Validation of TMJ osteoarthritis synthetic defect database via non-rigid registration

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Paniagua, Beatriz; Pera, Juliette; Budin, Francois; Gomes, Liliane; Styner, Martin; Lucia, Cevidanes; Nguyen, Tung

2015-03-01

Temporomandibular joint (TMJ) disorders are a group of conditions that cause pain and dysfunction in the jaw joint and the muscles controlling jaw movement. However, diagnosis and treatment of these conditions remain controversial. To date, there is no single sign, symptom, or test that can clearly diagnose early stages of osteoarthritis (OA). Instead, the diagnosis is based on a consideration of several factors, including radiological evaluation. The current radiological diagnosis scores of TMJ pathology are subject to misdiagnosis. We believe these scores are limited by the acquisition procedures, such as oblique cuts of the CT and head positioning errors, and can lead to incorrect diagnoses of flattening of the head of the condyle, formation of osteophytes, or condylar pitting. This study consists of creating and validating a methodological framework to simulate defects in CBCT scans of known location and size, in order to create synthetic TMJ OA database. User-generated defects were created using a non-rigid deformation protocol in CBCT. All segmentation evaluation, surface distances and linear distances from the user-generated to the simulated defects showed our methodological framework to be very precise and within a voxel (0.5 mm) of magnitude. A TMJ OA synthetic database will be created next, and evaluated by expert radiologists, and this will serve to evaluate how sensitive the current radiological diagnosis tools are.

MR angiography of the TMJ in asymptomatic volunteers

International Nuclear Information System (INIS)

Takagi, Ritsuo; Ohashi, Yasushi; Westesson, P.L.; Togashi, Hirosuke

1998-01-01

To evaluate the vascular anatomy of the temporomandibular joint (TMJ) and surrounding soft tissue non-invasively, we applied magnetic resonance (MR) angiography for delineating the arterial architecture around the TMJ. MR angiograms of the left and right TMJs in asymptomatic volunteers were obtained using 3D/Time-of-flight (TOF) (First Field Echo, TR/TE/FLIP=46 ms/6.8 ms/17 deg) with intravenous contrast. These MR angiograms were compared with experimental angiograms of human TMJ autopsy specimens in order to identify each of the branches of the arteries on the MR angiograms. This study enabled the depiction by MR angiography of arterial vessels around the TMJ region to some degree. In conclusion, MR angiography appears promising as a non-invasive tool to evaluate the vascular anatomy of the TMJ. (author)

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)

TMJ Disorders

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... Aching pain in and around your ear Difficulty chewing or pain while chewing Aching facial pain Locking of the joint, making ... disorder. When to see a doctor Seek medical attention if you have persistent pain or tenderness in ...

Neoplastic lesions of the temporomandibular joint (TMJ): diagnosis, differential diagnosis and intervention

International Nuclear Information System (INIS)

Vogl, T.J.; Abolmaali, N.; Schedel, H.; Bergh, B.

2001-01-01

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.) [de

TMJ surgery following orthognathic surgery: A case series

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C. Politis

2018-06-01

Full Text Available Orthognathic surgery may affect or cause temporomandibular joint (TMJ complaints. This study evaluated the need for TMJ surgery after orthognathic surgery.A retrospective cohort study was carried out on 630 consecutive patients undergoing at least a Le Fort I or bilateral sagittal split osteotomy (BSSO. The mean follow-up time was 2,3 years. Clinical, surgical and radiographic findings were collected.Ten of the 630 patients (1.6% had additional arthroscopic TMJ-surgery in one (9 or in both (1 joints because of internal derangement, resistant to conventional therapy. Only 4/10 patients had successful outcomes following arthroscopic surgery. One patient with unsuccessful outcome required multiple additional open TMJ-surgeries, all remaining ineffective to relieve pain and restricted mouth opening. If arthroscopy failed to relieve symptoms (5/10 patients, further conservative management was opted. Arthroscopy seemed effective mainly in patients without pre-existing TMJ complaints.A further five of the 630 patients (0.8% required more treatment because of bilateral postoperative condylar resorption, but none of them required TMJ-surgery.In contrast to patients with bilateral condylar resorption where the skeletal relapse remained the issue of concern, patients with internal derangement/osteoarthrosis exhibited major occlusal changes in one patient only (1/10, leaving the TMJ complaints as the main concern. Keywords: Sagittal split osteotomy, Le Fort I osteotomy, Orthognathic surgery, Condylar remodelling, Condylar resorption, Osteoarthrosis, Internal derangement, Relapse, Arthroscopy

Assessment of treatment response to splint therapy and evaluation of TMJ function using joint vibration analysis in patients exhibiting TMJ disc displacement with reduction: A clinical study

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Jyoti Devi

2017-01-01

Full Text Available Context, Aim, and Objectives: Diagnosis of temporomandibular joint (TMJ disc displacement with reduction (DDR is difficult. Literature combining different subjective parameters of TMJ function with an objective evaluation of TMJ function using joint vibration analysis (JVA is limited. Hence, the study was planned to diagnose temporomandibular disorder accurately, to do a subjective and objective evaluation of TMJ function, and to assess the effectiveness of different types of splint therapy over the conventional anterior repositioning appliance (ARA group. Design: Single-blind, randomized, comparative clinical trial conducted in thirty patients, 18–55 years of age, allocated to three groups, i.e., ARA conventional group, centric stabilization splint (CSS, and Soft splint (SS groups. Subjects and Methods: Preoperative values of comfortable mouth opening (CMO in mm, maximum mouth opening (MMO in mm, TMJ clicking and tenderness (grading 0–3, visual analog scale pain score (0–10 cm, and total energy (TE integral values of both TMJs using JVA were recorded. Postoperative values were taken at the time of delivery of splint at 1st, 2nd, 6th, and 10th week. Statistical Analysis and Results: Intergroup comparison – Kruskal–Wallis test showed no statistically significant difference in CMO, MMO, and TE values of right TMJs among three groups at any point. No significant difference was seen in TMJ clicking and tenderness among groups at any point of time except at 10 weeks and at 2 weeks, respectively, by Chi-square test. Intragroup comparison - Wilcoxon signed-rank test showed the significance of difference (P < 0.05* in postoperative visits for CMO, MMO, pain score, and TE values. Clinical effect size, extent, consistency, and percentage of cases showing improvement were maximum for CSS group. Conclusions: The study concludes that the use of JVA for diagnosis along with history and clinical examination increases the accuracy of the diagnosis of

Arthrography of the TMJ

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Jend, H.H.; Triebel, H.J.; Jend-Rossmann, I.; Hamburg Univ.

1986-01-01

Articular dysfunction of the TMJ with anterior displacement of the disc ('internal derangement') is an entity which has been separated from other types of the 'myofascial pain syndromes' and which can be treated conservatively or by surgery. Arthrography of the TMJ has contributed greatly to an understanding of normal and abnormal function and, in many cases, it can provide a diagnosis. On the basis of our experience with 80 investigations we discuss technical problems and the clinical indications. The indications for arthrography are in the pre-operative diagnosis, when clinical findings are uncertain, in order to demonstrate perforation, in order to confirm a suspected diagnosis and to assist in prosthetic treatment. (orig.) [de

Mesenchymal Stem Cells for Cartilage Regeneration of TMJ Osteoarthritis

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Dixin Cui

2017-01-01

Full Text Available 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 towards tissue repair and regeneration. Mesenchymal stem cells (MSCs, derived from the bone marrow, synovium, and even umbilical cord, play a role as seed cells for the cartilage regeneration of TMJ OA. MSCs possess multilineage differentiation potential, including chondrogenic differentiation as well as osteogenic differentiation. In addition, the trophic modulations of MSCs exert anti-inflammatory and immunomodulatory effects under aberrant conditions. Furthermore, MSCs combined with appropriate scaffolds can form cartilaginous or even osseous compartments to repair damaged tissue and impaired function of TMJ. In this review, we will briefly discuss the pathogenesis of cartilage degeneration in TMJ OA and emphasize the potential sources of MSCs and novel approaches for the cartilage regeneration of TMJ OA, particularly focusing on the MSC-based therapy and tissue engineering.

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

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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

Two different techniques of manufacturing TMJ replacements - A technical report.

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Kozakiewicz, Marcin; Wach, Tomasz; Szymor, Piotr; Zieliński, Rafał

2017-09-01

Presently, during the surgical treatment of the patients in maxillofacial surgery, one can use various medical implants. Moreover custom made implants are being used. Replacements may be fitted to the structure and shape of the human skull owing to CAD/CAM (custom aided design/manufacture) called customized implants. This study was aimed to report for the first time clinical material from which custom implants, using two different techniques, were manufactured to reconstruct the temporomandibular joint (TMJ). In this study, eleven patients with an average age of 54 years were included. All of the patients underwent TMJ reconstruction using direct metal laser sintering (DMLS) or computer numerical control milling (CNC) techniques for implant manufacture. Four of the eleven patients had a malignancy diagnosis, and seven had a benign diagnosis. Patients complained of hypomobility of the TMJ, facial asymmetry, pain and swelling of the preauricular region. Treatment included 7 CNC milled implants and 4 implants in DMLS. More metallic implant parts with a rough surface were associated with the DMLS technique. Post operational, uneventful healing was observed in all clinical cases during an average of 26.8 months of follow-up. Three months post-operation, facial nerve palsy, swallowing disturbances and pain were not observed. Infections, allergic reactions to materials and re-ankylosis were also not observed. Replacements received correct forms and functions owing to the CAM techniques. Post-operational maximal interincisal opening improved (p < 0.01) and was not significantly related to preoperational opening, age, sex, diagnosis or adjuvant radiotherapy. Considering both methods, the feature that differentiates the manufacture technique is the more subtractive surface finishing required for the DMLS implant than the CNC implant. Both techniques resulted the same clinical outcomes and can be used successfully in patients with neoplastic lesions and other TMJ disorders

Tinnitus with temporomandibular joint disorders: a specific entity of tinnitus patients?

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Vielsmeier, Veronika; Kleinjung, Tobias; Strutz, Jürgen; Bürgers, Ralf; Kreuzer, Peter Michael; Langguth, Berthold

2011-11-01

Tinnitus is frequently associated with temporomandibular joint (TMJ) dysfunction. However, the nature of the relationship is not fully understood. Here the authors compared 30 patients with a confirmed diagnosis of temporomandibular joint dysfunction and tinnitus to a group of 61 patients with tinnitus but without any subjective complaints of TMJ dysfunction with respect to clinical and demographic characteristics. Case-control study. Tertiary referral center. Tinnitus patients with and without TMJ dysfunction presenting at the Department of Prosthetic Dentistry and th: Tinnitus Clinic at the University of Regensburg. Tinnitus patients with TMJ disorder had better hearing function (P neck movements (P = .001). Classical risk factors for tinnitus (age, male gender, hearing loss) are less relevant in tinnitus patients with TMJ disorder, suggesting a causal role of TMJ pathology in the generation and maintenance of tinnitus. Based on this finding, treatment of TMJ disorder may represent a causally oriented treatment strategy for tinnitus.

[Whiplash lesions and temporomandibular joint disorders].

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Gola, R; Richard, O; Guyot, L; Cheynet, F

2004-11-01

Attributing dysfunction of the temporomandibular joint (TMJ) to whiplash injury is a difficult problem to solve. TMJ disorders do not seem to be secondary to direct articular trauma but rather caused by a postural disorder of the cervical spine. Occlusal disorders and stress further complicate the picture. Four clinical cases illustrate a new hypothetical approach.

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

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

2016-01-01

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

Dose-dependent sustained local release of dexamethasone from biodegradable thermosensitive hydrogel of PEG-PLGA-PEG triblock copolymers in the possible prevention of TMJ re-ankylosis (Arakeri's TMJ release technique).

