motor vehicles that underwent staged low-velocity rear-end collisions. Linear and moment forces generated at the TMJs were obtained from the resultant acceleration pulse at the craniomandibular complex, estimation of the mass properties of the mandible and its appended soft tissues, and the application of Newton's Second Law of motion. The maximum linear forces generated at the TMJ in a rear-end collision resulting in a velocity change of the test subject of 8 km/h (5 mph) were in the 7 to 10 N (1.6 to 2.2 lb) range. Moment forces at the joint peaked briefly at 0.55 N.m (4.81 lb-in). These force magnitudes generated at the TMJ constitute a minor fraction of the forces experienced at the joint during normal physiologic function. It is a conclusion of this study that injuries to the TMJ attributed to low-velocity "whiplash" cannot be accounted for by the joint forces produced by this maneuver.

  11. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M

    2013-12-01

    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Osteoarthritis in temporomandibular joint of Col2a1 mutant mice.

    Science.gov (United States)

    Ricks, M L; Farrell, J T; Falk, D J; Holt, D W; Rees, M; Carr, J; Williams, T; Nichols, B A; Bridgewater, L C; Reynolds, P R; Kooyman, D L; Seegmiller, R E

    2013-09-01

    Col2a1 gene mutations cause premature degeneration of knee articular cartilage in disproportionate micromelia (Dmm) and spondyloepiphesial dysplasia congenita (sedc) mice. The present study analyses the temporomandibular joint (TMJ) in Col2a1 mutant mice in order to provide an animal model of TMJ osteoarthritis (OA) that may offer better understanding of the progression of this disease in humans. Dmm/+ mice and controls were compared at two, six, nine and 12 months. Craniums were fixed, processed to paraffin sections, stained with Safranin-O/Fast Green, and analysed with light microscopy. OA was quantified using a Mankin scoring procedure. Unfolded protein response (UPR) assay was performed and immunohistochemistry (IHC) was used to assay for known OA biomarkers. Dmm/+ TMJs showed fissuring of condylar cartilage as early as 6 months of age. Chondrocytes were clustered, leaving acellular regions in the matrix. Significant staining of HtrA1, Ddr2 and Mmp-13 was observed in Dmm/+ mice (pTMJ. Dmm/+ mice are subject to early-onset OA in the TMJ. We observed upregulation of biomarkers and condylar cartilage degradation concomitant with OA. An upregulated UPR may exacerbate the onset of OA. The Dmm/+ mouse TMJ is a viable model for the study of the progression of OA in humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Oral rehabilitation of a patient with temporomandibular joint ankylosis caused by ankylosing spondylitis: A case report

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    Brkić Zlata

    2017-01-01

    Full Text Available Introduction. Ankylosing spondylitis (AS/Morbus Bechterew is a chronic inflammatory rheumatoid disease. The temporomandibular joint (TMJ dysfunction is involved in 4–35% of AS cases, and is correlated to the severity and extension of AS. Even though AS-caused TMJ ankylosis is exceptional, one should have high index of suspicion of TMJ ankylosis in AS for an early detection, because it is an extremely serious and disabling condition that causes problems with mastication, swallowing, digestion, speech, appearance and poor oral hygiene with heavy caries. Case report. A 54-year-old male patient sought medical attention at the Department of Periodontology and Oral Medicine, Clinic for Dentistry at the Military Medical Academy, Belgrade, Serbia, with the chief complaint of pain in the area of the upper left canine in the presence of limited mouth opening. The treatment plan consisted of upper left canine management and rehabilitation of the remaining teeth in the frontal and the premolar region in both, the upper and lower jaw. Even though molar region needed to be treated, unfortunately it was not in the treatment plan because ankylosis of TMJ made the treatment impossible. Conclusions. The patients with AS-caused TMJ ankylosis are considered a diagnostic challenge to routine dentistry. Accent should be given to early diagnosis and multidisciplinary approach in the treatment of the AS patients towards the favorable disease course and outcome.

  14. Effect of Lengthy Root Canal Therapy Sessions on Temporomandibular Joint and Masticatory Muscles

    Directory of Open Access Journals (Sweden)

    Safoora Sahebi

    2010-09-01

    Full Text Available Background and aims. Trauma is one of the major factors associated with temporomandibular joint disorders (TMD. These disorders result from macro-trauma or micro-trauma. Macro-trauma might be iatrogenic; for example, from intubation procedures, third molar extraction procedures, and lengthy dental appointments. The aim of this study was to evaluate the effect of lengthy root canal therapy (more than 2 hours on TMJ and its supporting structures. Materials and methods. Eighty patients whose root canal therapy session lasted more than 2 hours were examined for the status of TMJ and masticatory muscles. After one week the second part of the examination was carried out for TMJ problems and pain and tenderness levels of masticatory muscles. Data was analyzed using Wilcoxon statistical test. Results. Women showed more pain compared to men. There was a significant increase in pain in the external acoustic meatus examination one week after root canal therapy. Patients who were treated for their posterior teeth suffered more pain than those who were treated for the anteriors and premolars. Other aspects of the examination were not affected significantly by lengthy root canal therapy. Conclusion. Lengthy dental treatments can harm TMJ and masticatory muscles and wide opening of the mouth during such appointments can worsen the situation. Therefore, it is wise to break the appointment into shorter intervals and let the patients rest during treatment to close their mouth to prevent iatrogenic damage to TMJ.

  15. Electromyographic power spectrum of jaw muscles during clenching in unilateral temporomandibular joint osteoarthritis patients.

    Science.gov (United States)

    Park, I H; McCall, W D; Chung, J W

    2012-09-01

    The relationship between temporomandibular joints (TMJ) osteoarthritis and masticatory muscle disorders is poorly understood. The data are sparse, the results are conflicting, and electromyographic (EMG) power spectrum analysis has not been used. The aims of this study were to compare the differences in EMG power spectrum during, and pressure pain thresholds (PPTs) before and after, sustained clenching in patients with unilateral TMJ osteoarthritis and healthy control subjects. Nineteen patients with unilateral TMJ osteoarthritis without masticatory muscle pain and 20 control subjects were evaluated. We measured EMG amplitudes at maximum voluntary contraction, median frequency from the EMG power spectrum during sustained clenching at 70% and PPTs before and after the clenching in both temporalis and masseter muscles. There were no significant differences in PPT decrease between muscles or between groups during sustained clenching. There were no significant differences in maximum voluntary contraction EMG activity ratios of affected to unaffected sides between groups, or of masseter to temporalis muscles between affected and unaffected side of patients with TMJ osteoarthritis. Median frequencies decreased from the beginning to the end of the sustained clench, and the interaction between group and clench was significant: the median frequency decrease was larger in the osteoarthritis group. Our results suggested that masticatory muscles of patients with unilateral TMJ osteoarthritis are more easily fatigued during sustained clenching than normal subjects. © 2012 Blackwell Publishing Ltd.

  16. Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage

    Science.gov (United States)

    Yamano, Eizo; Inubushi, Toshihiro; Kuroda, Shingo

    2012-01-01

    This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and then orthodontic treatment was initiated. Titanium miniscrews were placed at the posterior maxilla to intrude the molars. After 2 years and 7 months of orthodontic treatment, an acceptable occlusion was achieved without any recurrence of TMJ symptoms. The retropositioned mandible was considerably improved, and the lips showed less tension upon lip closure. The maxillary molars were intruded by 1.5 mm, and the mandible was subsequently rotated counterclockwise. Magnetic resonance imaging of both condyles after treatment showed avascular necrosis-like structures. During a 2-year retention period, an acceptable occlusion was maintained without recurrence of the open bite. In conclusion, correction of open bite and clockwise-rotated mandible through molar intrusion using titanium miniscrews is effective for the management of TMJ-OA with jaw deformity. PMID:23112945

  17. Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage.

    Science.gov (United States)

    Tanaka, Eiji; Yamano, Eizo; Inubushi, Toshihiro; Kuroda, Shingo

    2012-06-01

    This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and then orthodontic treatment was initiated. Titanium miniscrews were placed at the posterior maxilla to intrude the molars. After 2 years and 7 months of orthodontic treatment, an acceptable occlusion was achieved without any recurrence of TMJ symptoms. The retropositioned mandible was considerably improved, and the lips showed less tension upon lip closure. The maxillary molars were intruded by 1.5 mm, and the mandible was subsequently rotated counterclockwise. Magnetic resonance imaging of both condyles after treatment showed avascular necrosis-like structures. During a 2-year retention period, an acceptable occlusion was maintained without recurrence of the open bite. In conclusion, correction of open bite and clockwise-rotated mandible through molar intrusion using titanium miniscrews is effective for the management of TMJ-OA with jaw deformity.

  18. Dentofacial characteristics of women with oversized mandible and temporomandibular joint internal derangement.

    Science.gov (United States)

    Moon, Beom-Seok; Yang, Il-Hyung; Ahn, Sug-Joon

    2011-05-01

    To analyze dentofacial characteristics of temporomandibular joint internal derangement (TMJ ID) in orthodontic patients with oversized mandible (skeletal Class III pattern). The sample consisted of 66 women whose mandibular body length to anterior cranial base ratio is greater than 1.12. They were divided into three groups based on magnetic resonance images of bilateral TMJs: bilateral normal disk position (BN), bilateral disk displacement with reduction (DDR), and bilateral disk displacement without reduction (DDNR). Thirty-five cephalometric variables regarding their lateral cephalograms were analyzed by Kruskal-Wallis test to evaluate differences in dentofacial morphology among the three groups. Subjects with TMJ ID had a clockwise rotation of the ramus, with backward position of mandible, labial tipping of mandibular incisors, and protrusion of upper and lower lips. However, TMJ ID did not significantly influence vertical skeletal relationships. Most of the significant dentofacial changes were found between BN and DDR, and dentofacial changes between DDR and DDNR were minimal. This study suggests that dentofacial changes associated with TMJ ID begin to appear when TMJ ID develops to DDR from BN in patients with oversized mandible.

  19. Dentists' knowledge of occlusal splint therapy for bruxism and temporomandibular joint disorders.

    Science.gov (United States)

    Candirli, C; Korkmaz, Y T; Celikoglu, M; Altintas, S H; Coskun, U; Memis, S

    2016-01-01

    The aim of this study was to investigate dentist's approaches to the use of splint therapy for myofascial pain, bruxism, and temporomandibular joint (TMJ) disorders and to assessment of treatment modalities. A 12-item questionnaire was developed to determine dentists' knowledge of TMJ disorders and approaches for occlusal splint treatments. The researchers spoke with each dentist included in the study at his/her clinic or by telephone to assess their immediate knowledge and approach to the TMJ disorders. Chi-squared test was performed to analyze the values. The confidence interval was set as 95%. A total of 370 dentists working in Turkey were participated in this study. The most common splint application reason for occlusal splint treatment was bruxism (77.8%) while TMJ pain was very rare (%1.4). The use of hard splint ratios for 0-5 years of professional experience was 57.0%, 42.4.0%, and 26.8% for the experience of 5-15 years and over 15 years groups, respectively (P < 0.001). While the dentists' with sufficient knowledge soft splint application rates were 11.6%, hard splint application rates were 43.4% for the dentists with sufficient knowledge. Occlusion adjustment rate of dentists who practice in all three groups was under 16.0%. The knowledge of the dentists about TMJ disorders and occlusal splint therapy were found to be insufficient. Their knowledge decreased with increasing experience.

  20. Non-neoplastic disorders of the temporomandibular joint; Nonneoplastische Arthropathien des Kiefergelenks

    Energy Technology Data Exchange (ETDEWEB)

    Lomoschitz, F.; Krestan, C.; Robinson, S.; Czerny, C.; Imhof, H. [Vienna Univ. (Austria). Zentrales Inst. fuer Radiodiagnostik

    2001-09-01

    The pathologic conditions that involve the TMJ are similar to those conditions that involve other joints in the body. Therefore, many of the radiologic characteristics are also similar. Nevertheless, because of the complex structure and function of this small joint, it is essential to know the variety of diseases that can involve the temporomandibular joint. It is also important to understand that functionally both TMJ's act as a single unit and that any alteration in function caused by a pathologic process on one side may lead to dysfunction on the contralateral side. It is essential that the radiologist is familiar with the principles of TMJ function as well as TMJ pathology. (orig.) [German] Die Krankheitsbilder, die zu einer Mitbeteiligung der Kiefergelenke fuehren, unterscheiden sich prinzipiell nicht von jenen, welche die uebrigen Gelenke im Koerper betreffen. Aus diesem Grund sind auch die radiologischen Veraenderungen im Prinzip aehnlich. Aufgrund der komplexen Morphologie und Funktion des Kiefergelenks ist es jedoch wichtig, die Vielfalt von Erkrankungen zu kennen, welche zu morphologischen und funktionellen Veraenderungen am Kiefergelenk fuehren koennen. Durch die funktionelle Einheit beider Kiefergelenke kann jede einseitige Erkrankung in weiterer Folge auch zur Dysfunktion der kontralateralen Seite fuehren. Der Radiologe sollte mit den Prinzipien der Funktionen sowie mit der Vielfalt der pathologischen Veraenderungen der Kiefergelenke vertraut sein. (orig.)

  1. Topical application of capsaicin for the treatment of localized pain in the temporomandibular joint area.

    Science.gov (United States)

    Winocur, E; Gavish, A; Halachmi, M; Eli, I; Gazit, E

    2000-01-01

    To determine the effectiveness of topical capsaicin cream application on localized pain in the temporomandibular joint (TMJ) area. A randomized, double-blind, placebo-controlled study was conducted on 30 patients suffering from unilateral pain in the TMJ area. Patients were randomly divided into experimental and placebo groups; they were instructed to apply 0.025% capsaicin cream or its vehicle to the painful TMJ area 4 times daily for 4 weeks. Subjective parameters of present pain, most severe pain, effect of pain on daily activities, and pain relief were assessed each week on a visual analog scale. Muscle and joint sensitivity to palpation on the painful and contralateral joints and maximal mouth opening (assisted/passive and non-assisted/active) were examined weekly by the same experienced examiner. Capsaicin cream produced no statistically significant influence on measured variables when compared to placebo. Both experimental and placebo groups showed statistically significant improvement in most variables during the experiment. The factor of time had a major effect in the non-specific improvement of the parameters assessed. The placebo effect played an important role in the treatment of patients with pain in the TMJ area.

  2. Temporomandibular joint reconstruction after condylar fracture complication related to osteosynthesis material.

    Science.gov (United States)

    Dantas, J F C; Nogueira Neto, J N; Sarmento, V A; Campos, P S F

    2018-01-01

    Total condylar resorption and the failure of bone synthesis material as postoperative complications of condyle fracture are seldom reported in the literature. When these occur, they may severely limit temporomandibular joint (TMJ) function. In such cases, a reconstruction of the joint is indicated, which can be achieved by means of an alloplastic prosthesis. This article reports a rare case of impaction of osteosynthesis material in the region of the base of the skull associated with a mandibular condyle fracture treated with rigid internal fixation, which resulted in complications. There was progression to condylar resorption, requiring an alloplastic TMJ reconstruction, which was performed in a single surgical session. Copyright © 2017. Published by Elsevier Ltd.

  3. Temporomandibular joint osteochondromatosis: an unusual cause of preauricular swelling.

    LENUS (Irish Health Repository)

    Phelan, Eimear

    2012-02-01

    We report an unusual and rare cause of preauricular swelling and review the most recent literature concerning synovial osteochondromatosis of the temporomandibular joint. We report the clinical and radiologic findings of a case of synovial osteochondromatosis of the temporomandibular joint that presented as preauricular swelling in a female patient. This disease typically affects large joints; fewer than 100 cases reported in the literature affect the temporomandibular joint. This case illustrates that disorders of the temporomandibular joint should also be included in the differential diagnosis of patients who present with a preauricular mass.

  4. Functional surgery of the temporomandibular joint with conscious sedation for "closed lock" using eminectomy as a treatment: a case series.

    LENUS (Irish Health Repository)

    Stassen, Leo F

    2011-06-01

    The purpose of this case series study was to evaluate the advantages and disadvantages of using local anesthesia and conscious sedation (CS) rather than general anesthesia (GA) for performing functional surgery on patients suffering from temporomandibular joint (TMJ) closed lock, using the eminectomy procedure. Performing this procedure using CS allows functional assessment of the TMJ meniscus at the time of surgery. The objectives of this study were to determine if this surgery is possible under CS, to determine the benefits of being able to see the meniscus in action, and to investigate the patients\\' acceptability for this form of anesthesia.

  5. Treatment of a case of skeletal class II malocclusion with temporomandibular joint disorder using miniscrew anchorage.

    Science.gov (United States)

    Kaku, Masato; Koseki, Hiroyuki; Kawazoe, Aki; Abedini, Sara; Kojima, Shunichi; Motokawa, Masahide; Ohtani, Junji; Fujita, Tadashi; Kawata, Toshitsugu; Tanne, Kazuo

    2011-04-01

    At the present time, there are no reports in the literature on the treatment of temporomandibular joint disorder (TMD) by intrusion of molars using mini-screws. This case report describes the treatment for a female patient, aged 19 years seven months, with a TMD and an excessive lower anterior facial height. Overjet and overbite were +5.0 mm and +0.5 mm, respectively. The patient had a history of orthodontic treatment in which her first premolars were all extracted. During the first orthodontic treatment, a clockwise mandibular rotation was observed as a result of the increase of posterior dentoalveolar height. She had temporomandibular joint (TMJ) pain during mouth opening and complained of difficulty in eating due to masticatory dysfunction. The pretreatment Schuller views of both TMJ showed a posterior condyle position. In order to correct the overjet, molar relationship and the mandibular condyle position, a miniscrew was inserted into the palatal region of the upper first molar to intrude the upper posterior teeth. As the upper molars were intruded, the overjet was decreased, and a class I molar relationship was achieved by a counterclockwise mandibular rotation. After one year of treatment, an acceptable occlusion was achieved, and the condyle moved into centric position in the glenoid fossa. The patient's teeth continued to be stable, and she had no pain in TMJ after a retention period of three years. The result of this treatment showed that molar intrusion using miniscrew anchorage is effective for treatment of a TMD patient with a posterior condyle position.

  6. Characterization of the temporomandibular joint of the harbour porpoise (Phocoena phocoena) and Risso's dolphin (Grampus griseus).

    Science.gov (United States)

    McDonald, M; Vapniarsky-Arzi, N; Verstraete, F J M; Staszyk, C; Leale, D M; Woolard, K D; Arzi, B

    2015-04-01

    The temporomandibular joint (TMJ) in cetaceans is largely uncharacterized. This study aims to describe the macroscopic, microscopic, biochemical and biomechanical features of the TMJ of two species of the suborder Odontoceti: the harbour porpoise (Phocoena phocoena) and Risso's dolphin (Grampus griseus). Furthermore, we aim to elucidate the structure-function relationship of their TMJs and their possible role in echolocation. The TMJs from fresh cadaver heads of harbour porpoise (n=4) and Risso's dolphin (n=2) acquired from stranding were examined. Following macroscopical evaluation, the TMJs were investigated for their histological, mechanical and biochemical properties. The TMJs of the studied odontocetes were found to be fundamentally different from other mammals. Macroscopically, the TMJ lacks the typical joint cavity found in most mammals and is essentially a syndesmosis. Histological and microstructural analysis revealed that the TMJ discs were composed of haphazardly intersecting fibrous-connective tissue bundles separated by adipose tissue globules and various calibre blood vessels and nerve fibres. The collagen fibre composition was primarily collagen type I with lesser amounts of collagen type II. Sulphated glycosaminoglycan (sGAG) content was lower compared to other studied mammals. Finally, mechanical testing demonstrated the disc was stronger and stiffer in the dorsoventral direction than in the mediolateral direction. The spatial position of the TMJ, the absence of an articulating synovial joint, and the properties of the TMJ discs all reflect the unique suction-feeding mechanism adopted by the harbour porpoise and Risso's dolphin for underwater foraging. In addition, the presence of unique adipose globules, blood vessels and nerves throughout the discs may indicate a functional need beyond food apprehension. Instead, the disc may play a role in neurological sensory functions such as echolocation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. A personalized 3D-printed prosthetic joint replacement for the human temporomandibular joint: From implant design to implantation.

    Science.gov (United States)

    Ackland, David C; Robinson, Dale; Redhead, Michael; Lee, Peter Vee Sin; Moskaljuk, Adrian; Dimitroulis, George

    2017-05-01

    Personalized prosthetic joint replacements have important applications in cases of complex bone and joint conditions where the shape and size of off-the-shelf components may not be adequate. The objective of this study was to design, test and fabricate a personalized 3D-printed prosthesis for a patient requiring total joint replacement surgery of the temporomandibular joint (TMJ). The new 'Melbourne' prosthetic TMJ design featured a condylar component sized specifically to the patient and fixation screw positions that avoid potential intra-operative damage to the mandibular nerve. The Melbourne prosthetic TMJ was developed for a 58-year-old female recipient with end-stage osteoarthritis of the TMJ. The load response of the prosthesis during chewing and a maximum-force bite was quantified using a personalized musculoskeletal model of the patient's masticatory system developed using medical images. The simulations were then repeated after implantation of the Biomet Microfixation prosthetic TMJ, an established stock device. The maximum condylar stresses, screw stress and mandibular stress at the screw-bone interface were lower in the Melbourne prosthetic TMJ (259.6MPa, 312.9MPa and 198.4MPa, respectively) than those in the Biomet Microfixation device (284.0MPa, 416.0MPa and 262.2MPa, respectively) during the maximum-force bite, with similar trends also observed during the chewing bite. After trialing surgical placement and evaluating prosthetic TMJ stability using cadaveric specimens, the prosthesis was fabricated using 3D printing, sterilized, and implanted into the female recipient. Six months post-operatively, the prosthesis recipient had a normal jaw opening distance (40.0 mm), with no complications identified. The new design features and immediate load response of the Melbourne prosthetic TMJ suggests that it may provide improved clinical and biomechanical joint function compared to a commonly used stock device, and reduce risk of intra-operative nerve damage

  8. Electrical (faradic) stimulation versus active mobilization exercise in the physical management of post-surgical temporomandibular joint hypomobility.

    Science.gov (United States)

    Sanya, A O; Balogun, A O; Arotiba, J T; Hamzat, T K

    2000-03-01

    This clinical study compared the efficacy of faradic stimulation and active mobilization exercises in the physical management of patients with post-surgical immobilization of the temporomandibular joint (TMJ) resulting in hypomobility of the joint. Eight volunteer dental patients with post-surgical immobilization TMJ hypomobility at the University College Hospital (U.C.H.), Ibadan, Nigeria participated in the study. Duration of TMJ immobilization was between 6 and 10 weeks (mean 7.13 +/- 1.55). Patients were alternately assigned to two groups as they became available. Patients in group A received mild infra-red radiation to the TMJ region and faradic stimulation to the muscles that move the joint while patients in group B had mild infra-red radiation and TMJ mobilization exercises. Treatment continued until pain relief and full range of the TMJ were attained. However after three treatment sessions, attendance became irregular because the patients were satisfied with their recovery. Pain perception was measured using the visual analogue scale. Interincisal opening was measured using a pair of mathematical set divider and a measuring ruler. The results showed that both faradic stimulation and exercises significantly improved the interincisal opening and pain perception although electrical stimulation improved mouth opening more significantly than active exercise.

  9. Prevalence, Course, and Associated Factors of Pain in the Temporomandibular Joint in Early Rheumatoid Arthritis: Results of a Longitudinal Cohort Study

    NARCIS (Netherlands)

    Sem, Jessica P. S. Chin Jen; van der Leeden, Marike; Visscher, Corine M.; Britsemmer, Karin; Turk, Samina A.; Dekker, Joost; van Schaardenburg, Dirkjan; Lobbezoo, Frank

    2017-01-01

    Aims: To assess the prevalence, 3-year course, and associated factors of temporomandibular joint (TMJ) pain in patients with newly diagnosed rheumatoid arthritis (RA). Methods: A total of 264 patients with newly diagnosed RA were included. Patients were assessed after 3 months, 6 months, 9 months, 1

  10. TMJ ankylosis: Management with reconstruction and interpositional ...

    African Journals Online (AJOL)

    Treatment of temporomandibular joint (TMJ) ankylosis usually requires adequate excision of the involved ankylotic 2 block (arthroplasty)or interpositional arthroplasty using autogenous or alloplastic materials. Early mobilization, 3 physiotherapy & strict follow up are essential to prevent postop adhesions. In our cases fascia ...

  11. Activational action of testosterone on androgen receptors protects males preventing temporomandibular joint pain.

    Science.gov (United States)

    Fanton, L E; Macedo, C G; Torres-Chávez, K E; Fischer, L; Tambeli, C H

    2017-01-01

    Testosterone protects male rats from Temporomandibular Joint (TMJ) pain. This study investigated whether this protective effect is mediated by an organizational action of testosterone during nervous system development, by central estrogen and androgen receptors and by the 5α-reduced metabolite of testosterone, dihydrotestosterone. A pharmacological approach was used to assess the ability of the androgen receptor antagonist flutamide, the estrogen receptor antagonist ICI 182 780 and the 5-α reductase inhibitor dutasteride to block the protective effect of testosterone, evaluated through the behavioral response induced by a TMJ injection of 0.5% formalin. Flutamide and ICI 182 780 were injected into the medullary subarachnoid space, and dutasteride and testosterone were systemically administered. The TMJ injection of 0.5% formalin induced a significant nociceptive behavioral response in gonadectomized male and naïve female, but not in sham gonadectomized male rats, confirming that endogenous testosterone prevents TMJ nociception in males. Testosterone administration prevented formalin-induced TMJ nociception in males gonadectomized either in the neonatal (at the day of birth) or adult period and in naïve female rats, suggesting that the protective effect of testosterone on TMJ nociception does not depend on its organizational actions during critical periods of development. The administration of flutamide and dutasteride but not of ICI 182 780 blocked the protective effect of testosterone. We conclude that the protective effect of testosterone on TMJ nociception depends on activational actions of dihydrotestosterone on androgen receptors rather than on organizational androgenic actions during central nervous system development or estrogenic actions. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. [Tinnitus and temporomandibular joint: State of the art].

    Science.gov (United States)

    Lina-Granade, G; Truy, E; Ionescu, E; Garnier, P; Thai Van, H

    2016-12-01

    Tinnitus has been described in temporomandibular joint dysfunction for a long time. Yet, other disorders, such as hearing loss, stress, anxiety and depression, play a major role in the pathophysiology of tinnitus. Temporomandibular joint dysfunctions seem to increase the risk of tinnitus in patients with other predisposing factors. Especially somatosensory tinnitus, which is characterized by sound modulations with neck or mandible movements, is frequently associated with temporomandibular joint dysfunction, but it is not pathognomonic of such a disorder. In such cases, functional therapy of the temporomandibular joint should be part of the multidisciplinary rehabilitation of patients with tinnitus. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Morphological changes in the temporomandibular joint before and after sagittal splitting ramus osteotomy of the mandible for skeletal mandibular protrusion.

    Science.gov (United States)

    Enami, Koji; Yamada, Kazuhiro; Kageyama, Toru; Taguchi, Akira

    2013-04-01

    Changes of temporomandibular joint (TMJ) morphology were analyzed in 21 patients with mandibular protrusion corrected using bilateral sagittal split ramus osteotomy (SSRO) and mini-plate fixation with TMJ cephalometric laminographs. The condylar pass angle, eminence to the FH plane angle, and total height of fossa and lower height of fossa in both left and right sides, significantly decreased after surgery. The width of the condyle, in both left and right sides, significantly increased after treatment. However, in the joint spaces, there were no significant differences before and after treatment. The amount of change in the eminence to the FH plane angle, total height of fossa and lower height of fossa, before and after surgery, showed significant positive correlations with that of SNB, before and after surgery. These results suggest that adaptive bone remodeling of the TMJ might occur due to the correction of occlusion and craniofacial morphology by SSRO in patients with mandibular protrusion.

  14. Masticatory muscle and temporomandibular joint pain in Croatian war veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Uhac, Ivone; Tariba, Petra; Kovac, Zoran; Simonić-Kocijan, Suncana; Lajnert, Vlatka; Mesić, Vesna Fugosić; Kuis, Davor; Braut, Vedrana

    2011-12-01

    The aim of this study was to investigate the prevalence and intensity of masticatory muscle and temporomandibular joint (TMJ) pain in Croatian war veterans with posttraumatic stress disorder (PTSD). The examined group consisted of 100 Croatian war veterans, in whom PTSD had previously been diagnosed. Patients were compared with 92 subjects who had not taken part in the war and in whom PTSD was excluded by psychiatric examination. The clinical examination consisted of palpation of the masticatory muscles, the prominent neck musculature, and TMJ. The examination technique used and the definition of items were previously tested for reliability and validity. 93% of the subjects with PTSD had masticatory muscle tenderness compared to 45.65% of the subjects in the control group (chi2 = 51.46, p TMJ tenderness compared to 3.26% of subjects in the control group (chi2 = 66.23, p TMJ in both groups was the left posterior capsule; in the PTSD group 38% and in subjects in the control group 2.17% of cases. The most painful location was the left posterior capsule in 28% of subjects with PTSD, while not one subject in the control group reported severe painful sensitivity. The very high frequency and intensity of pain in subjects with PTSD confirms the effect of stress on muscle and joint sensitivity, i.e. perception of pain.

  15. Total temporomandibular joint prosthesis as a surgical option for severe mouth opening restriction. A case report of a bilateral intervention

    Directory of Open Access Journals (Sweden)

    S. Berrone

    2011-09-01

    Full Text Available Temporomandibular disorders (TMD are a heterogeneous group of pathologies affecting the temporomandibular joint (TMJ and/or the masticator muscles, characterized by a molteplicity of signs and symptoms, the most common of which are pain localized in the preauricular area and/or in the masticatory muscles; jaw motion abnormalities; articular sounds, such as click and/or crepitus, during mandibular movements (1. A specific etiolpathogenesis is detectable in a minority of cases, since the occurrence of TMD symptoms is often...

  16. The Interface of Mechanics and Nociception in Joint Pathophysiology: Insights From the Facet and Temporomandibular Joints.

    Science.gov (United States)

    Sperry, Megan M; Ita, Meagan E; Kartha, Sonia; Zhang, Sijia; Yu, Ya-Hsin; Winkelstein, Beth

    2017-02-01

    Chronic joint pain is a widespread problem that frequently occurs with aging and trauma. Pain occurs most often in synovial joints, the body's load bearing joints. The mechanical and molecular mechanisms contributing to synovial joint pain are reviewed using two examples, the cervical spinal facet joints and the temporomandibular joint (TMJ). Although much work has focused on the macroscale mechanics of joints in health and disease, the combined influence of tissue mechanics, molecular processes, and nociception in joint pain has only recently become a focus. Trauma and repeated loading can induce structural and biochemical changes in joints, altering their microenvironment and modifying the biomechanics of their constitutive tissues, which themselves are innervated. Peripheral pain sensors can become activated in response to changes in the joint microenvironment and relay pain signals to the spinal cord and brain where pain is processed and perceived. In some cases, pain circuitry is permanently changed, which may be a potential mechanism for sustained joint pain. However, it is most likely that alterations in both the joint microenvironment and the central nervous system (CNS) contribute to chronic pain. As such, the challenge of treating joint pain and degeneration is temporally and spatially complicated. This review summarizes anatomy, physiology, and pathophysiology of these joints and the sensory pain relays. Pain pathways are postulated to be sensitized by many factors, including degeneration and biochemical priming, with effects on thresholds for mechanical injury and/or dysfunction. Initiators of joint pain are discussed in the context of clinical challenges including the diagnosis and treatment of pain.