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Arakeri, Gururaj; Brennan, Peter A

2012-05-01

Temporomandibular joint (TMJ) ankylosis is a devastating anatomico-pathological condition which severely affects the quality of human health. Over the last 70 years various treatments have been described to treat this distressing condition. But no single method has uniformly produced successful results. Although various surgical techniques have been improved periodically, the treatment results remain inefficient due to its recurrence as TMJ re-adhesion. Since recurrence remains as a problem in many cases, the TMJ ankylosis presents a major therapeutic challenge in head and neck surgery. The re-ankylosis is a unique phenomenon that so far has defied a full and logical explanation, based upon biological and mechanical factors that are linked together in a coherent fashion. Many factors have been implicated in the development of re-adhesion following TMJ surgery. But still the mechanism by which the TMJ re-adhesion develops is unclear. Hence, TMJ ankylosis demands an alternative effective treatment modality to prevent its recurrence as re-ankylosis. This paper postulates some critical biological factors responsible for re-ankylosis based on which a novel treatment modality is also proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

Clinical Utility of bone Scan in the Diagnosis of Temporomandibular disorders

International Nuclear Information System (INIS)

Kim, In Joo; Kang, Yang Ho; Son, Seok Man; Lee, Kyoung Seog; Lee, Jae Bok; Kim, Yong Ki; Seo, Bong Jik; Park, June Sang; Park, June Sang; Ko, Myung Yun; Son, Seong Pyo

1995-01-01

Bone scan is a very sensitive diagnostic imaging test for detecting bone and joint disorders. So it might be useful in the diagnosis of temporomandibular disorders of the joint origin. Thus, the effectiveness of bone scan for detecting temporomandibular joint(TMJ) diseases and differentiating the TMJ disc displacement from the TMJ arthritis was evaluated. Bone scan was done in 21 patients with TMJ disc displacement (I3 unilaterally affected, 8 bilaterally affected), 26 patients with TMJ arthritis (23 unilateral, 3 bilateral), and 39 volunteers with no signs, symptoms, or history of TMJ disease TMJ simple uptake rate(SUR) and difference of both TMJ SUR were calculated from the 100,000 count lateral image of head and neck region in 99m Tc MDP bone scan. Transcranial and panorama X-ray examination was also done in all patients. TMJ SUR(%) were 1.67 ±0.606 in TMJs affected with arthritis, 1.350±0.351 in TMJs affected with disc displacement, and 1.084±0.172 in TMJs of controls Significant differences were demonstrated among them(p mean+2SD of controls) in unilateral TMJ arthritis patients were significantly higher than those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). Conclusively, bone scan may help to detect TMJ disease and differentiate TMJ disc displacement from TMJ arthritis.

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

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

2014-01-01

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

Relation of the measuring values in cephalometric radiographs and TMJ tomographs

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Han, Jin Woo [Kangnung National Univ. College of Dentistry, Kangnung (Korea, Republic of)

2007-03-15

To examine whether the maxillofacial skeletal morphology correlates with the condylar position and the anatomic characteristics of articular eminence using measurements of lateral cephalometric radiographs and individualized sagittal temporomandibular joint (TMJ) tomographs. I compared measurements of 202 TMJs of 101 orthodontic patients of Kangnung National University Dental Hospital. I used Pearson's correlation for comparison of the measuring values in lateral cephalometric radiographs and individualized sagittal TMJ tomographs. Large occlusal plane angle tendency showed decreased width of posterior eminence slope, decreased depth of articular fossa and decreased posterior slope angle of eminence. Large mandibular plane angle tendency showed decreased superior joint space, decreased superior joint space, decreased depth of articular fossa and decreased posterior slope angle of eminence. Large genial angle tendency showed decreased depth of articular fossa, decreased posterior slope angle of eminence and anterior position of comdylar head. Large anterior facial height and large posterior facial height tendency showed increased width of posterior position of condylar head. Maxillofacial skeletal morphology has correlation with the anatomic characteristics of TMJ. Individualized sagittal TMJ tomographs can provide useful information for anatomical analysis of TMJ.

Investigation on physiological and clinical effects of different light sources in TMJ photobiomodulation therapy

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Kamenoff, J.

2017-02-01

Introduction Laser light Electromagnetic energy has some typical properties for discussions on laser irradiation abilities to control the acute and chronic disorders in TMJ. Material and Methods During the last six years we have been completed well controlled clinical trials based on the criteria of the American Academy of orofacial pain. The study over the 600 patients (300 women and 300 men), mean age of 47 years have been developed. Patients have been selected on the main clinical sign of TMJ pain and have been divided into four main groups according to the type of PDT method. Based on the action spectra, various wavelengths have been used for TMJ Photodynamic Therapy. Constant dose and time of exposition, as well as various range of frequencies have been applied. In this way the Laser biostimulation response has been directly proportional to the total energy dose, depending of light intensity. Physiological and clinical effects of the followed "active regions"- 660 - 680, 760 - 780, 810 - 830 and 904 - 987 nm have been valued by method of comparative analysis. Methods applied: LLLT - TENS - red surface laser acupuncture (LA), PIPBM - LA, Laser bioenergetics approach, Complex therapeutic program (CTP). Results evaluation will be demonstrated by comparative digital ortopantomograph analysis, EEG brain maps, VAS, a metric analysis of the level of the maximum active Mandible opening and EPST through electrophysiological signal evaluation of the patient's body.

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.

Assessment of growth factor treatment on fibrochondrocyte and chondrocyte co-cultures for TMJ fibrocartilage engineering.

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Kalpakci, Kerem N; Kim, Eric J; Athanasiou, Kyriacos A

2011-04-01

Treatments for patients suffering from severe temporomandibular joint (TMJ) dysfunction are limited, motivating the development of strategies for tissue regeneration. In this study, co-cultures of fibrochondrocytes (FCs) and articular chondrocytes (ACs) were seeded in agarose wells, and supplemented with growth factors, to engineer tissue with biomechanical properties and extracellular matrix composition similar to native TMJ fibrocartilage. In the first phase, growth factors were applied alone and in combination, in the presence or absence of serum, while in the second phase, the best overall treatment was applied at intermittent dosing. Continuous treatment of AC/FC co-cultures with TGF-β1 in serum-free medium resulted in constructs with glycosaminoglycan/wet weight ratios (12.2%), instantaneous compressive moduli (790 kPa), relaxed compressive moduli (120 kPa) and Young's moduli (1.87 MPa) that overlap with native TMJ disc values. Among co-culture groups, TGF-β1 treatment increased collagen deposition ∼20%, compressive stiffness ∼130% and Young's modulus ∼170% relative to controls without growth factor. Serum supplementation, though generally detrimental to functional properties, was identified as a powerful mediator of FC construct morphology. Finally, both intermittent and continuous TGF-β1 treatment showed positive effects, though continuous treatment resulted in greater enhancement of construct functional properties. This work proposes a strategy for regeneration of TMJ fibrocartilage and its future application will be realized through translation of these findings to clinically viable cell sources. Copyright © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Histologic effects of mandibular protrusion splints in antigen-induced TMJ arthritis in rabbits

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von Bremen, Julia; K?hler, Kernt; Siudak, Krystyna; Zahner, Daniel; Ruf, Sabine

2017-01-01

Background Although it is common clinical practice to treat children with Juvenile Idiopathic Arthritis (JIA) with functional appliances, the scientific evidence for this is limited. The aim of this study was to study the histologic effects of mandibular protrusion splints in temporomandibular joint (TMJ) arthritis in rabbits. Methods Twenty-eight ten-week old New Zealand white rabbits were randomly divided into four groups: AO (TMJ arthritis, no splint), AS (TMJ arthritis, mandibular splint ...

Disorders Incidence and Analysis of a Flat Stabilization Splint as Its Therapy Levantamento de Incidência de DTMS e Análise da Efetividade da Placa de Mordida Plana Como Terapia TMJ

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João Ricardo T. Milam

2004-10-01

Full Text Available In this research, temporomandibular disorder signs and symptoms incidence were detected in two groups of patients. Group I was composed of 40 patients (23,9% who presented TMJ disorders drawn out of a 167 patients universe that were referred to be treated in the Dental Clinics of the State University of Londrina; Group II was composed by 24 individuals (48% which presented TMJ disorders, selected from a larger group of 50 Dental College students of the same University. The clinical and anamnesis examination were performed according to the International Society of Head Symptoms (IHS criteria for diagnosis and classification of headaches, cranial neuralgias and facial pain, associated with the TMJ disorders Research Diagnosis Criteria. The diagnosed signs and symptoms in both groups, supported by the criteria mentioned above, consisted of patients presenting TMJ and/or masticatory muscles pain, movement limitation while opening and closing the mouth, even with mandibular locking, irradiated facial, neck and shoulders pain, a painful click or crepitation while opening the mouth, stimulated pain while yawning, chewing or wide opening the mouth, bruxism and pain related to occlusal problems. Only in Group I it was also analyzed the effectiveness of a hard acrylic flat stabilization splint use in the control of the presented signs and symptoms, as a reversible occlusal therapy, which showed to be efficient in all cases, eliminating pain symptoms. Neste trabalho foram levantadas as incidências de sinais e sintomas de desordens têmporo-mandibulares (DTMs em dois grupos de pessoas: Grupo I: composto de 40 pessoas (23,9% que apresentaram incidência de DTMs em um universo de 167 pacientes pesquisados nos serviços prestados nas clínicas do Curso de Odontologia da Universidade Estadual de Londrina – UEL. Grupo II: composto de 24 pessoas (48% que apresentaram incidência de DTMs de um universo de 50 alunos pesquisados do mesmo Curso. O exame anamn

Mechanical properties of human articular disk and its influence on TMJ loading studied with the finite element method.

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Tanaka, E; Sasaki, A; Tahmina, K; Yamaguchi, K; Mori, Y; Tanne, K

2001-03-01

The present study was designed to investigate the elastic modulus of human temporomandibular joint (TMJ) disk under tension and its influences on TMJ loading. Seven human TMJ disks served as specimens. Continuous tensile stress was applied to each specimen, and the elastic moduli of human TMJ disks were calculated at 2% strain. Furthermore, using a three-dimensional finite element model of the mandible including the TMJ, changes in the TMJ stresses during clenching were evaluated in association of varying elastic moduli of the articular disk determined by the tensile tests. The elastic moduli at 2% strain varied from 27.1 to 65.2 MPa with a mean of 47.1 MPa. A significant correlation was found between the elastic moduli and age (P elastic moduli of the TMJ disk was varied from 25 to 65 MPa. In the TMJ disk, shear stresses in all the areas became larger with greater stiffness. In conclusion, it is shown that the elastic modulus of human TMJ disk is increased with age and that higher stiffness of the disk exerts substantial influences on mechanical loading for the TMJ structures.

Temporomandibular disorders and tension-type headache.

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Mongini, Franco

2007-12-01

Pathologies currently defined as temporomandibular disorders may be different in nature. Temporomandibular joint (TMJ) disorders and craniofacial and cervical myogenous pain (MP) are distinct pathologies but may be superimposed and share some etiologic factors. Tension-type headache (TTH) may often be associated with craniofacial and cervical pain, and the same pharmacologic and nonpharmacologic treatment may be efficacious for both. Psychiatric comorbidity (depression and/or anxiety disorder) is less frequent in sheer TMJ disorders, compared with MP and TTH. A screening for the presence of an underlying psychiatric disorder should be part of the clinical evaluation in patients suffering from headache and facial pain.

Increased risk of tinnitus in patients with temporomandibular disorder: a retrospective population-based cohort study.

Science.gov (United States)

Lee, Chun-Feng; Lin, Ming-Chia; Lin, Hui-Tzu; Lin, Cheng-Li; Wang, Tang-Chuan; Kao, Chia-Hung

2016-01-01

This study determined whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). We used information from health insurance claims obtained from Taiwan National Health Insurance (TNHI). Patients aged 20 years and older who were newly diagnosed with TMJ disorder served as the study cohort. The demographic factors and comorbidities that may be associated with tinnitus were also identified, including age, sex, and comorbidities of hearing loss, noise effects on the inner ear, and degenerative and vascular ear disorders. A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). Patients with TMJ disorder might be at increased risk of tinnitus.

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

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

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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.

Estradiol upregulates voltage-gated sodium channel 1.7 in trigeminal ganglion contributing to hyperalgesia of inflamed TMJ.

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Rui-Yun Bi

Full Text Available Temporomandibular disorders (TMDs have the highest prevalence in women of reproductive age. The role of estrogen in TMDs and especially in TMDs related pain is not fully elucidated. Voltage-gated sodium channel 1.7 (Nav1.7 plays a prominent role in pain perception and Nav1.7 in trigeminal ganglion (TG is involved in the hyperalgesia of inflamed Temporomandibular joint (TMJ. Whether estrogen could upregulate trigeminal ganglionic Nav1.7 expression to enhance hyperalgesia of inflamed TMJ remains to be explored.Estrous cycle and plasma levels of 17β-estradiol in female rats were evaluated with vaginal smear and enzyme linked immunosorbent assay, respectively. Female rats were ovariectomized and treated with 17β-estradiol at 0 μg, 20 μg and 80 μg, respectively, for 10 days. TMJ inflammation was induced using complete Freund's adjuvant. Head withdrawal thresholds and food intake were measured to evaluate the TMJ nociceptive responses. The expression of Nav1.7 in TG was examined using real-time PCR and western blot. The activity of Nav1.7 promoter was examined using luciferase reporter assay. The locations of estrogen receptors (ERα and ERβ, the G protein coupled estrogen receptor (GPR30, and Nav1.7 in TG were examined using immunohistofluorescence.Upregulation of Nav1.7 in TG and decrease in head withdrawal threshold were observed with the highest plasma 17β-estradiol in the proestrus of female rats. Ovariectomized rats treated with 80 μg 17β-estradiol showed upregulation of Nav1.7 in TG and decrease in head withdrawal threshold as compared with that of the control or ovariectomized rats treated with 0 μg or 20 μg. Moreover, 17β-estradiol dose-dependently potentiated TMJ inflammation-induced upregulation of Nav1.7 in TG and also enhanced TMJ inflammation-induced decrease of head withdrawal threshold in ovariectomized rats. In addition, the estrogen receptor antagonist, ICI 182,780, partially blocked the 17β-estradiol effect on Nav1

Reported concepts for the treatment modalities and pain management of temporomandibular disorders

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Wieckiewicz, Mieszko; Boening, Klaus; Wiland, Piotr; Shiau, Yuh-Yuan; Paradowska-Stolarz, Anna

2015-01-01

Background Pain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management. Methods A survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ ...

Traumas of the middle skull base with TMJ involvement. Case report.

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Bottini, D J; Gnoni, G; De Angelis, B; Savo, P; Trimarco, A; Cervelli, G; Cervelli, V

2006-03-01

The authors report their experience with temporomandibular joint (TMJ) traumas involving breakage of the roof of the glenoid cavity, an infrequent event that occurs in those cases in which, as a result of the condylar neck not fracturing, the traumatic energy is transmitted to the middle skull base. As the literature contains no valid series for establishing standardized protocols for the treatment of these fractures, we propose our own orthopedic-functional approach. The patient observed by us had suffered a cranio-facial trauma and presented the classical symptoms and signs of TMJ traumas and complete bilateral Bell paralysis. He was subjected to a CAT scan and then to 2-stage treatment consisting of functional rest with liquid diet followed by physiotherapy. An almost total recovery in TMJ function was observed after 1 month. At 1-year follow-up the facial paralysis had resolved completely. On the basis of our experience, breakages of the glenoid cavity can be compared, in terms of treatment procedure, to intracapsular fractures of the TMJ with surgery confined to cases of ankylosis sequelae. To avoid the onset of ankylosis careful control of clinical, functional and radiological follow-up is required.

Arthrography of the TMJ. Indications, technique and interpretation

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Jend, H.H.; Triebel, H.J.; Jend-Rossmann, I.

1986-09-01

Articular dysfunction of the TMJ with anterior displacement of the disc ('internal derangement') is an entity which has been separated from other types of the 'myofascial pain syndromes' and which can be treated conservatively or by surgery. Arthrography of the TMJ has contributed greatly to an understanding of normal and abnormal function and, in many cases, it can provide a diagnosis. On the basis of our experience with 80 investigations we discuss technical problems and the clinical indications. The indications for arthrography are in the pre-operative diagnosis, when clinical findings are uncertain, in order to demonstrate perforation, in order to confirm a suspected diagnosis and to assist in prosthetic treatment.

Gnathological splint therapy in temporomandibular joint disorder

OpenAIRE

Gnanashanmugham, K.; Saravanan, B.; Sukumar, M. R.; Tajir, T. Faisal

2015-01-01

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...

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

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

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

2009-03-01

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

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

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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.

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

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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.

TMJ ankylosis: Management with reconstruction and interpositional ...

African Journals Online (AJOL)

Temporomandibular joint (TMJ) ankylosis is a very desolating structural condition that involves fusion of the 1 mandibular condyle to the base of the skull. It causes difficulty in mastication and breathing.Trauma and Infections are usually responsible.If trauma occurs in young age,it leads to disturbance in growth & facial ...

Bruxism and TMD disorders of everyday dental clinical practice.

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Kapusevska, Biljana; Dereban, Nikola; Popovska, Mirjana; Nikolovska, Julijana; Popovska, Lidija

2013-01-01

Bruxism, as an etiological factor for the development of TMD, includes different disorders of the TMJ and the masticatory muscles, exhibiting pain and disruption of the stomatognathic functions. Our goal was to study patients with bruxism and TMD from everyday dental clinical practice, in terms of diagnosis, identification of etiological factors, classification and treatment of these disorders. We treated 120 patients, divided into 2 groups of 60 patients. The first group had disorders of the TMJ, and the second of the masticatory muscles. The groups were divided into subgroups of 20 patients with dislocation of the articular disk with or without reduction and inflammation of TMJ. The second group was organized from patients with myofascial pain, myositis and muscular trismus. Our conservative treatment consisted of patient education, NSAID, myorelaxants, fabrication of prosthetics, repositioning and stabilization splints. The progress of the patients was followed immediately after the delivery of the prosthetics and the splint, after 1, 6 and 12 months. The results showed that in patients with disorders of the TMJ there were visible signs of recovery after 6 months in 68.3% patients, and in 85% after 12 months. In the second group we achieved faster results with the elimination of symptoms. Patients with afflictions of the muscles in 88.3% of cases noticed relief of symptoms even after 6 months and in 98.3% after 12 months. As therapists we concluded that timely treated complications of bruxism and TMD prevent the destruction of the TMJ, masticatory muscles and the entire stomatognatic system.

Four years of experience with temporamandibular joint (TMJ) arthrography

International Nuclear Information System (INIS)

Duarte Filho, D.L.; Wagner, R.

1990-01-01

The imaging investigation of the internal derangements of temporomandibular joint (TMJ) has been recently enriched with state of the art tools, such as CT and MRI. However these equipments are not widely available in our country. In addition, some lesions such as perforation of the MJ meniscus, are not demonstrated by either one of these methods, been fairly easily showed by arthorography. The purpose of this paper is to show our experience with 386 arthrograms performed in 193 patients. Our results are compatible with those of the literature. In the last group of 176 patients, we have abandonned the local anesthesia procedure, with good advantages. Arthrography is a very usefull method in the evaluation of TMJ and should be more used in our country. (author)

TMJ degeneration in SAMP8 mice is accompanied by deranged Ihh signaling.

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Ishizuka, Y; Shibukawa, Y; Nagayama, M; Decker, R; Kinumatsu, T; Saito, A; Pacifici, M; Koyama, E

2014-03-01

The temporomandibular joint (TMJ) functions as a load-bearing diarthrodial joint during mastication, and its continuous use and stress can lead to degeneration over age. Using senescence-accelerated (SAMP8) mice that develop early osteoarthritis-like changes in synovial joints at high frequency, we analyzed possible molecular mechanisms of TMJ degeneration and tested whether and how malocclusion may accelerate it. Condylar articular cartilage in young SAMP8 mice displayed early-onset osteoarthritic changes that included reductions in superficial/chondroprogenitor cell number, proteoglycan/collagen content, and Indian hedgehog (Ihh)-expressing chondrocytes. Following malocclusion induced by tooth milling, the SAMP8 condyles became morphologically defective, displayed even lower proteoglycan levels, and underwent abnormal chondrocyte maturation compared with malocclusion-treated condyles in wild-type mice. Malocclusion also induced faster progression of pathologic changes with increasing age in SAMP8 condyles as indicated by decreased PCNA-positive proliferating chondroprogenitors and increased TUNEL-positive apoptotic cells. These changes were accompanied by steeper reductions in Ihh signaling and by expression of matrix metalloproteinase 13 at the chondro-osseous junction in SAMP8 articular cartilage. In sum, we show for the first time that precocious TMJ degeneration in SAMP8 mice is accompanied by--and possibly attributable to--altered Ihh signaling and that occlusal dysfunction accelerates progression toward degenerative TMJ disease in this model.

Radiodiagnostics of the temporomandibular joint of disorders

International Nuclear Information System (INIS)

Ondrasovicova, J.; Jenca, A.

2008-01-01

Temporomandibularis disorders have a multifactorial etiology with very variable clinical symptoms. On the X-ray image can see the configuration of the joint structures correctly or TMJ disorders ( luxation, subluxation, arthrosis). (authors)

Radiographic study of bone changes on TMJ arthrosis

International Nuclear Information System (INIS)

You, Dong Soo

1982-01-01

The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthrosis was eburnation of cortical bone (35.64%) of total cases. Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed state, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relationships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movement in 332 cases (28.55%), bone on bone relationships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). Bone on bone relationships in 248 cases (21.32%) and downward positioning of

Radiographic study of bone changes on TMJ arthrosis

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

1982-11-15

The author analyzed the morphologic changes of bone structures from 1256 radiographs of 314 patients with temporomandibular joint arthrosis, which were obtained by the oblique-lateral projection and orthopantomography. The interrelations of the bone changes and clinical symptoms were examined. Also, the positional relationships of condylar head, articular fossa and articular eminence in the mouth open and closed state were observed in the patients with bone changes. The results were as follows; 1. The most frequent bone change in the TMJ arthrosis was eburnation of cortical bone (35.64%) of total cases. Then came bone surface erosion and localized radiolucency (26.18%), marginal proliferation (9.7%) and flattening of articular surface (9.58%) in that order. 2. The most frequent site of bone change was articular eminence (41.70%). The came condylar head (21.09%) and articular fossa (20.73%) in that order. 3. In the patients with bone changes, their clinical symptoms were pain (51.55%), clicking sound during mandibular movement (37.71%) and limited mandibular movement (10.73%). In the patients complaining pain, their radiographs showed eburnation of cortical bone (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening in the (30.68%), bone surface erosion and localized radiolucency (27.45%) and flattening of articular surface (10.68%). 4. The condylar positional changes in the TMJ arthrosis patients with bone changes were as follows: in the mouth closed state, there were the widening of joint space in 624 cases (50.00%), the narrowing of joint space in 543 cases (43.47%) and bone on bone relationships in 82 cases (6.57%). In the mouth open state, there were forward positioning of the condyle in 332 cases (28.55%), limitation of movement in 332 cases (28.55%), bone on bone relationships in 248 cases (21.31%) and downward positioning of condyle in 217 cases (18.66%). Bone on bone relationships in 248 cases (21.32%) and downward positioning of

The effects of oxygen level and glucose concentration on the metabolism of porcine TMJ disc cells.

Science.gov (United States)

Cisewski, S E; Zhang, L; Kuo, J; Wright, G J; Wu, Y; Kern, M J; Yao, H

2015-10-01

To determine the combined effect of oxygen level and glucose concentration on cell viability, ATP production, and matrix synthesis of temporomandibular joint (TMJ) disc cells. TMJ disc cells were isolated from pigs aged 6-8 months and cultured in a monolayer. Cell cultures were preconditioned for 48 h with 0, 1.5, 5, or 25 mM glucose DMEM under 1%, 5%, 10%, or 21% O2 level, respectively. The cell viability was measured using the WST-1 assay. ATP production was determined using the Luciferin-Luciferase assay. Collagen and proteoglycan synthesis were determined by measuring the incorporation of [2, 3-(3)H] proline and [(35)S] sulfate into the cells, respectively. TMJ disc cell viability significantly decreased (P oxygen levels significantly increased viability (P oxygen levels significantly reduced ATP production (P oxygen was significant in regards to cell viability (P oxygen are important, glucose is the limiting nutrient for TMJ disc cell survival. At low oxygen levels, the production of ATP, collagen, and proteoglycan are severely inhibited. These results suggest that steeper nutrient gradients may exist in the TMJ disc and it may be vulnerable to pathological events that impede nutrient supply. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

The craniocervical connection: a retrospective analysis of 300 whiplash patients with cervical and temporomandibular disorders.