  17. Osteoarthritis-like damage of cartilage in the temporomandibular joints in mice with autoimmune inflammatory arthritis

    Science.gov (United States)

    Ghassemi-Nejad, S.; Kobezda, T.; Rauch, T.A.; Matesz, C.; Glant, T.T.; Mikecz, K.

    2011-01-01

    Summary Objective To study temporomandibular joint (TMJ) involvement in an autoimmune murine model of rheumatoid arthritis (RA), a disease characterized by inflammatory destruction of the synovial joints. Although TMJ dysfunction is frequently found in RA, TMJ involvement in RA remains unclear, and TMJ pathology has not been studied in systemic autoimmune animal models of RA. Methods Proteoglycan (PG) aggrecan-induced arthritis (PGIA) was generated in genetically susceptible BALB/c mice. TMJs and joint tissues/cartilage were harvested for histological and immunohistochemical analyses and RNA isolation for quantitative polymerase chain reaction. Serum cytokine levels were measured in mice with acute or chronic arthritis, and in non-arthritic control animals. Results Despite the development of destructive synovitis in the limbs, little or no synovial inflammation was found in the TMJs of mice with PGIA. However, the TMJs of arthritic mice showed evidence of aggrecanase- and matrix metalloproteinase-mediated loss of glycosaminoglycan-containing aggrecan, and in the most severe cases, structural damage of cartilage. Serum levels of pro-inflammatory cytokines, including interleukin (IL)-1β, were elevated in arthritic animals. Expression of the IL-1β gene was also high in the inflamed limbs, but essentially normal in the TMJs. Local expression of genes encoding matrix-degrading enzymes (aggrecanases and stromelysin) was upregulated to a similar degree in both the limbs and the TMJs. Conclusion We propose that constantly elevated levels of catabolic cytokines, such as IL-1β, in the circulation (released from inflamed joints) create a pro-inflammatory milieu within the TMJ, causing local upregulation of proteolytic enzymes and subsequent loss of aggrecan from cartilage. PMID:21262368

  18. Involvement of trigeminal ganglionic Nav 1.7 in hyperalgesia of inflamed temporomandibular joint is dependent on ERK1/2 phosphorylation of glial cells in rats.

    Science.gov (United States)

    Bi, R-Y; Kou, X-X; Meng, Z; Wang, X-D; Ding, Y; Gan, Y-H

    2013-08-01

    Inflammation is a major cause of temporomandibular disorder-related pain. The Nav 1.7 sodium channel has a critical function in pain perceptions. However, whether and how Nav 1.7 in the trigeminal ganglion is involved in temporomandibular joint (TMJ) inflammatory pain remains to be examined. TMJ inflammation was induced by complete Freund's adjuvant in female rats. The expression of trigeminal ganglionic Nav 1.7 and other sodium channels was examined using real-time polymerase chain reaction or Western blotting. Immunohistofluorescence with fluorescent retrograde neuronal tracer DiI was used to confirm Nav 1.7 in the trigeminal neurons innervating TMJ. The functions of trigeminal ganglionic Nav 1.7 and extracellular signal-regulated kinase 1/2 (ERK1/2) phosphorylation were blocked with the microinjection of the Nav 1.7 antibody or U0126 into the trigeminal ganglion. Head withdrawal threshold and food intake was measured to evaluate TMJ nociceptive responses. TMJ inflammation significantly up-regulated Nav 1.7 mRNA and protein; however, the mRNA of Nav 1.3 was not affected and those of Nav 1.8 and Nav 1.9 were only slightly up-regulated. TMJ inflammation specifically induced Nav 1.7 in the neurons innervating TMJ. In addition, blocking the Nav 1.7 function significantly attenuated the hyperalgesia of the inflamed TMJ. Moreover, TMJ inflammation up-regulated ERK1/2 phosphorylation only in the glials; blocking ERK1/2 phosphorylation in the glials blocked Nav 1.7 up-regulation in the neurons and correspondingly attenuated the hyperalgesia of the inflamed TMJ. Trigeminal ganglionic Nav 1.7 has an important function in the hyperalgesia of the inflamed TMJ, which is dependent on the communication with the satellite glials. © 2012 European Federation of International Association for the Study of Pain Chapters.

  19. Calcium pyrophosphate dihydrate crystal deposition disease presenting as a pseudotumor of the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Vargas, A.; Teruel, J.; Pont, J.; Velayos, A. [Department of Radiology, Hospital de Girona ``Dr. Josep Trueta``, Av. de Franca s/n, E-17 007 Girona (Spain); Trull, J. [Department of Oral Surgery, Hospital de Girona, Dr. ``Josep Trueta``, Av. de Franca s/n, E-17 007 Girona (Spain); Lopez, E. [Department of Pathology, Hospital de Girona, Dr. ``Josep Trueta``, Av. de Franca s/n, E-17 007 Girona (Spain)

    1997-12-01

    We report a case of a 66-year-old white woman with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease. The patient related a 2-month history of swelling with tenderness over the left pre-auricular region. A CT scan suggested a synovial chondromatosis. Surgical removal was done and histologic study showed CPPD crystals. This disease rarely involves the temporomandibular joint (TMJ) and is not usually considered in the differential diagnosis. To our knowledge, only 14 cases have been reported in the literature. (orig.) With 3 figs., 10 refs.

  20. Alterations of the Temporomandibular Joint on Magnetic Resonance Imaging according to Growth and Development in Schoolchildren

    Science.gov (United States)

    Tanaka, Tatsurou; Konoo, Tetsuro; Habu, Manabu; Oda, Masafumi; Kito, Shinji; Kodama, Masaaki; Kokuryo, Shinya; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Nishida, Ikuko; Morikawa, Kazumasa; Saeki, Katsura; Maki, Kenshi; Tominaga, Kazuhiro; Masumi, Shin-ichi; Terashita, Masamichi; Morimoto, Yasuhiro

    2012-01-01

    The paper explains the alterations of the temporomandibular joint (TMJ) visualized by magnetic resonance imaging (MRI) according to the growth and development of schoolchildren. Appearance and disappearance of a “double contour-like structure” (DCLS) of the mandibular condyle on MRI according to the growth and development of schoolchildren were demonstrated. In addition, possible constituents of DCLS and the significance of detection of DCLS on MRI were also speculated. The relationship between red marrow and yellow marrow in the articular eminence of temporal bone, the disappearance of DCLS, and alterations of the mandibular condyle have been elucidated. PMID:23316233

  1. Analysis of the cytokine profiles of the synovial fluid in a normal temporomandibular joint: preliminary study.

    Science.gov (United States)

    Kim, Young-Kyun; Kim, Su-Gwan; Kim, Bum-Soo; Lee, Jeong-Yun; Yun, Pil-Young; Bae, Ji-Hyun; Oh, Ji-Su; Ahn, Jong-Mo; Kim, Jae-Sung; Lee, Sook-Young

    2012-12-01

    The purpose of this study was to compare the cytokine profiles of the synovial fluid from the temporomandibular joint (TMJ) spaces of normal individuals and temporomandibular disorder (TMD) patients. Thirty-four patients with planned orthognathic surgery did not present abnormalities of the TMJ on magnetic resonance images and radiographs and did not show the symptoms identified by the Research Diagnostic Criteria for TMD (RDC-TMD); as a result, they were assigned to the control group. Twenty-two patients who sought treatment for TMD during the same period were assigned to the TMD group. Synovial fluid was collected from superior TMJ spaces, and cytokine expression was analysed by an enzyme-linked immunosorbent assay (ELISA). Significant differences were tested using Fisher's exact test (pTMD group, whereas no cytokines were detected in the control group. The most prevalent cytokines in the TMD group were IL-1β, IL-6 and GM-CSF. IL-4 and IL-5 were not detected in either the TMD group or in the control group. None of the cytokines that were detected in patients with TMD were found in the articular spaces of normal individuals. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  2. Expression of β-defensin 4 on temporomandibular joint discs with anterior displacement without reduction.

    Science.gov (United States)

    Sicurezza, Edoardo; Loreto, Carla; Musumeci, Giuseppe; Almeida, Luis Eduardo; Rusu, Mugurel; Grasso, Carmelo; Leonardi, Rosalia

    2013-12-01

    β-defensin-4 is a member of antimicrobial peptides (APs) of the immunity system. This molecule has antimicrobial activity but it seems to be involved in articular inflammatory processes too, as it happens during osteoarthritic disease (OA). Considering the possible relation existing between (OA) and temporomandibular disorders (TMD), the aim of our study was to evaluate immunohistochemically the presence of β- defensin-4 in pathological temporomandibular joint (TMJ) discs affected by internal derangement without reduction (ADDwoR). Eighteen TMJ-displaced disc specimens were considered in this study and were analysed by immunohistochemical evaluation. They were compared with a control sample of sixteen healthy discs and two scores, intensity of staining (IS) and extent score (ES) were estimated. Findings of our analysis showed a significant difference between control and study sample (P TMJ discs affected by ADDwoR, hypothesing a possible role of this molecule in articular bone disruption. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  3. Laser therapy reduces gelatinolytic activity in the rat trigeminal ganglion during temporomandibular joint inflammation.

    Science.gov (United States)

    Desiderá, A C; Nascimento, G C; Gerlach, R F; Leite-Panissi, C R A

    2015-07-01

    To investigate whether low-level laser therapy (LLLT) alters the expression and activity of MMP-2 and MMP-9 in the trigeminal ganglion (TG) during different stages of temporomandibular joint (TMJ) inflammation in rats. It also evaluated whether LLLT modifies mechanical allodynia and orofacial hyperalgesia. Wistar rats (±250 g) were divided into groups that received saline (SAL) or complete Freund's adjuvant (CFA, 50 μl) in the TMJ, and that later underwent LLLT (20 J cm(-2) ) at their TMJ or not (groups SAL, SAL + LLLT, CFA, and CFA + LLLT). LLLT was applied on days 3, 5, 7, and 9 after SAL or CFA. Mechanical allodynia was evaluated on days 1, 3, 5, 7, and 10; orofacial hyperalgesia was assessed on day 10. Gelatin zymography and in situ zymography aided quantification of MMPs in the TG. Low-level laser therapy abolished the reduction in the mechanical orofacial threshold and the increase in orofacial rubbing during the orofacial formalin test induced by CFA. LLLT also decreased the CFA-induced rise in the levels of MMP-9 and MMP-2 as well as the gelatinolytic activity in the TG. Low-level laser therapy could constitute an adjuvant therapy to treat temporomandibular disorders and prevent inflammation-induced alterations in the levels of MMP-2 and MMP-9 and in the gelatinolytic activity in TGs. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Internal derangements of the temporomandibular joint: findings in the pediatric age group

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    Katzberg, R.W.; Tallents, R.H.; Hayakawa, K.; Miller, T.L.; Goske, M.J.; Wood, B.P.

    1985-01-01

    Findings in 31 pediatric patients with pain and dysfunction of the temporomandibular joint (TMJ) are reported. The average age was 14 years and the average duration of symptoms was 21.4 months. Internal derangements were found in 29 patients (94%) and degenerative arthritis in 13 (42%). In 12 patients (39%), the problem could be traced to an injury to the jaw. Secondary condylar hypoplasia was associated with the meniscal abnormality in 3 patients (10%). Further awareness of internal derangements of the TMJ in the pediatric population should permit greater recognition of their etiology. It is important that threatment be initiated as soon as possible, not only to minimize the development of osseous disease in young adults but also to prevent facial growth deformities.

  5. Temporomandibular Joint Ankylosis as a Complication of Neonatal Septic Arthritis; Report of two cases

    Directory of Open Access Journals (Sweden)

    Noor J. Al-Saadi

    2015-11-01

    Full Text Available Temporomandibular joint (TMJ ankylosis as a complication of neonatal septic arthritis is rarely reported in the literature. We report two clinical cases of unilateral TMJ ankylosis occurring in paediatric patients subsequent to neonatal septic arthritis. The first case was a 15-month-old male infant who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in May 2010. According to the published English scientific literature, he is the youngest person yet to be diagnosed with this condition. The second case was a five-year-old female who presented to the Al-Nahda Hospital, Muscat, Oman, in October 2011. Both cases presented with facial asymmetry and trismus. They subsequently underwent gap arthroplasty and interpositional temporalis muscle and fascia grafts which resulted in an immediate improvement in mouth opening. Postoperatively, the patients underwent active jaw physiotherapy which was initially successful. Both patients were followed up for a minimum of two years following their surgeries.

  6. Biomaterials in temporomandibular joint replacement: current status and future perspectives-a narrative review.

    Science.gov (United States)

    De Meurechy, N; Braem, A; Mommaerts, M Y

    2017-11-07

    The alloplastic total temporomandibular joint (TMJ) prosthesis has a long history, with many different materials and designs used. While several of these materials have proven valuable over time, many others have not been suitable for implantation, resulting in failure and the need for explantation of the implant. Because of the failure of several of these systems, the use of alloplastic prostheses has reduced dramatically, despite their advantages over autogenous restoration. The aim of this narrative review is to discuss the criteria that must be met by a biomaterial in order for it to be considered suitable for implantation, as well as the common complications that can occur. Currently used materials are highlighted, as well as potential future materials that might prove better suitable for implantation. Several surface modification techniques are proposed as an alternative to the materials used in current TMJ prosthesis systems. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Ooi, K; Inoue, N; Matsushita, K; Yamaguchi, H; Mikoya, T; Minowa, K; Kawashiri, S; Nishikata, S; Tei, K

    2018-01-02

    The aim of this study was to investigate the incidence of anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) in patients with dentofacial deformity. Eighty-eight female patients (176 joints) with skeletal class III malocclusion and 33 female patients (66 joints) with skeletal class II malocclusion, with or without anterior open bite and asymmetry, were evaluated. Magnetic resonance imaging (MRI) of the TMJ was used to diagnose ADDwoR. A statistical analysis was performed to examine the relationship between ADDwoR and skeletal structure. ADDwoR was present in 37 of the 66 joints (56.1%) in class II compared to 34 of the 176 joints (19.3%) in class III (P<0.05). In class III, ADDwoR was significantly more common in joints with mandibular asymmetry (24/74; 32.4%) than in joints with open bite (9/62; 14.5%) and joints with open bite and without mandibular asymmetry (1/38; 2.6%). In class II, ADDwoR was significantly less common in joints with mandibular asymmetry and without open bite (1/8; 12.5%). ADDwoR was only observed on the deviated side in both class III and class II with mandibular asymmetry. The prevalence of ADDwoR differed according to the dentofacial morphology. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Ultrasound assessment of increased capsular width in temporomandibular joint internal derangements: relationship with joint pain and magnetic resonance grading of joint effusion.

    Science.gov (United States)

    Bas, Burcu; Yılmaz, Nergiz; Gökce, Erkan; Akan, Hüseyin

    2011-07-01

    The relationship between radiologic evidence of effusion in the temporomandibular joint (TMJ) and the occurrence of clinical symptoms (e.g., pain) is still unclear. Increased capsular width (CW) measured in ultrasonographic imaging (USI) of the TMJ was considered to be an indirect marker of TMJ effusion. The purpose of this study was to evaluate the relationship between the grades of magnetic resonance imaging (MRI)-depicted joint effusion (JE), increased CW measured in USI, and joint pain in TMJ internal derangement (ID) patients. During a 4-year period, 91 patients clinically diagnosed with TMJ ID according to the Research Diagnostic Criteria for Temporomandibular Disorders classification were included in the study. Those with mainly myogenic complaints were excluded. In clinical examination, the severity of pain was assessed by visual analog scale (VAS, 0 to 10). All TMJs (n = 182) were evaluated to detect the presence of joint effusion by means of USI and MRI. MRI-depicted effusion was classified as no effusion, moderate effusion, and severe effusion. Receiver operating characteristic curve analysis was performed to depict the critical cutoff value for TMJ CW. USI sensitivity was evaluated by means of MRI effusion, and a cutoff value was depicted that was considered to be the threshold to discriminate the TMJs with and without effusion. The relationship between the joint pain and USI and MRI findings of effusion were evaluated with Friedman and Wilcoxon tests. The average VAS scores of the TMJs without effusion was found to be 2.55, with moderate effusion 2.92, and with severe effusion 4.80. A significant positive correlation was found between the VAS scores and the intensity of MRI JE (P = .003). The most accurate cutoff value of CW is found to be 1.65 mm. The average VAS score with CW 1.65 was found to be 3.75. A significant positive correlation was found between the clinical pain scores and CW measured in USI (P = .001). Both MRI-depicted effusion and USI

  9. The use of pseudo-dynamic magnetic resonance imaging for evaluating the relationship between temporomandibular joint anterior disc displacement and joint pain.

    Science.gov (United States)

    Lin, W-C; Lo, C-P; Chiang, I-C; Hsu, C-C; Hsu, W-L; Liu, D-W; Juan, Y-H; Liu, G-C

    2012-12-01

    The relationship between temporomandibular joint (TMJ) pain and the magnetic resonance imaging (MRI) finding of articular disc displacement is debated. The purpose of this study is to investigate the correlation between TMJ pain and anterior disc displacement (ADD) using pseudo-dynamic MRI. A retrospective review of MRI studies was carried out on 130 TMJs in 65 patients presenting unilateral TMJ pain. The contralateral asymptomatic joints served as the control group. Bilateral oblique sagittal and coronal MRIs as well as pseudo-dynamic studies in the oblique sagittal plane were obtained. The disc-condyle relationship was divided into three subtypes (normal disc position, ADD with reduction, and ADD without reduction), based on the pseudo-dynamic MRI findings. Fisher's exact test was used to determine whether the TMJ pain was linked to ADD. The results showed that TMJ pain was significantly related to ADD (with and without reduction) compared to the group with a normal disc position (P=.0001). A significant correlation was found between TMJ pain and the ADD subtype without reduction, as compared to the ADD subtype with reduction (P=.0156). These data suggest that a displaced disc, particularly in the subtype without reduction, is an important source of pain. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  10. Platelet-rich plasma for the therapeutic management of temporomandibular joint disorders: a systematic review.

    Science.gov (United States)

    Bousnaki, M; Bakopoulou, A; Koidis, P

    2018-02-01

    This systematic review aimed to investigate whether intra-articular injections of platelet-rich plasma (PRP) are beneficial for the treatment of degenerative temporomandibular disorders, such as temporomandibular joint osteoarthritis (TMJ-OA) and disc displacement with osteoarthritic lesions, when compared to other treatments, such as injections of hyaluronic acid (HA) or saline. An electronic search of the MEDLINE and Scopus databases was performed using combinations of the terms "temporomandibular" and "platelet rich plasma", to identify studies reported in English and published up until May 2017. A hand-search of relevant journals and the reference lists of selected articles was also performed. The initial screening identified 153 records, of which only six fulfilled the inclusion criteria and were included in this review. Of these studies, three compared PRP with HA, while three compared PRP with Ringer's lactate or saline. Four of the studies found PRP injections to be superior in terms of improvements in mandibular range of motion and pain intensity up to 12 months after treatment, while the remaining two studies found similar results for the different treatments. There is slight evidence for the potential benefits of intra-articular injections of PRP in patients with TMJ-OA. However, a standardized protocol for PRP preparation and application needs to be established. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  11. Can skull form predict the shape of the temporomandibular joint? A study using geometric morphometrics on the skulls of wolves and domestic dogs.

    Science.gov (United States)

    Curth, Stefan; Fischer, Martin S; Kupczik, Kornelius

    2017-11-01

    The temporomandibular joint (TMJ) conducts and restrains masticatory movements between the mammalian cranium and the mandible. Through this functional integration, TMJ morphology in wild mammals is strongly correlated with diet, resulting in a wide range of TMJ variations. However, in artificially selected and closely related domestic dogs, dietary specialisations between breeds can be ruled out as a diversifying factor although they display an enormous variation in TMJ morphology. This raises the question of the origin of this variation. Here we hypothesise that, even in the face of reduced functional demands, TMJ shape in dogs can be predicted by skull form; i.e. that the TMJ is still highly integrated in the dog skull. If true, TMJ variation in the dog would be a plain by-product of the enormous cranial variation in dogs and its genetic causes. We addressed this hypothesis using geometric morphometry on a data set of 214 dog and 60 wolf skulls. We digitized 53 three-dimensional landmarks of the skull and the TMJ on CT-based segmentations and compared (1) the variation between domestic dog and wolf TMJs (via principal component analysis) and (2) the pattern of covariation of skull size, flexion and rostrum length with TMJ shape (via regression of centroid size on shape and partial least squares analyses). We show that the TMJ in domestic dogs is significantly more diverse than in wolves: its shape covaries significantly with skull size, flexion and rostrum proportions in patterns which resemble those observed in primates. Similar patterns in canids, which are carnivorous, and primates, which are mostly frugivorous imply the existence of basic TMJ integration patterns which are independent of dietary adaptations. However, only limited amounts of TMJ variation in dogs can be explained by simple covariation with overall skull geometry. This implies that the final TMJ shape is gained partially independently of the rest of the skull. Copyright © 2017 Elsevier Gmb

  12. Effect of Surgery First Orthognathic Approach on the Temporomandibular Joint: A Clinical Evaluation.

    Science.gov (United States)

    Pelo, Sandro; Saponaro, Gianmarco; De Angelis, Paolo; Gasparini, Giulio; Garagiola, Umberto; Moro, Alessandro

    2018-01-05

    Correction of severe malocclusions with skeletal discrepancies requires orthodontic treatment in combination with orthognathic surgery. Even though conventional orthognathic surgery (COS) is a common and well-accepted approach its influence on the signs and symptoms of temporomandibular disorders (TMDs) is still debated. Recently with the introduction of surgery first approach, a different timing for the management of dentoskeletal imbalances has been proposed. The present study is aimed at assessing the relationship between surgery first approach and temporomandibular joint (TMJ) disorders. The study sample consisted of 24 patients who were selected to be treated with surgery first approach. Clinical follow-ups after surgery were performed every week for the first month, at 3 months, 6 months, and at 1 year. A radiological follow-up was performed at 1 week and at 1 year after the operation with a panorex and a latero-lateral teleradiograph. To assess the effect of surgery first approach on the TMDs signs and symptoms, a clinical assessment was performed 4 days before surgery (T1), 6 months after surgery (T2), and 1 year postoperatively (T3). The results of the authors' study show that pain assessment revealed a general improvement of this symptom in correspondence to TMJ and masticatory muscles except in the masseter and neck region. Also joint noises, TMJ functioning, migraine, and headache underwent a considerable improvement. Surgery first approach is an innovative orthognathic procedure and, by undergoing surgery first approach, patients with pre-existing TMJ dysfunction may experience a significant improvement or even resolution of the TMDs signs and symptoms.

  13. Determination of a pressure pain threshold cut-off value for the diagnosis of temporomandibular joint arthralgia.

    Science.gov (United States)

    Cunha, C O; Pinto-Fiamengui, L M S; Castro, A C P C; Lauris, J R P; Conti, P C R

    2014-05-01

    Temporomandibular joint (TMJ) disorders are divided by the American Academy of Orofacial Pain into five categories. The most common ones are joint pain, as arthralgia and joint disorders, as disc displacements. An important clinical presentation of arthralgia is the painful tenderness to manual palpation or decreased pressure pain threshold (PPT). The authors conducted a study to determine the appropriate PPT value to discriminate asymptomatic TMJ individuals from those with moderate to severe arthralgia. Forty-nine individuals was evaluated and divided into groups: TMJ arthralgia, asymptomatic disc displacement and control group. Magnetic resonance images were obtained for all the groups, and algometry was performed on the TMJ lateral pole. Patients with arthralgia filled out a visual analogue scale (VAS). anova test with 1% of significance analysed the data. Specificity, sensitivity and ROC curve were also determined. Arthralgia group had significant lower PPT (mean of 1.07 kgf cm(-2) ) than the others. Asymptomatic disc displacement group (mean of 1.64 kgf cm(-2) ) has shown significant lower PPT than the control (mean of 2.35 kgf cm(-2) ). 89.66% of specificity and 70% of sensitivity were obtained when 1.36 kgf cm(-2) was applied to the TMJ (ROC area = 0.90). This value was considered to be the most appropriate to detected moderate to severe TMJ arthralgia. Indeed, the presence of disc displacement seems to significantly decrease PPT levels in asymptomatic subjects. The PPT value of 1.36 kgf cm(-2) can be used in the calibration procedures of the professionals involved with temporomandibular disorders and orofacial pain. © 2014 John Wiley & Sons Ltd.

  14. Time-dependent analysis of nociception and anxiety-like behavior in rats submitted to persistent inflammation of the temporomandibular joint.

    Science.gov (United States)

    do Nascimento, Glauce Crivelaro; Leite-Panissi, Christie Ramos Andrade

    2014-02-10

    Temporomandibular disorder (TMD) is prevalent in dental clinics and can involve problems with the masticatory muscles or the temporomandibular joints (TMJ). The pain of TMD is frequently associated with inflammation in the TMJs, but it's etiology is considered to be multifactorial and includes biologic, behavioral, environmental, social, emotional and cognitive factors. The purpose of this investigation was to evaluate the anxiety-like behavior in rats exposed to temporomandibular inflammation via injection of Freund's Adjuvant (CFA) with the elevated plus maze (EPM) and light/dark box (LDB) tests and to evaluate nociceptive behavior with the von Frey test at different periods. Moreover, this study measured TMJ inflammation using plasma extravasation (Evans blue test) and the intraarticular infiltration of polymorphonuclear neutrophils (myeloperoxidase quantification). The results showed that rats that were submitted to TMJ inflammation exhibited a decreased number of entries into the open arms of the EPM and a decrease in the time spent in the light compartment and in the number of transitions in the LDB. Additionally, the number of entries in closed arms in the EPM, used as indicator of locomotor activity, did not alter between treatments. Furthermore, increases in mechanical sensitivity and increases in plasma extravasation in the joint tissue occurred throughout the inflammation process, along with an increase in myeloperoxidase in the synovial fluid of TMJ. Our results suggest that the temporomandibular inflammation induced by CFA produced anxiety-like behaviors in rats and induced nociceptive behavior across different periods of inflammation. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Temporomandibular joint involvement in juvenile idiopathic arthritis: clinical predictors of magnetic resonance imaging signs

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    Argyropoulou, Maria I.; Margariti, Persefoni N.; Astrakas, Loukas; Kosta, Paraskevi [Medical School University of Ioannina, Department of Radiology, Ioannina (Greece); Karali, Aikaterini; Alfandaki, Sapfo; Siamopoulou, Antigoni [University of Ioannina, Department of Child Health, Medical School, Ioannina (Greece)

    2009-03-15

    The aim of the study was to define clinical predictors of magnetic resonance imaging (MRI) findings of temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA). Forty-six patients, aged 2.08-36.7 years, with JIA (oligoartitular 18, polyarticular 17, systemic type 11) were examined with standard plain and contrast-enhanced sequences. Of 88 TMJs examined, an abnormal condyle was observed in 32%, flattened articular eminence in 27%, flattened articular disk in 17%, intra-articular fluid in 10%, enhancing pannus in 45% and restricted condylar motion in 9%. Logistic regression analysis revealed that for abnormal condyle and flattened articular eminence, independent predictors were type of JIA (P < 0.015), age at onset (P < 0.038), and duration of disease activity (P < 0.001). Plots of the logistic regression models showed that TMJ involvement approached certainty for systemic sooner than for the other JIA types. Pannus was present with probability >0.5 when the disease started before 4 years of age. In conclusion, the systemic type of JIA, young age at onset and long duration of activity are risk factors for TMJ damage. MRI of the TMJ should be performed in patients who are less than 4 years of age at the onset of JIA, and in those with the systemic type, whatever the age of onset. (orig.)

  16. Tissue engineering of the temporomandibular joint disc: current status and future trends.

    Science.gov (United States)

    Shu, Weina; Liu, Lin; Bao, Guangjie; Kang, Hong

    2015-02-01

    Temporomandibular joint disorders are extremely prevalent and there is no ideal treatment clinically for the moment. For severe cases, a discectomy often need to be performed, which will further result in the development of osteoarthritis. In the past thirty years, tissue engineering has provided a promising approach for the effective remedy of severe TMJ disease through the creation of viable, effective, and biological functional implants. Although TMJ disc tissue engineering is still in early stage, unremitting efforts and some achievements have been made over the past decades. In this review, a comprehensive summary of the available literature on the progress and status in tissue engineering of the TMJ disc regarding cell sources, scaffolds, biochemical and biomechanical stimuli, and other prospects relative to this field is provided. Even though research studies in this field are too few compared to other fibrocartilage (e.g., knee meniscus) and numerous, difficult tasks still exist, we believe that our ultimate goal of regenerating a biological implant whose histological, biochemical, and biomechanical properties parallel native TMJ discs for clinical therapy will be achieved in the near future.

  17. Roles of hypoxia inducible factor-1α in the temporomandibular joint.

    Science.gov (United States)

    Mino-Oka, Akiko; Izawa, Takashi; Shinohara, Takehiro; Mori, Hiroki; Yasue, Akihiro; Tomita, Shuhei; Tanaka, Eiji

    2017-01-01

    Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative disease characterized by permanent cartilage loss. Articular cartilage is maintained in a low-oxygen environment. The chondrocyte response to hypoxic conditions involves expression of hypoxia inducible factor 1α (HIF-1α), which induces chondrocytes to increase expression of vascular endothelial growth factor (VEGF). Here, we investigated the role of HIF-1α in mechanical load effects on condylar cartilage and subchondral bone in heterozygous HIF-1α-deficient mice (HIF-1α+/-). Mechanical stress was applied to the TMJ of C57BL/6NCr wild-type (WT) and HIF-1α+/- mice with a sliding plate for 10 days. Histological analysis was performed by HE staining, Safranin-O/Fast green staining, and immunostaining specific for articular cartilage homeostasis. HIF-1α+/- mice had thinner cartilage and smaller areas of proteoglycan than WT controls, without and with mechanical stress. Mechanical stress resulted in prominent degenerative changes with increased expression of HIF-1α, VEGF, and the apoptosis factor cleaved Caspase-3 in condylar cartilage. Our results indicate that HIF-1α may be important for articular cartilage homeostasis and protective against articular cartilage degradation in the TMJ under mechanical stress condition, therefore HIF-1α could be an important new therapeutic target in TMJ-OA. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

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    Bang, Seo Howan; Kim, Jae Duck [Dept. of Oral Radiology, Division of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1987-11-15

    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<0.01) br> 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<0.01) br> 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.