Science.gov (United States)

Friedman, M H; Weisberg, J

2000-07-01

Because the concept of whiplash as a causative factor for temporomandibular disorders (TMD) is highly controversial, we decided to do a retrospective analysis of patients treated in our office who had sustained whiplash injuries and were treated for cervical and temporomandibular disorders. The records of 300 patients with TMD preceded by a motor vehicle accident were examined retrospectively. The most common presenting symptoms, in order, were: jaw pain, neck pain, post-traumatic headache, jaw fatigue, and severe temporomandibular joint (TMJ) clicking. The most common TMD diagnoses were: masseter trigger points, closing jaw muscle hyperactivity, TMJ synovitis, opening jaw muscle hyperactivity, and advanced TMJ disk derangement. Based primarily on the physical examination, we concluded that the TMJ and surrounding musculature should be examined similarly to other joints, with no preconceived notion that TMD pathology after whiplash is unlikely.

TMJ: Symptoms, Diagnosis and Treatment | NIH MedlinePlus the Magazine

Science.gov (United States)

... teeth are the most widely used treatment for TMJ. Studies of their effectiveness at relieving pain are inconclusive. Splints should be used only for a short time and not cause permanent changes in ...

Psychoneuroimmunological disorders and temporomandibular joint pain: A review

Directory of Open Access Journals (Sweden)

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.

Patients with restored occlusions. Part III: The effect of occlusal splint therapy and occlusal adjustments on TMJ dysfunction.

Science.gov (United States)

Lederman, K H; Clayton, J A

1983-07-01

An earlier study of 50 patients with occlusions restored by fixed partial dentures indicated a high percent (68%) of TMJ dysfunction. Occlusal interferences can play a significant role in causing TMJ dysfunction. To determine the significance of occlusal interferences, occlusal splints were placed in 10 of these restored patients who had moderate to severe dysfunction. The PRI was used to detect the presence or absence of TMJ dysfunction. The PRI TMJ dysfunction scores were reduced in all 10 patients after use of the occlusal splint. Five of the patients achieved reproducible tracings (no TMJ dysfunction) during the experiment time of 7 months. The occlusion of two patients was adjusted to eliminate the need for the occlusal splint. Patients who wore the splint 24 hours a day showed a significant (0.0004 level) reduction in TMJ dysfunction. Those patients who did not wear the splint regularly or had high levels of stress had PRI scores that varied. This finding indicates that the occlusal splint is not a treatment, as its removal permits reactivation of the occlusal interference. Resolution of dysfunction did not occur until occlusal interferences were removed. The changes in PRI scores to different dysfunction categories (none, slight, moderate, and severe) for the experimental group were significant at the 0.01 level. A control group of five patients had similar pantographic tracings but no other treatment. Their PRI scores varied, but there was no significant change in PRI scores or dysfunction categories. It was concluded that occlusal interferences were active causes of TMJ dysfunction in 10 of 36 patients in a population with restored occlusions.

[The value of double contrast arthrotomography combined with cinematography in the diagnosis of functional and structural TMJ alterations].

Science.gov (United States)

Engelke, W; Grossniklaus, B; Sailer, H F

1991-01-01

Double contrast arthrotomography combined with cinematography as a diagnostic instrument establishing functional and structural TMJ alterations is evaluated for its diagnostic value and reliability within the chain of diagnostic measures applied. In 131 patients double-contrast arthrotomography was followed by a comprehensive history of joint problems, and verification of the clinical findings as well as the arthrographic diagnosis and the post-arthrographic TMJ alterations. Our interest was focussed, among others, on the question whether arthrography alone would have any therapeutic effect or produce an alteration in TMJ function.

Radiodiagnostics of the temporomandibular joint of disorders; Radiodiagnostika ochoreni TMK

Energy Technology Data Exchange (ETDEWEB)

Ondrasovicova, J; Jenca, A [Klinika stomatologie a maxilofacialnej chirurgie, Lekarska fakulta, Univerzita Pavla Jozefa Safarika a Fakultna nemocnica L. Pasteura, Kosice (Slovakia)

2008-06-15

Temporomandibularis disorders have a multifactorial etiology with very variable clinical symptoms. On the X-ray image can see the configuration of the joint structures correctly or TMJ disorders ( luxation, subluxation, arthrosis). (authors)

Relationship between clinical findings of temporomandibular disorders and magnetic resonance imaging

International Nuclear Information System (INIS)

Iizuka, Yasuyuki; Miura, Hiroyuki; Ishikawa, Fujiro; Kikuchi, Shiori; Konishi, Nobuhiro; Sakamaki, Kimio

1996-01-01

The present study was conducted to investigate the relationship between magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) and clinical findings of patients having symptoms of temporomandibular disorders, and to consider the possibility to grasp the internal derangement of the TMJ from clinical findings. Subjects were 80 patients who visited to ask orthodontic treatment 16 males and 64 females. The average age was 22 years and 4 months. We performed a investigation of both their previous and present illness. In addition, to decide the correct condition concerning the internal derangement of the TMJ, patients were given MRI examinations (G. E. medical system Signa 1.5 Tesla) before orthodontic treatment. Results were as follows: The three symptoms of temporomandibular disorders-noise, pain, and abnormal mandibular movement, were not related to constant disk displacement. It seemed difficult to infer and obtain the diagnosis of the condition of internal derangement of the TMJ only from clinical findings. In a dental clinics having no medical imaging instrument such as MRI, it was, however, considered that the following items will make it possible to define the condition of internal derangements of the TMJ from clinical findings. As to respects concerning clinical findings, it is necessary to consider the previous illness as well as present illness. TMJ noise indicates a higher relationship to the disk displacement in MRI findings. The temporomandibular joint with plural symptoms indicated a higher incidence of disk displacement examined by MR Imaging than that with a single symptom. (author)

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

Signs and symptoms of temporomandibular disorders in the elderly.

Science.gov (United States)

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

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. 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 examination. The results were analyzed through descriptive statistics as well as using χ2 and the tendency tests. The presence of TMD was observed in 61% of the sample (mild: 43.5%, moderate: 13%, severe: 4.5%). A significantly greater prevalence of TMD was found for females (72.4%) compared with that for men (41.1%) (pheadaches and the presence of TMD (p=0.0001). The association between the presence of joint noises and sensitivity to TMJ palpation was not significant. The elderly presented high TMD prevalence, mostly in females, with mild severity and related to TMJ and masticatory/cervical muscles palpation. Thus, the accomplishment of a detailed clinical examination to investigate the presence of such disorders is essential and it must not be neglected during the treatment of elderly patients.

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

DEFF Research Database (Denmark)

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

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

Evaluation of the TMJ by means of Clinical TMD Examination and MRI Diagnostics in Patients with Rheumatoid Arthritis

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Silke Witulski

2014-01-01

Full Text Available This study included 30 patients with diagnosed rheumatoid arthritis (RA and 30 test subjects without RA (control group. The objective of the study was to examine both groups for the presence of temporomandibular disorders (TMD and morphological changes of the temporomandibular joint (TMJ. All individuals were examined using a systematic detailed clinical TMD examination as well as magnetic resonance imaging (MRI. The clinical TMD examination yielded significant differences between the RA patients and the control group concerning crepitus of the TMJ, and palpation tenderness of the masticatory muscles as well as the unassisted mandibular opening. The evaluation of the MRI images for the RA group showed significantly more frequent deformations of the condyle, osteophyte formations and erosions in the condylar compacta, and degenerative changes in the spongiosa. Increased intra-articular accumulation of synovial liquid and signs of inflammatory changes of the spongiosa were only found in the RA group. Statistical analysis showed a significant correlation between crepitus and specific osteoarthrotic changes (MRI, respectively, and between crepitus and a complete anterior disk displacement without reduction (MRI. The duration of the RA disease correlated neither with the anamnestic and clinical dysfunction index by Helkimo nor with RA-specific MRI findings.

Dosimetry in CBCT with different protocols: emphasis on small FOVs including exams for TMJ

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Nascimento, Helena Aguiar Ribeiro; Nascimento, Eduarda Helena Leandro; Freitas, Deborah Queiroz, E-mail: eduarda.hln@gmail.com [Universidade de Campinas (UNICAMP), Piracicaba, SP (Brazil). Departmento de Diagnose Oral; Andrade, Marcos Ely Almeida [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Departmento de Energia Nuclear; Frazão, Marco Antonio Gomes [Faculdade de Odontologia de Recife (FOR), Recife, PE (Brazil). Divisao de Radiologia Oral; Ramos-Perez, Flavia Maria Moraes [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil). Departmento de Clinica e Odontologica Preventiva

2017-07-15

This study aimed to estimate the absorbed dose in cone beam computed tomography (CBCT) exams according to different exposure parameters and size and position of the field of view (FOV). In addition was compared the absorbed dose of two smaller FOV scans with that of a larger FOV scan for evaluation of temporomandibular joint (TMJ), as it is a bilateral structure. CBCT scans were obtained on OP300 Maxio unit varying scanning mode (standard, high and endo) as well as size (5 x 5, 6 x 8 and 8 x 15 cm) and positioning of FOV. With a small FOV, different areas were scanned (maxilla or mandible, anterior or posterior and TMJ). Absorbed doses were determined using thermoluminescent dosimeters on the skin surface of sensitive organs of an anthropomorphic phantom. Endo mode showed the highest dose, followed by the high and standard modes in all FOV positions. With small FOV, doses were higher in the posterior region, especially in the mandible. Dose reduction occurred when small FOVs were used, but it was not proportional to FOV size reduction. For TMJ, the dose in a single acquisition with large FOV was greater than two acquisitions with small FOV, but lower than two acquisitions with medium FOV (6x8 cm). In conclusion, scanning mode, size and FOV position have great influence on the absorbed dose. Small FOV decreases the dose, but there is no linear relation between FOV size and dose. For bilateral exams of TMJ, double acquisition with small FOVs produces decrease in absorbed dose relative to a large FOV. (author)

Magnetic resonance imaging findings of the retrodiskal tissue in TMJ internal derangement

International Nuclear Information System (INIS)

Cho, Bong Hae

2003-01-01

To describe the MRI findings of the retrodiskal tissue in patients presenting with TMJ internal derangement and to correlate these findings with clinical and other MRI manifestations. One hundred eighteen joints of 63 patients with TMJ internal derangement were examined by MRI. T1-weighted sagittal MR images taken in both closed- and open-mouth were evaluated for the presence of demarcation between disk and retrodiskal tissue, the presence of low signal intensity, and the depiction of the temporal part of the posterior attachment. The results were correlated with the duration of TMJ internal derangement, the presence of pain, and other MRI findings, including the type of internal derangement, the extent of disk displacement, the degree of disc deformation, and the presence of osteoarthrosis. A significant relationship between the presence of low signal intensity in the retrodiskal tissue and other MRI findings was determined. Low signal intensity on the open-mouth view was observed more frequently in patients with disc displacement without reduction, severe disc displacement and deformation, and osteoarthrosis (p<0.05). The demarcation between disk and retrodiskal tissue, and the depiction of the temporal part of the posterior attachment (TPA) were correlated neither with clinical, nor with other MRI findings. This study suggests that low signal intensity in the retrodiskal tissue on open-mouth MR image can be indicative of advanced stages of disk displacement.

Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder Avaliação radiográfica da coluna cervical de indivíduos com distúrbios internos da articulação temporomandibular

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...

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.

The relationship of temporomandibular disorders with headaches: a retrospective analysis.

Science.gov (United States)

Özkan, Nilüfer Cakir; Ozkan, Fatih

2011-01-01

The objective of this study was to retrospectively analyze the incidence of the concurrent existence of temporomandibular disorders (TMD) and headaches. Forty patients (36 female, 4 male, mean age: 29.9±9.6 years) clinically diagnosed with TMD were screened. Patient records were analyzed regarding: range of mouth opening, temporomandibular joint (TMJ) noises, pain on palpation of the TMJ and masticatory muscles and neck and upper back muscles, and magnetic resonance imaging of the TMJ. According to patient records, a total of 40 (66.6%) patients were diagnosed with TMD among 60 patients with headache. Thirty-two (53%) patients had TMJ internal derangement (ID), 8 (13%) patients had only myofascial pain dysfunction (MPD) and 25 (41.6%) patients had concurrent TMJ ID/MPD. There were statistically significant relationships between the number of tender masseter muscles and MPD patients (p=0.04) and between the number of tender medial pterygoid muscles and patients with reducing disc displacement (RDD) (p=0.03). The TMJ and associated orofacial structures should be considered as possible triggering or perpetuating factors for headaches, especially tension-type. There might be a significant connection between TMD and headache. However, most medical and dental practitioners are unaware of this relationship. Therefore, a careful evaluation of the TMJ and associated orofacial structures is required for a correct interpretation of the craniofacial pain in headache patients, and these patients should be managed with a multidisciplinary approach.

Mechanical stiffness of TMJ condylar cartilage increases after artificial aging by ribose.

Science.gov (United States)

Mirahmadi, Fereshteh; Koolstra, Jan Harm; Lobbezoo, Frank; van Lenthe, G Harry; Ghazanfari, Samaneh; Snabel, Jessica; Stoop, Reinout; Everts, Vincent

2018-03-01

Aging is accompanied by a series of changes in mature tissues that influence their properties and functions. Collagen, as one of the main extracellular components of cartilage, becomes highly crosslinked during aging. In this study, the aim was to examine whether a correlation exists between collagen crosslinking induced by artificial aging and mechanical properties of the temporomandibular joint (TMJ) condyle. To evaluate this hypothesis, collagen crosslinks were induced using ribose incubation. Porcine TMJ condyles were incubated for 7 days with different concentrations of ribose. The compressive modulus and stiffness ratio (incubated versus control) was determined after loading. Glycosaminoglycan and collagen content, and the number of crosslinks were analyzed. Tissue structure was visualized by microscopy using different staining methods. Concomitant with an increasing concentration of ribose, an increase of collagen crosslinks was found. The number of crosslinks increased almost 50 fold after incubation with the highest concentration of ribose. Simultaneously, the stiffness ratio of the samples showed a significant increase after incubation with the ribose. Pearson correlation analyses showed a significant positive correlation between the overall stiffness ratio and the crosslink level; the higher the number of crosslinks the higher the stiffness. The present model, in which ribose was used to mimic certain aspects of age-related changes, can be employed as an in vitro model to study age-related mechanical changes in the TMJ condyle. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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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.

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

International Nuclear Information System (INIS)

Orhan, Kaan; Nishiyama, Hideyoshi; Tadashi, Sasaki; Shumei, Murakami; Furukawa, Souhei

2005-01-01

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

Head, Neck, and Oral Cancer

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Full Text Available ... Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety ... Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety ...

Obstructive Sleep Apnea

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Full Text Available ... Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety ... Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety ...

Corrective Jaw Surgery

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Full Text Available ... Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety ... Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety ...

Administration of Anesthesia

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Full Text Available ... Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety ... Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals with a TMJ disorder may experience a variety ...

Isolated marginal facial nerve paresis after TMJ discopexy: a case report.

Science.gov (United States)

Reychler, H; Mahy, P

2011-01-01

Isolated marginal facial nerve paresis after TMJ discopexy: a case report. This is the first report of a transient, isolated marginal facial nerve paresis after temporomandibular joint arthrotomy. The paresis seems to have resulted from a crush lesion by Backhaus forceps, placed transcutaneously during the operation to distract the intra-articular space.

Contemporary management of TMJ involvement in JIA patients and its orofacial consequences.

Science.gov (United States)

Niibo, Priit; Pruunsild, Chris; Voog-Oras, Ülle; Nikopensius, Tiit; Jagomägi, Triin; Saag, Mare

2016-01-01

Juvenile idiopathic arthritis is the most common chronic rheumatic condition during childhood. Temporomandibular joint arthritis is frequently asymptomatic. When it takes place during childhood, it may affect condylar growth; therefore, these children are at risk of unfavorable long-term outcomes from the associated joint damage. The etiology is not completely understood, but it is considered as multifactorial with both genetic and environmental factors involved. The standardized examination and imaging protocols serve important purpose to diagnose temporomandibular joint (TMJ) arthritis not only to establish an early interventional strategy but also to assess craniofacial growth and the progression of signs and symptoms in those patients. Although the treatment of juvenile idiopathic arthritis (JIA) has changed dramatically over the last decades due to new therapeutic options, TMJ arthritis still can develop during the course of the disease. In clinical experience, TMJs appear to respond less well to the standard of care used to treat other joints. More individualized approach to the patient's treatment serves as the main goal of personalized medicine. It could be achieved by adopting new methods of medical imaging such as conebeam computer tomography as well as developing reliable biomarkers which may assist with predicting disease type, course, or severity and predicting response to medication. This article provides an overview of current information on orofacial complications in JIA and its management. Based on information provided in this review, more precise diagnosis, proper tools for recognizing people at risk, and more efficient treatment approaches could be implemented. This may lead to more personalized treatment management strategies of TMJ complications of JIA patients.

Administration of Anesthesia

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Full Text Available ... more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ... more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ...

Obstructive Sleep Apnea

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Full Text Available ... more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ... more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ...

Corrective Jaw Surgery

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Full Text Available ... more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ... more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ...

Head, Neck, and Oral Cancer

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Full Text Available ... more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ... more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ...

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

International Nuclear Information System (INIS)

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

2012-01-01

Purpose: 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. Materials and methods: 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 p < 0.05. Results: A significant difference was observed between the internal and external contrast enhancement of the joints with partial

Corrective Jaw Surgery

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Full Text Available ... out more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ... out more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ...

Obstructive Sleep Apnea

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Full Text Available ... out more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ... out more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ...

Head, Neck, and Oral Cancer

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Full Text Available ... out more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ... out more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ...

Administration of Anesthesia

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Full Text Available ... out more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ... out more. TMJ and Facial Pain TMJ and Facial Pain Temporomandibular Joint (TMJ) disorders are not uncommon. Individuals ...

Reported concepts for the treatment modalities and pain management of temporomandibular disorders.

Science.gov (United States)

Wieckiewicz, Mieszko; Boening, Klaus; Wiland, Piotr; Shiau, Yuh-Yuan; Paradowska-Stolarz, Anna

2015-01-01

Pain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management. A survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ rheumatoid disorders and TMJ surgery. Original articles and review papers which presented the clinical relevance and practical validity regarding the possibility of application in TMD management have been included. Authors have excluded articles without outstanding practical aspect and evidence-based background. A first selection was carried out by reviewing titles and abstracts of all articles found according to the criteria. After that the full texts of potentially suitable articles were assessed. In line with these criteria, among 11467 results the writers have included 66 papers. The most commonly reported conservative treatments are massage therapy and individually fabricated occlusal splints. In addition to massage, other popular methods include manual therapy and taping, warming/cooling of aching joints, and light and laser therapy. Drugs are also commonly used. In the most severe cases of the temporomandibular joint degeneration, surgical restoration of the joint is sometimes applied. The authors concluded that conservative treatment including counselling, exercises, occlusal splint therapy, massage, manual therapy and others should be considered as a first choice therapy for TMD pain because of their low risk of side effects. In the case of severe acute pain or chronic pain resulting from serious disorders, inflammation and/or degeneration pharmacotherapy, minimally invasive and invasive procedures should be considered.

Distribution of craniomandibular disorders, occlusal factors and oral parafunctions in a paediatric population.

Science.gov (United States)

Corvo, G; Tartaro, G; Giudice, A; Diomajuta, A

2003-06-01

The aim of this work was to gather clinical data on craniomandibular (CMD)/temporomandibular joint (TMJ) disorders in a paediatric population. The clinical study population comprised patients with TMJ disorders who were being treated in the orthognathic ambulatory clinic of the University of Naples, where an instrumental and clinical study was performed. Data were recorded for extra and intraoral findings, Angles classification and malocclusions. Radiographic examinations were carried out. Study models were fabricated for evaluation. TMJs were assessed by palpation as well as masseter, temporal, suprahyoid, sternocleidomastoid, suboccipital, paravertebral and trapezius muscles to evaluate any possible pain. Auscultation of the TMJ was used to determine presence of articular sounds and their type (cracks, crunches, clicks) by the use of a stethoscope. Pain localisation was evaluated according to these movements taking into account site, intensity, frequency, and duration. Episodes of headache were recorded according to its intensity (mild, moderate, intense), frequency (daily, weekly, monthly), site (top of the head, occiput, temple, frontal, overorbital region, back of the head) and the duration of the episodes (in minutes, hours or whether constant). A substantial number of the 106 patients included in the study showed a malocclusion with prevalence in Angles Class II cases. Bruxism, onychophagy, TMJ pain, headache, mouth opening partial inability, mastication difficulty and articular sound were the most representative symptoms. The identification and recognition of factors, such as malocclusions and parafunctions, are considered fundamental to early diagnosis of TMJ problems, which is the most useful way to avoid a dysfunctional state of the stomatognathic system.

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

Science.gov (United States)

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

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 submitted to clinical and radiographic evaluation. Clinical evaluation comprised anamnesis and stomatognathic system physical examination. Radiographic evaluation comprised analysis of lateral cervical spine X-rays by three physical therapists and tracing on the same images. The test group presented twice as much cervical spine hyperlordosis as the control group (20.7% versus 10.5%), but almost half of rectification prevalence (41.4 versus 79.0%, p = 0.03). After that, the test group was divided into three subgroups according to TMJ dysfunction severity, evaluated by Helkimo's index. These subgroups were not significantly different, but the subgroup with more severe TMD showed a tendency to cervical spine hyperlordosis prevalence. Results showed a tendency for subjects with more severe TMD to exhibit cervical spine hyperlordosis. Nevertheless, studies with a larger number of subjects suffering from severe TMD are encouraged in order to corroborate the present findings.

TMJ Disorders

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TMJ Disorders

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Development of collagen fibers and vasculature of the fetal TMJ.

Science.gov (United States)

Yang, L; Wang, H; Wang, M; Ohta, Y; Suwa, F

1992-10-01

Using 12 human fetuses, histological development and changes in connective fiber structure and fine vascular patterns have been investigated in various fetal gestational stages by light and scanning electron microscopy. The main arterial supply of the articular disc was from the bilaminar region and pterygoideus lateralis muscle. The vascular network on the disc surface was related with fluid secretion. When the bilaminar region was compressed, it caused ischemia and fibrosis as the main pathological changes in TMJ derangement. A decrease in fluid from blood vessels might occur in TMJ degeneration. Collagen fibers in the disc passed mainly anteroposteriorly. In the anterior and posterior bands, muscular tendon fibers came from the pterygoideus lateralis muscle and superior stratum of the bilaminar region. In the posterior band three-dimensional structures of collagen fibers suitable for load bearing were observed. The compass network and process on the disc showed the normal structure that is formed gradually and has functions including dispersion, pressure bearing, friction-proofing and storage of the synovial fluid. Attachments of the disc were suitable for disc function. Large elastic fibers in the posterolateral part of the superior stratum of the bilaminar region may be antagonistic to the upper head of the pterygoideus lateralis muscle fibers passing medioanteriorly, indicating that this antagonism is available for disc function.

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.)

Chewing ability as a parameter for evaluating the disability of patients with temporomandibular disorders.