  19. Eminectomy for Habitual Luxation of the Temporomandibular Joint with Sedation and Local Anesthesia: A Case Series

    Directory of Open Access Journals (Sweden)

    Joe Iwanaga

    2016-01-01

    Full Text Available Eminectomy which is one of the popular and most effective treatments for habitual temporomandibular joint luxation was first described by Myrhaug in 1951. There are few reports which described eminectomy being performed under local anesthesia and conscious sedation. We present a case series of habitual luxation of the TMJ treated by eminectomy performed under local anesthesia and conscious sedation and general anesthesia. Five patients were examined and found to have recurrent luxation of the TMJ. The age of patients ranged from 18 to 93 years. Bilateral eminectomy of the TMJ was performed for two patients, and unilateral eminectomy was performed for three patients. Two were examined under intravenous propofol sedation and local anesthesia, while three patients were examined under general anesthesia. One patient died from ileus one month after surgery. The follow-up period except for the case that died from ileus ranged from 12 to 33 months. No recurrent dislocation of the TMJ has been identified. Based on our experience and two other series in the literature, eminectomy with sedation and local anesthesia can be considered and might be a good option in elderly patients.

  20. Pigmented villonodular synovitis of the temporomandibular joint: MR findings in four cases

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    Kim, Kyoung Won; Han, Moon Hee E-mail: hanmh@radcom.snu.ac.kr; Park, Sun-Won; Kim, Se Hyung; Lee, Hyun Ju; Jae, Hwan Jun; Kang, Joon Won; Chang, Kee Hyun

    2004-03-01

    Objective: Although it is a rare condition, pigmented villonodular synovitis (PVNS) may involve temporomandibular joint (TMJ). The purpose of this study was to describe magnetic resonance (MR) findings of PVNS of the TMJ. Methods and material: Between April 1992 and August 2000, four patients (two men and two women, 22-58-year-old) who had histologically proven diagnoses of PVNS in their TMJ were found in our institution. Their MR findings were reviewed retrospectively, and were correlated with pathologic findings. Results: In all four patients, MR images invariably showed profound hypointensity on both T1- and T2-weighted sequences. This finding was seen diffusely and homogeneously throughout the lesion, and was considered to be due to paramagnetic effect attributed to heavy hemosiderin pigmentation, which was revealed by histopathological examination. MR images also showed aggressive nature of the lesions with adjacent skull base destruction and intracranial extension in two of them. Conclusion: As is the case in the other anatomic site, PVNS of the TMJ can be confidently diagnosed on MR imaging on the basis of the presence of hemosiderin. MR imaging also plays a pivotal role in surgical planning by precise and detailed localization of the lesion.

  1. Osteoarthritis of the temporomandibular joint in southern sea otters (Enhydra lutris nereis).

    Science.gov (United States)

    Arzi, B; Winer, J N; Kass, P H; Verstraete, F J M

    2013-11-01

    Museum skull specimens (n = 1,008) of southern sea otters (Enhydra lutris nereis) were examined macroscopically according to defined criteria for the presence, severity and characteristics of temporomandibular joint osteoarthritis (TMJ-OA). The specimens were from stranded young adult to adult animals. Overall, 4.1% of the specimens had findings consistent with TMJ-OA. Of these, 61.0% were from females and 39.0% were from males. In addition, 85.4% of the affected specimens were from adults and 14.6% were from young adults. However, there was no significant association between age and sex with the presence or severity of TMJ-OA. Lesion severity was mild in 41.5%, moderate in 19.5% and severe in 39.0% of affected specimens. The most prominent changes were the presence of osteophytes and subchondral bone defects and porosity. The mandibular condylar process and fossa were affected equally. The lengths of the right and left mandibular heads were significantly associated with age (P = 0.002 and P = 0.003, respectively) and sex (P = 0.0009 and P = 0.001, respectively), but not with the presence of TMJ-OA. The significance of this disease in sea otters remains elusive, but this condition may play an important role in survival of these animals. Copyright © 2013 Elsevier Ltd. All rights reserved.

  2. Temporomandibular joint disorder complaints in tinnitus: further hints for a putative tinnitus subtype.

    Directory of Open Access Journals (Sweden)

    Veronika Vielsmeier

    Full Text Available OBJECTIVE: Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ disorder complaints and compared the two groups with respect to etiologic factors. METHODS: 1204 Tinnitus patients from the Tinnitus Research Initiative (TRI Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan. RESULTS: Tinnitus patients with TMJ complaints (22% of the whole group were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt, onset related events (whiplash etc., character (pulsatile or not, hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.. CONCLUSION: Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical

  3. Digital panoramic radiography for diagnosis of the temporomandibular joint: CBCT as the gold standard

    Directory of Open Access Journals (Sweden)

    Daniela Brait Silva LADEIRA

    2015-01-01

    Full Text Available Three-dimensional imaging modalities have been reported to be more accurate than panoramic radiographs (PR for the assessment of bone components of the temporomandibular joint (TMJ. No exact prior information is available that demonstrates which specific limitations occur in terms of TMJ diagnosis when using PR for this purpose. This study aimed to assess the clinical validity of digital panoramic radiography (DPR when diagnosing morphological disorders of the TMJ using cone-beam computed tomography (CBCT images as the gold standard. A sample composed of TMJ images (N = 848, including 212 DPR and 212 CBCT images obtained from the same patient, was used to assess any morphological changes in the TMJ. Four appraisers diagnosed all of the DPR images, whereas the CBCT images were used to establish the gold standard. The reliability of each appraiser’s response pattern was analyzed using the Kappa test (κ, and diagnostic tests were performed to assess each appraiser’s performance using a significance level setting of 5% (α = 0.05. Reliability of each appraiser’s response pattern compared to the gold standard ranged from a slight-to-moderate agreement (0.18 ≤ κ ≤ 0.45; and among the different appraisers, the response pattern showed a fair agreement (0.22 ≤ κ ≤ 0.39. Diagnostic tests showed a wide range among the different possible morphological changes diagnosed. DPR does not have validity when diagnosing morphological changes in the TMJ; it underestimates the radiological findings with higher prevalence, and thus, it cannot be used effectively as a diagnostic tool for bone components within this region.

  4. {sup 99m}Tc-labeled-1-thio-{beta}-D-glucose as a new tool to temporomandibular joint inflammatory disorders diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Borges Brasileiro, Claudia, E-mail: cbbrasileiro@gmail.co [Departamento de Engenharia Nuclear-PCA, Escola de Engenharia, Universidade Federal de Minas Gerais (UFMG)-Avenida Presidente Antonio Carlos, 6627, CEP: 31270-100 Belo Horizonte, MG (Brazil); Fonseca Pacheco, Cinthia Mara da, E-mail: cinthia@newtonpaiva.b [Faculdade de Ciencias Biologicas e da Saude, Centro Universitario Newton Paiva-Avenida Silva Lobo, 1730, Belo Horizonte, MG (Brazil); Martins Queiroz-Junior, Celso, E-mail: cmqj@yahoo.com.b [Departamento de Clinica, Patologia e Cirurgia Odontologica, Faculdade de Odontologia, Universidade Federal de Minas Gerais (UFMG)-Avenida Presidente Antonio Carlos, 6627, Belo Horizonte, MG (Brazil); Flavia de Lima, Carla, E-mail: carla.flavia@terra.com.b [Nucleo de Diagnostico Cardiovascular (ECOGRAF)-Rua dos Otoni, 881, Belo Horizonte, MG (Brazil); Batista da Silva, Juliana, E-mail: silvajb@cdtn.b [Unidade de Pesquisa e Producao de Radiofarmacos, Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN)-Avenida Presidente Antonio Carlos, 6627, Belo Horizonte, MG (Brazil); Passos Ribeiro de Campos, Tarcisio, E-mail: campos@nuclear.ufmb.b [Departamento de Engenharia Nuclear-PCA, Escola de Engenharia, Universidade Federal de Minas Gerais (UFMG)-Avenida Presidente Antonio Carlos, 6627, CEP: 31270-100 Belo Horizonte, MG (Brazil)

    2010-12-15

    Aim: The aim of this study was to evaluate early detection of temporomandibular joint (TMJ) inflammatory changes based on 1-thio-{beta}-D-glucose radiolabeled with technetium-99m. Method: The method applied a TMJ inflammation model in rats followed by radiopharmaceutical synthesis, intravenous administration of {sup 99m}Tc-1-TG and kinetic scintigraphy imaging. Results: Results show a significant difference of {sup 99m}Tc-1-TG uptake between inflamed TMJ and the control joint. The biodistribution of {sup 99m}Tc-1-TG by images showed the kidneys' excretion. Conclusion: As conclusion, {sup 99m}Tc-1-TG is a helpful tool in TMJ inflammatory process detection.

  5. Arthrocentesis followed by intra-articular autologous blood injection for the treatment of recurrent temporomandibular joint dislocation.

    Science.gov (United States)

    Bayoumi, A M; Al-Sebaei, M O; Mohamed, K M; Al-Yamani, A O; Makrami, A M

    2014-10-01

    Temporomandibular joint (TMJ) dislocation is an excessive forward movement of the condyle beyond the articular eminence with complete separation of the articular surfaces and fixation in that position. This study was conducted to assess autologous blood injection to the TMJ for the treatment of chronic recurrent TMJ dislocation. Fifteen patients with bilateral chronic recurrent condylar dislocation were included in the study. Bilateral TMJ arthrocentesis was performed on each patient, followed by the injection of 2ml of autologous blood into the superior joint compartment and 1ml onto the outer surface of the joint capsule. Preoperative and postoperative assessment included a thorough history and physical examination to determine the maximal mouth opening, presence of pain and sounds, frequency of luxation, recurrence rate, and presence of facial nerve paralysis. Eighty percent of the subjects (12 patients) had a successful outcome with no further episodes of dislocation and required no further treatment at their 1-year follow-up, whereas three patients had recurrent dislocation as early as 2 weeks after treatment. Autologous blood injection is a safe, simple, and cost-effective treatment for chronic recurrent TMJ dislocation. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Temporomandibular joint reconstruction with stock and custom-made devices: Indications and results of a 14-year experience.

    Science.gov (United States)

    Gerbino, Giovanni; Zavattero, Emanuele; Bosco, Gianfranco; Berrone, Sid; Ramieri, Guglielmo

    2017-10-01

    Temporomandibular joint (TMJ) reconstruction with alloplastic implants is a reliable, safe and effective treatment option for selected debilitating pathologies of the TMJ. This study retrospectively analyzes our 14-year experience in total alloplastic reconstruction of the TMJ using stock and custom Biomet prostheses. Indications, results and rationale for the choice of stock and custom-made devices are discussed. Patients were enrolled in the study who underwent single-stage alloplastic total joint replacement from January 2000 to October 2014. The subjective and objective variables were as follows: TMJ pain, diet, jaw function, maximum interincisal opening (MIO), quality of life and occlusion. The minimum follow-up was 12 months. A total of 38 patients (55 joints) met the inclusion criteria and were enrolled in the study. Of the patients, 25 underwent Biomet total joint reconstruction system with stock prosthesis, 12 patients underwent total joint reconstruction system with custom made (patient matched) prosthesis, and 1 patient underwent bilateral total joint reconstruction using stock system on one side and custom system on the other side. The following adverse events and complications were recorded: bleeding, 2 cases; malocclusion, 1 case; postoperative infection with prosthesis removal, 1 case; heterotopic bone formation, 1 case; and contralateral TMJ overload in unilateral cases, 1 case. The occlusion was habitual unchanged in 29 of 38 cases. In 1 patient occlusion worsened with less stable functional contact. The patient refused postoperative orthodontic treatment. In 8 patients, a concomitant orthognatic procedure was planned in order to improve the occlusion. In all these patients, the occlusion improved. Quality of life and MIO relevantly improved in all cases. This study supports the use of total joint reconstruction for end-stage TMJ disease. Both stock and custom implants allow consistent results, but there are precise indications for the use of

  7. Diagnostic MR imagings of temporomandibular joint disorders by 1. 5 tesla superconducting magnet

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Ken-ichiro; Tsuda, Yoshitugu; Moriya, Hiroyuki; Segami, Natsuki; Konishi, Junji; Iizuka, Tadahiko (Kyoto Univ. (Japan). Faculty of Medicine)

    1991-01-01

    For diagnostic imaging of temporomandibular joint (TMJ) disorders, 1.5 tesla superconducting magnet system was applied in 65 patients with 75 joints. MR imaging was performed with GE-Signa 1.5 tesla MR imaging system with the body coil used as the transmitter and 3 inch surface coil as the receiver. For detecting T{sub 1} weighted images, the following parameters were used; TR: 1000, TE: 25, Excitation: 1. Data matrix: 256 x 128, FOV: 8 cm, Slice thickness: 3 mm. For taking T{sub 2} weighted images, TR: 2200, TE:80 was used. For anatomical interpretation of TMJ, 3-mm thick images with a 1-mm interspace sagittal multiplane with TR: 1000/TE: 25 sequence was useful, and additional coronal images were beneficial for examining condylar morphology as well as mediolateral disk position. T{sub 2} weighted imaging obtained the joint effusion suspected of intra-articular inflammation. These findings suggest that MR imaging is useful in the detection and evaluation of TMJ patho-morphology. (author).

  8. Alloplastic total temporomandibular joint replacements: do they perform like natural joints? Prospective cohort study with a historical control.

    Science.gov (United States)

    Wojczyńska, A; Leiggener, C S; Bredell, M; Ettlin, D A; Erni, S; Gallo, L M; Colombo, V

    2016-10-01

    The aim of this study was to qualitatively and quantitatively describe the biomechanics of existing total alloplastic reconstructions of temporomandibular joints (TMJ). Fifteen patients with unilateral or bilateral TMJ total joint replacements and 15 healthy controls were evaluated via dynamic stereometry technology. This non-invasive method combines three-dimensional imaging of the subject's anatomy with jaw tracking. It provides an insight into the patient's jaw joint movements in real time and provides a quantitative evaluation. The patients were also evaluated clinically for jaw opening, protrusive and laterotrusive movements, pain, interference with eating, and satisfaction with the joint replacements. The qualitative assessment revealed that condyles of bilateral total joint replacements displayed similar basic motion patterns to those of unilateral prostheses. Quantitatively, mandibular movements of artificial joints during opening, protrusion, and laterotrusion were all significantly shorter than those of controls. A significantly restricted mandibular range of motion in replaced joints was also observed clinically. Fifty-three percent of patients suffered from chronic pain at rest and 67% reported reduced chewing function. Nonetheless, patients declared a high level of satisfaction with the replacement. This study shows that in order to gain a comprehensive understanding of complex therapeutic measures, a multidisciplinary approach is needed. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Are temporomandibular joint signs and symptoms associated with magnetic resonance imaging findings in juvenile idiopathic arthritis patients? A longitudinal study.

    Science.gov (United States)

    Zwir, Liete M L Figueiredo; Terreri, Maria Teresa R A; Sousa, Soraia Ale; Fernandes, Artur Rocha Corrêa; Guimarães, Antônio Sérgio; Hilário, Maria Odete E

    2015-12-01

    The aims of this longitudinal study were to perform a comprehensive clinical evaluation of temporomandibular joint (TMJ) and to investigate the association between the clinical and magnetic resonance imaging (MRI) findings in the TMJs of patients with juvenile idiopathic arthritis (JIA). Seventy-five patients with JIA participated in this study. All patients underwent a rheumatological examination performed by a paediatric rheumatologist, a TMJ examination performed by a single dentist and an MRI with contrast of the TMJs. These examinations were scheduled on the same date. The patients were examined again 1 year later. Twenty-eight (37.3 %) patients reported symptoms at the first evaluation and 11 (14.7 %) patients at the second evaluation. In relation to signs, 35 (46.7 %) of the patients presented at least one sign at the first evaluation and 29 (38.7 %) at the second. Intense contrast enhancement of TMJ was significantly associated with disease activity (p TMJ involvement is highly prevalent in JIA patients, with asymptomatic children presenting severe structural alterations of the TMJ. The TMJ should always be evaluated in JIA patients, even in the absence of signs and symptoms.

  10. Conditional Deletion of Fgfr3 in Chondrocytes leads to Osteoarthritis-like Defects in Temporomandibular Joint of Adult Mice.

    Science.gov (United States)

    Zhou, Siru; Xie, Yangli; Li, Wei; Huang, Junlan; Wang, Zuqiang; Tang, Junzhou; Xu, Wei; Sun, Xianding; Tan, Qiaoyan; Huang, Shuo; Luo, Fengtao; Xu, Meng; Wang, Jun; Wu, Tingting; Chen, Liang; Chen, Hangang; Su, Nan; Du, Xiaolan; Shen, Yue; Chen, Lin

    2016-04-04

    Osteoarthritis (OA) in the temporomandibular joint (TMJ) is a common degenerative disease in adult, which is characterized by progressive destruction of the articular cartilage. To investigate the role of FGFR3 in the homeostasis of TMJ cartilage during adult stage, we generated Fgfr3(f/f); Col2a1-CreER(T2) (Fgfr3 cKO) mice, in which Fgfr3 was deleted in chondrocytes at 2 months of age. OA-like defects were observed in Fgfr3 cKO TMJ cartilage. Immunohistochemical staining and quantitative real-time PCR analyses revealed a significant increase in expressions of COL10, MMP13 and AMAMTS5. In addition, there was a sharp increase in chondrocyte apoptosis at the Fgfr3 cKO articular surface, which was accompanied by a down-regulation of lubricin expression. Importantly, the expressions of RUNX2 and Indian hedgehog (IHH) were up-regulated in Fgfr3 cKO TMJ. Primary Fgfr3 cKO chondrocytes were treated with IHH signaling inhibitor, which significantly reduced expressions of Runx2, Col10, Mmp13 and Adamts5. Furthermore, the IHH signaling inhibitor partially alleviated OA-like defects in the TMJ of Fgfr3 cKO mice, including restoration of lubricin expression and improvement of the integrity of the articular surface. In conclusion, our study proposes that FGFR3/IHH signaling pathway plays a critical role in maintaining the homeostasis of TMJ articular cartilage during adult stage.

  11. Analysis of the collagen I and fibronectin of temporomandibular joint synovial fluid and discs.

    Science.gov (United States)

    Natiella, Joseph R; Burch, Lindsay; Fries, Kristin M; Upton, L George; Edsberg, Laura E

    2009-01-01

    The objective of this study was to investigate the content of synovial fluid aspirates and temporomandibular joint (TMJ) disc tissue for collagen I and total fibronectin in patients with closed lock. Fibronectin contains dual properties of assisting with wound healing and inducing cartilage degradation. Native fibronectin has been shown to assist with wound repair, whereas particular fibronectin fragments may degrade cartilage. In addition, collagen I is the major supporting protein of the TMJ disc and will degrade as osteoarthritis progresses. Fibronectin or collagen I expression in human TMJ synovial aspirates and disc tissue may indicate the proteins' involvement in closed lock. The hypothesis of this study is that TMJ discs and serum of patients with closed lock will contain an increased amount of fibronectin and decreased amount of collagen I. We analyzed a total of 8 diseased TMJ discs and 4 diseased synovial fluid aspirates. For our control samples, we assessed 5 synovial samples from healthy patients and control skin samples. Using an enzyme-linked immunosorbent assay allowed us to measure the total amount of fibronectin and collagen I in synovial aspirates. Furthermore, we used light microscopy to assess TMJ disc histology and collagen architecture in control skin samples. Lastly, using fluorescent staining, we examined fibronectin and collagen I expression in TMJ discs. We compared the fluorescent staining and light microscopy results of both proteins within each disc to confirm fibronectin and collagen I expression. Disc specimens with advanced morphologic pathology showed significant labeling for fibronectin in 3 of 3 cases and for collagen I in 4 of 4 cases. There was no considerable difference in detection of either fibronectin or collagen I in TMJ synovial aspirates from patients with advanced disc pathology compared with controls. The levels of fibronectin and collagen I in the TMJ disc and synovial fluid may be influenced by the stage of disease

  12. Assessment of diagnostic accuracy of high-resolution ultrasonography in determination of temporomandibular joint internal derangement

    Directory of Open Access Journals (Sweden)

    Byahatti Sujata

    2010-01-01

    Full Text Available Aim : The aim of this study was to determine the value of dynamic high-resolution ultrasonography (HR-US in the evaluation of internal derangements of a temporomandibular joint (TMJ in the open and closed mouth position. Settings and Design : The study designed to collect the sample from the Outpatient Department of Oral Medicine and Radiology at GDC, Bangalore. Patients with pain, clicking, deviation, and tenderness were included in the study as a symptomatic group. The asymptomatic group was free of any symptoms. Materials and Methods : Maximum mandibular range of motion (Open and Closed was performed during HR-US of TMJ in 100 consecutive patients, (50 symptomatic and 50 asymptomatic cases, a total of 400 joints, with 200 joints in the right and left closed and open mouth position;36 males and 64 females; age range, 16 - 50 years; mean age 27.56 years. Subsequently, the entire group, after clinical diagnosis, went for HR-US. Sonography confirmed the diagnosis by showing internal derangement in 34 (68% of the symptomatic group and the remaining 16 (32% patients failed to show any derangement. In the asymptomatic group 40 patients did not show any pathology associated with TMJ, whereas, 10 patients showed internal derangement. The data obtained was analyzed statistically. Results : HR-US performed during the maximal range of motion (Open and Closed helped to detect 34 instances (68 joints of internal derangement, which were true positive cases, whereas, 16 patients (32 joints showed a false positive finding for internal derangement (ID. The results obtained showed a sensitivity of 64%, specificity of 88%, positive predictive value of 84%, and a negative predictive value of 71%, with an accuracy of 76%. Conclusions : Dynamic HR-US being non-invasive can provide valuable information about internal derangement of the TMJ in mandibular closed mouth than open mouth position.

  13. Role of Subchondral Bone during Early-stage Experimental TMJ Osteoarthritis

    OpenAIRE

    Embree, M.; Ono, M.; Kilts, T.; Walker, D.; Langguth, J.; Mao, J.; Bi, Y; Barth, J.L.; Young, M

    2011-01-01

    Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative disease that affects both cartilage and subchondral bone. We used microarray to identify changes in gene expression levels in the TMJ during early stages of the disease, using an established TMJ OA genetic mouse model deficient in 2 extracellular matrix proteins, biglycan and fibromodulin (bgn-/0fmod-/-). Differential gene expression analysis was performed with RNA extracted from 3-week-old WT and bgn-/0fmod-/- TMJs with an int...

  14. Juvenile idiopathic arthritis and the temporomandibular joint ...

    African Journals Online (AJOL)

    A significant positive correlation was found between total MRI score and disease activity, functional and pain scores in patients with JIA. Conclusions: TMJ arthritis is common among patients with JIA, therefore; examination of the TMJ is mandatory during the follow up of patients. Clinical signs of TMJ arthritis can be used as ...

  15. Treatment Effects of Maxillary Flat Occlusal Splints for Painful Clicking of the Temporomandibular Joint

    Directory of Open Access Journals (Sweden)

    Sung-Wen Chang

    2010-06-01

    Full Text Available Existing therapies for symptoms related to painful clicking of the temporomandibular joint (TMJ have rarely met with complete success and predicting prognosis remains difficult. Few studies have reported the efficacy of maxillary flat occlusal splints (MFOSs for the treatment of painful clicking of the TMJ, and few studies have evaluated the predisposing factors that influence the clinical outcomes of MFOSs. The aim of this study was to investigate the treatment efficacy of MFOSs for painful clicking of the TMJ, and to determine the factors influencing TMJ therapy with MFOSs. We conducted a retrospective study of 109 patients suffering from unilateral clicking concurrent with preauricular area pain for at least 2 months between 2004 and 2008. Seventy-five patients were treated with an MFOS, while 34 patients did not receive MFOS therapy. Clicking score, pain-free maximal mouth opening, pain score, duration of the clicking sounds, age and bruxism were recorded during treatment and involved into the reviews. The degree of joint clicking was determined by a stethoscope placed in the anterolateral area of the external auditory canal and was divided into four grades. Data were analyzed using a Mann-Whitney U test, Fisher's exact test, and Student's t test. Results showed statistically significant differences in treatment outcomes between the MFOS-treated and control groups in clicking index, maximal mouth opening, pain and complete remission rates of symptoms within 1 year. Furthermore, for patients treated with MFOS, there were statistically significant differences in the clinical outcomes between those with a high clicking index and those with a low index before treatment. Factors significantly correlated with successful outcomes of MFOS included nocturnal bruxism, patient age and duration of clicking. MFOSs can be used to treat patients with painful clicking of the TMJ and related symptoms. The severity of clicking, bruxism, age and duration of

  16. The effect of acute unilateral inflammation of the equine temporomandibular joint on the kinematics of mastication.

    Science.gov (United States)

    Smyth, T T; Carmalt, J L; Treen, T T; Lanovaz, J L

    2016-07-01

    Diseases of the temporomandibular joint (TMJ) are well reported in man and some domestic animals other than the horse. The pathophysiology of equine TMJ disease and the effects of disease on the kinematics of mastication are unknown. To determine whether transient unilateral inflammation of the equine TMJ results in alterations in the masticatory cycle. An experimental controlled study utilising 6 horses of various ages with normal dentition. Each horse was equipped with an optical motion tracking (kinematic) system. Horses were observed chewing grass hay over 3 min intervals. Regardless of the initial side of the power stroke in the masticatory cycle, lipopolysaccharide (LPS) was injected in the left TMJ in each horse and the horses were reassessed after 6 h. Four horses developed effusion of the injected TMJs; 2 of these also began quidding. All horses injected on the original side of the power stroke switched sides while the 2 injected on the contralateral side did not. All horses developed reduced vertical pitch (vertical opening) of the mandible. Overall, rostrocaudal movement of the mandible did not change; however, the timing of this movement relative to the phase of the masticatory cycle did. Injection with LPS did not affect the amount of lateral movement of the mandible. Injection of LPS into the TMJ significantly altered the masticatory cycle compared with baseline values representing avoidance behaviour due to inflammation of the joint, despite which the horses continued to eat using the contralateral mandible. Lipopolysaccharide administration also led to quidding and a loss of feed efficiency (in some individuals). © 2015 EVJ Ltd.

  17. Arthroscopic discopexy is effective in managing temporomandibular joint internal derangement in patients with Wilkes stage II and III.

    Science.gov (United States)

    McCain, Joseph P; Hossameldin, Reem H; Srouji, Samer; Maher, Amr

    2015-03-01

    Disc repositioning for temporomandibular joint (TMJ) internal derangement (ID) is a well-established surgical technique with variable success. The purpose of the present study was to assess the outcomes after arthroscopic disc repositioning (discopexy) for TMJ ID. This was a prospective, cohort, single-institutional clinical study. The study included patients with TMJ ID in whom diagnostic arthroscopy had failed. These patients were presented and treated at Miami Oral and Maxillofacial Surgery, Baptist Hospital (Miami FL). The predictive variable was the Wilkes diagnostic categories, presented in 2 groups: II and III versus IV and V. The primary outcome variable was the absence of joint pain at 12 months postoperatively. The secondary outcome variables included joint function, maximum interincisal opening, medication use, joint loading sign, and muscle pain. The patients were followed for 1 year postoperatively. The statistical analyses included paired and independent sample Student's t test, χ(2) test, and logistic regression analysis. A total of 32 subjects (42 joints), with a mean age of 31 years, were included in the present study; 28 (87.5%) were women. Of the 42 joints, 71.4% were classified as Wilkes stage II and III. A successful outcome was seen in 69% of the studied subjects and in 86.7% of the Wilkes II and III group versus 25% of the Wilkes IV and V group (P = .001). The results of the present study have shown that TMJ arthroscopic discopexy is an effective and predictable treatment of patients with TMJ ID in whom primary TMJ arthroscopy failed. Our results have also shown that patients with Wilkes II or III TMD will have the most successful outcome. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  18. [Analysis of factors related to the number of mesenchymal stem cells derived from synovial fluid of the temporomandibular joint].

    Science.gov (United States)

    Sun, Y P; Zheng, Y H; Zhang, Z G

    2017-06-09

    Objective: To analyze related factors on the number of mesenchymal stem cells in the synovial fluid of the temporomandibular joint (TMJ) and provide an research basis for understanding of the source and biological role of mesenchymal stem cells derived from synovial fluid in TMJ. Methods: One hundred and twenty-two synovial fluid samples from 91 temporomandibular disorders (TMD) patients who visited in Department of TMJ Center, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University from March 2013 to December 2013 were collected in this study, and 6 TMJ synovial fluid samples from 6 normal volunteers who were studying in the North Campus of Sun Yat-sen University were also collected, so did their clinical information. Then the relation between the number of mesenchymal stem cells derived from synovial fluid and the health status of the joints, age of donor, disc perforation, condylar bony destruction, blood containing and visual analogue scale score of pain were investigated using Mann-Whitney U test and Spearman rank correlation test. Results: The number of mesenchymal stem cells derived from synovial fluid had no significant relation with visual analogue scale score of pain (r=0.041, P=0.672), blood containing (P=0.063), condylar bony destruction (P= 0.371). Linear correlation between the number of mesenchymal stem cells derived from synovial fluid and age of donor was very week (r=0.186, P=0.043). The number of mesenchymal stem cells up-regulated when the joint was in a disease state (P=0.001). The disc perforation group had more mesenchymal stem cells in synovial fluid than without disc perforation group (P=0.042). Conclusions: The number of mesenchymal stem cells derived from synovial fluid in TMJ has no correlation with peripheral blood circulation and condylar bony destruction, while has close relation with soft tissue structure damage of the joint.

  19. Bilateral temporomandibular joint ankylosis as sequel of bilateral fracture of the mandibular condyle and symphysis.

    Science.gov (United States)

    Benaglia, Matheus B; Gaetti-Jardim, Ellen Cristina; Oliveira, Janayna G Paiva; Mendonça, Jose Carlos Garcia

    2014-03-01

    Temporomandibular joint (TMJ) ankylosis is an extremely disabling affliction that causes problems in mastication, digestion, speech, appearance, and hygiene. The disease also has an impact on the psychological development of the patients. A 49-year-old male patient came to our unit with complaint of restriction in his alimentation and of mouth opening. In the anamnesis, the patient reported that this limitation began 11 years ago, soon after a serious car accident that caused trauma on the face. In the clinical examination, the patient's mouth opening was 1 mm, and there was satisfactory occlusion. He was diagnosed with bilateral temporomandibular joint (TMJ) ankylosis after an imaging examination. In order to confirm the post-traumatic etiology of the anquilose, we got the medical records from the hospital where the patient received the first treatment. The records, at that time, reported facial trauma with bilateral condylar fracture and comminuted symphyseal fracture which was reduced and fixed followed by maxillomandibular fixation that remained for 45 days. After collecting all the information needed for diagnosis, surgical treatment was proposed through arthroplasty. The patient was placed on immediate post-operative jaw physiotherapy, and 12 months after surgery, his mouth opening improved to 35 mm. Thus, in our case, ankylosis may have been developed as a sequel of the mandibular fractures.

  20. Inferior displacement of the lower belly of the lateral pterygoid muscle: a sign of temporomandibular joint lesions.

    Science.gov (United States)

    Ochoa Escudero, Martin; Juliano, Amy F; Curtin, Hugh D

    2015-01-01

    The purposes of this article are to report the imaging finding of inferior displacement of the lower belly of the lateral pterygoid muscle (LPM) in patients with lesions arising from the temporomandibular joint (TMJ) and to propose that this imaging finding is suggestive of the presence of a TMJ lesion. We reviewed computed tomographic and magnetic resonance images of 9 patients with lesions involving the TMJ. Images were evaluated for identification of an inferiorly displaced lower belly of the LPM. Pathology reports were reviewed to determine the histopathologic diagnosis of the TMJ lesion. Inferior displacement of the lower belly of the LPM was observed in all cases on magnetic resonance images, computed tomographic images, or both. In 2 cases, the diagnosis was calcium pyrophosphate deposition disease. The remaining cases were ganglion cyst, joint effusion due to dermatomyositis, septic arthritis, chondromyxoid fibroma, synovial chondromatosis, pigmented villonodular synovitis, and giant cell tumor of bone. Inferior displacement of the lower belly of the LPM is a useful radiologic sign to suggest that a lesion arises from the TMJ.

  1. Neocondyle distraction osteogenesis in the management of temporomandibular joint ankylosis: Report of five cases with review of literature

    Directory of Open Access Journals (Sweden)

    Ravi Sharma

    2017-01-01

    Full Text Available Introduction and Objectives: Management of temporomandibular joint (TMJ ankylosis is a challenging and rather daunting task owing to complex abnormal anatomy and its sequel to craniofacial structures. Various autogenous grafts and alloplastic materials have been tried with variable success for creation of a near-normal joint. In recent years, neocondyle distraction has added a new dimension to the management of TMJ ankylosis. The aim of this paper is to describe the role of neocondyle distraction in TMJ ankylosis. Materials and Methods: Neocondyle distraction was carried out in five patients with TMJ ankylosis following gap arthroplasty. Computed tomogram scans were taken before surgery and 1-year postdistraction for surgical planning and postoperative assessment, respectively. The intraoral distractors (KLS Martin, Jacksonville, FL, USA were used in this study. Results: All five patients reported with adequate mouth opening and functional jaw movements. The procedure was well tolerated by all the patients. None of the patients underwent reankylosis following neocondyle distraction. Conclusion: With proper surgical planning and distraction protocol, neocondyle distraction is an effective and safe technique for TMJ reconstruction and preventing reankylosis.

  2. Reconstrucción de la articulación temporomandibular: injertos autólogos Reconstruction of the temporomandibular joint: autogenous grafts

    Directory of Open Access Journals (Sweden)

    A. García-Rozado González

    2005-02-01

    Full Text Available Las indicaciones para la reconstrucción de la articulación temporomandibular (ATM están bien establecidas en la literatura médica y en la práctica clínica de la Cirugía Oral y Maxilofacial. Sin embargo, la técnica reconstructiva más adecuada para cada caso permanece controvertida. El desarrollo de nuevos materiales para la confección de prótesis de ATM no ha conseguido desplazar a los injertos autólogos, que conservan numerosas indicaciones reconstructivas merced a las indudables ventajas que supone el empleo de tejidos del propio paciente.The indications for surgical reconstruction of the temporomandibular joint (TMJ are well-established in medical literature and even in clinical practice of Oral and Maxillofacial Surgery. The optimal reconstructive method for each case, however, is still controversial. The progressive developing of new materials to obtain better TMJ prostheses has not been enough to replace autogenous tissue reconstruction. It still maintains a great number of indications in TMJ reconstruction due to the remarkable advantages that undoubtedly provides the use of tissue harvested from the same patient.

  3. Mesenchymal Stem Cells for Cartilage Regeneration of TMJ Osteoarthritis

    OpenAIRE

    Dixin Cui; Hongyu Li; Xin Xu; Ling Ye; Xuedong Zhou; Liwei Zheng; Yachuan Zhou

    2017-01-01

    Temporomandibular joint osteoarthritis (TMJ OA) is a degenerative disease, characterized by progressive cartilage degradation, subchondral bone remodeling, synovitis, and chronic pain. Due to the limited self-healing capacity in condylar cartilage, traditional clinical treatments have limited symptom-modifying and structure-modifying effects to restore impaired cartilage as well as other TMJ tissues. In recent years, stem cell-based therapy has raised much attention as an alternative approach...

  4. Morphologic Analysis of the Temporomandibular Joint Between Patients With Facial Asymmetry and Asymptomatic Subjects by 2D and 3D Evaluation: A Preliminary Study.

    Science.gov (United States)

    Zhang, Yuan-Li; Song, Jin-Lin; Xu, Xian-Chao; Zheng, Lei-Lei; Wang, Qing-Yuan; Fan, Yu-Bo; Liu, Zhan

    2016-03-01

    Signs and symptoms of temporomandibular joint (TMJ) dysfunction are commonly found in patients with facial asymmetry. Previous studies on the TMJ position have been limited to 2-dimensional (2D) radiographs, computed tomography (CT), or cone-beam computed tomography (CBCT). The purpose of this study was to compare the differences of TMJ position by using 2D CBCT and 3D model measurement methods. In addition, the differences of TMJ positions between patients with facial asymmetry and asymptomatic subjects were investigated. We prospectively recruited 5 patients (cases, mean age, 24.8 ± 2.9 years) diagnosed with facial asymmetry and 5 asymptomatic subjects (controls, mean age, 26 ± 1.2 years). The TMJ spaces, condylar and ramus angles were assessed by using 2D and 3D methods. The 3D models of mandible, maxilla, and teeth were reconstructed with the 3D image software. The variables in each group were assessed by t-test and the level of significance was 0.05. There was a significant difference in the horizontal condylar angle (HCA), coronal condylar angle (CCA), sagittal ramus angle (SRA), medial joint space (MJS), lateral joint space (LJS), superior joint space (SJS), and anterior joint space (AJS) measured in the 2D CBCT and in the 3D models (P 3D measurement method is more accurate and effective for clinicians to investigate the morphology of TMJ than the 2D method.

  5. The development of interpretation for temporomandibular joint roentgenograms

    Energy Technology Data Exchange (ETDEWEB)

    You, Dong Soo; Ahn, Pyung Kyu; Park, Tae Won [Department of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1984-11-15

    The authors analyzed the morphological change of bone structure from 3,140 radiographs (1570 joints) of 785 patients with temporomandibular joint arthrosis, which were obtained by the oblique lateral transcranial projection and orthopantomographs. The interrelation of bone change and clinical symptoms duration of the disease were examined. Also, the bone changes of articular eminence, condyle, articular fossa were examined according to positional change of the condyle in the mouth open and close state. The results were as follows. 1. In the 785 patients with TMJ arthrosis, 782 patients (99.62%) show the positional change of the condyle. Among them 691 patients (88.03%) show the bone change. 2. In TMJ arthrosis patients with bone changes 451 patients (65.27%) showed both the condylar positional changes and bone changes bilaterally. 198 patients (28.65%) show the condylar positional changes bilaterally and bone changes unilaterally. 3. The bone changes in the TMJ arthrosis were in order of frequency eburnation (647 cases, 32.8%), erosion (548 cases , 27.79%), flattening (418 cases, 21.20%), deformity (138 cases, 6.99%), sclerosis (115 cases, 5.83%), marginal proliferation (106 cases, 5.38%). The region of bone change in TMJ arthrosis with condylar positional changes were in order of frequency the articular eminence (43.97%) condylar head (38.64%), articular fossa (17.39%). 4. In the patients with bone changes, their clinical symptoms were pain (44.34%), clicking sound (33.5%), limitation of mouth opening (22.52%). In the patients complaining pain the most frequent bone change was erosion (28.60%), in the patients complaining clicking sound, eburnation (28.97%) in the patients complaining the limitation, eburnation (29.40%). Also in the patients with the duration below 1 year most common bone change was eburnation. 5. The most common condylar positional change was downward position (39.94%) in closed state, restricted movement of condyle (30.07%) in open state. The

  6. [Diagnosis and treatment of diffuse tenosynovial giant cell tumor arising from temporomandibular joints].

    Science.gov (United States)

    Meng, J H; Guo, Y X; Luo, H Y; Guo, C B; Ma, X C

    2016-12-18

    To retrospectively analyze the clinical features, treatment and prognosis to the diffuse tenosynovial giant cell tumor (D-TSGCT) arising from the temporomandibular joint (TMJ), and to give a reference for the early diagnosis and treatment of this disease. In this study, 15 patients finally diagnosed as D-TSGCT of TMJ histopathologically at the Peking University Hospital of Stomatology from October 2003 to August 2015 were selected and reviewed. Their clinical manifestations, imaging and histological features, diagnoses and differential diagnoses, treatments and follow-ups were summarized and discussed. D-TSGCT of TMJ showed obvious female predominance (12/15), the main symptoms included painful preauricular swelling or mass, limited mouth-opening and mandibular deviation with movement. D-TSGCT on computed tomography (CT) scan often showed ill-defined soft tissue masses around TMJ, enhancement after contrast administration, usually with widening of the joint spaces and with bone destruction of the condyle, the fossa and even the skull base. On magnetic resonance images (MRI), the majority of lesions on T1 weighted images and T2 weighted images both showed the characteristics of low signals (6/11). The lesions could extend beyond the joints (9/11) and into the infratemporal fossa (4/11) and the middle cranial fossa (4/11). Surgical resection was performed in 14 cases and biopsy in 1 case. Postoperative radiotherapy was performed in 3 cases. In follow-ups, 3 cases showed recurrence postoperatively. D-TSGCT arising from TMJ should be differentiated with TMJ disorders, other tumors and tumor-like lesions of TMJ and parotid neoplasms, etc. CT and MRI examinations have important values in the diagnosis and treatment design of D-TSGCT. Because of the local aggressive and extensive behavior, complete resection should be performed as soon as possible. Postoperative radiotherapy was helpful for the extensive lesions including destruction of skull base and may be a good

  7. Temporomandibular joint health status in war veterans with post-traumatic stress disorder.

    Science.gov (United States)

    Mottaghi, Ahmad; Zamani, Elham

    2014-01-01

    The objective of this study was to determine the prevalence of signs and symptoms of temporomandibular joint dysfunction (TMJD) in the Iran/Iraq war veterans suffering from post-traumatic stress disorder. A total of 120 subjects in the age range of 27 to 55 years were included; it included case group (30 war veterans with PTSD) and three control groups (30 patients with PTSD who had not participated in the War, 30 healthy war veterans, and 30 healthy subjects who had not participated in the War). All subjects underwent a clinical TMJ examination that involved the clinical assessment of the TMJ signs and symptoms. The groups of veterans had high prevalence of TMJD signs and symptoms vs. other groups; history of Trauma to joint was significantly higher in subjects who had participated in the war compare with subjects who had not participated in the war (P = 0.0006). Furthermore, pain in palpation of masseter, temporal, pterygoideus, digastric, and sternocleidomastoid muscles in the groups of veterans was significantly greater than other groups (P TMJ functional status than the control subjects.

  8. Quality of life: patient-reported outcomes after total replacement of the temporomandibular joint.

    Science.gov (United States)

    Kunjur, J; Niziol, R; Matthews, N S

    2016-09-01

    Since publication of the UK guidelines on total replacement of the temporomandibular joint (TMJ) in 2008 by the British Association of Oral and Maxillofacial Surgeons (BAOMS), pain scores, mouth opening, and diet have been used as markers of success. We have looked at quality of life (QoL) as another. We analysed the data from a single surgeon on patients who had had joints replaced and devised a questionnaire to find out about the subjective, functional, psychological, and social aspects of TMJ disease. A total of 18 patients who had the same operation were included (mean (range) age 50 (33 - 73) years, mean (range) follow up 30 (18 - 48) months). Jaw function and facial aesthetics had improved, and patients needed less analgesia. Overall, they reported a better QoL with improvements in mood and social interaction, and the activities of daily life were easier. The NHS uses QoL questionnaires to measure success in fields such as orthopaedic surgery, but currently we know of no nationally accepted questionnaire that measures success after total replacement of the TMJ. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Bony deviations revealed by cone beam computed tomography of the temporomandibular joint in subjects without ongoing pain.

    Science.gov (United States)

    Bakke, Merete; Petersson, Arne; Wiesel, Mie; Svanholt, Palle; Sonnesen, Liselotte

    2014-01-01

    To assess the prevalence of temporomandibular joint (TMJ) bony changes in cone beam computed tomography (CBCT) images of adult subjects without ongoing orofacial pain or complaints from the TMJ. The study included 84 TMJs from 28 men and 14 women (mean age [± SD]: 51 ± 11 years) without orofacial pain or TMJ complaints who were participants in a study of patients with obstructive sleep apnea. They were examined before any treatment with the Research Diagnostic Criteria for Temporomandibular Disorders and with CBCT (NewTom VGi; 15 × 15 cm, exposure time 18 seconds, axial thickness 0.3 mm). Osseous TMJ deviations were assessed blindly and classified. Degenerative changes were noted in the CBCT images of 33 (39.3%) of the TMJs, of which 21 were classified as osteoarthritic alterations and 12 as indeterminate changes of osteoarthritis. Two TMJs were clinically classified as osteoarthrosis and 6 as disc displacement with reduction. The CBCT images of the 2 TMJs with a clinical diagnosis of osteoarthrosis showed also bony changes, but the CBCT images also revealed osteoarthritic bony changes in the 18 TMJs without any clinical diagnosis. CBCT images of asymptomatic adult TMJs commonly show degenerative bony alterations. Accordingly, such radiographic findings should be used with care and only as a supplement to clinical assessment.

  10. Interrelationship between temporomandibular joint osteoarthritis (OA) and cervical spine pain: Effects of intra-articular injection with hyaluronic acid.

    Science.gov (United States)

    Guarda-Nardini, Luca; Cadorin, Cristina; Frizziero, Antonio; Masiero, Stefano; Manfredini, Daniele

    2017-09-01

    The aim of this study was to evaluate cervical spine pain and function after five sessions of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) osteoarthritis. Forty-nine patients, (79% females, aged between 43-81 years), affected by TMJ osteoarthritis and concurrent cervical spine pain and limited function were recruited. All patients underwent a cycle of five weekly arthrocenteses and viscosupplementation with 1 ml of medium molecular weight HA according to the single-needle arthrocentesis technique. Outcome variables were TMJ pain (VAS), cervical active ranges of motion, cervical disability (NPDS), and presence of painful palpation sites. Assessments were carried out at baseline and at one, three and six months after the end of treatment protocol. A significant reduction over time was shown both in TMJ pain levels and in NPDS values with respect to baseline (p pain. These findings add to the complex amount of literature on the relationship between temporomandibular disorders and cervical spine disorders.

  11. Signs and symptoms of Temporomandibular Disorders in the elderly

    OpenAIRE

    Camacho, José Gustavo Dala Déa; Oltramari-Navarro, Paula Vanessa Pedron; Navarro, Ricardo de Lima; Conti, Ana Cláudia de Castro Ferreira; Conti, Marcio Rodrigues de Almeida; Marchiori, Luciana Lozza de Moraes; Fernandes, Karen Barros Parron

    2014-01-01

    Purpose: This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. Methods: The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a muscular ...

  12. Signs and symptoms of Temporomandibular Disorders in the elderly

    OpenAIRE

    Camacho,José Gustavo Dala Déa; Oltramari-Navarro,Paula Vanessa Pedron; Navarro,Ricardo de Lima; Conti,Ana Cláudia de Castro Ferreira; Conti,Marcio Rodrigues de Almeida; Marchiori,Luciana Lozza de Moraes; Fernandes,Karen Barros Parron

    2014-01-01

    Purpose: This study investigated the prevalence of Temporomandibular Disorders (TMD) in the elderly and its association with palpation of the temporomandibular joint (TMJ), masticatory and cervical muscles as well as the presence of headache and joint noises. Methods: The sample consisted of 200 elderly of both genders (mean age: 69.2±5.7 years). The clinical evaluation of TMD signs and symptoms was divided into three stages: an anamnestic questionnaire, a TMJ evaluation, and a musc...

  13. The Role of Transcutaneous Electrical Nerve Stimulation in the Management of Temporomandibular Joint Disorder.

    Science.gov (United States)

    Awan, Kamran Habib; Patil, Shankargouda

    2015-12-01

    Temporomandibular joint disorders (TMD) constitutes of a group of diseases that functionally affect the masticatory system, including the muscles of mastication and temporomandibular joint (TMJ). A number of etiologies with specific treatment have been identified, including the transcutaneous electrical nerve stimulation (TENS). The current paper presents a literature review on the use of TENS in the management of TMD patients. Temporomandibular joint disorder is very common disorder with approximately 75% of people showing some signs, while more than quarter (33%) having at least one symptom. An attempt to treat the pain should be made whenever possible. However, in cases with no defined etiology, starting with less intrusive and reversible techniques is prescribed. Transcutaneous electrical nerve stimulation is one such treatment modality, i.e. useful in the management of TMD. It comprises of controlled exposure of electrical current to the surface of skin, causing hyperactive muscles relaxation and decrease pain. Although the value of TENS to manage chronic pain in TMD patients is still controversial, its role in utilization for masticatory muscle pain is significant. However, an accurate diagnosis is essential to minimize its insufficient use. Well-controlled randomized trials are needed to determine the utilization of TENS in the management of TMD patients.

  14. Correlating cone beam CT results with temporomandibular joint pain of osteoarthritic origin.

    Science.gov (United States)

    Palconet, G; Ludlow, J B; Tyndall, D A; Lim, P F

    2012-02-01

    The purpose of this study was to determine whether bony changes in temporomandibular joint (TMJ) osteoarthritis (OA) is correlated with pain and other clinical signs and symptoms. Clinical data and cone beam CT (CBCT) images of 30 patients with TMJ OA were analysed. The criteria of Koyama et al (Koyama J, Nishiyama H, Hayashi T. Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofac Radiol 2007; 36: 472-477.) and Ahmad et al [Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 844-860.] were used to classify the condyles observed on the CBCT. Clinical measures included self-reported pain, mandibular range of motion, TMJ sound, pain on palpation of the TMJ and masticatory muscles, and pain on jaw function. Generalized linear modelling was used to correlate the clinical and radiographic findings and Spearman's rho was used to correlate the two classification systems. There was poor correlation between the maximum condyle change and pain rating (Koyama: r² = 0.1443, p = 0.3995; Ahmad: r² = 0.0273, p = 0.9490), maximum mouth opening (Koyama: r² = 0.2910, p = 0.0629; Ahmad: r² = 0.2626, p = 0.0951), protrusion (Koyama: r² = 0.0875, p = 0.7001; Ahmad: r² = 0.1658, p = 0.3612), right lateral motion (Koyama: r² = 0.0394, p = 0.9093; Ahmad: r² = 0.0866, p = 0.6877) and left lateral motion (Koyama: r² = 0.0943, p = 0.6494; Ahmad: r² = 0.1704, p = 0.3236). Strong correlation was observed between Koyama et al's and Ahmad et al's classifications for average (r = 0.9216, p TMJ OA.

  15. Results of a multinational survey regarding the diagnosis and treatment of temporomandibular joint involvement in juvenile idiopathic arthritis.

    Science.gov (United States)

    Foeldvari, Ivan; Tzaribachev, Nikolay; Cron, Randy Q

    2014-01-25

    Temporomandibular joint (TMJ) involvement occurs in up to 80% of patients with juvenile idiopathic arthritis (JIA). Currently there are no standardized procedures regarding diagnosis and treatment of this common complication of JIA. The aim of the study was to assess the current clinical practices in many countries regarding diagnosis and treatment of TMJ involvement in JIA. Pediatric rheumatologists were asked to fill out a survey with 8 items regarding diagnosis and treatment of TMJ involvement. The survey was distributed over the worldwide pediatric rheumatology electronic list-serve. Data was collected in an Excel spread sheet and analyzed using Excel software. Eighty-seven centers responded to the survey between December 2009 and April 2010. All responding centers were actively screening for TMJ involvement. All centers were screening by physical exam, 85 (97%) by history, and 2 (3%) by imaging. Seventy-seven (88%) centers were screening at the first visit and 76 (87%) at each follow-up visit. If imaging was requested, 77% of the centers reported that they asked for MRI, 10% for ultrasound, 9% for CT and 33% for X-ray. The first line treatment of TMJ arthritis was a non-biologic DMARD in 36%, an NSAID in 33%, an intraarticular corticosteroid injection in 26%, and an anti-TNF agent in 5%. Overall, 57 (65%) of the centers were using intraarticular corticosteroid injections as treatment. TMJ arthritis is common among children with JIA. This survey shows that a wide array of diagnostic and therapeutic approaches is being employed for TMJ disease in 87 international centers. Due to this lack of agreement in how to diagnose and treat this JIA complication, we believe that an expert opinion/consensus statement regarding TMJ arthritis in JIA will likely benefit patients worldwide.

  16. Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Frid, Paula; Nordal, Ellen; Bovis, Francesca; Giancane, Gabriella; Larheim, Tore A; Rygg, Marite; Pires Marafon, Denise; De Angelis, Donato; Palmisani, Elena; Murray, Kevin J; Oliveira, Sheila; Simonini, Gabriele; Corona, Fabrizia; Davidson, Joyce; Foster, Helen; Steenks, Michel H; Flato, Berit; Zulian, Francesco; Baildam, Eileen; Saurenmann, Rotraud K; Lahdenne, Pekka; Ravelli, Angelo; Martini, Alberto; Pistorio, Angela; Ruperto, Nicolino

    2017-05-01

    To evaluate the demographic, disease activity, disability, and health-related quality of life (HRQOL) differences between children with juvenile idiopathic arthritis (JIA) and their healthy peers, and between children with JIA with and without clinical temporomandibular joint (TMJ) involvement and its determinants. This study is based on a cross-sectional cohort of 3,343 children with JIA and 3,409 healthy peers, enrolled in the Pediatric Rheumatology International Trials Organisation HRQOL study or in the methotrexate trial. Potential determinants of TMJ involvement included demographic, disease activity, disability, and HRQOL measures selected through univariate and multivariable logistic regression. Clinical TMJ involvement was observed in 387 of 3,343 children with JIA (11.6%). Children with TMJ involvement, compared to those without, more often had polyarticular disease course (95% versus 70%), higher Juvenile Arthritis Disease Activity Score (odds ratio [OR] 4.6), more disability, and lower HRQOL. Children with TMJ involvement experienced clearly more disability and lower HRQOL compared to their healthy peers. The multivariable analysis showed that cervical spine involvement (OR 4.6), disease duration >4.4 years (OR 2.8), and having more disability (Childhood Health Assessment Questionnaire Disability Index >0.625) (OR 1.6) were the most important determinants for TMJ involvement. Clinical TMJ involvement in JIA is associated with higher disease activity, higher disability, and impaired HRQOL. Our findings indicate the need for dedicated clinical and imaging evaluation of TMJ arthritis, especially in children with cervical spine involvement, polyarticular course, and longer disease duration. © 2016, American College of Rheumatology.

  17. Dislocation of the temporomandibular joint meniscus: contrast arthrography vs. computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, J.R.; Christiansen, E.; Sauser, D.; Hasso, A.N.; Hinshaw, D.B. Jr.

    1985-01-01

    A prospective study to determine the accuracy of computed tomography (CT) for the diagnosis of dislocation of the temporomandibular joint (TMJ) meniscus was made by performing both CT and contrast arthrography on 18 joints suspected of meniscus dislocation. Arthography rather than surgery was chosen as the quality standard for comparing CT findings, as not all patients undergoing the studies underwent surgery. The results of each test were reported independently by the radiologist who obtained either all of the arthograms or all of the CT scans. For dislocation of the meniscus, there were excellent agreement between the two methods. CT seems to be nearly as accurate as arthrography for showing meniscus dislocation, is performed with lower x-ray exposure, and is noninvasive. Arthrograpy discloses more detailed information about the joint meniscus, such as perforation and maceration, and should continue to be used when this kind of information is clinically important.

  18. Internal derangement of temporomandibular joint: an evaluation of effect of corticosteroid injection compared with injection of sodium hyaluronate after arthrocentesis.

    Science.gov (United States)

    Giraddi, Girish B; Siddaraju, A; Kumar, Bimleshwar; Singh, Chandravir

    2012-09-01

    Internal derangements are the commonest disorders of temporomandibular joint (TMJ). Different treatment modalities including conservative and surgical methods have been proposed to treat the same. Arthrocentesis is gaining popularity in the treatment of internal derangement of TMJ. Being minimally invasive it does not have the demerits of surgical approaches and at the same time is producing better results than conservative approaches. This study evaluates and compares corticosteroid and sodium hyaluronate after arthrocentesis in the treatment of internal derangement of TMJ. Sixteen patients with internal derangement were randomly selected and divided into 2 groups (8 in each group). Arthrocentesis of the upper joint space was then performed using Ringer lactate under local anaesthesia followed by injection of either betamethasone or sodium hyaluronate into the joint. Clinical data was collected in the form of pain (visual analog scale), maximum mouth opening, joint sound and deviation before and after treatment up to 6 months. Both groups of patients were benefited from the treatment at the 6 month follow up and there was slightly less intensity of pain in sodium hyaluronate group compared with corticosteroid group. Maximum mouth opening was also increased in both groups. A decrease in clicking and deviation were seen in both groups. There was no statistically significant difference between betamethasone and sodium hyaluronate. Intra articular injection of corticosteroid or sodium hyaluronate after arthrocentesis had considerable effect on the TMJ. Both betamethasone and sodium hyaluronate can be used after arthrocentesis with similar results.

  19. Upregulation of cystathionine-β-synthetase expression contributes to inflammatory pain in rat temporomandibular joint.

    Science.gov (United States)

    Miao, Xiuhua; Meng, Xiaowen; Wu, Geping; Ju, Zhong; Zhang, Hong-Hong; Hu, Shufen; Xu, Guang-Yin

    2014-02-03

    Hydrogen sulfide (H2S), an endogenous gaseotransmitter/modulator, is becoming appreciated that it may be involved in a wide variety of processes including inflammation and nociception. However, the role for H2S in nociceptive processing in trigeminal ganglion (TG) neuron remains unknown. The aim of this study was designed to investigate whether endogenous H2S synthesizing enzyme cystathionine-β-synthetase (CBS) plays a role in inflammatory pain in temporomandibular joint (TMJ). TMJ inflammatory pain was induced by injection of complete Freund's adjuvant (CFA) into TMJ of adult male rats. Von Frey filaments were used to examine pain behavioral responses in rats following injection of CFA or normal saline (NS). Whole cell patch clamp recordings were employed on acutely isolated TG neurons from rats 2 days after CFA injection. Western blot analysis was carried out to measure protein expression in TGs. Injection of CFA into TMJ produced a time dependent hyperalgesia as evidenced by reduced escape threshold in rats responding to VFF stimulation. The reduced escape threshold was partially reversed by injection of O-(Carboxymethyl) hydroxylamine hemihydrochloride (AOAA), an inhibitor for CBS, in a dose-dependent manner. CFA injection led to a marked upregulation of CBS expression when compared with age-matched controls. CFA injection enhanced neuronal excitability as evidenced by depolarization of resting membrane potentials, reduction in rheobase, and an increase in number of action potentials evoked by 2 and 3 times rheobase current stimulation and by a ramp current stimulation of TG neurons innervating the TMJ area. CFA injection also led to a reduction of IK but not IA current density of TG neurons. Application of AOAA in TMJ area reduced the production of H2S in TGs and reversed the enhanced neural hyperexcitability and increased the IK currents of TG neurons. These data together with our previous report indicate that endogenous H2S generating enzyme CBS plays an

  20. Tenosynovial giant cell tumors of the temporomandibular joint and lateral skull base: Review of 11 cases.

    Science.gov (United States)

    Carlson, Matthew L; Osetinsky, L Mariel; Alon, Eran E; Inwards, Carrie Y; Lane, John I; Moore, Eric J

    2017-10-01

    To elucidate the clinical behavior, treatment, and outcomes of tenosynovial giant cell tumors (TGCT) involving the temporomandibular joint (TMJ) and adjacent temporal bone. Retrospective case series with histopathologic review. A retrospective chart review was performed identifying and collecting data from all cases of TGCT involving the TMJ and adjacent temporal bone that were treated at the authors' center between January 1960 and December 2015. Eleven histopathologically confirmed cases met inclusion criteria. The median age at diagnosis was 49 years, eight patients were men, and the median follow-up was 116 months. Computed tomographic (CT) imaging revealed a lytic expansile mass centered on the TMJ. Magnetic resonance imaging (MRI) most commonly exhibited hypointense signal on precontrast T1- and T2-weighted sequences and variable postcontrast enhancement. The median delay in diagnosis was 24 months, and the most common presenting symptoms were hearing loss and pain. All patients underwent surgical resection, eight receiving gross total removal, one receiving near total removal, and two patients from early in the series receiving subtotal resection with neoadjuvant or adjuvant radiation. Histopathological review of surgical specimens revealed chondroid metaplasia in seven tumors. Eight of nine cases receiving gross total or near total resection have no evidence of recurrence to date. TGCT of the TMJ and temporal bone are rare and locally aggressive tumors that commonly present with nonspecific symptoms. A careful review of CT and MRI followed by early biopsy is critical in establishing an accurate diagnosis and facilitating appropriate treatment. TGCT of the TMJ more commonly contain chondroid metaplasia when compared to TGCT at other anatomic locations. Gross total resection is achievable in most cases and offers long-term cure. Radiation may be considered for recurrent disease or adjuvant therapy following subtotal resection. 4. Laryngoscope, 127

  1. Incidence and clinical significance of zygomaticomaxillary complex fracture involving the temporomandibular joint with emphasis on trismus.

    Science.gov (United States)

    Chang, Chia-Ming; Ko, Edward C; Kao, Chu-Chiang; Chang, Pei-Ying; Chen, Michael Y C

    2012-06-01

    Trismus is frequently a sequel of temporomandibular joint (TMJ) involvement in a zygomaticomaxillary complex (ZMC) fracture. Although trismus is commonly observed in patients with ZMC fracture, continuous follow-up examinations of their degree of mouth opening have rarely been documented. The aim of this retrospective study was to determine the incidence and clinical significance of ZMC fracture involving the glenoid fossa or articular eminence of the TMJ with an emphasis on trismus. The medical and computed tomography (CT) imaging data of 28 patients with ZMC fracture treated by oral and maxillofacial surgeons (OMFSs) (OMFS group) and 174 patients with ZMC fracture treated by surgeons other than OMFSs (non-OMFS group) between May 2002 and May 2006 were reviewed. Maximal interincisal opening (MIO) less than 35 mm or three-finger width was considered limited mouth opening and indicative of trismus. Preoperative CT imaging data indicated that about 64% (18/28) and 50% (87/174) of the patients in the OMFS and non-OMFS groups, respectively, had a ZMC fracture involving the TMJ. Among these OMFS patients, 17 (94.40%) patients had limited mouth opening (MIO range, 7-33 mm) preoperatively, which improved markedly postoperatively. Among the non-OMFS patients with such fractures, 42 (48.3%) patients had trismus preoperatively and two retained trismus postoperatively. Lack of proper preoperative CT images, inadequate postoperative follow-up protocol, and/or neglect by patients and medical staff could influence the outcomes of ZMC fracture involving the TMJ. We make recommendations for reducing the risk of complications subsequent to ZMC fracture involving the TMJ. Copyright © 2012. Published by Elsevier B.V.