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Kurita, H; Ohtsuka, A; Kurashina, K; Kopp, S

2001-05-01

Restoration of chewing ability is an important aspect of the treatment for temporomandibular disorders (TMDs). However, too little attention has been paid to it. We have used a questionnaire to evaluate and score the chewing ability of TMD patients. The questionnaire includes 19 kinds of food and a chewing task. The patient was asked if she/he experiences difficulty in enjoying eating. The aim of this study was to evaluate correlations between score of chewing ability (SCA) and other symptoms/signs of TMD. Four hundred and seventy-three consecutive TMD patients were evaluated for SCA and other symptoms/signs including temporomandibular joint (TMJ) pain, TMJ and muscle tenderness, TMJ noise (clicking and crepitus), and maximum mouth opening. The relationship between SCA and other symptoms/signs were analysed by multiple regression analysis. Score of chewing ability correlated significantly with TMJ pain and mouth opening capacity but not with TMJ noise and muscle tenderness. Age was a background factor but sex was not. The result of this study suggests that SCA correlated with dysfunction of the TMD patients. This method could be used to evaluate the ability of chewing in assessment of TMD.

Patients profiles and outcomes of care in temporomandibular disorders

NARCIS (Netherlands)

Su, N.

2018-01-01

Temporomandibular disorders (TMDs) are a frequent disease in general population. Patients with TMDs may have orofacial pain, jaw functional limitation and joint sounds, which may negatively affect patients’ physical and psychological wellbeing. Temporomandibular joint osteoarthritis (TMJ OA) and

Chondroblastoma of the TMJ: Case Report

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Mahammad Davudov

2017-11-01

Full Text Available Background: Chondroblastoma is one of the rare diseases. It often localizes in the epiphysis of the long bones. It is very rare in the flat bones (20 % in men, especially in the facial bones and TMJ. Usually it is found in young people under the age of 20 and its rate in women is 2 times lesser than in men. Its etiology is still unknown. Case report: Patient M.P., a 45 years old male, applied to Clinic with limited mouth opening and swelling on the right periauricular masticatory region. The tumor was removed by surgical operation under the general anesthesia, sent to pathohistologic analysis, and the diagnosis of chondroblastoma was confirmed. Conclusion: Treatment has been successful and no recurrent findings or postoperative complications, including functional restrictions, have occurred in the one year following the complete tumor excision.

The relationship between the TMJ internal derangement state including rotational displacement and perforation and the clinical characteristics

International Nuclear Information System (INIS)

Jeong, Hwan Seok; You Dong Soo

1998-01-01

This study was designed to reveal the correlationship between the internal derangement state of TMJ and clinical characteristics including pain and mandibular dysfuntion. One hundred and twenty five subjects with TMJ signs and symptoms were chosen for two years. The level of pain and mandibular dysfuntion were evaluated by Visual Analog Scale (VAS) and Craniomandibular Index (CMI). The diagnostic categories of TMJ internal derangement were determined by arthrography and they included normal disc position, anterior disc displacement with reduction (ADDR), rotational disc displacement with reduction (RDDR), andterior disc displacement without reduction (ADDNR), and rotational disc displacement without reduction (RDDNR). Also disc perforation was used as a criteria to divide the diagnostic subgroups. The obtained results were as follows ; 1. The patient distribution of each group was 5 in normal disc position (4%), 40 in ADDR (32%), 30 in RDDR (24%), 34 in ADDNR (27%), and 16 in RDDNR (13%). 2. Perforation was observed in 8% of ADDR, 10% of RDDR, 32% of ADDNR, and 19% of RDDNR. 3. CMI of perforation group was higher than that of reduction or normal group(p 0.05).

Distribution of stress on TMJ disc induced by use of chincup therapy: assessment by the finite element method

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Calçada, Flávio Siqueira; Guimarães, Antônio Sérgio; Teixeira, Marcelo Lucchesi; Takamatsu, Flávio Atsushi

2017-01-01

ABSTRACT Objective: To assess the distribution of stress produced on TMJ disc by chincup therapy, by means of the finite element method. Methods: a simplified three-dimensional TMJ disc model was developed by using Rhinoceros 3D software, and exported to ANSYS software. A 4.9N load was applied on the inferior surface of the model at inclinations of 30, 40, and 50 degrees to the mandibular plane (GoMe). ANSYS was used to analyze stress distribution on the TMJ disc for the different angulations, by means of finite element method. Results: The results showed that the tensile and compressive stresses concentrations were higher on the inferior surface of the model. More presence of tensile stress was found in the middle-anterior region of the model and its location was not altered in the three directions of load application. There was more presence of compressive stress in the middle and mid-posterior regions, but when a 50o inclined load was applied, concentration in the middle region was prevalent. Tensile and compressive stresses intensities progressively diminished as the load was more vertically applied. Conclusions: stress induced by the chincup therapy is mainly located on the inferior surface of the model. Loads at greater angles to the mandibular plane produced distribution of stresses with lower intensity and a concentration of compressive stresses in the middle region. The simplified three-dimensional model proved useful for assessing the distribution of stresses on the TMJ disc induced by the chincup therapy. PMID:29160348

Comparison of static MRI and pseudo-dynamic MRI in temporomandibular joint disorder patients

International Nuclear Information System (INIS)

Lee, Jin Ho; Yun, Kyoung In; Park, In Woo; Choi, Hang Moon; Park, Moon Soo

2006-01-01

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

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.

Temporomandibular disorders in young people with an intellectual disability: prevalence of signs and symptoms.

Science.gov (United States)

Tanboga, I; Durhan, M A; Durmus, B; Marks, L A

2014-12-01

To assess the prevalence of signs and symptoms related to TMJ disorders in a group of young people with intelectual disability (ID) and a matched group of healthy adolescents. A group of 105 young Special Olympics (SO) athletes (ID group) aged from 14 to 25 years and a control group were examined for the presence or absence of signs and symptoms of TMD through interview and clinical examination. A total of 64 young people with ID (61%) had at least one sign of TMD compared to 41 (39%) of the individuals screened that was free of any TMD symptoms. A significantly higher prevalence of TMJ sounds (palpation and stethoscope), TMJ tenderness, maximum vertical opening, headaches were observed among SO athletes compared to the healthy control group (pdisabled patients and a possible cause of pain that should be examined more in detail. We suggest that oral screening in people with a mental disability should be modified by including basic TMJ examination parameters in order to allow better understanding of the pathological aspects so as to address effective preventive and therapeutic measures.

The role of temporomandibular joint dysfunction and occlusal disorders in the pathophysiology of somatogenic cochlear and vestibular syndrome

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A. V. Boldin

2016-01-01

Full Text Available Rationale: Temporomandibular joint (TMJ dysfunction and occlusion abnormalities can cause cochlear and vestibular disorders. This issue is at the crossroads of several disciplines: otoneurology, physiotherapy, dentistry, medical rehabilitation and posturology, which often makes it difficult to timely diagnose them and delays the onset of treatment. Aim: To assess the role of abnormal dental occlusion and TMJ disorders in the pathophysiology and clinical manifestation of cochleovestibular syndrome. Materials and methods: We examined 300 subjects with clinical signs of cochleovestibular syndrome, asymmetry of occlusion and/or TMJ dysfunction (the main group, 55 patients with signs of TMJ structural and functional disorders and occlusal disorders without a cochleovestibular syndrome (the reference group, and 35 healthy volunteers (the control group. All patients were examined by a neurologist, an ENT specialist, a dentist and a physiotherapist. A series of additional investigations of the brachiocephalic vessels, cervical spine, TMJ, auditory and vestibular function, premature tooth contacts were performed. Results: The main group patients had high values of TMJ dysfunction in the Hamburg test (5.85 vs 2.2 in the reference group and higher proportions of patients with moderate and severe TMJ dysfunction (n = 243, 81% and n = 13, 23.7%, respectively. The functional muscle test parameters and the results of manual muscle testing in the main group patients were significantly different from those in the control group (р < 0.05, whereas most values obtained in the reference group did not differ significantly (р > 0.05. Patients with cochleoves-tibular syndrome had 2 to 3-fold higher rates of vertebrogenic dysfunctions than those from the reference group. The video nystamography technique detected the positional cervical nystagmus in 100% (n = 300 of patients from the main group, whereas there were no nystagmus in those from the reference group

Evaluation of osseous changes of TMJ in internal derangement and osteoarthritis patients using MRI

International Nuclear Information System (INIS)

Cho, Su Beom; Koh, Kwang Joon

2001-01-01

To evaluate the osseous changes of TMJ in internal derangement and osteoarthritis patients using MRI. MR images of 111 TMJs in 64 patients were analyzed to evaluate the osseous changes. 111 TMJs were divided into 6 groups according to the radiologic Stages by Schellhas and Wilkes. On MR images, we evaluate the osseous changes of articular eminence and condylar head. The most frequent Stage in internal derangement of TMJ was Stage Ι. And 38 joints (25.2%) revealed osteoarthritis with internal derangement. When osseous change of articular eminence and condylar head occur, flattening was the most common osseous change. Sclerosis was observed in all Stages and osteophytosis of condylar head was observed in Stage ΙΙ (1.8%) and ΙΙΙ (0.9%). Out of 28 joints with osteoarthritis, 6 joints (21.4%) showed joint effusion. MR image revealed abnormal configuration of disk, but the detection of minimal osseous change was subtle

Temporomandibular disorders after whiplash injury

DEFF Research Database (Denmark)

Kasch, Helge; Hjorth, Tine; Svensson, Peter

2002-01-01

Aims: Whiplash injury to the neck, is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies however have examined TMD-related pain in acute whiplash...... patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Methods: Prospectively, 19 acute whiplash patients exposed...... obtained at each visit. Results: One whiplash patient and I ankle-injury patient bad jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ...

Osseous changes and condyle position in TMJ tomograms: impact of RDC/TMD clinical diagnoses on agreement between expected and actual findings.

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Wiese, Mie; Wenzel, Ann; Hintze, Hanne; Petersson, Arne; Knutsson, Kerstin; Bakke, Merete; List, Thomas; Svensson, Peter

2008-08-01

The objective of this study was to evaluate the impact of clinical TMJ diagnosis, gender, and age on the agreement between expected and actual radiographic findings. A total of 204 patients with TMJ symptoms were examined using the Research Diagnostic Criteria (RDC/TMD). Expected radiographic findings were recorded. TMJ tomograms in closed and open mouth position were assessed for osseous changes and condyle position. Expected and actual findings were compared. Logistic regression analyses were performed with agreement on radiographic findings as the dependent variable and with clinical RDC/TMD diagnoses, gender and age as the independent variables. The number of radiographic findings was mostly underestimated. A clinical diagnosis of osteoarthritis and age increased the chance of overestimating osseous changes. Disc displacement and age decreased the chance of agreement on certain condyle positions. Tomography often revealed unexpected findings. It was not possible to select particular patient groups who would benefit more or less from a radiographic examination.

THE RELATIONSHIP BETWEEN TMJ DISORDER AND HEAD AND NECK POSTURE

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Sesi R. Puspita Dewi

2015-06-01

Full Text Available Temporomandibular joint disorders may be caused by variety of factors; one of which is the posture of head and neck. However, this remains controversial and a subject of debate by experts. The objective of this study was to know whether there was a relation between temporomandibular disorders and the head and neck posture seen radiographically. Subjects were 40 dental students from University of Indonesia who met the inclusion criteria, selected through questionnaire, and subjective examination based on Helkimo’s dysfunction index. Then, lateral cephalometric radiographs were done to all subjects. In the radiogram, a horizontal line was made from the nasion point to the sella tursica, and a vertical line was drawn along the prominent bone of C1 – C5. The angle between the two lines was measured, and used to represent the head and neck posture. The design of the study was cross sectional. Based on statistical analysis, there was no significant relationship between the anamnestic dysfunction index as well as the clinical dysfunction index that represented the temporomandibular joint disorders and the posture of the head and neck seen radiographically.

Executive summary of the Diagnostic Criteria for Temporomandibular Disorders for clinical and research applications.