  2. Incidence and clinical significance of zygomaticomaxillary complex fracture involving the temporomandibular joint with emphasis on trismus

    Directory of Open Access Journals (Sweden)

    Chia-Ming Chang

    2012-06-01

    Full Text Available Trismus is frequently a sequel of temporomandibular joint (TMJ involvement in a zygomaticomaxillary complex (ZMC fracture. Although trismus is commonly observed in patients with ZMC fracture, continuous follow-up examinations of their degree of mouth opening have rarely been documented. The aim of this retrospective study was to determine the incidence and clinical significance of ZMC fracture involving the glenoid fossa or articular eminence of the TMJ with an emphasis on trismus. The medical and computed tomography (CT imaging data of 28 patients with ZMC fracture treated by oral and maxillofacial surgeons (OMFSs (OMFS group and 174 patients with ZMC fracture treated by surgeons other than OMFSs (non-OMFS group between May 2002 and May 2006 were reviewed. Maximal interincisal opening (MIO less than 35 mm or three-finger width was considered limited mouth opening and indicative of trismus. Preoperative CT imaging data indicated that about 64% (18/28 and 50% (87/174 of the patients in the OMFS and non-OMFS groups, respectively, had a ZMC fracture involving the TMJ. Among these OMFS patients, 17 (94.40% patients had limited mouth opening (MIO range, 7–33 mm preoperatively, which improved markedly postoperatively. Among the non-OMFS patients with such fractures, 42 (48.3% patients had trismus preoperatively and two retained trismus postoperatively. Lack of proper preoperative CT images, inadequate postoperative follow-up protocol, and/or neglect by patients and medical staff could influence the outcomes of ZMC fracture involving the TMJ. We make recommendations for reducing the risk of complications subsequent to ZMC fracture involving the TMJ.

  3. Temporomandibular Joint Discectomy With Abdominal Fat Graft Versus Temporalis Myofascial Flap: A Comparative Study.

    Science.gov (United States)

    DeMerle, Matt; Nafiu, Olubukola O; Aronovich, Sharon

    2017-06-01

    Open temporomandibular joint (TMJ) arthroplasty with discectomy has been described as a primary surgical treatment and as a secondary treatment when minimally invasive procedures have failed. The aim of the present study was to compare TMJ discectomy with a fat graft versus TMJ discectomy with a temporalis graft using the pain score and maximal interincisal opening (MIO). We performed a retrospective study of patients who had undergone TMJ arthroplasty and discectomy with an abdominal fat graft or an interpositional temporalis flap at the University of Michigan from 1999 to 2014. The predictor variable was the type of surgical intervention. The main outcome variables were the pain score and MIO. Additional outcome variables were diet, medication use, the presence of myofascial pain, and occlusal outcomes. The statistical analysis included the mean ± standard deviation, a 1-way analysis of variance for continuous data, and Pearson's χ(2) test for categorical variables. The study cohort included 50 patients, of whom 30 had undergone discectomy with a fat graft and 20 had undergone discectomy with a temporalis myofascial graft. The mean pain scores were decreased by 78.3% in the myofascial flap group and 52.8% in the fat graft group. Changes in MIO showed a statistically significant increase in the fat graft group but only approached statistical significance in the myofascial flap group. The patients who had undergone TMJ arthroplasty and discectomy with a temporalis myofascial flap showed significantly greater improvement in pain scores and marginal improvement in the MIO compared with patients who had received an abdominal fat graft. Copyright © 2016. Published by Elsevier Inc.

  4. Accurate 3D kinematic measurement of temporomandibular joint using X-ray fluoroscopic images

    Science.gov (United States)

    Yamazaki, Takaharu; Matsumoto, Akiko; Sugamoto, Kazuomi; Matsumoto, Ken; Kakimoto, Naoya; Yura, Yoshiaki

    2014-04-01

    Accurate measurement and analysis of 3D kinematics of temporomandibular joint (TMJ) is very important for assisting clinical diagnosis and treatment of prosthodontics and orthodontics, and oral surgery. This study presents a new 3D kinematic measurement technique of the TMJ using X-ray fluoroscopic images, which can easily obtain the TMJ kinematic data in natural motion. In vivo kinematics of the TMJ (maxilla and mandibular bone) is determined using a feature-based 2D/3D registration, which uses beads silhouette on fluoroscopic images and 3D surface bone models with beads. The 3D surface models of maxilla and mandibular bone with beads were created from CT scans data of the subject using the mouthpiece with the seven strategically placed beads. In order to validate the accuracy of pose estimation for the maxilla and mandibular bone, computer simulation test was performed using five patterns of synthetic tantalum beads silhouette images. In the clinical applications, dynamic movement during jaw opening and closing was conducted, and the relative pose of the mandibular bone with respect to the maxilla bone was determined. The results of computer simulation test showed that the root mean square errors were sufficiently smaller than 1.0 mm and 1.0 degree. In the results of clinical application, during jaw opening from 0.0 to 36.8 degree of rotation, mandibular condyle exhibited 19.8 mm of anterior sliding relative to maxillary articular fossa, and these measurement values were clinically similar to the previous reports. Consequently, present technique was thought to be suitable for the 3D TMJ kinematic analysis.

  5. Upregulation of lncRNA HOTAIR contributes to IL-1β-induced MMP overexpression and chondrocytes apoptosis in temporomandibular joint osteoarthritis.

    Science.gov (United States)

    Zhang, Chunping; Wang, Peng; Jiang, Pengfei; Lv, Yongbin; Dong, Changxia; Dai, Xiuyu; Tan, Lixia; Wang, Zhenlin

    2016-07-25

    Temporomandibular joint osteoarthritis (TMJ OA) is a common and heterogeneous disease that causes painful and progressive joint degeneration, which restricts daily activities, including talking and chewing. Long noncoding RNAs (lncRNAs) are an important class of genes involved in various physiological and pathological functions, including osteoarthritis (OA).The present study aimed to identify the lncRNAs that are important in TMJ OA and their potential functions. Here, we found that HOTAIR was significantly upregulated in the synovial fluid of TMJ OA patients compared with that of normal controls. Increased HOTAIR was similarly observed in the synovial fluid of TMJ OA rabbits as compared to control rabbits. Furthermore, in interleukin-1β (IL-1β)-induced TMJ OA in vitro model (primary rabbit condylar chondrocytes), the expressions of matrix metalloproteinase (MMP)-1, MMP3, MMP9 and HOTAIR were all dramatically increased. Most importantly, knockdown of HOTAIR in IL-1β-induced TMJ OA in vitro model could not only reverse the IL-1β-stimulated expressions of MMP1, MMP3 and MMP9, but also significantly decrease the apoptosis rate induced by IL-1β in primary rabbit condylar chondrocytes. Our data provides new insight into the mechanisms of chondrocytes destruction in TMJ OA. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Functional profile of patients with temporomandibular joint dysfunction under physiotherapy treatment

    Directory of Open Access Journals (Sweden)

    Andrezza Pinheiro Bezerra de Menezes Kinote

    2011-12-01

    Full Text Available Objectives: To assess the functional profile of patients with temporomandibular joint dysfunction (TMJD receiving physical therapy. Methods: A cross-sectional study carried with 21 patients receiving physiotherapy care during the year of 2007 at the Center for Integrated Medical Care (Núcleo de Atenção Médica Integrada - NAMI, in Fortaleza-CE, Brazil. Those were submitted to anamnesis (age, presence of pain, affected sites and parafunctional habits and functional assessment (presence of trigger points, movement amplitude and postural evaluation. Results: The age varied from 16 to 56 years, with an average of 31.3 ± 14.85 and female gender was the most affected with 17 (81.0% patients. Of the assessed patients, 13 (61.9% presented pain of moderate intensity, with an average of 5.4 ± 0.50. The most common sites of pain were the temporomandibular joint (TMJ, reported by 15 (71.4%,and cervical region, reported by 13 (61.9% patients. We found that 13 (61.9% assessed patients reported clenching as parafunctional habit. Significant limitation of mouth opening and movements of the cervical region were observed when compared to normal values (p <0.05. The most painful muscles on palpation were upper trapezius (n=19, medial pterygoid (n=15 and the masseter (n=15. The TMJ presented strong pain (degree 3 on palpation in 3 (14.3% patients. In postural assessment, 10 (47.6% had cervical hyperlordosis, 7 (33% had forward head posture and 7 (33% had raised shoulders. Conclusion: Patients with TMJD receiving physical therapy present limitations in TMJ and cervical movement, pain, presence of trigger points and postural changes at a more compromised and symptomatic stage of this dysfunction. In view of this, it becomes necessary to provide early evaluation and treatment with physical therapy.

  7. Functional profile of patients with temporomandibular joint dysfunction under physiotherapy treatment -

    Directory of Open Access Journals (Sweden)

    Andrezza Pinheiro Bezerra de Menezes Kinote

    2012-01-01

    Full Text Available Objectives: To assess the functional profile of patients with temporomandibular joint dysfunction (TMJD receiving physical therapy. Methods: A cross-sectional study carried with 21 patients receiving physiotherapy care during the year of 2007 at the Center for Integrated Medical Care (Núcleo de Atenção Médica Integrada - NAMI, in Fortaleza-CE, Brazil. Those were submitted to anamnesis (age, presence of pain, affected sites and parafunctional habits and functional assessment (presence of trigger points, movement amplitude and postural evaluation. Results: The age varied from 16 to 56 years, with an average of 31.3 ± 14.85 and female gender was the most affected with 17 (81.0% patients. Of the assessed patients, 13 (61.9% presented pain of moderate intensity, with an average of 5.4 ± 0.50. The most common sites of pain were the temporomandibular joint (TMJ, reported by 15 (71.4%, and cervical region, reported by 13 (61.9% patients. We found that 13 (61.9% assessed patients reported clenching as parafunctional habit. Significant limitation of mouth opening and movements of the cervical region were observed when compared to normal values (p <0.05. The most painful muscles on palpation were upper trapezius (n=19, medial pterygoid (n=15 and the masseter (n=15. The TMJ presented strong pain (degree 3 on palpation in 3 (14.3% patients. In postural assessment, 10 (47.6% had cervical hyperlordosis, 7 (33% had forward head posture and 7 (33% had raised shoulders. Conclusion: Patients with TMJD receiving physical therapy present limitations in TMJ and cervical movement, pain, presence of trigger points and postural changes at a more compromised and symptomatic stage of this dysfunction. In view of this, it becomes necessary to provide early evaluation and treatment with physical therapy.

  8. Radiographic analysis of temporomandibular joint arthrosis

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

    1984-11-15

    The author analysed the bone changes, the positional relationships between condylar head and articular fossa, and the interrelationship between the bone changes and the abnormal position of condylar head, from 1,036 radiographs of 259 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral transcranial projection and orthopantomograms. The results were as follows: 1. Among the radiographic bone changes of the temporomandibular joint arthrosis, deformity was 36..90% (217 cases), sclerosis 34.18% (201 cases), erosive change 25.58% (152 cases) and marginal proliferation 3.06% (18 cases) respectively. 2. In the positional changes between condylar head and articular fossa, the downward positioning of condylar head in centric occlusion was most frequent (36.90%), of which frequency was significantly higher than forward positioning (11.22%) and backward positioning (4.76%) in same condition. Also, radiographs showed that the enlargement of articular space showed higher frequency than its narrowing. In the opening position of mouth, the restrict ed movement of condylar head within articular fossa was most frequent (35.03%). The forward positioning and the downward positioning was 15.65% and 9.52% respectively. Also, radiographs revealed that the incomplete movement or no positional change of condylar head was most frequent. 3. In the interrelationship between bone changes and abnormal position of condylar head, deformity was 42.79% in the cases of downward positioning of condylar head in centric occlusion and 37.50% in those of normal positioning of condylar head in same condition. This revealed that deformity was most frequent bone change in above condylar positionings. However, erosive change was 34.62% in the cases of downward positioning of condylar head in centric occlusion and 33 .33% in those of forward positioning. In opening position of condylar head, and deformity in the cases of norma l positioning, forward positioning and

  9. HLA II class alleles in juvenile idiopathic arthritis patients with and without temporomandibular joint arthritis.

    Science.gov (United States)

    Dāvidsone, Zane; Eglīte, Jeļena; Lazareva, Arina; Dzelzīte, Sarmīte; Šantere, Ruta; Bērziņa, Dace; Staņēviča, Valda

    2016-04-19

    Temporomandibular joint (TMJ) arthritis is seen very often (38-87 %) in children with juvenile idiopathic arthritis (JIA). With contrast enhanced magnetic resonance imaging (MRI) we can detect more cases of TMJ arthritis than ever before. Previous studies show that HLA II class alleles may have protective or risk importance in JIA subtypes. Our objective is to identify HLA II class alleles of risk and protection in JIA patients with TMJ arthritis. During the period from 2010 to 2015 MRI for TMJ was performed in 85 JIA patients who were genotyped for HLA- DRB1; DQB1 and DQA1 using RT-PCR with sequence-specific primers. As a control group, data of 100 individuals were taken from the genetic bank of RSU Joint Laboratory of Clinical Immunology and Immunogenetics. Associations of DRB1; DQB1; DQA1 alleles in patients were examined individually using the χ (2) test. P-value (disease was 3.07 ± 2.35 years (range 0.2-11.0 year). JIA subtypes were as follows: seronegative polyarthritis 51 (60 %), seropositive polyarthritis 6(7 %), oligoarthritis extended 7(8 %), oligoarthritis persistent 2 (2 %) arthritis with enthesitis 14 (17 %), undifferentiated 3 (4 %) and 2 (2 %) systemic arthritis. Two groups where separated after TMJ MRI exam: first with at least two signs of active inflammation and/or any structural damage (n = 62); second with no pathologic signs or with slight contrast enhancement (n = 23). We discovered that there are risk alleles that are found in all JIA patient's groups (MRI positive and negative groups) versus controls such as DRB1*07:01, DQB1*03:03; DQB1*05:01. Also some protective alleles as DRB1*18:01, DQB1*06:02-8 were found in overall JIA group. Alleles DRB1*12:01, DQB1*03:01; DQA1*05:01 were found to be protective for TMJ arthrits. In our study there were no convincing risk alleles, but there are alleles that probably are protective for TMJ arthritis like DRB1*12:01, DQB1*03:01; DQA1*05:01.

  10. Quantifying the Effect of Temporomandibular Joint Intra-Articular Steroid Injection on Synovial Enhancement in Juvenile Idiopathic Arthritis.

    Science.gov (United States)

    Resnick, Cory M; Vakilian, Pouya M; Kaban, Leonard B; Peacock, Zachary S

    2016-12-01

    To quantify the effect of intra-articular steroid injections (IASIs) on temporomandibular joint (TMJ) synovitis in children with juvenile idiopathic arthritis (JIA) using gadolinium-enhanced magnetic resonance imaging (MRI). The present study was a retrospective study of children with JIA who had undergone TMJ IASIs at Boston Children's Hospital. The patients were included if they had undergone contrast-enhanced MRI both before and after IASI and if the pre-IASI MRI had demonstrated synovitis (enhancement ratio [ER] >1.55). Patients with TMJ pathology or pain unrelated to JIA or a history of facial trauma were excluded. The predictor variables were age, gender, JIA subtype, exposure to medications for arthritis, and a family history of autoimmune disease. The primary outcome variable was the ER. Additional outcome variables included patient-reported pain and the maximal incisal opening (MIO). Twenty-nine subjects (83% female) with a total of 50 injected TMJs were included. The average age at JIA diagnosis and at IASI was 6.8 ± 1.7 years and 12.1 ± 1.9 years, respectively. The mean follow-up period was 22.9 ± 4.3 months (range 5 to 48). The ER decreased in all injected joints, with a mean reduction of 1.05 ± 1.01 (P TMJ synovitis, TMJ IASI was associated with a reduction in synovial enhancement, decreased pain, and an increased MIO. Only 18% of injected joints, however, experienced complete resolution of synovitis. These results support the use of IASI in the management of the pain and dysfunction associated with TMJ synovitis. Further study is required to determine the efficacy of IASI in limiting inflammation and future joint destruction. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Association of Temporomandibular Joint Signs & Symptoms with Dental Fluorosis & Skeletal Manifestations in Endemic Fluoride Areas of Dungarpur District, Rajasthan, India.

    Science.gov (United States)

    Asawa, Kailash; Singh, Anukriti; Bhat, Nagesh; Tak, Mridula; Shinde, Kushal; Jain, Sandeep

    2015-12-01

    Endemic fluorosis resulting from high fluoride concentration in groundwater is a major public health problem. India is among the numerous nations, where fluoride sullied groundwater is creating wellbeing issues. Safe drinking water in rural areas of India is predominantly rely on groundwater sources, which are exceptionally contaminated with fluoride. To investigate the association of temporomandibular joint Signs & Symptoms with Dental Fluorosis & Skeletal Manifestations among people living in Dad, Bokersal & Deotalab villages of Dungarpur District, Rajasthan, India. The study group consisted of 750 subjects who were born & brought up in Dad, Bokersal & Deotalab villages of Dungarpur District, Rajasthan. Temporomandibular joint & Dental fluorosis was assessed by performing type III clinical examination according to WHO guidelines (1997). For the assessment of skeletal manifestations, participants were asked to perform three diagnostic tests: (1)Touching the toes without bending the knees; (2) Touching the chest with the chin; (3) Stretching the arms sideways & folding the arms to touch the back of the head. Chi Square test & Multiple Logistic Regression were applied for statistical analysis. Among the 750 (462 males & 288 females) who participated in the study, 53% had moderate grade of dental fluorosis. The most prominent symptom suggesting Temporomandibular Joint Disorder was the clicking sound affecting 21.4% population.(p>0.001). TMJ Signs & Symptoms were prominent in the age group of 45-54 years & males were highly affected than females. Clinical examination of TMJ in Dental Fluorosis & Skeletal Fluorosis subjects showed a significant association with Dental Fluorosis & Skeletal Fluorosis.

  12. Pterygoid dysjunction: new minimally invasive technique for the treatment of painful temporomandibular joint dysfunction.

    Science.gov (United States)

    Kannan, Sadesh V

    2010-07-01

    To evaluate the efficacy of pterygoid dysjunction for the surgical management of temporomandibular joint (TMJ) pain and dysfunction. This study was composed of 10 patients (20 joints), of whom 2 patients had bilateral joint pain. Patients were those who complained of TMJ pain and dysfunction with mild to moderate internal derangement and who have failed to respond to all methods of conservative management. Only patients whose complaints of pain were confined to the pterygoid muscles on palpation were considered for this study. Clinical examination included pain and tenderness in relation to joint, muscles of mastication, movement of joint, and abnormal joint noises. Under general anesthesia, pterygomaxillary dysjunction was done bilaterally, the pterygoid plates were pushed backward, and the outcome was evaluated using computed tomography. Immediately after operation, most patients were free from pain, and the intensity of pain was reduced in the rest of the patients. There was progressive improvement of mouth opening, and clicking was reduced in most of the patients in the late postoperative phase. Follow-up and regular counseling were done for 2 years. Clicking and mouth opening have considerable significance, but all patients were free from pain and were comfortable, except for some patients who have simple complaints, which are irrelevant to this study. Although the total number of patients was too small to arrive at any definitive conclusion, the encouraging results, especially the relief from pain, show that this technique has a significant role in the treatment of painful TMJ dysfunction, with mild to moderate internal derangement, and is devoid of other major complications.

  13. Influence of oral stabilization appliances in intra-articular pressure of the temporomandibular joint.

    Science.gov (United States)

    Casares, Guillermo; Thomas, Alejandro; Carmona, Joaquin; Acero, Julio; Vila, Carlos Navarro

    2014-07-01

    This study analyzed the intra-articular pressure in the upper compartment of the temporomandibular joint (TMJ) under different functional conditions. The influence of stabilization appliances on intra-articular pressure was studied. Seventy-four joints from 64 patients (55 women and 9 men; mean age: 43.2 ± 11.86 years; range: 19-61 years) with TMJ disorders were examined. Only 50 joints passed the inclusion criteria. Intra-articular pressure was measured using a 21G needle inserted into the joint and connected to a pressure transducer. Pressure was measured with the jaw in the following positions: at rest, maximal mouth opening, clenching in maximal intercuspal position, and clenching with an oral interoclusal appliance. Fifty joints were included in the study (without blood reflux), mean pressure at rest was negative (-6.06 ± 4.55 mmHg); when the mouth was opened to its maximal position the pressure was lower (-26.09 ± 6.42 mmHg). Mean intra-articular pressure was higher in the maximal intercuspal position (58.56 ± 24.90 mmHg). When an interoclusal appliance device was fitted, mean intra-articular pressure reduced its value by 31.24%, which reached a mean value of 40.56 ± 18.84 mmHg (P<0.001). There were no significant differences in sex. The group over 45 years old had higher pressure values in maximal open mouth position than the group of patients under 45 years old (P<0.02). Interoclusal appliances can reduce pressure in the upper compartment of the TMJ and improve functional status of the joint.

  14. Influence of estrogen cycle on temporomandibular joint synovial membrane in rat with deviated mandible.

    Science.gov (United States)

    Kishimoto, Giovanna; Hosomichi, Jun; Muramoto, Takeshi; Kanno, Zuisei; Soma, Kunimichi

    2007-03-01

    Temporomandibular disorders (TMD) are known to be more prevalent and severe in women than in men, especially in those who are in their reproductive age. In those patients reproductive hormones may play a vital role in the host adaptive capacity of the temporomandibular joint (TMJ). In order to clarify the relationship between TMD prevalence and estrogen cycle, a mandible deviated animal model was carried out, and the expression of inducible nitric oxide synthase (iNOS), an essential enzyme in the pathogenesis of inflammatory arthritis, was investigated in the rat's synovial tissue. An appliance was attached to the rat's incisors to produce a lateral deviation of the mandible during the metestrus phase, and the animals were sacrificed in the proestrus and estrus phase, when the estrogen was at the highest and lowest level, respectively. Immunostaining was then performed for 2 consecutive estrous cycles to demonstrate iNOS expression in the synovial membrane of the TMJ. The immunoreactivity for iNOS was more intense in the synovial membrane on the contralateral side in the proestrus phase (estrogen peak phase). These observations suggest that iNOS expression in the synovial membrane with mandibular deviation may be exacerbated in the presence of estrogen.

  15. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint... implanted in the human jaw to replace the mandibular condyle and augment the glenoid fossa to functionally...

  16. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation.

    Science.gov (United States)

    Akinbami, Babatunde O

    2011-06-15

    Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques.

  17. Relationship between activity of gluthatione peroxidase and nitric oxide in synovial fluid and the progression of temporomandibular joint internal derangement.

    Science.gov (United States)

    Güven, Orhan; Tozoğlu, Sinan; Tekin, Umut; Salmanoğlu, Berrin; Güneş, Onur

    2015-05-01

    The purposes of this study were to measure the activity of glutathione peroxidase (GPX) and nitric oxide (NO) in the synovial fluid of patients with temporomandibular joint (TMJ) internal derangement (ID) and to indicate the relationship between the activity of GPX and NO and the progress of the ID. Twenty-six patients with TMJ ID were identified and classified according to Wilkes staging through clinical and radiologic examinations. Levels of GPX were determined indirectly by a coupled reaction with glutathione reductase. Levels of NO were measured colorimetrically. The activity of GPX and NO was observed to be progressively increasing as the stage of the TMJ ID progressed. There were significant correlations between the 2 substances and the Wilkes stages. Oxidative stress may have a role in the pathogenesis of TMJ ID. In synovial fluid, GPX and NO activities are increased as the stage of the disease increased. Increase in the activities of GPX might not be enough to prevent progression of the TMJ ID.

  18. Juvenile idiopathic arthritis and rheumatoid arthritis: bacterial diversity in temporomandibular joint synovial fluid in comparison with immunological and clinical findings.

    Science.gov (United States)

    Olsen-Bergem, H; Kristoffersen, A K; Bjørnland, T; Reseland, J E; Aas, J A

    2016-03-01

    Temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) occurs in up to 80% of affected children. The purpose of this study was to investigate the presence of bacterial DNA in synovial fluid, and to compare this with clinical and immunological findings in children with JIA, adults with persistent JIA, and adults with rheumatoid arthritis, in order to detect whether bacteria contribute to inflammation in TMJ arthritis. Synovial fluid and skin swab samples were collected from 30 patients (54 TMJs). Bacterial detection was performed using 16S rRNA pyrosequencing. Bacterial DNA was detected in 31 TMJs (57%) in 19 patients (63%). A positive statistically significant correlation was registered between bacterial DNA detected in TMJ synovial fluid and the following factors: total protein concentration in synovial fluid, interleukin 1β, tumour necrosis factor alpha, adrenocorticotropic hormone, and adiponectin, as well as the duration of the general medical disease. Fourteen different bacterial species were detected in synovial fluid. Bacterial DNA in TMJ synovial fluid without contamination was detected in more than 50% of the patients. Studies are needed to evaluate the consequences of this bacterial DNA in synovial fluid with regard to TMJ arthritis. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Successful reconstruction of nongrowing hemifacial microsomia patients with unilateral temporomandibular joint total joint prosthesis and orthognathic surgery.

    Science.gov (United States)

    Wolford, Larry M; Bourland, T Campbell; Rodrigues, Daniel; Perez, Daniel E; Limoeiro, Evelin

    2012-12-01

    Traditionally, patients with hemifacial microsomia (HFM) and significant ipsilateral hypoplasia or absence of the condyle and ramus undergo reconstruction on the ipsilateral side with autogenous tissues such as rib grafts, often with compromised results. This study analyzed the surgical treatment outcomes of nongrowing patients with HFM and reconstruction of the ipsilateral temporomandibular joint (TMJ) and advancement of the mandible with a patient-fitted TMJ total joint prosthesis (TMJ Concepts, Inc, Ventura, CA), a contralateral mandibular ramus sagittal split osteotomy, and maxillary osteotomies performed in 1 operation. All nongrowing patients with HFM treated with this surgical protocol from 1997 to 2010 in a single private practice were included in this study and subjectively evaluated before surgery and at the longest postsurgical follow-up for pain, diet, jaw function, and disability using a visual numerical scale (0 to 10). Surgical changes and postsurgical stability were analyzed using lateral cephalograms before surgery, immediately after surgery, and at the longest follow-up. Six patients (4 female and 2 male) were included in this study, with an average age at surgery of 23.5 years (range, 14 to 39 yrs) and an average follow-up of 6 years 3 months (range, 1 yr to 11 yrs 4 mo). For all subjective parameters, all patients improved or remained the same. Incisal opening improved or remained the same in 4 of the 6 patients, with 2 patients having decreased opening. Excursive movements decreased. The maxillomandibular complex was surgically rotated counterclockwise, advanced, and transversely leveled, with the anterior maxillary reference points (anterior nasal spine, point A) undergoing relative small movements. The mandibular incisor tips (lower incisor tips) advanced a mean of 8.9 mm, point B 14.8 mm, pogonion 18.6 mm, menton 17.5 mm and the occlusal plane angle decreased -12.3°. Postsurgical long-term stability indicated that the anterior maxillary

  20. [TMJ, eating and breathing].

    Science.gov (United States)

    Cheynet, F

    2016-09-01

    The study of the relationship between temporomandibular joints (TMJ), mastication and ventilation and the involvement of these two functions in the genesis of primary Temporomandibular Disorders (TMD) and in some dentofacial deformities, was initiated in France, more than 30years, by Professor Raymond Gola. Once criticized the weakness of the scientific literature in this domain, the originality of the TMJ within the masticatory system is recalled with its huge adaptation potential to very different biomechanical constraints according to the age and masticatory activities during the day. But the biomechanics of the masticatory system does not stop at night and the positions of the mandible and head during sleep should be studied carefully. In case of nocturnal mouth breathing with open mouth, the predominant sleeping position (generating small but long-term strengths) may be deleterious to the condyle-disc complex, to the surrounding muscles and the occlusal relationships. Some condyle-disc displacements and asymmetric malocclusions occur in this long portion of life what sleep, especially as oral breathing leads to a lot of dysfunctions (low position of the tongue, labio-lingual dysfunctions, exacerbation of bruxism sleep…). The aim of this work was to share our multidisciplinary experience of the biomechanical consequences of the nocturnal mouth breathing on the face involving orthodontists, maxillofacial surgeons, ENT, allergists, speech therapists, physiotherapists and radiologists. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  1. Ultrasound versus magnetic resonance imaging of the temporomandibular joint in juvenile idiopathic arthritis: a systematic review.

    Science.gov (United States)

    Hechler, B L; Phero, J A; Van Mater, H; Matthews, N S

    2018-01-01

    A systematic review of published articles on ultrasound (US) and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) in juvenile idiopathic arthritis (JIA) was performed to answer the question "What is the sensitivity and specificity of US as compared to MRI in diagnosing acute and chronic joint changes in patients with JIA?" The most recent evidence was sought in published articles via a search of the PubMed, Ovid, and Embase databases. Article appraisal was performed by two reviewers. Nineteen articles reporting prospective or ambispective studies comparing US to MRI in TMJ imaging were found. Six of these articles were specific to JIA patients. The heterogeneity of these articles made comparison difficult. Of the acute and chronic changes assessed (disk displacement, joint effusion, bony deformity), only joint effusion was appropriately assessed by multiple authors, with US having a sensitivity of 0-72% and specificity of 70-83% as compared to MRI. There was a paucity of studies specific to JIA, with many studying adult, non-rheumatic patients. This systematic review found that dynamic imaging with high-resolution US improves sensitivity and specificity compared to static, low-resolution US. Additionally, there is evidence to suggest that US imaging following a baseline MRI can increase US sensitivity and specificity and may have a future role in disease surveillance. Published by Elsevier Ltd.

  2. Comparison of static MRI and pseudo-dynamic MRI in temporomandibular joint disorder patients

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    Lee, Jin Ho; Yun, Kyoung In [Eulji Univ. School of Medicine, Seoul (Korea, Republic of); Park, In Woo; Choi, Hang Moon; Park, Moon Soo [Kangnung National Univ. College of Dentistry, Kangnung (Korea, Republic of)

    2006-12-15

    The purpose of this study was to elevate comparison of static MRI and pseudo-dynamic (cine) MRI in temporomandibular joint (TMJ) disorder patients. In this investigation, 33 patients with TMJ disorders were examined using both conventional static MRI and pseudo-dynamic MRI. Multiple spoiled gradient recalled acquisition in the steady state (SPGR) images were obtained when mouth opened and closed. Proton density weighted images were obtained at the closed and open mouth position in static MRI. Two oral and maxillofacial radiologists evaluated location of the articular disk, movement of condyle and bony change respectively and the posterior boundary of articular disk was obtained. No statistically significant difference was found in the observation of articular disk position, mandibular condylar movement and posterior boundary of articular disk using static MRI and pseudo-dynamic MRI (P>0.05). Statistically significant difference was noted in bony changes of condyle using static MRI and pseudo-dynamic MRI (P<0.05). This study showed that pseudo-dynamic MRI didn't make a difference in diagnosing internal derangement of TMJ in comparison with static MRI. But it was considered as an additional method to be supplemented in observing bony change.

  3. The role of three-dimensional computed tomography in the evaluation of temporomandibular joint ankylosis

    Directory of Open Access Journals (Sweden)

    Thangavelu Kavin

    2012-01-01

    Full Text Available Aims: The aim of the study was to evaluate the role of three-dimensional computed tomography (3D-CT in the assessment of temporomandibular joint (TMJ ankylosis and its importance in treatment planning. The objectives of study were to measure and assess the mediolateral extent of ankylosis mass in 3D-CT and to compare the extent with intraoperative assessment. The study was also aimed to measure the coronoid process elongation in 3D-CT and its significance in treatment planning. Materials and Methods: This prospective study included 3D-CT evaluation of 11 patients with TMJ ankylosis during the period of February 2006-October 2007. Results: The 3D-CT assessment provided the length of the coronoid process and the relation of vital structures including maxillary artery to the ankylosed mass. Measurement of ankylosed mass also aids in preoperative measurement of the graft required to reconstruct the defect following removal of the ankylosed mass. Conclusion: Our study concludes that 3D-CT is a useful tool in the diagnosis and treatment planning of TMJ ankylosis.

  4. A new method for three-dimensional reconstruction and animation of the temporomandibular joint.

    Science.gov (United States)

    Krebs, M; Gallo, L M; Airoldi, R L; Palla, S

    1995-01-01

    The aim of this project was to develop a new method for the three-dimensional reconstruction and animation of the temporomandibular joint (TMJ). Magnetic resonance (MR) tomograms of the TMJ were combined, using an extraorally placed reference system, with jaw motion data, recorded with six degrees of freedom, by means of the opto-electronic tracking system Jaws-3D. The three-dimensional reconstruction of the TMJ was calculated and animated on a graphics workstation by means of kinematic transformations. A subject without any past or present history of myoarthropathies of the masticatory system, performed jaw opening and closing and chewed chewing gum. The animation provided a three-dimensional visualisation of the movements of the entire condyle within the fossa. The condyle-fossa distance was computed for every condylar point and represented by shading the surface of the condyle with pseudo-colours. The position of the minimum distance between condyle and fossa was calculated and displayed in a plane graph representing the condylar surface.

  5. Management of middle meningeal and superficial temporal artery hemorrhage from total temporomandibular joint replacement surgery with a gelatin-based hemostatic agent.

    Science.gov (United States)

    Cillo, Joseph E; Sinn, Douglas; Truelson, John M

    2005-03-01

    Complications associated with temporomandibular joint (TMJ) replacement surgery may include injury to nerves, blood vessels, and otologic structures. Vascular injuries can be associated with trauma to the carotid artery and its terminal branches, the superficial temporal artery, and the internal maxillary artery. Suggested management to control hemorrhage has included uniand bipolar electrocautery, laser ablation, local anesthetics with vasoconstrictors, direct pressure, embolization, and ligation. In this case report, the iatrogenic injury to both the middle meningeal and superficial temporal arteries during total TMJ replacement surgery controlled by using a gelatin-based hemostatic agent is discussed.

  6. Outcomes of open temporomandibular joint surgery following failure to improve after arthroscopy: is there an algorithm for success?

    Science.gov (United States)

    Tzanidakis, Konstantinos; Sidebottom, Andrew J

    2013-12-01

    We reviewed the results of one surgeon's experience of open surgical management of the temporomandibular joint (TMJ) in patients who fail to respond to arthroscopy and aimed to identify groups of patients that may or may not benefit from the intervention. Over a 7-year period (2005-2012) we retrospectively collected data from the medical notes of patients who underwent discectomy, disc plication, eminectomy, eminoplasty, and adhesiolysis, according to the clinical findings for joint pain, restriction, and locking. A total of 22 patients (71%) reported improvement in pain score and 19 (61%) reported an improvement in mouth opening 12 months postoperatively. Overall, 12 patients (39%) ultimately needed TMJ replacement. This group included 5/6 patients in Wilkes' stage IV and 6/15 in stage V, 5/7 patients with a preoperative pain score of 90-100, and half of those with preoperative mouth opening of 20-29 mm (7/14). Open surgical management of the TMJ can benefit patients despite the previous failure of arthroscopy to manage pain, restriction, and locking. Arthroscopy seems to reduce the percentage of patients that need open TMJ surgery, but also the success of subsequent operations compared with previous studies. TMJ replacement is increasingly being done successfully to treat end-stage disease. These results may be used when obtaining a patient's consent for open TMJ surgery, particularly if they are in the groups considered to have a high risk of subsequently requiring a replacement joint. Copyright © 2013 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. MRI thresholds for discrimination between normal and mild temporomandibular joint involvement in juvenile idiopathic arthritis.

    Science.gov (United States)

    Ma, Grace Mang Yuet; Amirabadi, Afsaneh; Inarejos, Emilio; Tolend, Mirkamal; Stimec, Jennifer; Moineddin, Rahim; Spiegel, Lynn; Doria, Andrea S

    2015-12-01

    Currently there is no consensus agreement on the degree of enhancement in normal temporomandibular joints (TMJ) in children, which makes it difficult for clinicians to distinguish between the presence/absence of mild synovitis. Quantitative measurements of synovial and condylar enhancement may be useful additions to current qualitative methods on early MRI diagnosis and follow up of TMJ involvement in JIA. The purpose of the study is to establish thresholds/tendencies for quantitative measures that enable distinction between mild TMJ involvement and normal TMJ appearance based on the degree of synovial and bone marrow enhancement in JIA patients. TMJ MRI examinations in 67 children with JIA and in 24 non-rheumatologic children who underwent MRI for neurologic/orbit indications were retrospectively assessed. As a priori determined TMJs of JIA patients were categorized into three groups by experienced staff radiologists based on the degree of synovial and condylar enhancement: no active disease (rheumatologic control), mild and moderate/severe findings. The signal intensity (SI) of the synovial tissue around each condyle and of the bone marrow was measured to calculate the enhancement ratio (ER) and relative SI change. The ER was calculated using signal to noise ratios, while relative SI change was calculated using signal intensities alone. Quantitative measurements of synovial and condylar enhancement of TMJs with mild or moderate/severe findings were compared with the rheumatologic and non-rheumatologic controls. Mean ER values were significantly different between the TMJs without active disease and those with mild and moderate/severe synovial enhancement, with highest values in the moderate/severe group (P  0.10). 27/60 (45%) TMJs without active disease had osteochondral changes. 8/40 (20%) TMJs in the mild group did not demonstrate any synovial thickening. Quantitative signal to noise ratios of TMJ synovial and condylar enhancement generate thresholds

  8. Effects of sleep deprivation on pain-related factors in the temporomandibular joint.

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    Wu, Gaoyi; Chen, Lei; Wei, Geng; Wei, Gang; Li, Ying; Zhu, Guoxiong; Zhao, Zhengwei; Huang, Fei

    2014-11-01

    The objective of this study was to investigate the effects of experimental sleep deprivation (SD) on the temporomandibular joint (TMJ) in rats by examining pain-related factors and to determine the possible involvement of estrogen and NF (nuclear factor) κB signaling in the TMJ synovial membrane. The influence of SD, conducted in rats using the modified multiple platform method, was estimated by observing behavioral manifestations and examining changes in serum hormone levels. The morphologic changes of synovial tissue were observed with light microscopy and the serum levels of estrogen were measured by radioimmunoassay. Activation of NF-κB in the synovial membrane was examined using an immunofluorescence technique, and the expression levels of interleukin (IL) 1β, IL-6, tumor necrosis factor α, cyclooxygenase 2, and inducible nitric oxide synthase were measured with real-time polymerase chain reaction. The SD group showed evidence of elevated anxiety and stress, and increased plasma levels of estradiol compared with the control group. The activity of NF-κB was significantly enhanced and translocation of NF-κB p65 was evident in the synovial membrane after SD. The expression of pain-related factors IL-1β, IL-6, cyclooxygenase-2, tumor necrosis factor α, and inducible nitric oxide synthase in the synovial membrane significantly increased after SD. These results indicate that SD increases serum levels of estrogen and induces alterations in pain-related factors in the TMJ. The NF-κB pathway has been associated with the regulation of these inflammatory cytokines and plays an important role in temporomandibular disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Effect of low-level laser on healing of temporomandibular joint osteoarthritis in rats.

    Directory of Open Access Journals (Sweden)

    Ali Peimani

    2014-06-01

    Full Text Available Temporomandibular disorders (TMD are clinical conditions characterized by pain and sounds of the temporomandibular joint (TMJ. This study was designed to assess the effect of low-level laser therapy (LLLT on healing of osteoarthritis in rats with TMD.Thirty-two male Wistar rats (250-200 g were housed in standard plastic cages. After injection of Complete Freund's adjuvant into the TMJ, rats were randomly divided into two groups of 16 (case and control and anesthetized; then osteoarthritis was induced via intraarticular injection of 50 µl of Complete Freund's adjuvant; into the bilateral TMJs. In the case group, LLLT was done transcutaneously for 10 minutes daily, starting the day after the confirmation of osteoarthritis. Exposure was performed for 10 minutes at the right side of the TMJ with 880 nm low-level laser with 100 mW power and a probe diameter of 0.8 mm. Control rats were not treated with laser.After three days of treatment the grade of cartilage defects, number of inflammatory cells, angiogenesis, number of cell layers and arthritis in rats in the case group were not significantly different compared with controls (P>0.05. After seven days, the grade of cartilage defects, number of inflammatory cells, number of cell layers, and arthritis in the case group improved compared to controls (P<0.05; angiogenesis in both groups was similar.Treatment of TMD with LLLT after 7 days of irradiation with a wavelength of 880 nm was associated with a greater improvement compared to the control group.

  10. Dynamic high-resolution sonography compared to magnetic resonance imaging for diagnosis of temporomandibular joint disk displacement.

    Science.gov (United States)

    Habashi, Hadeel; Eran, Ayelet; Blumenfeld, Israel; Gaitini, Diana

    2015-01-01

    The purpose of this study was to determine the value of dynamic high-resolution sonography for evaluation of temporomandibular joint (TMJ) disk displacement compared to magnetic resonance imaging (MRI) with the mouth closed and during the maximal mandibular range of motion. Dynamic high-resolution sonography with the mouth closed and during the maximal mandibular range of motion was performed on 39 consecutive patients (78 joints; 13 male and 26 female; age range, 18-77 years; mean age ± SD, 37.23 ± 16.26 years) with TMJ disorders. A TMJ MRI study was performed 1 to 7 days after sonography. We searched for signs of disk displacement and findings compatible with degenerative joint disease. Both studies were performed and interpreted independently by blinded operators. Magnetic resonance imaging depicted 22 normal joints (28.2%), 21 (26.9%) with anterior disk displacement with reduction, 15 (19.2%) with anterior disk displacement without reduction, and 20 (25.6%) with degenerative disease. Sonography depicted 30 normal joints (38.5%), 22 (28.2%) with anterior disk displacement with reduction, 12 (15.4%) with anterior disk displacement without reduction, and 14 (17.9%) with degenerative disease. The overall sensitivity, specificity, and accuracy of sonography for diagnosis of disk displacement were 74.3%, 84.2%, and 77.7%, respectively. The sensitivity, specificity, and accuracy for diagnosis of disk displacement with reduction were 78.6%, 66.7%, and 73.0%, and the values for diagnosis of disk displacement without reduction were 66.7%, 78.6%, and 73.0%. Dynamic high-resolution sonography is a potential imaging method for diagnosis of TMJ disk displacement and degenerative diseases. Further studies are needed to make dynamic high-resolution sonography the first-line test for diagnosis of TMJ disk displacement. © 2015 by the American Institute of Ultrasound in Medicine.

  11. Three-dimensional versus two-dimensional sonography of the temporomandibular joint in comparison to MRI

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    Landes, Constantin A. [Oral, Maxillofacial and Plastic Facial Surgery, Frankfurt University Medical Centre, Theodor-Stern-Kai 7, 60596 Frankfurt (Germany)]. E-mail: c.landes@lycos.com; Goral, Wojciech A. [Oral, Maxillofacial and Plastic Facial Surgery, Frankfurt University Medical Centre, Theodor-Stern-Kai 7, 60596 Frankfurt (Germany)]. E-mail: w.goral@gmx.de; Sader, Robert [Oral, Maxillofacial and Plastic Facial Surgery, Frankfurt University Medical Centre, Theodor-Stern-Kai 7, 60596 Frankfurt (Germany)]. E-mail: r.sader@em.uni-frankfurt.de; Mack, Martin G. [Department of Diagnostic and Interventional Radiology, Frankfurt University Medical Centre, Theodor-Stern-Kai 7, 60596 Frankfurt (Germany)]. E-mail: martinmack@arcor.de

    2007-02-15

    Aim: To compare clinical feasibility of static two-dimensional (2D) to three-dimensional (3D) sonography of the temporomandibular joint (TMJ) in assessment of disk dislocation and joint degeneration compared to magnetic resonance imaging (MRI). Method: Thirty-three patients, 66 TMJ were prospectively sonographed 2D and 3D (8-12.5 MHz step motor scan), in occlusion and maximum opening with a probe position parallel inferior to the zygomatic arch. Axial 2D images were judged independent from the 3D scans; 3D volumes were cut axial, sagittal, frontal and rotated in real-time. Disk position and joint degeneration were assessed and compared to a subsequent MRI examination. Results: The specific appearance of the disk was hypoechogenic overlying a hyperechogenic condyle in axial (2D) or sagittal and frontal (3D) viewing. Specificity of 2D sonography for disk dislocation was 63%, sensitivity 58%, accuracy 64%, positive predictive value 46%, negative predictive value 73%; for joint degeneration synonymously 59/68/61/38/83%. 3D sonography for disk displacement reached synonymously 68/60/69/51/76%, for joint degeneration 75/65/73/48/86%. 2D sonographic diagnoses of disk dislocation in the closed mouth position and of joint degeneration showed significantly different results from the expected values (MRI) in {chi} {sup 2} testing; 3D diagnoses of disk dislocation in closed mouth position, of joint degeneration, 2D and 3D diagnoses in open mouth position were nonsignificant. Conclusions: Acceptable was the overall negative predictive value, as specificity and accuracy for joint degeneration in 3D. 3D appears superior diagnosing disk dislocation in closed mouth position as for overall joint degeneration. Sensitivity, accuracy and positive predictive value will have to ameliorate with future equipment of higher resolution in real-time 2D and 3D, if sonographic screening shall be clinically applied prior to MRI.

  12. Management of temporomandibular joint degenerative disorders with human amniotic membrane: Hypothesis of action.

    Science.gov (United States)

    Guarda-Nardini, Luca; Trojan, Diletta; Paolin, Adolfo; Manfredini, Daniele

    2017-07-01

    Approaches providing the positioning of human amniotic membrane (HAM) within the intra-articular space of arthritic TMJs have never been investigated. This contrasts with the increasing amount of evidence suggesting the potential positive effects of HAM on a number of surgical conditions, even included the interpositional arthroplasty for TMJ ankylosis. Thus, the possible usefulness of HAM to restore joint functions in severely damaged TMJs could be hypothesized. Based on these premises, the clinical research question "Is human amniotic membrane positioning effective to reduce symptoms and restore jaw function in patients with severe inflammatory-degenerative disorders of the temporomandibular joint?" has been addressed by performing a systematic review of the literature. Out of potential 11988 and 8883 citations in the PubMed and Scopus databases, respectively, only five were of possible interest for inclusion in the review, but none of them addressed specifically the clinical research question. Thus, the hypothetical background for usefulness was discussed. The benefits of HAM positioning in TMJs with severe inflammatory-degenerative disorders could be related with its anti-inflammatory and anti-microbial and analgesic properties as well as its low immunogenicity. Studies in which HAM is positioned within the joint space of patients with severe TMJ degeneration, either as a disc-replacing film during major surgeries for discectomy and arthroplasty or as an injectable solution that can be needle-inserted after an arthrocentesis procedure, should be designed to test the hypothesis. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Internal derangement of the temporomandibular joint MR imaging for staging. KST-Diagnostik des 'internal derangement' des Temporomandibulargelenkes

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    Vogl, T.J.; Lissner, J. (Muenchen Univ. (Germany, F.R.). Radiologische Klinik und Poliklinik); Eberhard, D.; Randzio, J.; Schmid, C. (Muenchen Univ. (Germany, F.R.). Klinik und Poliklinik fuer Kieferchirurgie)

    1991-11-01

    On the basis of MR imaging studies in 150 temporomandibular joints (TMJs) a classification system for internal derangement of the TMJ was defined. Clinically, internal derangement is characterized by disc displacement and disorders of the mandibular condyle. MR imaging enables a differentiation of early stages (I, II) with disc displacement, the intermediate stage (III), and the later stages (IV, V) with osseous destruction. Optimal diagnostic results (n=140) allowed the use of proton-density sequences in both open and closed joint positions (TR/TE=1000/28). Dynamic imaging of the TMJ was performed using fast-gradient echo sequences and a self-developed hydraulic opening deuce (n=20). MR imaging has proved to be the method of choise for the pre- and post-therapeutic evaluation of internal derangement of the TMJ. (orig.).

  14. Synovial chondromatosis of the temporomandibular joint.

    Science.gov (United States)

    Reyes Macías, Juan Francisco; Sánchez Prieto, Martín

    2007-01-01

    Synovial Chondromatosis (SC) is a disease whose etiology is unknown, can be defined as a benign synovial process characterized by the formation of metaplastic cartilaginous nodes inside connective tissue of articular surfaces, is considered an active metaplastic phenomenon better than a neoplastic process; it presents a greater preference to affect women who constitute almost 70% of reported cases, the age range is wide and oscillates between 18-75 years (average 44.6 years). Between the main clinical findings are: pain, crackle, volume augmentation and a limited buccal opening. SC is an unusual state and the reports in the English literature are no more than 75 cases, only 66 of those where histologically verified, most of those were affecting great joints like hip, knee and shoulder, but if SC is not frequent in this sites, is even more infrequent on temporomandibular joint. The aim of this paper is to report a clinical case and at the same time to realize a brief review of the literature.

  15. An ex vivo study on immunohistochemical localization of MMP-7 and MMP-9 in temporomandibular joint discs with internal derangement

    Directory of Open Access Journals (Sweden)

    C. Loreto

    2013-04-01

    Full Text Available Internal derangement (ID is among the most common disorders of the temporomandibular joint (TMJ. Previous research by our group highlighted a correlation between apoptosis and TMJ ID. Metalloproteinases (MMP-7 and -9 have been shown to play an important role in extracellular matrix ECM homeostasis and, through it, in joint disc remodelling. The immunohistochemical expression of MMP-7 and -9 was investigated in discs from patients with TMJ ID and from healthy donors and compared with the degree of histological tissue degeneration. The collagen fibre arrangement in pathological discs exhibited varying degrees of disruption. New vessels were consistently detected; endothelial cells from these vessels were immunolabelled with both MMP-7 and MMP-9. More or less intense MMP-7 and MMP-9 immunolabelling was detected in the cytoplasm of disc cells from all patients. MMP-7 and MMP-9 immunostaining was significantly different between pathological and normal discs and correlated with the extent of histopathological degeneration. MMP-7 and MMP-9 upregulation in discs from patients with TMJ ID demonstrates their involvement in disc damage in this disorder. A greater understanding of these processes could help identify ways to curb MMP overproduction without affecting their tissue remodelling action. The design of specific inhibitors for these MMPs would not only help to gain insights into the biological roles of MMPs, but would also aid in developing therapeutic interventions for diseases associated with abnormal ECM degradation.

  16. An Ex Vivo Study on Immunohistochemical Localization of MMP-7 and MMP-9 in Temporomandibular Joint Discs with Internal Derangement

    Science.gov (United States)

    Loreto, C.; Leonardi, R.; Musumeci, G.; Pannone, G.; Castorina, S.

    2013-01-01

    Internal derangement (ID) is among the most common disorders of the temporomandibular joint (TMJ). Previous research by our group highlighted a correlation between apoptosis and TMJ ID. Metalloproteinases (MMP)-7 and -9 have been shown to play an important role in extracellular matrix ECM) homeostasis and, through it, in joint disc remodelling. The immunohistochemical expression of MMP-7 and -9 was investigated in discs from patients with TMJ ID and from healthy donors and compared with the degree of histological tissue degeneration. The collagen fibre arrangement in pathological discs exhibited varying degrees of disruption. New vessels were consistently detected; endothelial cells from these vessels were immunolabelled with both MMP-7 and MMP-9. More or less intense MMP-7 and MMP-9 immunolabelling was detected in the cytoplasm of disc cells from all patients. MMP-7 and MMP-9 immunostaining was significantly different between pathological and normal discs and correlated with the extent of histopathological degeneration. MMP-7 and MMP-9 upregulation in discs from patients with TMJ ID demonstrates their involvement in disc damage in this disorder. A greater understanding of these processes could help identify ways to curb MMP overproduction without affecting their tissue remodelling action. The design of specific inhibitors for these MMPs would not only help to gain insights into the biological roles of MMPs, but would also aid in developing therapeutic interventions for diseases associated with abnormal ECM degradation. PMID:23807291

  17. Modemmethodsofcomputerdiagnosticsdentalocclusionand TMJ, craniomandibular system and facial aesthetics

    Directory of Open Access Journals (Sweden)

    O. O. Yanushevich

    2015-01-01

    Full Text Available To date, the traditional methods of instrumental diagnosis of occlusion and TMJ - quite time consuming and difficult to perform.Requires a very high qualification of experts capable of conducting such a diagnosis. In this regard, the existing and evolving digital technologycan not only producevarious removable and nonremovableorthodonticand orthopedicdesign, but also allow for a precise and easier to perform, diagnoseocclusion of dentition with the biomechanicsof the temporomandibular joint and the aesthetics of the patient's face.

  18. [Frequency of signs and symptoms of temporomandibular joint disorders, vertical orthodontic anomalies and their relationships based on screening of a large population].

    Science.gov (United States)

    Madléna, Melinda; Fejérdy, Pál; Kaán, Miklós; Hermann, Péter

    2015-03-01

    Altogether 4606 volunteers (2923 vomen, 1683 men) participated in the representative national epidemiological study to screen the alterations of temporomandibular joint (TMJ). The characteristic clinical signs and subjective complaints according to TMJ were evaluated by medical history taking and physical examination. Regarding the orthodontic anomalies, the vertical abnormalities (deep bite and open bite) were specifically noted. Clinical signs showing functional problems of TMJ were found in 45.19% of the screened population, mainly in the group of 35-44 year olds. The frequency of clicking and crepitation of TMJ was significantly higher in women compared to men (p disorders was found in the South-Transdanubian region, the lowest rate in the Middle-Transdanubian region, between these regions it was a significant difference regarding the frequency of deviation/deflexion (p < 0.05). Of the vertical abnormalities, deep bite occured most frequently in the 35-44 ys old age group. The prevalence of deep bite was higher among males than females in the whole screened population, but the difference was not statistically significant. Significant relationship was detected between deep bite and TMJ pain, deep bite and noises in the joint in the majority of the population. The most frequent anomaly in the South-Transdanubian region was deep bite, while the open bite occured most frequently in south middle part of Hungary. Conclusion: the Hungarian population needs well organized specific programs to improve the oral health including TMJ and orthodontic aspects.

  19. Does Adjunctive Botulinum Toxin A Reduce Pain Scores When Combined With Temporomandibular Joint Arthroscopy for the Treatment of Concomitant Temporomandibular Joint Arthralgia and Myofascial Pain?

    Science.gov (United States)

    Thomas, Nicholas J; Aronovich, Sharon

    2017-12-01

    Currently, there is no standard of care for the treatment of refractory myofascial pain and concomitant temporomandibular joint (TMJ) arthralgia. This comparative study was conducted to determine the effectiveness of botulinum toxin A (Btx), as an adjunct to TMJ arthroscopy, in this patient population. A retrospective cohort study was conducted of patients who underwent TMJ arthroscopy with (Btx group) or without (control group) intramuscular Btx for TMJ arthritis and refractory myofascial pain at the University of Michigan (Ann Arbor) from 2011 through 2014. For patients in the Btx group, intramuscular injections of Btx were administered at sites of maximal tenderness within the masseter and temporalis muscles. The primary outcome variable was pain score on the visual analog scale (VAS; 0 to 10). The secondary outcome variables included maximal interincisal opening, total score for sites of tenderness, total number of tender sites, and diet consistency tolerated. Statistical analysis included means and standard deviations, Student t test, simple regression analysis, and multiple regression analysis. The study cohort included 52 patients (30 in Btx group, 22 in control group), of which 48 (92.3%) were women. The mean follow-up was 5.56 ± 1.41 months. Patients in the Btx group had a significantly greater decrease in mean pain score (P = .04) on the VAS compared with the control group (score, 3.24 for Btx group; score, 1.13 for control group). On multivariate regression analysis, treatment with Btx trended toward significance (P = .084) and the preoperative pain score (P = .0007) was significantly correlated with the change in pain observed. The use of Btx appears to correlate with a clinically superior decrease in pain score compared with the control group. The use of Btx could be useful as an adjunctive treatment modality in the management of refractory myofascial pain. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published

  20. Comparison between cone beam computed tomography and magnetic resonance imaging of the temporomandibular joint

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    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)

    2008-09-15

    To compare and evaluate the diagnostic ability of cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). CBCT and MRI of 46 TMJs of 23 patients with TMJ disorders were evaluated. They were divided into 3 groups according to the position of the articular disc of the TMJ at closed mouth position and the reduction of the disc during open mouth position on MRI: no disc displacement group (NDD), disc displacement with reduction group (DDR), and disc displacement without reduction group (DDWR). With PACS viewing software, position of mandibular condyle in the articular fossa, osseous change of mandibular condyle, shape of articular fossa, and mediolateral and anteroposterior dimensions of mandibular condyle were evaluated on CBCT and MRI. Each value was tested statistically. The position of mandibular condyle in the articular fossa were concentric in the NDD, DDR, and DDWR of CBCT and NDD of MRI. However, condyle was positioned posteriorly in DDR and DDWR of MRI. Flattening, sclerosis and osteophyte of the mandibular condyle were much more apparent on DDR of CBCT than MRI. And the erosion of the condyle was much more apparent on DDWR of MRI than CBCT. Box and Sigmoid types of articular fossa were found most frequently in DDR of MRI. Flattened type was found most frequently in DDR of CBCT and deformed type was found most frequently in DDWR of CBCT. No significant difference in mediolateral and anteroposterior dimensions were shown on CBCT and MRI. Since MRI and CBCT has unique diagnostic imaging ability, both modalities should be used together to supplement each other to evaluate TMJ.

  1. Infliximab partially alleviates the bite force reduction in a mouse model of temporomandibular joint pain.

    Science.gov (United States)

    Kim, Sang-Hyon; Son, Chang-Nam; Lee, Hyo-Jung; Cho, Ho-Chan; Jung, Sung-Won; Hur, Ji An; Baek, Won-Ki; Jung, Hye Ra; Hong, Ji Hee

    2015-05-01

    Temporomandibular joint (TMJ) disorder is clinically important because of its prevalence, chronicity, and therapy-refractoriness of the pain. In this study, we investigated the effect of infliximab in a mouse model of TMJ pain using a specially-engineered transducer for evaluating the changes in bite force (BF). The mice were randomly divided into three groups (7 mice per group): the control group, the complete Freund's adjuvant (CFA) group, and the infliximab group. BF was measured at day 0 (baseline BF). After measuring the baseline BF, CFA or incomplete Freund's adjuvant was injected into both TMJs and then the changes in BF were measured at days 1, 3, 5, 7, 9, and 13 after the TMJ injection. For measuring the BF, we used a custom-built BF transducer. Control, CFA, and infliximab groups showed similar baseline BF at day 0. From day 1, a significant reduction in BF was observed in the CFA group, and this reduction in BF was statistically significant compared to that in the control group (P < 0.05). This reduction in BF was maintained until day 7, and BF started to recover gradually from day 9. In the infliximab group also, the reduction in BF was observed on day 1, and this reduction was maintained until day 7. However, the degree of reduction in BF was less remarkable compared to that in the CFA group. The reduction in BF caused by injection of CFA into the TMJ could be partially alleviated by the injection of anti-tumor necrosis factor alpha, infliximab.

  2. Reactive arthritis in relation to internal derangements of the temporomandibular joint: a case control study.

    Science.gov (United States)

    Lund, Bodil; Holmlund, Anders; Wretlind, Bengt; Jalal, Shah; Rosén, Annika

    2015-09-01

    The aim of this study was to find out if reactive arthritis was involved in the aetiology of chronic closed lock of the temporomandibular joint (TMJ) by looking for bacterial antigens in the synovial membrane of the TMJ, and by studying the antibody serology and carriage of human leucocyte antigen (HLA) B27 in patients with chronic closed lock. Patients with reciprocal clicking and healthy subjects acted as controls. We studied a total of 43 consecutive patients, 15 with chronic closed lock, 13 with reciprocal clicking, and 15 healthy controls with no internal derangements of the TMJ. Venous blood samples were collected from all subjects for measurement of concentrations of HLA tissue antigen and serology against Chlamydia trachomatis, Yersinia enterocolitica, Salmonella spp., Campylobacter jejuni, and Mycoplasma pneumoniae. Samples of synovial tissue from patients with closed lock and reciprocal clicking were obtained during discectomy and divided into two pieces, the first of which was tested by strand displacement amplification for the presence of C trachomatis, and the second of which was analysed for the presence of species-specific bacterial DNA using 16s rRNA pan-polymerase chain reaction (PCR). There were no significant differences between the groups in the incidence of antibodies against M pneumoniae, Salmonella spp. or Y enterocolitica. No patient had antibodies towards C trachomatis or C jejuni. We found no bacterial DNA in the synovial fluid from any patient. The HLA B27 antigen was present in 2/15 subjects in both the closed lock and control groups, and none in the reciprocal clicking group. In conclusion, reactive arthritis does not seem to be the mechanism of internal derangement of the TMJ. Copyright © 2015. Published by Elsevier Ltd.

  3. The Relationship between Osseous Changes of the Temporomandibular Joint and RDC/TMD Groups in CBCT Images

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    Mahrokh Imanimoghaddam

    2014-09-01

    Full Text Available Abstract Introduction: Temporomandibular joint disorders (TMD are the most common disorders of the jaw, and despite their clinical importance, they are not completely understood. This study was aimed to evaluate the changes of temporomandibular joint (TMJ on cone beam computed tomography (CBCT images in disc displacement vs. osteoarthritis of the TMJ. Methods: In this study, 45 patients, including 37 women and 8 men (13-89 years of age, were examined. The patients were selected based on RDC/TMD criteria and group I disorders were excluded from the study. Accordingly, group II consisted of 43 joints with jaw clicking or displaced discs, and group III comprised 46 joints with crepitus. CBCT images in sagittal, coronal, and axial sections were examined to assess osseous changes in terms of flattening, sclerosis, erosion, resorption, and osteophyte formation. Data were analyzed using statistical tests including the chi-square, Mann-Whitney, and Kolmogorov-Smirnov tests with the confidence interval of 95%. Results: Mann-Whitney test for the comparison of mean age between groups II and III was not statistically significant (p value=0.06. A significant differences was found between two (RDC/TMD groups according to the prevalence of condylar erosion, resorption, and osteophyte (p

  4. Intra-articular injections with corticosteroids and sodium hyaluronate for treating temporomandibular joint disorders: a systematic review.