Science.gov (United States)

Schiffman, Eric; Ohrbach, Richard

2016-06-01

In this executive summary, the authors describe a protocol for assessing patients with temporomandibular disorder (TMD). It is based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for clinical and research applications. The DC/TMD was developed using published Axis I physical diagnoses for the most common TMDs. Axis I diagnostic criteria were derived from pertinent clinical TMD signs and symptoms. Axis II consists of psychosocial and behavioral questionnaires already in the public domain. A panel of experts vetted and modified the Axis I and Axis II diagnostic protocols. Recommended changes were assessed for diagnostic accuracy by using the Validation Project's data set, which formed the basis for the development of the DC/TMD. Axis I diagnostic criteria for TMD pain-related disorders have acceptable validity and provide definitive diagnoses for pain involving the temporomandibular joint (TMJ) and masticatory muscles. Axis I diagnostic criteria for the most common TMJ intra-articular disorders are appropriate for screening purposes only. A definitive diagnosis for TMJ intra-articular disorders requires computed tomography or magnetic resonance imaging. Axis II questionnaires provide valid assessment of psychosocial and behavioral factors that can affect management of TMD. The DC/TMD provides a questionnaire for the pain history in conjunction with validated clinical examination criteria for diagnosing the most common TMDs. In addition, it provides Axis II questionnaires for assessing psychosocial and behavioral factors that may contribute to the onset and perpetuation of the patient's TMD. The DC/TMD is appropriate for use in clinical and research settings to allow for a comprehensive assessment of patients with TMD. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

Magnetic resonance images of patients with temporomandibular disorders: Prevalence and correlation between disk morphology and displacement

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Amaral, Ruana de Oliveira, E-mail: ruana.amaral@hotmail.com [Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais (Brazil); Damasceno, Naiana Nolasco de Lima, E-mail: naiananolasketi@yahoo.com.br [Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais (Brazil); Azevedo de Souza, Lílian, E-mail: lilianazevedo@msn.com [Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais (Brazil); Devito, Karina Lopes, E-mail: karina.devito@ufjf.edu.br [Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais (Brazil)

2013-06-15

Using magnetic resonance imaging (MRI), this study aimed to evaluate the morphology of the articular disc of the temporomandibular joint (TMJ) in patients with temporomandibular disorder (TMD). There were 218 TMJ of 109 assessed patients; 88 were females and 21 males, and all were diagnosed as symptomatic for temporomandibular disorder. The articular disc positions were classified in the normal position and with anterior disc displacement with and without reduction. Regarding the morphology, the discs were classified as follows: biconcave (normal), biplanar, rounded, biconvex, folded, thickening in the posterior band, thickening in the anterior band and hemiconvex. The results indicated that females were the most affected by morphological changes of the articular disc (p = 0.008/Cramer's V = 0.295). There was no statistical significance when correlating the disc morphology with the sides (right and left). There was a significant correlation between the position and morphology of the articular disc (p < 0.001/Cramer's V = 0.609), and in the normal position of the discs presenting biplanar and biconcave morphologies. In TMJ with anterior displacement of the disc with reduction (ADDR), there was a greater correlation with rounded, hemiconvex and biconvex morphologies. Already in the TMJ with displacement without reduction (ADDWR), there was a higher prevalence of folded discs. It can be concluded that morphological changes in the disc are influenced by the type of displacement, and more serious deformations are associated with ADDWR cases.

A comparative study of mandibular movements with their MR images in patients with internal derangement of the TMJ

International Nuclear Information System (INIS)

Miyamoto, Satoshi; Ogawa, Takumi; Hosoda, Yutaka

1993-01-01

Thirty one patients with internal derangement of the TMJ and 12 subjects with normal TMJ were selected and their MR imaging and border movements of the mandible were recorded. In addition, the relationship between them were examined. In this study, the disk position and configuration in MR findings were classified as follows. Disk position: superior, anterior and anterolateral (medial and lateral were omitted), grade of anterior disk displacement (with and without reduction): slight, moderate and severe, disk configuration: biconcave, enlargement of posterior band, even thickness and biconvex. Border movements of the mandible were influenced not only by unilateral or bilateral interior derangement but also by with or without reduction of the disk. Border movements in patients with anterolateral disk displacement were more severely restricted than those with anterior disk displacement. Border movements were remarkably limited in patients with slight disk displacement, especially in unilateral cases with reduction of the disk. Border movements in patients with even thickness and biconvex types of disk configuration were a little restricted and rather similar to those of normal subjects. There was significant correlation between border movements and disk position and configuration. It means that measurement of the mandibular movements is very significant to diagnose the condition of internal derangements of the TMJ. (author)

Evaluation of bone and disc configuration in TMJ internal derangement

International Nuclear Information System (INIS)

Park, Cheol Woo; Hwang, Eui Hwan; Lee, Sang Rae

2001-01-01

To investigate bone and disc configuration on MR images in internal derangement related to age. MR images of 150 TMJs in 107 patients were analyzed to determine the morphologic changes. Two groups were distinguished to be correlated with age. Group 1 consisted of TMJs that were diagnosed as having anterior disc displacement with reduction (ADDwR), and Group 2 consisted of TMJs that were diagnosed as having anterior disc displacement without reduction (ADDwR). We assessed the configuration of the articular disc, degree of anterior disc displacement, and osseous changes of TMJs. The third decade (83 of 150 joints) was most frequent in this study. In the ADDwR group biconcave disc was most frequent at all ages except fifth decade, but in the ADDwoR group deformed discs was most frequent at third and forth decades. In the ADDwR group slightly displaced discs was most frequent at all ages, but in the ADDwoR group severely displaced discs was most frequent at second decade, and the degree of disc displacement was increased with aging over 30 years of age. TM joints showed osseous changes in 17% of the ADDwR group, and in 30% of the ADDwoR group. MR findings of osseous changes of the TMJ were not found to be significantly correlated with age. The prevalence of deformation of disc, displacement of disc, and osseous changes of TMJ was higher in the ADDwoR group than in the ADDwR group. MR findings of disc configuration and degree of disc displacement were found to be correlated with age

Signs of Bruxism and Temporomandibular Disorders among Patients with Bipolar Disorder

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Gurbuz Ozlem

2017-11-01

Full Text Available Background/Aim: There is an abundance of data regarding temporomandibular disorders (TMD and bruxism specific to patients with bipolar disorder (BD. This study aimed to investigate the prevalence of TMD signs in subjects with and without BD. Material and Methods: The case group included 242 adult patients (103 men and 139 women with BD and and the control group included 187 subjects without BD (89 men and 98 women. The case and control groups were compared for the presence of bruxism and the signs of TMD including muscle and temporomandibular joint (TMJ tenderness to palpation, limitation of maximum mouth opening, and TMJ sounds. Results: The frequency of at least one sign of TMD was significantly higher in patients with BD (191 ⁄242, 78.9% than the control group (95 ⁄187, 50.8% (p<0.001. Statistically significant differences were found between the case and control groups in terms of joint pain on palpation (p<0.05, masseter muscle pain on palpation (p<0.01, joint clicks (p<0.001 and limited mouth opening (p<0.001. Bruxism was significantly higher in patients with BD (49.6% than the control group (19.8% (p<0.001. Conclusions: Patients with BD appear to be more prone to having TMD signs and bruxism compared to the control group, but this comorbidity should be better understood by further studies.

Orofacial myofunctional disorder in subjects with temporomandibular disorder.

Science.gov (United States)

Ferreira, Cláudia Lúcia Pimenta; Da Silva, Marco Antônio M Rodrigues; de Felício, Cláudia Maria

2009-10-01

To determine the frequency and degree of orofacial myofunctional disorder (OMD) in a sample of patients with temporomandibular disorder (TMD), the dental records of 240 patients with a diagnosis of TMD were reviewed. Mean patient age and mean TMD duration, gender frequency, complaints, and signs and symptoms were calculated. The results showed that the sample studied was quite characteristic of a TMD group. The presence of the following signs/symptoms was significant: muscular pain, TMJ pain, joint noise, at least one otologic symptom, headache, and neck and shoulder pain. Most subjects presented some degree of OMD, with grade high prevailing over grade low. The importance of evaluating the stomatognathic structures and functions during the clinical examination of patients with TMD is emphasized.

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

International Nuclear Information System (INIS)

You, Dong Soo

1983-01-01

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

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

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

1983-11-15

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

Prediction of Splint Therapy Efficacy Using Bone Scan in Patients with Unilateral Temporomandibular Disorder

International Nuclear Information System (INIS)

Lee, Sang Mi; Lee, Won Woo; Yun, Pil Young; Kim, Young Kyun; Kim, Sang Eun

2009-01-01

It is not known whether bone scan is useful for the prediction of the prognosis of patients with temporomandibular disorders (TMD). The aim of the present study was to identify useful prognostic markers on bone scan for the pre-therapeutic assessment of patients with unilateral TMD. Between January 2005 and July 2007, 55 patients (M:F=9:46; mean age, 34.7±14.1 y) with unilateral TMD that underwent a pre-therapeutic bone scan were enrolled. Uptake of Tc-99m HDP in each temporomandibular joint (TMJ) was quantitated using a 13X13 pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratios and asymmetric indices were calculated. TMD patients were classified as improved or not improved and the bone scan findings associated with each group were investigated. Forty-six patients were improved, whereas 9 patients were not improved. There was no significant difference between the two groups of patients regarding the TMJ uptake ratio of the involved joint, the TMJ uptake ratio of the non-involved joint, and the asymmetric index (p>0.05). However, in a subgroup analysis, the patients with an increased uptake of Tc-99m HDP at the disease-involved TMJ, by visual assessment, could be easily identified by the asymmetric index; the patients that improved had a higher asymmetric index than the patients that did not improve (1.32±0.35 vs. 1.08±0.04, p=0.023), The Tc-99m HDP bone scan may help predict the prognosis of patients with unilateral TMD after splint therapy when the TMD-involved joint reveals increased uptake by visual assessment

Prediction of Splint Therapy Efficacy Using Bone Scan in Patients with Unilateral Temporomandibular Disorder

Energy Technology Data Exchange (ETDEWEB)

Lee, Sang Mi; Lee, Won Woo; Yun, Pil Young; Kim, Young Kyun; Kim, Sang Eun [Seoul National University Bundang Hospital, Seoul (Korea, Republic of)

2009-04-15

It is not known whether bone scan is useful for the prediction of the prognosis of patients with temporomandibular disorders (TMD). The aim of the present study was to identify useful prognostic markers on bone scan for the pre-therapeutic assessment of patients with unilateral TMD. Between January 2005 and July 2007, 55 patients (M:F=9:46; mean age, 34.7{+-}14.1 y) with unilateral TMD that underwent a pre-therapeutic bone scan were enrolled. Uptake of Tc-99m HDP in each temporomandibular joint (TMJ) was quantitated using a 13X13 pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratios and asymmetric indices were calculated. TMD patients were classified as improved or not improved and the bone scan findings associated with each group were investigated. Forty-six patients were improved, whereas 9 patients were not improved. There was no significant difference between the two groups of patients regarding the TMJ uptake ratio of the involved joint, the TMJ uptake ratio of the non-involved joint, and the asymmetric index (p>0.05). However, in a subgroup analysis, the patients with an increased uptake of Tc-99m HDP at the disease-involved TMJ, by visual assessment, could be easily identified by the asymmetric index; the patients that improved had a higher asymmetric index than the patients that did not improve (1.32{+-}0.35 vs. 1.08{+-}0.04, p=0.023), The Tc-99m HDP bone scan may help predict the prognosis of patients with unilateral TMD after splint therapy when the TMD-involved joint reveals increased uptake by visual assessment.

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

Temporomandibular joint disorder in a patient with multiple sclerosis--review of literature with a clinical report.

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Badel, Tomislav; Carek, Andreja; Podoreski, Dijana; Pavicin, Ivana Savić; Lovko, Sandra Kocijan

2010-09-01

Temporomandibular disorders are a form of musculoskeletal disorders, which reduce the function of stomatognathic system and they are related to some other diseases causing painful conditions and disorders of oral function. The aim of this paper is to describe a one year follow up clinical case of a female patient with comorbid multiple sclerosis and a relatively rare form of articular disc disorder. Primary clinical diagnostics encompassed manual methods of TMJ examination. Definite diagnosis included radiologic examination. Clinical hyperextensive condyle position was palpated bilaterally and subsequently confirmed by a functional panoramic radiograph of TMJ. The anterior displacement of disc with reduction was diagnosed by magnetic resonance and in the right joint there was a disc displacement upon excursive movement. From relevant literature, the relationship of a number of diseases that can be related to functional disorder of the orofacial system, such as multiple sclerosis, has been described from many aspects. Also, apart from the standard classification of one form of anterior displacement of the disc, made primarily by magnetic resonance, cases of disc displacement upon excursive mandibular movement can rarely be found in literature.