    Science.gov (United States)

    Machado, Eduardo; Bonotto, Daniel; Cunali, Paulo Afonso

    2013-01-01

    In some cases, conservative treatment of internal derangements of the Temporomandibular Joint (TMJ) is considered little responsive. Thus, it is necessary to accomplish treatments that aim at reducing pain and improve function in patients who present arthrogenic temporomandibular disorders. This study, by means of a systematic review of the literature, aimed to analyze the effectiveness of intra-articular injections with corticosteroids and sodium hyaluronate for treating internal derangements of the TMJ. Carry out a research in the following databases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs, and BBO, considering publications issued between 1966 and October 2010, focusing on randomized or quasi-randomized controlled clinical trials, single or double-blind. After applying the inclusion criteria we collected 9 articles, 7 of which were randomized controlled double-blind clinical trials and 2 randomized controlled single-blind clinical trials. After analyzing the literature, it was found that intra-articular injection with corticosteroids and sodium hyaluronate seems to be an effective method for treating internal derangements of the TMJ. However, further randomized controlled clinical trials, with representative samples and longer follow-up time must be carried out in order to assess the real effectiveness of this technique.

  5. Intra-articular injections with corticosteroids and sodium hyaluronate for treating temporomandibular joint disorders: a systematic review

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    Eduardo Machado

    2013-10-01

    Full Text Available INTRODUCTION: In some cases, conservative treatment of internal derangements of the Temporomandibular Joint (TMJ is considered little responsive. Thus, it is necessary to accomplish treatments that aim at reducing pain and improve patients' functions who present arthrogenic temporomandibular disorders. OBJECTIVE: This study, by means of a systematic review of the literature, aimed to analyze the effectiveness of intra-articular injections with corticosteroids and sodium hyaluronate for treating internal derangements of the TMJ. METHODS: Carry out a research in the following databases: MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs, and BBO, considering publications issued between 1966 and October of 2010, focusing on randomized or quasi-randomized controlled clinical trials, single or double-blind. RESULTS: After applying the inclusion criteria we collected 9 articles, 7 of which were randomized controlled double-blind clinical trials and 2 randomized controlled single-blind clinical trials. CONCLUSION: After analyzing the literature, it was found that intra-articular injection with corticosteroids and sodium hyaluronate seems to be an effective method for treating internal derangements of the TMJ. However, further randomized controlled clinical trials, with representative samples and longer follow-up time must be carried out in order to assess the real effectiveness of this technique.

  6. Management of temporomandibular joint disorders caused by complication of teeth extraction

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    Endang Syamsuddin

    2016-06-01

    Full Text Available Complicated tooth extractions may lead to various post-extraction complications, including Temporomandibular Joint Disorders (TMD. Despite of the rare incidence, a delayed treatment of the TMD will cause more problems in the future as well as increased morbidity rate. The purpose of the current study was to elaborate the symptoms as well as the management of TMD as a post tooth extraction complication. The types of TMD as a post tooth extraction complication includes dislocated condyle, osteoarthritis, fracture condyle and disc displacement. These type of complications may resulted from an extensive opening of the mouth as well as an over pressure on the mandible during tooth extraction. In relation to this, some of the TMD symptoms that might cause a certain level of interference for patients may include pain, limited mouth opening and joint sounds, with pain and limited mouth opening as the initial symptoms. The first measure of the pain management would be warm light compress around the TMJ followed by a soft diet for food intake. A definitive treatment should then be based on the diagnosis of the TMD. It is concluded that TMD may occur as a complication of a tooth extraction that initiated by pain and limited mouth opening. Immediate treatment would be pain relieve and load reduction of the Temporomandibular Joint by employing soft diet and mandibular movement restriction.

  7. Gap Arthroplasty in the Treatment of Temporomandibular Joint ...

    African Journals Online (AJOL)

    Pain is uncommon. Early diagnosis and treatment are crucial if the worst sequelae of this condition are to be avoided. Surgery of TMJ ankylosis needs careful evaluation and planning to yield predictable results. Ankylosis may be corrected surgically by an array of procedures like gap arthroplasty, joint reconstruction and ...

  8. One-Stage Treatment of Giant Condylar Osteoma: Alloplastic Total Temporomandibular Joint Replacement Aided by Digital Templates.

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    Xu, Xin; Ma, Hailong; Jin, Shufang

    2017-10-26

    To introduce the surgical techniques and evaluate the effect of alloplastic total temporomandibular joint (TMJ) replacement aided by digital templates in giant condylar osteoma. Three patients with giant condylar osteoma were enrolled in this study. The maximal mouth opening was 1.9 cm on average. All the patients were underwent the computed tomography scan (slice thickness 1 mm) and the data were imported to Proplan 1.3 software for 3-dimensional bony segmentation and reconstruction. Osteotomy line and digital template according the 3-dimensional measurement were designed. All the joints were replaced with Biomet standard prosthesis under general anesthesia. All the operations were successfully performed. The follow-up period was from 6 to 18 months (average, 12 months). Pain relief of the joint and mouth-opening improvement were significant in 3 patients. No infection or loosening the prostheses was occurred. The occlusal relationship kept stable in all patients. Total TMJ replacement with standard prosthesis is a good strategy for TMJ reconstruction after giant condylar osteoma excision. The joint pain and the mouth-opening limitation resulted from giant condylar osteoma were markedly improved. Long-term effect remains to be evaluated based on a long-term follow-up.

  9. Temporomandibular Joint Anatomy Assessed by CBCT Images

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    Silvia Caruso

    2017-01-01

    Full Text Available Aim. Since cone beam computed tomography (CBCT has been used for the study of craniofacial morphology, the attention of orthodontists has also focused on the mandibular condyle. The purpose of this brief review is to summarize the recent 3D CBCT images of mandibular condyle. Material and Methods. The eligibility criteria for the studies are (a studies aimed at evaluating the anatomy of the temporomandibular joint; (b studies performed with CBCT images; (c studies on human subjects; (d studies that were not clinical case-reports and clinical series; (e studies reporting data on children, adolescents, or young adults (data from individuals with age ≤ 30 years. Sources included PubMed from June 2008 to June 2016. Results. 43 full-text articles were initially screened for eligibility. 13 full-text articles were assessed for eligibility. 11 articles were finally included in qualitative synthesis. The main topics treated in the studies are the volume and surface of the mandibular condyle, the bone changes on cortical surface, the facial asymmetry, and the optimum position of the condyle in the glenoid fossa. Conclusion. Additional studies will be necessary in the future, constructed with longitudinal methodology, especially in growing subjects. The limits of CBCT acquisitions are also highlighted.

  10. Use of autologous conditioned serum (Orthokine®) for the treatment of the dege-nerative osteoarthritis of the temporomandibular joint. Review of the literature

    Science.gov (United States)

    Álvarez-Camino, Juan C.; Vázquez-Delgado, Eduardo

    2013-01-01

    Objectives: Treatment of osteoarthritis (OA) using autologous conditioned serum (ACS) has become in recent years an alternative to consider in the approach of the degenerative joint disease of the knee. There is no support in the literature for the use of ACS for the treatment of OA of the temporomandibular joint (TMJ), although the promising results obtained in human patients with knee joint disease as well as in animal studies are opening the way for its use at the TMJ. The aim of this paper is to conduct a review of the published literature regarding the use of the ACS for the treatment of OA in humans, considering the level of scientific evidence, and following the principles of the evidence-based medicine and dentistry. Material and Methods: A PubMed-MEDLINE search was carried out of articles published between 1980 and 2011. After an initial search, a total of 102 articles were obtained, followed by a selection of the most relevant articles according to the topic; a total of 8 articles were selected, which were stratified according to their level of scientific evidence using SORT criteria (Strength of Recommendation Taxonomy). Results: At the time of this review, there is no available literature referring the use of ACS at the TMJ. However, the use of the ACS in other joints is well documented, both experimentally and clinically, in humans and animals. The reviewed articles, with a level of evidence 1 and 2 according to the SORT criteria, have generally promising results. Discussion and Conclusions: The use of ACS in the treatment of OA in joints other than the TMJ, is endorsed by the level of evidence found in the literature, which opens the door to future studies to determine the feasibility of the use of the ACS in the treatment of degenerative OA that affects TMJ. Key words:Osteoarthritis, temporomandibular joint, autologous conditioned serum. PMID:23524415

  11. Correlation between internal derangement and osteoarthrosis in the temporomandibular joint using magnetic resonance imaging

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    Song, Haeng Un; Choi, Sun Young; Koh, Kwang Joon [School of Dentistry, Chonbuk National University, Jeonju (Korea, Republic of)

    2002-12-15

    To evaluate the relationship between internal derangement and osteoarthrosis in the temporomandibular joint (TMJ) using magnetic resonance imaging (MRI). One hundred and six MR images of TMJs in 53 patients were evaluated. Disc displacements and osseous changes of the TMJs were assessed. Lateral and rotational disc displacements were also evaluated on coronal images. No significant differences in the frequency of osseous changes of the TMJs between disc displacement with reduction and disc displacement without reduction groups were found. The erosion of the condylar head and the sclerosis of the articular eminence were more frequent in the internal derangement group than in the no disc displacement group. The flattening was the most frequently observed osseous change of both the condylar head and articular eminence. The relationship between internal derangement and osteoarthrosis is obscure, but it is thought that both disorders adversely affect each other.

  12. Calcium pyrophosphate dihydrate deposition disease (CPPD/Pseudogout of the temporomandibular joint - FNA findings and microanalysis.

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    Naqvi Asghar

    2008-01-01

    Full Text Available We report a case of a Calcium pyrophosphate dihydrate deposition disease (CPPD presenting as a mass in the parotid and temporomandibular joint (TMJ that simulated a parotid tumor. A 35 year-old man presented with pain in the left ear area. A CT Scan of the area showed a large, calcified mass surrounding the left condylar head, and extending into the infratemporal fossa. FNA of the mass showed birefringent crystals, most of which were rhomboid with occasional ones being needle shaped, embedded in an amorphous pink substance. Scanning electron microscopy (SEM with energy dispersive x-ray spectroscopy (EDS of these crystals showed peaks corresponding to calcium and phosphorus. SEM/EDS is a rapid method of diagnosing calcium pyrophosphate dihydrate deposition disease (CPPD and an alternative to more commonly used method of special staining of cell block sections coupled with polarizing microscopy.

  13. Temporomandibular Joint Disorders in Patients with Rheumatoid Arthritis

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    Yi-Chun Lin

    2007-12-01

    Conclusion: There was a high prevalence of TMD in RA patients. The severity of TMD variably correlated with RA severity. Clinically, a high score of hand-joint space narrowing may serve as an early indicator of RA patients at risk of severe TMD. This may facilitate early management and prevent the functional impairment of the temporomandibular joint.

  14. Magnetic Resonance Imaging (MRI) Evaluation for Anterior Disc Displacement of the Temporomandibular Joint.

    Science.gov (United States)

    Yang, Zhongjun; Wang, Mingguo; Ma, Yingwei; Lai, Qingguo; Tong, Dongdong; Zhang, Fenghe; Dong, Lili

    2017-02-08

    BACKGROUND Magnetic resonance imaging (MRI) is the criterion standard imaging technique for visualization of the temporomandibular joint (TMJ) region, and is currently considered the optimum modality for comprehensive evaluation in patients with temporomandibular joint disorder (TMD). This study was aimed at finding the value of MRI in pre-clinical diagnosis of TMJ disc displacement. MATERIAL AND METHODS Patients primarily diagnosed as having anterior disc displacement by clinical symptoms and X-ray were selected in the present study. MRI was used to evaluate surrounding anatomical structures and position, as well as morphological and signal intensity change between patients and normal controls. RESULTS Posterior band position was significantly different between the patient group and control group. At the maximum opened-mouth position, the location of disc intermediate zone returned to normal. At closed-mouth position, the thickness of anterior and middle, but not posterior, band increased. The motion range of the condyle in the anterior disc displacement without reduction (ADDWR) patient group was significantly less than the value in the anterior disc displacement with reduction (ADDR) patient group and the control group. Whether at closed-mouth position or maximum opened-mouth position, the exudate volume in the patient group was greater than in the normal group. CONCLUSIONS MRI can be successfully used to evaluate multiple morphological changes at different mouth positions of normal volunteers and patients. The disc-condyle relationship can serve as an important indicator in assessing anterior disc displacement, and can be used to distinguish disc displacement with or without reduction.

  15. Expression of lumican related to CD34 and VEGF in the articular disc of the human temporomandibular joint.

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    N. Kiga

    2010-07-01

    Full Text Available Lumican belongs to the small leucine-rich repeat proteoglycan (SLRP gene family and has been reported to exist in the cornea, intervertebral disc and tendon. Lumican plays a significant role in the assembly and regulation of collagen fibres. The human temporomandibular joint (TMJ disc is made up of fibrocartilage with an extracellular matrix (ECM composed of collagen and proteoglycans. The existence and behaviour of lumican have not been studied in the human TMJ disc. Therefore, we used immunohistochemical methods to detect lumican, CD34 and vascular endothelial growth factor (VEGF and histochemical staining with toluidine blue in 13 human TMJ specimens (10 surgically removed and 3 obtained from autopsy. In both normal and deformed discs we observed staining with toluidine blue. We found that the area of metachromasia inside the deformed disc was uneven and expression of lumican was strong in the areas negative for metachromasia. Staining of VEGF and CD34 inside the deformed disc was seen. We confirmed the expression of lumican in the human TMJ disc and showed that a large number of fibroblastlike cells existed in the area of strong lumican expression. These new findings about the behaviour of lumican suggest that it may play a key role in the generation of a new collagen network by fibroblast-like cells.

  16. Effects of chronic sleep deprivation on the extracellular signal-regulated kinase pathway in the temporomandibular joint of rats.

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    Chuan Ma

    Full Text Available OBJECTIVES: To examine the possible involvement and regulatory mechanisms of extracellular signal-regulated kinase (ERK pathway in the temporomandibular joint (TMJ of rats subjected to chronic sleep deprivation (CSD. METHODS: Rats were subjected to CSD using the modified multiple platform method (MMPM. The serum levels of corticosterone (CORT and adrenocorticotropic hormone (ACTH were tested and histomorphology and ultrastructure of the TMJ were observed. The ERK and phospho-ERK (p-ERK expression levels were detected by Western blot analysis, and the MMP-1, MMP-3, and MMP-13 expression levels were detected by real-time quantitative polymerase chain reaction (PCR and Western blotting. RESULTS: The elevated serum CORT and ACTH levels confirmed that the rats were under CSD stress. Hematoxylin and eosin (HE staining and scanning electron microscopy (SEM showed pathological alterations in the TMJ following CSD; furthermore, the p-ERK was activated and the mRNA and protein expression levels of MMP-1, MMP-3, and MMP-13 were upregulated after CSD. In the rats administered with the selective ERK inhibitor U0126, decreased tissue destruction was observed. Phospho-ERK activation was visibly blocked and the MMP-1, MMP-3, and MMP-13 mRNA and protein levels were lower than the corresponding levels in the CSD without U0126 group. CONCLUSION: These findings indicate that CSD activates the ERK pathway and upregulates the MMP-1, MMP-3, and MMP-13 mRNA and protein levels in the TMJ of rats. Thus, CSD induces ERK pathway activation and causes pathological alterations in the TMJ. ERK may be associated with TMJ destruction by promoting the expression of MMPs.

  17. Malocclusion model of temporomandibular joint osteoarthritis in mice with and without receptor for advanced glycation end products.

    Science.gov (United States)

    Matías, E M Chávez; Mecham, D K; Black, C S; Graf, J W; Steel, S D; Wilhelm, S K; Andersen, K M; Mitchell, J A; Macdonald, J R; Hollis, W R; Eggett, D L; Reynolds, P R; Kooyman, D L

    2016-09-01

    This study has two aims: 1. Validate a non-invasive malocclusion model of mouse temporomandibular joint (TMJ) osteoarthritis (OA) that we developed and 2. Confirm role of inflammation in TMJ OA by comparing the disease in the presence and absence of the receptor for advanced glycation end products (RAGE). The malocclusion procedure was performed on eight week old mice, either wild type (WT) or without RAGE. We observed TMJ OA at two weeks post-misalignment/malocclusion. The modified Mankin score used for the semi-quantitative assessment of OA showed an overall significantly higher score in mice with malocclusion compared to control mice at all times points (2, 4, 6 and 8 weeks). Mice with malocclusion showed a decrease in body weight by the first week after misalignment but returned to normal weight for their ages during the following weeks. The RAGE knock out (KO) mice had statistically lower modified Mankin scores compared to WT mice of the same age. The RAGE KO mice had statistically lower levels of Mmp-13 and HtrA1 but higher Tgf-β1, as measured by immunohistochemistry, compared to WT mice at eight weeks post malocclusion. We demonstrate an inexpensive, efficient, highly reproducible and non-invasive model of mouse TMJ OA. The mechanical nature of the malocclusion resembles the natural development of TMJ OA in humans, making this an ideal model in future studies that aim to elucidate the pathogenesis of the disease leading to the discovery of a treatment. The RAGE plays a role in mouse TMJ OA. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Usefulness of quantitative SPECT in unilateral temporomandibular joint disorder: correlation with signs and symptoms

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    Kim, Ho Sung; Jeong, Jong Cheol; Kim, Keon Jung; Choi, Jae Sun; Sung, Dae Kyung; Lee, Gye Huyk; Kim, Jong Ho [Gachon Medical College, Gil Medical Center, Inchon (Korea, Republic of)

    1998-07-01

    The aims of this study was to compare the diagnostic accuracy of Conventional Radiography (CR). Radionuclide Angiography (RNA). Planar Scintigraphy (PS) and Single Photon Emission Computed Tomography (SPECT) for the evaluation of temporomandibular joint (TMJ) disorder; and to show whether technetium-99m-MDP uptake on quantitative SPECT correlated with the symptom and/or signs. Three Phase Bone Scintigraphy (TPBS) and SPECT of both TMJ were performed in 51 patients (M : F = 10 : 41 mean age= 30.4 :28.6, respectively) with unilateral TMJ disorder after an intravenous injection of 25 mCi (925 MBq) of 99mTc-MDP. Data were analyzed by creating three regions of interest (ROIs) over designated areas both on the PS and SPECT: Lesion (L). Non-lesion(NL) which is contralateral to L and Background (BG). L/ NL and L/BG (=[(L-BG)/500,000] x 100 (%)] ratios were calculated for each patients. L/NL ratios on SPECT were compared according to the symptom/signs or not. There was a fair correlation of L/N values between three slice-and seven slice-added SPECT images (r=0.5124, p=0.006, y=0.5588 + 0.5414X). The percentages of symptoms or signs were: pain (76.5%), mouth opening limitation (49.0%), joint sound (39.2%), discomfort (43.1%), headache(27.5%), neck stiffness (21.6%), closed lock (5.9%) / tenderness (47.1%), joint click (54.9%) and limitation of maximum mouth opening (45.1%). The Sensitive of SPECT(86.3%) was better than PS(66.7%), RNA(27.5%), and CR(26.3%). According to the presence of symptom/sign or not, comparative analysis of L/NL ratios on SPECT showed a fair correlation in pain (1.16 : 1.11) mouth opening limitation (1.21 : 1.09), joint sound (1.19 : 1.08), discomfort (1.22 : 1.09), headache (1.19: 1.13), tenderness (1.16 : 1.14) and limitation of maximum mouth opening (1.16 : 1.13), but little correlation in neck stiffness (1.12 : 1.15), closed lock (1.06 : 1.15), dislocation (1.08 : 1.15) joint click (1.12 : 1.18). In conclusion, quantitative SPECT is the noninvasive

  19. Global self-rating of oral health, concerns about oral health, and history of jaw injury related to temporomandibular joint symptoms in Korean adults.

    Science.gov (United States)

    Han, Dong-Hun; Park, Deok-Young; Kim, Baek-Il; Koh, Myung-Yun; Ahn, Yong-Woo; Kim, Jin-Bom

    2011-01-01

    To examine the association between temporomandibular joint (TMJ) symptoms and the global self-rating of oral health, concerns about oral health, and a history of jaw injury or third molar extraction in a representative Korean population. From the Korean National Oral Health Survey 2006, 4,546 adults aged 18 years and older were included in the analysis. The dependent variable was TMJ symptoms. The independent variables were the global self-rating of oral health, concerns about oral health, and a history of jaw injury or third molar extraction. The demographic information (age and gender), socioeconomic status (education level, monthly household income, vocation, and residence), and behavioral factors (recent dental visit and smoking) were evaluated as confounders. Multivariate linear and logistic regression analyses were applied. The overall prevalence of TMJ symptoms in Koreans was 15.3%. The younger, more educated, middle class, those employed in office and sales, and those who resided in city areas had more TMJ symptoms. The TMJ symptoms were significantly associated with the global self-rating of oral health, concerns about oral health, and history of jaw injury. No significant association was found between the TMJ symptoms and a history of a third molar extraction. The global self-rating of oral health, concerns about oral health, and history of jaw injury had a dose-effect relationship with the severity of TMJ symptoms. Age and gender modified the effect of the global self-rating of oral health, concerns about oral health, and the history of jaw injury on TMJ symptoms. The global self-rating of oral health, concerns about oral health, and a history of jaw injury might be associated with TMJ symptoms.

  20. Role of central opioid on the antinociceptive effect of sulfated polysaccharide from the red seaweed Solieria filiformis in induced temporomandibular joint pain.

    Science.gov (United States)

    Araújo, Ianna Wivianne Fernandes; Chaves, Hellíada Vasconcelos; Pachêco, José Mário; Val, Danielle Rocha; Vieira, Lorena Vasconcelos; Santos, Rodrigo; Freitas, Raul Sousa; Rivanor, Renata Line; Monteiro, Valdécio Silvano; Clemente-Napimoga, Juliana Trindade; Bezerra, Mirna Marques; Benevides, Norma Maria Barros

    2017-03-01

    This study aimed to investigate the effect of sulfated polysaccharide from red seaweed Solieria filiformis (Fraction F II) in the inflammatory hypernociception in the temporomandibular joint (TMJ) of rats. Male Wistar rats were pretreated (30min) with a subcutaneous injection (s.c.) of vehicle or FII (0.03, 0.3 or 3.0mg/kg) followed by intra-TMJ injection of 1.5% Formalin or 5-hydroxytryptamine (5-HT, 225μg/TMJ). In other set of experiments rats were pretreated (15min) with an intrathecal injection of the non-selective opioid receptors Naloxone, or μ-opioid receptor antagonist CTOP, or δ-opioid receptor Naltridole hydrochloride, or κ-opioid receptor antagonist Nor-Binaltorphimine (Nor-BNI) followed by injection of FII (s.c.). After 30min, the animals were treated with an intra-TMJ injection of 1.5% formalin. After TMJ treatment, behavioral nociception response was evaluated for a 45-min observation period, animals were terminally anesthetized and periarticular tissue, trigeminal ganglion and subnucleus caudalis (SC) were collected plasma extravasation and ELISA analysis. Pretreatment with F II significantly reduced formalin- and serotonin-induced TMJ nociception, inhibit the plasma extravasation and inflammatory cytokines release induced by 1.5% formalin in the TMJ. Pretreatment with intrathecal injection of Naloxone, CTOP, Naltridole or Nor-BNI blocked the antinociceptive effect of F II in the 1.5% formalin-induced TMJ nociception. In addition, F II was able to significantly increase the β-endorphin release in the subnucleus caudalis. The results suggest that F II has a potential antinociceptive and anti-inflammatory effect in the TMJ mediated by activation of opioid receptors in the subnucleus caudalis and inhibition of the release of inflammatory mediators in the periarticular tissue. Copyright © 2017. Published by Elsevier B.V.

  1. Bilateral increases in ERK activation at the spinomedullary junction region by acute masseter muscle injury during temporomandibular joint inflammation in the rats.

    Science.gov (United States)

    Kurose, Masayuki; Imbe, Hiroki; Nakatani, Yosuke; Hasegawa, Mana; Fujii, Noritaka; Takagi, Ritsuo; Yamamura, Kensuke; Senba, Emiko; Okamoto, Keiichiro

    2017-03-01

    We determined the role of persistent monoarthritis of temporomandibular joint region (TMJ) on bilateral masseter muscle (MM) nociception in male rats using orofacial nocifensive behaviors, phosphorylated extracellular signal-regulated kinase and Fos induction at the trigeminal subnucleus caudalis/upper cervical spinal cord (Vc/C 2 ) region in response to formalin injection to the MM region. TMJ inflammation was induced by local injection of CFA into the left TMJ region. Orofacial nocifensive behaviors evoked by formalin injection ipsilateral or contralateral to the TMJ inflammation appeared to be increased at 1-14 days or at 1, 10 and 14 days after induction of TMJ inflammation, respectively, while increases in behavioral duration were seen mainly in the late phase rather than the early phase. The number of pERK positive cells was investigated in superficial laminae at the Vc/C 2 region at 3, 10, 20, 60 and 80 min after MM stimulation with formalin at 14 days after TMJ inflammation. TMJ-inflamed rats displayed greater responses of pERK expression by the ipsilateral MM stimulation at 3-60 min, while contralateral MM stimulation increased pERK expression at 3, 10 and 20 min compared to non-CFA rats. Fos expression by MM stimulation was increased at 14 days after induction of TMJ inflammation regardless of the affected side. These findings showed that persistent TMJ inflammation for 10 and 14 days is sufficient to enhance MM nociception indicated by behaviors and neural responses in superficial laminae at the Vc/C 2 region.

  2. Clinical and magnetic resonance evaluation of the temporomandibular joint with rotational disc displacement

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    Chiba, Masatoshi; Sakurada, Motoyuki; Echigo, Seishi [Tohoku Univ., Sendai (Japan). School of Dentistry; Kumagai, Masahiro; Kochi, Shoko

    1998-03-01

    The most common direction of temporomandibular joint (TMJ) disc displacement is anterior. Anterior disc displacement is associated with lateral or medial disc displacement, termed rotational disc displacement (RDD). There have been few systematic studies of the clinical and magnetic resonance imaging (MRI) findings of TMJs with RDD. The aim of this study was to assess the prevalence of RDD and to evaluate the relations between the direction of disc displacement (anteromedial RDD, anterolateral RDD, and pure anterior disc displacement) and clinical findings, including joint pain, joint sound, and range of motion, as well as MRI findings, including disc shape, disc reduction, disc mobility, degree of disc displacement, bone changes of the condyle, and degree of condylar translation. The study was based on MRI of 529 TMJs in 409 patients with symptoms and signs of TMJ. Sagittal and coronal T1-weighted SE images (1.5 Tesla) were used. MRI showed anteromedial RDD in 96 joints (18.1%), anterolateral RDD in 64 joints (12.1%), and anterior disc displacement in 207 joints (39.1%). There were no statistical differences between anterolateral RDD, anteromedial RDD, and anterior disc displacement with regard to clinical findings. The incidence of reducible disc was higher in anterolateral RDD than in anteromedial RDD or anterior disc displacement. The incidence of bone changes was lower in anterolateral RDD than in anterior disc displacement. There were no significant differences between anteromedial RDD and anterior disc displacement with regard to MRI findings. In conclusion, anteromedial RDD may represent the same clinical entity as anterior disc displacement, but it remains unclear whether or not anterolateral RDD differs from anteromedial RDD or anterior disc displacement. (author)

  3. Expressing human SHOX in Shox2SHOX KI/KI mice leads to congenital osteoarthritis‑like disease of the temporomandibular joint in postnatal mice.

    Science.gov (United States)

    Liang, Wenna; Li, Xihai; Chen, Houhuang; Shao, Xiang; Lin, Xuejuan; Shen, Jianying; Ding, Shanshan; Kang, Jie; Li, Candong

    2016-10-01

    The temporomandibular joint (TMJ), a unique synovial joint whose development differs from that of other synovial joints, develops from two distinct mesenchymal condensations that grow toward each other and ossify through different mechanisms. The short stature homeobox 2 (Shox2) gene serves an important role in TMJ development and previous studies have demonstrated that Shox2SHOX KI/KI mice display a TMJ defective phenotype, congenital dysplasia and premature eroding of the articular disc, which is clinically defined as a TMJ disorder. In the present study, Shox2SHOX KI/KI mouse models were used to investigate the mechanisms of congenital osteoarthritis (OA)‑like disease during postnatal TMJ growth. Shox2SHOX KI/KI mice were observed to develop a severe muscle wasting syndrome from day 7 postnatal. Histological examination indicated that the condyle and glenoid fossa of Shox2SHOX KI/KI mice was reduced in size in the second week after birth. The condyles of Shox2SHOX KI/KI mice exhibited reduced expression levels of collagen type II and Indian hedgehog, and increased expression of collagen type I. A marked increase in matrix metalloproteinase 9 (MMP9) and MMP13 in the condyles was also observed. These cellular and molecular defects may contribute to the observed (OA)‑like phenotype of Shox2SHOX KI/KI mouse TMJs.

  4. Facial nerve injury following surgery for temporomandibular joint ankylosis: A prospective clinical study

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    S Gokkulakrishnan

    2013-01-01

    Full Text Available Objective: The purpose of this prospective study was to evaluate the incidence and degree of facial nerve damage and time taken for its recovery following surgery for temporomandibular joint (TMJ ankylosis. Materials and Methods: A total of 30 subjects with the TMJ ankylosis with or without history of previous surgery were included in this prospective study. House-Brackmann grading system was used to assess the function of the facial nerve post-operatively. Results: Most of the subjects were in the age range of 13-15 years. Eight subjects had bilateral ankylosis and remaining 22 had unilateral ankylosis. Out of 32 joints in which gap arthroplasty was performed, 4 had Grade 1 injury, 14 had Grade 2 injury, 12 had Grade 3, and 2 with the Grade 4 injury 24 h post-operatively. Whereas, out of 6 cases of interpositional arthroplasty 4 had Grade 1 injury and 2 had Grade 4 injury. According to House-Brackmann grading system, at 24 h, 78.9% patients had different grades of facial nerve injury, which gradually improved and came to normal limits within 1-3 months post-operatively. Comparison of change in the Grade of injury at 3 months follow-up as compared to baseline (24 h showed full recovery in all the cases (100% showing a statistically significant difference from baseline (P < 0.001. Conclusion: When proper care is taken during surgery for TMJ ankylosis, permanent facial nerve injury is rare. However, the incidence and degree of temporary nerve injury could be either due to the heavy retraction causing compression and or stretching of nerve fiber resulting in neuropraxia.

  5. Prevalence of the types of the petrotympanic fissure in the temporomandibular joint dysfunction

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    Cakur, Binali; Sumbullu, Muhammed Akif; Durna, Dogan; Akgul, Hayati Murat (Dept. of Oral Diagnosis and Oral Radiology, Faculty of Dentistry, Ataturk Univ., Erzurum (Turkey)), email: bcakur@atauni.edu.tr

    2011-06-15

    Background Petrotympanic fissure (PTF) is a fissure in the temporal bone that runs from the temporomandibular joint (TMJ) to the tympanic cavity (TC). In PTF, the discomallear ligament (DML) connects the malleus in the tympanic cavity and the articular disc and capsule of the temporomandibular joint. PTF with the DML is a possible cause of aural symptoms related to temporomandibular joint dysfunction (TMD). Purpose To investigate the prevalence of different types of PTF in TMD using dental volumetric tomography (DVT) and determine whether PTF type correlates with age. Material and Methods DVT scans in the sagittal planes of PTFs of 134 patients with TMD were examined for the types of PTF present. Three main PTF types were described: wide, tunnel-shaped structure (type 1); tunnel-shaped structure that is wide open in the PTF entrance to the mandibular fossa and gradually thins out in the tympanic cavity (type 2), tunnel-shaped structure that is wide open in the entrance of the mandibular fossa, with a middle region with a flat-shaped tunnel structure and a narrow exit in the tympanic cavity (type 3). Results In DVT scans, PTF types 1, 2 and 3 were seen in 67.2%, 1.5%, and 31.3% of cases, respectively. We found no significant relationship between age or gender and PTF type. Conclusion The low percentage of type 2 PTF and high percentage of type 1 PTF must be taken into consideration during pre-surgical planning related to TMD. However, future well-designed clinical studies involving larger numbers of subjects will be necessary to confirm the findings of this study

  6. Prevalence, Course, and Associated Factors of Pain in the Temporomandibular Joint in Early Rheumatoid Arthritis: Results of a Longitudinal Cohort Study.

    Science.gov (United States)

    Chin Jen Sem, Jessica P; van der Leeden, Marike; Visscher, Corine M; Britsemmer, Karin; Turk, Samina A; Dekker, Joost; van Schaardenburg, Dirkjan; Lobbezoo, Frank

    To assess the prevalence, 3-year course, and associated factors of temporomandibular joint (TMJ) pain in patients with newly diagnosed rheumatoid arthritis (RA). A total of 264 patients with newly diagnosed RA were included. Patients were assessed after 3 months, 6 months, 9 months, 1 year, 1.5 years, 2 years, and 3 years. TMJ pain was scored by manual palpation, and the prevalence of TMJ pain was calculated at baseline and at all seven follow-up intervals during 3 years. Factors assessed for a potential association with TMJ pain at baseline included: demographic factors (gender and age), disease-related factors (symptom duration, rheumatoid factor [RF], anti-cyclic citrullinated protein [anti-CCP], C-reactive protein [CRP], and Disease Activity Score 28 [DAS28]), and functional factors (Health Assessment Questionnaire [HAQ] and European Quality of Life 5 Dimensions Questionnaire [EQ5D]-anxiety/depression). A stepwise logistic regression model was used to determine factors associated with TMJ pain in patients with RA. The prevalence of TMJ pain in patients with RA was 10.6% at baseline, which decreased to 3.6% in the first year after inclusion and remained stable thereafter. Disease activity as determined by the DAS28 was significantly associated with TMJ pain (odds ratio [OR] = 1.51; 95% confidence interval [95% CI] = 1.12-2.05; P = .009) at baseline. A second logistic regression analysis was performed with the following variables of the DAS28: erythrocyte sedimentation rate (ESR), tender joint count, swollen joint count, and global health. Tender joint count (OR = 1.06; 95% CI = 1.01-1.12; P = .03) and global health (OR = 1.02; 95% CI = 1.00-1.03; P = .03) were significantly associated with TMJ pain at baseline. The remaining factors included in the analysis were not significantly associated with TMJ pain at baseline. The prevalence of TMJ pain in patients with newly diagnosed RA is approximately 10% and decreases during follow-up, especially in the first year

  7. managing temporomandibular joint dislocation in ibadan

    African Journals Online (AJOL)

    syndrome (EDS), Marfan's syndrome or muscular dystonias3,5. Factors associated with the onset of ... disorder on Thioridazone (Mellenil) and diazepam had idiopathic TMJ dislocation. Two other patients had a .... condyles. He had reduction using the Hippocrates manouvre and subsequent immobilization with maxillo-.

  8. Tomographic evaluation of TMJ in adolescents with temporomandibular disorders Avaliação tomográfica da ATM em adolescentes com disfunção temporomandibular

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    Luciano José Pereira

    2004-09-01

    Full Text Available This study evaluated the TMJ images of normal subjects and of those who presented TMD (temporomandibular disorders using linear tomography at rest position. Craniomandibular Index (CMI and a questionnaire on subjective symptoms were used to assess 217 subjects aged 12 to 18 years. Those with the highest and the lowest scores were divided into Control (n = 20 and TMD groups (n = 20, respectively. Corrected tomography was used to measure the narrowest anterior, superior and posterior joint spaces, to determine the condyle position in all 40 subjects. The distance means did not correlate with CMI scores (p > 0.05. The number of posteriorly positioned condyles was significantly higher in TMD patients (p = 0.05, especially in females. It was concluded that condyle position in linear tomography at rest position cannot yield TMD diagnosis.O objetivo deste estudo foi avaliar imagens da ATM de indivíduos portadores e não portadores de distúrbios temporomandibulares (DTM, através da tomografia linear corrigida na posição de repouso. Foram avaliados 217 adolescentes com idade entre 12 e 18 anos através do Índice Craniomandibular (CMI e de questionário de sintomas subjetivos. Foram selecionados 40 indivíduos com escores extremos, 20 sem DTM e 20 com DTM, para a formação dos grupos controle e DTM, respectivamente. Os espaços articulares anterior, superior e posterior foram mensurados pela tomografia corrigida, tendo como referência a região de menor comprimento subjetivo, determinando a posição condilar. As médias das distâncias não se correlacionaram com os escores do CMI (p > 0,05. O número de côndilos posteriorizados foi significativamente maior nos pacientes com DTM (p = 0,05, principalmente no sexo feminino. Concluímos que a posição condilar na posição de repouso não pode predizer diagnóstico de DTM.

  9. Global body posture evaluation in patients with temporomandibular joint disorder

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    Eliza Tiemi Saito

    2009-01-01

    Full Text Available AIM: To identify the relationship between anterior disc displacement and global posture (plantar arches, lower limbs, shoulder and pelvic girdle, vertebral spine, head and mandibles. Common signs and symptoms of anterior disc displacement were also identified. INTRODUCTION: Global posture deviations cause body adaptation and realignment, which may interfere with the organization and function of the temporomandibular joint. METHODS: Global posture evaluation was performed in a group of 10 female patients (20 to 30 years of age with temporomandibular joint disc displacement and in a control group of 16 healthy female volunteers matched for age, weight and height. Anterior disc displacement signs, symptoms and the presence of parafunctional habits were also identified through interview. RESULTS: Patients with disc displacement showed a higher incidence of pain in the temporomandibular joint area, but there were no differences in parafunctional habits between the groups. In the disc displacement group, postural deviations were found in the pelvis (posterior rotation, lumbar spine (hyperlordosis, thoracic spine (rectification, head (deviation to the right and mandibles (deviation to the left with open mouth. There were no differences in the longitudinal plantar arches between the groups. CONCLUSION: Our results suggest a close relationship between body posture and temporomandibular disorder, though it is not possible to determine whether postural deviations are the cause or the result of the disorder. Hence, postural evaluation could be an important component in the overall approach to providing accurate prevention and treatment in the management of patients with temporomandibular disorder.

  10. MRI and arthrography in the evaluation of TMJ disorders

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    Nakasato, Tatsuhiko; Ehara, Shigeru; Tamakawa, Yoshiharu (Iwate Medical Univ., Morioka (Japan). School of Medicine); Kobayakawa, Takafumi

    1991-08-01

    Arthrosis of the temporomandibular joint (TMJ) is a noninfectious, noninflammatory condition characterized by joint pain, noise (clicking) and abnormal motion. It contains various disease processes, such as abnormalities in the menisci or masticating muscles, subluxation of the condyle and degenerative joint disease. Analysis of the morphology and dynamics of TMJ by means of imaging modalities has become highly advanced since the development of arthrography in the late 1970s. Magnetic resonance imaging (MRI) has become the modality of choice in the evaluation of TMJ owing to the development of surface coils. We retrospectively studied MRI and inferior joint compartment arthrography in the evaluation of TMJ disorders. Nineteen joints of 14 patients included 15 with internal derangement, two with osteoarthrosis and two normal joints. Sagittal MR images were routinely obtained in a resting position and in positions with the mouth half open, and also with the mouth fully open on balanced images. Although perforation of the menisci was difficult to evaluate, MRI and arthrography were equally useful in identifying the shape and position of the meniscus. However, MRI was more reliable in depicting TMJ abnormalities than arthrography. MRI is considered to be the modality of choice in screening arthrosis of TMJ, making the definitive diagnosis of internal derangement and monitoring conservative therapy for arthrosis. (author).

  11. The efficacy of treatment performed for temporomandibular joint patients at dental school of Tehran University of Medical Sciences

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    Sahebi Majid

    2015-01-01

    Full Text Available   Background and Aims: Temporomandibular joint disorders are common problems among patients referring to dental schools and clinics. However appropriate treatment modalities are performed for the TMD patients in dental school, the results and success rate of these treatments are not studied distinctly. The aims of this study was to determine the treatment performed for temporomandibular patients at the TMJ department of Tehran University dental school in 2010-11 .   Materials and Methods: In a descriptive cross-sectional trial, 85 TMD patients treated at the TMJ department of Tehran University dental school were examined at least 3 months after the treatments. The patients demographic data ,TMD signs and symptoms and the improvements occurred in TMD disorder were determined (complete, partial and no improvement. The patients satisfaction regarding the treatment results were investigated and data were analyzed regarding the presence of different TMD signs and symptoms before and after the treatment using Mann-Whitney U test .   Results: TMJ pain (35 cases, 42.2%, click (33 cases, 39.8% and muscle tenderness (26 cases, 31.3% were the most prevalent obtained signs and symptoms. The mean age of the patients were 32.3 years old while females were the predominant group (72 cases vs.11 one. 44 individuals (53.0% were treated by splint, 11 ones (13.3% with anterior repositioning splint and 17 individuals (92.5% were managed by physiotherapy plus splint. 65 patients (87.3% were satisfied with the results and 16 ones (19.3% were not. After the treatment, patients with TMJ pain (P0.05 .   Conclusion: The results showed that the treatments presented for the TMD patients at Tehran University dental school were successful and most patients received satisfactory treatment.

  12. Mechanisms involved in antinociception induced by a polysulfated fraction from seaweed Gracilaria cornea in the temporomandibular joint of rats.

    Science.gov (United States)

    Coura, Chistiane Oliveira; Chaves, Hellíada Vasconcelos; do Val, Danielle Rocha; Vieira, Lorena Vasconcelos; Silveira, Felipe Dantas; Dos Santos Lopes, Fernanda Maxcynne Lino; Gomes, Francisco Isaac Fernandes; Frota, Annyta Fernandes; Souza, Ricardo Basto; Clemente-Napimoga, Juliana Trindade; Bezerra, Mirna Marques; Benevides, Norma Maria Barros

    2017-04-01

    Temporomandibular disorder is a common clinical condition involving pain in the temporomandibular joint (TMJ) region. This study assessed the antinociceptive effects of a polysulfated fraction from the red seaweed Gracilaria cornea (Gc-FI) on the formalin-induced TMJ hypernociception in rats and investigated the involvement of different mechanisms. Male Wistar rats were pretreated with injection (sc) of saline or Gc-FI 1h before intra- TMJ injection of formalin to evaluate the nociception. The results showed that pretreatment with Gc-FI significantly reduced formalin-induced nociceptive behavior. Moreover, the antinociceptive effect of the Gc-FI was blocked by naloxone (a non-selective opioid antagonist), suggesting the involvement of opioids selective receptors. Thus, the pretreatment with selective opioids receptors antagonists, reversed the antinociceptive effect of the Gc-FI in the TMJ. The Gc-FI antinociceptive effect depends on the nitric oxide/cyclic GMP/protein kinase G/ATP-sensitive potassium channel (NO/cGMP/PKG/K(+)ATP) pathway because it was prevented by pretreatment with inhibitors of nitric oxide synthase, guanylate cyclase enzyme, PKG and a K(+)ATP blocker. In addition, after inhibition with a specific heme oxygenase-1 (HO-1) inhibitor, the antinociceptive effect of the Gc-FI was not observed. Collectively, these data suggest that the antinociceptive effect induced by Gc-FI is mediated by μ/δ/κ-opioid receptors and by activation NO/cGMP/PKG/K(+)ATP channel pathway, besides of HO-1. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Evaluation of the role of splint therapy in the treatment of temporomandibular joint pain on the basis of MRI evidence of altered disc position.

    Science.gov (United States)

    Hasegawa, Yoko; Kakimoto, Naoya; Tomita, Seiki; Fujiwara, Masanori; Ishikura, Reichi; Kishimoto, Hiromitsu; Honda, Kosuke

    2017-04-01

    To clarify whether altering temporomandibular joint (TMJ) condyle and disc positions by occlusal splint (splint) therapy relieves TMJ pain and to determine whether splint therapy facilitates improvement of the ranges of condyle and articular disc motions. A total of 150 joints of 75 patients admitted with TMJ pain/discomfort were evaluated. A visual analog scale for TMJ pain was administered during visits following the start of splint treatment. At the start of splint treatment, MRI was performed with/without splint insertion, after which condyle/disc movements were evaluated. Disc position and function, disc configuration, joint effusion, osteoarthritis, and the bone marrow were evaluated. Pearson's correlation coefficients, linear regression, and multiple regression analyses were used for statistical analysis. Splint-related anterior movement of the condyle was related to TMJ pain. With a biconvex disc and/or bone marrow abnormality, splint treatment was ineffective for reducing TMJ pain. Splint therapy was not likely to be successful for any kind of TMJ abnormalities, such as bone marrow abnormalities and/or a biconvex disc appearance on MRI. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  14. Management of temporomandibular joint ankylosis type III: lateral arthroplasty as a treatment of choice.

    Science.gov (United States)

    Singh, V; Bhagol, A; Dhingra, R; Kumar, P; Sharma, N; Singhal, R

    2014-04-01

    Many surgical techniques for the management of temporomandibular joint (TMJ) ankylosis have been described in the literature. The purpose of this study was to report our experience using a lateral arthroplasty technique in the management of type III ankylosis. The records of 15 patients treated for TMJ ankylosis at our institution between 2007 and 2011 were reviewed. Pre- and postoperative information collected included age, gender, aetiology, ankylosis type/classification, existing facial asymmetry, maximum pre- and postoperative mouth opening, complications, and recurrence of ankylosis. The mean maximum inter-incisal opening in the preoperative period was 12.9 mm and in the postoperative period was 36.2mm. No major complication was observed in any patient. No recurrence was noted in any patient. Our working hypothesis was that for patients with ankylosis type III, the medially displaced condyle and disc can fulfil their role in mandibular function and growth after extirpation of the ankylozed mass. Although they are located in an awkward medial position, they should function exactly as they would after a properly treated, displaced condylar fracture. Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. Chewing side preference - Impact on facial symmetry, dentition and temporomandibular joint and its correlation with handedness

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    Shreyasi Tiwari

    2017-01-01

    Full Text Available Introduction: Habitual unilateral chewing develops subconsciously and serves as an example for lateral preference. This study aims to assess the possible impact of chewing side preference to facial asymmetry, temporomandibular joint (TMJ and oral hygiene and existence of any link between the preferred chewing side (PCS and handedness. Materials and Methods: A 2-month cross-sectional (observational study was performed on 76 healthy dentate subjects [24 males (31.6% and 52 females (68.4%] with a mean age of 20.8 ± 1.5 years who participated in this study according to the selection criteria. Results: A total of 75 subjects out of 76 (98.6% were observed to have a PCS. Out of them, 38 chewed on their right and 37 on the left side. Of the 74 right-handed subjects, 48.6% chewed on the right, 50% on the left and 1.4% chewed equally on both the sides. Conclusion: Chewing side preference has a detrimental effect on the TMJ of the corresponding side and is also related to lateral facial asymmetry, which suggests that examination and recording of chewing side preference merit consideration in routine dental examination and treatment planning.

  16. A custom-made temporomandibular joint prosthesis for fabrication by selective laser melting: Finite element analysis.

    Science.gov (United States)

    Xu, Xiangliang; Luo, Danmei; Guo, Chuanbin; Rong, Qiguo

    2017-08-01

    A novel and custom-made selective laser melting (SLM) 3D-printed alloplastic temporomandibular joint (TMJ) prosthesis is proposed. The titanium-6aluminium-4vanadium (Ti-6Al-4V) condyle component and ultra-high molecular weight polyethylene (UHMWPE) fossa component comprised the total alloplastic TMJ replacement prosthesis. For the condyle component, an optimized tetrahedral open-porous scaffold with combined connection structures, i.e. an inlay rod and an onlay plate, between the prosthesis and remaining mandible was designed. The trajectory of movement of the intact condyle was assessed via kinematic analysis to facilitate the design of the fossa component. The behaviours of the intact mandible and mandible with the prosthesis were compared. The biomechanical behaviour was analysed by assessing the stress distribution on the prosthesis and strain distribution on the mandible. After muscle force was applied, the magnitude of the compressive strain on the condyle neck of the mandible with the prosthesis was lower than that on the condyle neck of the intact mandible, with the exception of the area about the screws; additionally, the magnitude of the strain at the scaffold-bone interface was relatively high. Copyright © 2017. Published by Elsevier Ltd.

  17. Methotrexate pharmacotherapy for implant-related temporomandibular joint pain: a case report.

    Science.gov (United States)

    Edwards, J Paul; Peterson, Erik J; Durham, Justin; Nixdorf, Donald R

    2014-08-01

    This article presents a patient experiencing several years of pain associated with bilateral failed temporomandibular joint (TMJ) Proplast/Teflon fossa prostheses. Despite surgical removal of the prostheses and comprehensive conservative management, including typical pharmacotherapy approaches for chronic pain, pain was still not relieved, and management was revised to target a putative chronic inflammatory disorder. Methotrexate was prescribed because of its known efficacy for inflammation and pain reduction in rheumatoid arthritis. Titration of methotrexate dosage over 5 months to a weekly dose of 20 mg resulted in reduced pain intensity at rest, increased pain-free maximal jaw opening, and a reduction in the sensory component of the McGill Pain Questionnaire. Maximum assisted jaw opening remained the same, as did the palpation tenderness of both TMJs and of the masseter and temporalis muscles. Methotrexate pharmacotherapy may represent a viable option when conservative treatments have failed to provide significant pain relief in patients who have had Proplast/Teflon TMJ implants. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Morphometric analysis for evaluating the relation between incisal guidance angle, occlusal plane angle, and functional temporomandibular joint shape variation.

    Science.gov (United States)

    Han, Seulgi; Shin, Sang Min; Choi, Yong-Seok; Kim, So Yeun; Ko, Ching-Chang; Kim, Yong-Il

    2018-01-11

    The correlations between morphology of the temporomandibular joint structure, the anterior guidance angle, and occlusal plane were investigated. A cone beam computed tomography analysis was performed in 158 patients (86 women and 72 men). 3D software was employed to obtain the coordinates of the shape of the incisal guidance angle, occlusal guidance angle, articular fossa, and mandibular condyle. Generalized Procrustes analysis including principal components analysis (PCA) were performed and produced principal components (PCs) scores of each shape and their centroid size (CS). A significant Pearson correlation coefficient of 0.3451 (p angle and occlusal plane. The CS also showed a correlation with the incisal guidance angle, but not with the occlusal plane angle. The PCA results revealed that there were no significant correlations between the temporomandibular joint structure (TMJ) shape (fossa and condyle) and the incisal guidance angle. Incisor guidance angle and occlusal plane angle were correlated. In addition, there was a correlation between CS and incisal guidance angle. In the PCA, It can be concluded that the size is more related to the incisor guidance angle than the morphological factors of the constituent components of the TMJ.

  19. Temporomandibular joint computed tomography: development of a direct sagittal technique

    Energy Technology Data Exchange (ETDEWEB)

    van der Kuijl, B.; Vencken, L.M.; de Bont, L.G.; Boering, G. (Univ. of Groningen, (Netherlands))

    1990-12-01

    Radiology plays an important role in the diagnosis of temporomandibular disorders. Different techniques are used with computed tomography offering simultaneous imaging of bone and soft tissues. It is therefore suited for visualization of the articular disk and may be used in patients with suspected internal derangements and other disorders of the temporomandibular joint. Previous research suggests advantages to direct sagittal scanning, which requires special positioning of the patient and a sophisticated scanning technique. This study describes the development of a new technique of direct sagittal computed tomographic imaging of the temporomandibular joint using a specially designed patient table and internal light visor positioning. No structures other than the patient's head are involved in the imaging process, and misleading artifacts from the arm or the shoulder are eliminated. The use of the scanogram allows precise correction of the condylar axis and selection of exact slice level.

  20. Serotonergic Mechanisms Influence the Response to Glucocorticoid Treatment in TMJ Arthritis

    Directory of Open Access Journals (Sweden)

    Lars Fredriksson

    2005-01-01

    Full Text Available The aims of this study were to investigate the influence of serotonin (5-HT on the effects of intra-articular injections of glucocorticoid on pain of the temporomandibular joint (TMJ in patients with inflammatory disorders of the TMJ. The pretreatment synovial fluid 5-HT was negatively, and plasma 5-HT positively, correlated to change in TMJ pain after treatment. The pretreatment plasma 5-HT was positively correlated to change in pressure-pain threshold after treatment. In conclusion, this study shows that local and systemic serotonergic mechanisms partly determine the effect of intra-articular glucocorticoid treatment on TMJ pain in patients with chronic TMJ arthritis of systemic nature, while change in pressure-pain threshold over the TMJ is influenced by systemic serotonergic mechanisms.

  1. Biological reconstruction of the temporomandibular joint by chondro-osseous graft: clinical and experimental study.

    Science.gov (United States)

    Kummoona, Raja K

    2013-05-01

    This study includes 35 children treated by reconstruction of the temporomandibular joint (TMJ) by chondro-osseous graft harvested from iliac crest for management of 2 diseases; the first one was ankylosis of the TMJ. There were 25 cases of 9 girls and 16 boys, and there were 10 cases of hypoplasia of the TMJ of first-arch dysplasia syndrome or hemifacial microsomia, of which 4 were females and 6 were males. Their ages ranged between 4 and 13 years (mean, 8.5 years); follow-up of the patients ranged from 3 to 5 years. All patients showed good result and without recurrence of ankylosis or restriction of mouth opening, and growth of the face was acceptable and without using osteotomies for correction of jaw relationship or distraction techniques.Experimental studies on rabbits were performed to prove the condyle as growth center and after excision of the head of condyle and disk in newly growing rabbits of 3 months of age; after 3 months of follow-up, we observed severe deformity of the rabbits' mandible, and the mandible deviated to the affected side on the first experiment. In the second experiment, reconstruction of the TMJ and condyle of the rabbits by chondro-osseous graft harvested from iliac crest of the same rabbit was carried out in 8 animals to assess the viability and value of chondro-osseous graft to replace the TMJ. After 3 months, all animals were killed. Postmortem studies were done to assess the healing process of the graft or any resorption of the graft. Histological studies of the graft showed 4 layers: the first articular layer was thick because of functional demand of masticatory process for hard food of rabbits; the second layer was the granular mesenchymal stem cells layer, very active and multiple layers that represent the proliferative layer; the third layer showed conversion of cartilage cells to osteoid cells, and the fourth layer was the osteoid layer. On follow-up of clinical cases, the graft was continued for functional demand of growth

  2. Nontraumatic bifid mandibular condyles in asymptomatic and symptomatic temporomandibular joint subjects

    Energy Technology Data Exchange (ETDEWEB)

    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.

  3. Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint

    Energy Technology Data Exchange (ETDEWEB)

    Kocasarac, Husniye Demirturk [Dept. of Comprehensive Dentistry, The University of Texas Health Science Center, San Antonio (United States); Celenk, Peruze [Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ondokuz Mayis University, Samsun (Turkmenistan)

    2017-06-15

    Erosions and osteophytes are radiographic characteristics that are found in different stages of temporomandibular joint (TMJ) osteoarthritis. This study assessed the effectiveness of digital subtraction radiography (DSR) in diagnosing simulated osteophytes and erosions in the TMJ. Five intact, dry human skulls were used to assess the effectiveness of DSR in detecting osteophytes. Four cortical bone chips of varying thicknesses (0.5 mm, 1.0 mm, 1.5 mm, and 2.0 mm) were placed at the medial, central, and lateral aspects of the condyle anterior surface. Two defects of varying depth (1.0 mm and 1.5 mm) were created on the lateral, central, and medial poles of the condyles of 2 skulls to simulate erosions. Panoramic images of the condyles were acquired before and after artificially creating the changes. Digital subtraction was performed with Emago dental image archiving software. Five observers familiar with the interpretation of TMJ radiographs evaluated the images. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic accuracy of the imaging methods. The area under the ROC curve (Az) value for the overall diagnostic accuracy of DSR in detecting osteophytic changes was 0.931. The Az value for the overall diagnostic accuracy of panoramic imaging was 0.695. The accuracy of DSR in detecting erosive changes was 0.854 and 0.696 for panoramic imaging. DSR was remarkably more accurate than panoramic imaging in detecting simulated osteophytic and erosive changes. The accuracy of panoramic imaging in detecting degenerative changes was significantly lower than the accuracy of DSR (P<.05). DSR improved the accuracy of detection using panoramic images.

  4. Assessing the reliability of MRI-CBCT image registration to visualize temporomandibular joints.

    Science.gov (United States)

    Al-Saleh, M A Q; Jaremko, J L; Alsufyani, N; Jibri, Z; Lai, H; Major, P W

    2015-01-01

    To evaluate image quality of two methods of registering MRI and CBCT images of the temporomandibular joint (TMJ), particularly regarding TMJ articular disc-condyle relationship and osseous abnormality. MR and CBCT images for 10 patients (20 TMJs) were obtained and co-registered using two methods (non-guided and marker guided) using Mirada XD software (Mirada Medical Ltd, Oxford, UK). Three radiologists independently and blindly evaluated three types of images (MRI, CBCT and registered MRI-CBCT) at two times (T1 and T2) on two criteria: (1) quality of MRI-CBCT registrations (excellent, fair or poor) and (2) TMJ disc-condylar position and articular osseous abnormalities (osteophytes, erosions and subcortical cyst, surface flattening, sclerosis). 75% of the non-guided registered images showed excellent quality, and 95% of the marker-guided registered images showed poor quality. Significant difference was found between the non-guided and marker-guided registration (χ(2) = 108.5; p correlation coefficient (ICC) = 0.50 at T1, 0.56 at T2] was lower than that in MRI-CBCT registered images [ICC = 0.80 (0.52-0.92) at T1, 0.84 (0.62-0.93) at T2]. Erosions and subcortical cysts were noticed less frequently in the MRI-CBCT images than in CBCT images. Non-guided registration proved superior to marker-guided registration. Although MRI-CBCT fused images were slightly more limited than CBCT alone to detect osseous abnormalities, use of the fused images improved the consistency among examiners in detecting disc position in relation to the condyle.

  5. Voice-supported Electronic Health Record for Temporomandibular Joint Disorders

    Czech Academy of Sciences Publication Activity Database

    Hippmann, R.; Dostálová, T.; Zvárová, Jana; Nagy, Miroslav; Seydlová, M.; Hanzlíček, Petr; Kříž, P.; Šmídl, L.; Trmal, J.

    2010-01-01

    Roč. 49, č. 2 (2010), s. 168-172 ISSN 0026-1270 R&D Projects: GA MŠk(CZ) 1M06014 Institutional research plan: CEZ:AV0Z10300504 Keywords : electronic health record * structured data entry * dentistry * temporomandibular joint disorder Subject RIV: IN - Informatics, Computer Science Impact factor: 1.472, year: 2010

  6. Biomechanical modeling of open locks of the human temporomandibular joint

    NARCIS (Netherlands)

    Tuijt, M.; Koolstra, J.H.; Lobbezoo, F.; Naeije, M.

    2012-01-01

    Background Patients with hypermobility of the temporomandibular joint may have problems closing their mouth after opening widely. In the worst case, the mandibular condyles become trapped in front of the articular eminences and the jaw muscles cannot reposition them into the fossae (open lock). The

  7. Design and wear testing of a temporomandibular joint prosthesis articulation

    NARCIS (Netherlands)

    van Loon, JP; Verkerke, GJ; de Vries, MP; de Bont, LGM

    As part of the development of a total temporomandibular joint prosthesis, a prosthesis articulation was designed. The articulation consists of a spherical head (ball) of the mandibular part, rotating against an enveloping ultra-high-molecular-weight polyethylene (UHMWPE) disc with a flat cranial

  8. High resolution ultrasound investigation of the temporomandibular joint in patients with chronic polyarthritis.

    Science.gov (United States)

    Jank, S; Zangerl, A; Kloss, F R; Laimer, K; Missmann, M; Schroeder, D; Mur, E

    2011-01-01

    40 patients with chronic polyarthritis were investigated prospectively. The TMJ was investigated to detect clicking, crepitation, and pain. High resolution ultrasound (HR-US) assessed destructive changes, effusion, and disc dislocation. The results of the clinical investigation and the HR-US investigation were compared using the χ(2) test. The statistical calculation of the correlation between the HR-US results and the clinical TMJ investigation by the χ(2) test showed a significant correlation between TMJ sounds, destructive changes and disc dislocation. A significant correlation between TMJ joint effusion, TMJ pathology and TMJ pain was detected using the χ(2) test. Pain on palpation of the masseter and temporal muscle correlated significantly with TMJ effusion. There was significant correlation between TMD and the HR-US diagnosis of destructive changes and effusion. The significant correlation between TMJ effusion and actual TMJ pain and TMJ pain on palpation shows the ability of HR-US to detect acute TMJ affection with high significance. There was a significant correlation between effusion and pain on palpation of the masticatory muscles, which could be interpreted as the ability of HR-US to determine acute TMD. That any TMD correlated significantly with destructive changes and TMJ effusion suggests that HR-US could detect chronic and acute TMD. Copyright © 2010. Published by Elsevier Ltd.

  9. Arthrocentesis and lavage for treating temporomandibular joint disorders.

    Science.gov (United States)

    Guo, Chunlan; Shi, Zongdao; Revington, Peter

    2009-10-07

    Temporomandibular joint disorders are important oral health problems, reducing the quality of life of sufferers. It has been estimated that approximately 20% to 30% of the adult population will experience temporomandibular joint dysfunction. Arthrocentesis and lavage has been used to treat temporomandibular joint disorders for about 10 years, but the clinical effectiveness of the therapy has not been summarized in the form of a systematic review. To assess the effectiveness and complications of arthrocentesis and lavage for the treatment of temporomandibular joint disorders compared with controlled interventions. The Cochrane Oral Health Grou