Evaluation relationship between temporomandibular joint disorder and headache: A review literature

OpenAIRE

Farzaneh Aghahosseini; Nafiseh Sheykhbahaei

2017-01-01

Background and Aims: Headache is among the most common complaints in patients suffering from temporomandibular joint disorders (TMD). Thus, it seems that evaluation of patients with headache in terms of temporomandibular joint (TMJ) disorders is necessary. In people with TMD, parafunctional activities play an important etiologic role. Considering the high prevalence of bruxism and TMDs in patients with headache, assessment the accuracy and severity of this association can play a key role in d...

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.

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

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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.

Assessment of temporomandibular and cervical spine disorders in tinnitus patients.

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Björne, Assar

2007-01-01

In treating patients with temporomandibular joint (TMJ) dysfunction it was noticed that tinnitus and vertigo were common in such patients and there was also muscular tension in jaw and neck. During treatment of these patients it was also noted that injection of lidocaine in a jaw muscle (m. pt. lat.) reduced not only their muscular problems but also that the tinnitus was reduced while the local anesthetic was active. Evaluation of 39 patients with disabling tinnitus, and all suffered from tinnitus, revealed that 10 of them had bilateral tinnitus and TMJ disorders revealed that pain in the face, temples or jaw occurred often among these patients. Many of such patients had also symptoms of cervical spine disorders, head, neck and shoulder pain, and limitations in side bending and rotation were also frequent complaints. One-third of these patients could influence tinnitus by jaw movements and 75% could trigger vertigo by head or neck movements. Treatment of jaw and neck disorders in 24 patients with Ménière's disease had a beneficial effect on not only their episodic vertigo but also on their tinnitus and aural fullness. At the 3-year follow-up, intensity of all symptoms were significantly reduced (p<0.001).

Incidence of ′headache attributed to temporomandibular disease′ in patients with clicking sound in the region temporomandibular joint

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Caner Sahin

2015-01-01

Conclusion TMJ 2014 consortium network showed that headache attributed to TMD may be in associated with cephalalgia. The rate of headache is higher in patients with TMJ disorders. TMJ disorders should also be kept in mind in the differential diagnosis of cephalalgia considering the quality of life of patients.

The effects of temporo mandibular joint disorder with clicking symptom on children mastication performance in Deutero Malay race children aged 12-15 years

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Henri Hartman

2014-11-01

Full Text Available Temporo Mandibular Joint Disorder (TMD could be caused by forward head posture. Articular sound/TMJ clicking is the most often sign and symptom for TMD that could happen in human being. The presence of TMD such as TMJ clicking would cause an imbalance masticatory system. The purpose of this research is to investigate TMJ clicking effects to masticatory performance. This research was cross-sectional study with a type of epidemiology survey. Subject were children aged 12-15 years old Deutero-Malay sub-races Live in Bandung and was taken using multi-stage random sampling technique. Subject; consisted of 24 children as control group and 28 children as TMJ clicking group. Both group were then checked for masticatory performance using multiple sieve method and 20x chewing of artificial test food. Mastication performance value represented by median particle size (MPS particle distribution (b for each group. MPS from TMJ clicking group (3.0571,SD=0.9990 showed higher value than control group (2.28958,SD=0.66838. Statistic analysis with t-test showed that there’s a significant result in both of group (pvalue=0,0024, α = 0,05. Conclussion, temporo mandibular joint clicking subject has lower masticatory performance.

Temporomandibular disorders in headache patients

Science.gov (United States)

Mello, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Siqueira Quintans, Jullyana-de Souza; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues

2012-01-01

Objective: To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its seve-rity in individuals with headache. Study Design: 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic questionnaire. The severity of TMD was defined by the temporomandibular index (TMI). Results: The TMD signs and symptoms were always more frequent in individuals with headache, especially report of pain in TMJ area (CDH, n=16; EH, n=12; WH, n=6), pain to palpation on masseter (CDH, n=19; EH, n=16; WH, n=11) which are significantly more frequent in episodic and chronic daily headache. The mean values of temporomandibular and articular index (CDH patients) and muscular index (CDH and EH patients) were statistically higher than in patients of the control group, notably the articular (CDH=0.38; EH=0.25;WH=0.19) and muscular (CDH=0.46; EH=0.51; WH=0.26) indices. Conclusions: These findings allow us to speculate that masticatory and TMJ pain are more common in headache subjects. Besides, it seems that the TMD is more severe in headache patients. Key words:Temporomandibular dysfunction, headache disorders. PMID:22926473

Magnetic Resonance Imaging (MRI) of TMJ. Inter-observer influence on diagnosis or therapy and difference of interpretation regarding abnormal signs

International Nuclear Information System (INIS)

Iinuma, Hideto; Minowa, Kazuyuki; Kobayashi, Ichizou; Matsuda, Akemi; Kaneko, Masayuki

2006-01-01

The purpose of study was to evaluate the influence of a head and neck radiologist after MRI examinations of the temporomandibular joint on the therapeutic strategy in patients with temporomandibular disorders and, furthermore, to analyze interobserver agreement for defined MRI criteria. Eighteen patients including 36 TMJ (10 males and 8 females; age 15-53 years) were enrolled. All were clinically evaluated, diagnosed ''TMD'' and MRI examinations were performed. The medical and MRI records of 18 patients were retrospectively reviewed. Four MR images (proton density, T1, T2-weighted and Gd-DTPA enhanced sagittal images at the open and closed mouth) were obtained. Therapeutic strategies before and after performance of the MRI were compared. One radiologist and main dentist independently analyzed the sagittal MR images for position of the disk, position of the condyle, signal intensity of the disk and bilaminar zone, bone changes and several additional findings. Additionally, the agreement between one radiologist and main dentist with respect to the diagnoses was evaluated. There were 13 cases that the modification of diagnosis was needed after MRI examinations. In 10 of the 18 subjective symptom-free subjects, there were abnormal signs anatomically. Also in 1 subjective and objective symptom-free subjects, abnormal signs were seen on MRI. In 1 individual, MRI revealed larger abnormal signs in clinically asymptomatic TMJ as compared with symptomatic TMJ. Whereas as for 1 symptomatic subject, Abnormal signs could not be identified in any of the TMJs. There were no cases that the change of treatment methods was needed after MRI examinations, but as for 13 cases, the correction of treatment contents was needed, such as the changes of the therapeutic regimen and the form of the sprint were registered after MRI. The disagreement between one radiologist and main dentist was seen in: the bone change of condyle; 30 TMJs, the change of temporal bone ;6 TMJs, the relationship

Temporomandibular joint dysfunction and orthognathic surgery: a retrospective study

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Raoul Gwénael

2010-11-01

Full Text Available Abstract Background Relations between maxillo-mandibular deformities and TMJ disorders have been the object of different studies in medical literature and there are various opinions concerning the alteration of TMJ dysfunction after orthognathic surgery. The purpose of the present study was to evaluate TMJ disorders changes before and after orthognathic surgery, and to assess the risk of creating new TMJ symptoms on asymptomatic patients. Methods A questionnaire was sent to 176 patients operated at the Maxillo-Facial Service of the Lille's 2 Universitary Hospital Center (Chairman Pr Joël Ferri from 01.01.2006 to 01.01.2008. 57 patients (35 females and 22 males, age range from 16 to 65 years old, filled the questionnaire. The prevalence and the results on pain, sounds, clicking, joint locking, limited mouth opening, and tenseness were evaluated comparing different subgroups of patients. Results TMJ symptoms were significantly reduced after treatment for patients with pre-operative symptoms. The overall subjective treatment outcome was: improvement for 80.0% of patients, no change for 16.4% of patients, and an increase of symptoms for 3.6% of them. Thus, most patients were very satisfied with the results. However the appearance of new onset of TMJ symptoms is common. There was no statistical difference in the prevalence of preoperative TMJ symptoms and on postoperative results in class II compared to class III patients. Conclusions These observations demonstrate that: there is a high prevalence of TMJ disorders in dysgnathic patients; most of patients with preoperative TMJ signs and symptoms can improve TMJ dysfunction and pain levels can be reduced by orthognathic treatment; a percentage of dysgnathic patients who were preoperatively asymptomatic can develop TMJ disorders after surgery but this risk is low.

Disorders without borders: current and future directions in the meta-structure of mental disorders.

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Carragher, Natacha; Krueger, Robert F; Eaton, Nicholas R; Slade, Tim

2015-03-01

Classification is the cornerstone of clinical diagnostic practice and research. However, the extant psychiatric classification systems are not well supported by research evidence. In particular, extensive comorbidity among putatively distinct disorders flags an urgent need for fundamental changes in how we conceptualize psychopathology. Over the past decade, research has coalesced on an empirically based model that suggests many common mental disorders are structured according to two correlated latent dimensions: internalizing and externalizing. We review and discuss the development of a dimensional-spectrum model which organizes mental disorders in an empirically based manner. We also touch upon changes in the DSM-5 and put forward recommendations for future research endeavors. Our review highlights substantial empirical support for the empirically based internalizing-externalizing model of psychopathology, which provides a parsimonious means of addressing comorbidity. As future research goals, we suggest that the field would benefit from: expanding the meta-structure of psychopathology to include additional disorders, development of empirically based thresholds, inclusion of a developmental perspective, and intertwining genomic and neuroscience dimensions with the empirical structure of psychopathology.

Evaluation of the research diagnostic criteria for temporomandibular disorders for the recognition of an anterior disc displacement with reduction

NARCIS (Netherlands)

Naeije, M.; Kalaykova, S.; Visscher, C.M.; Lobbezoo, F.

2009-01-01

The aim of this Focus Article is to review critically the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for the recognition of an anterior disc displacement with reduction (ADDR) in the temporomandibular joint (TMJ). This evaluation is based upon the experience gained

Pseudodynamic MR imaging of temporomandibular joint disorders

International Nuclear Information System (INIS)

Nakasato, Tatsuhiko; Ehara, Shigeru

1992-01-01

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)

Pseudodynamic MR imaging of temporomandibular joint disorders

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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).

Application of Infrared Thermal Imaging in a Violinist with Temporomandibular Disorder.

Science.gov (United States)

Clemente, M; Coimbra, D; Silva, A; Aguiar Branco, C; Pinho, J C

2015-12-01

Temporomandibular disorders (TMD) consist of a group of pathologies that affect the masticatory muscles, temporomandibular joints (TMJ), and/or related structures. String instrumentalists, like many orchestra musicians, can spend hours with head postures that may influence the biomechanical behavior of the TMJ and the muscles of the craniocervicomandibular complex (CCMC). The adoption of abnormal postures acquired during performance by musicians can lead to muscular hyperactivity of the head and cervical muscles, with the possible appearance of TMD. Medical infrared thermography is a non-invasive procedure that can monitor the changes in the superficial tissue related to blood circulation and may serve as a complement to the clinical examination. The objective of this study was to use infrared thermography to evaluate, in one subject, the cutaneous thermal changes adjacent to the CCMC that occur before, during, and after playing a string instrument.

Does muscle strength predict future musculoskeletal disorders and sickness absence?

DEFF Research Database (Denmark)

Faber, A; Sell, L; Hansen, J V

2012-01-01

High muscle strength is considered relevant for preventing musculoskeletal disorders and long-term sickness absence. However, prospective studies on the association between muscle strength and future musculoskeletal disorders and long-term sickness absence are few and show contrasting results....

Prevalence of the different Axis I clinical subtypes in a sample of patients with orofacial pain and temporomandibular disorders in the Andalusian Healthcare Service

Science.gov (United States)

Blanco-Aguilera, Antonio; Blanco-Aguilera, Elena; Serrano-del-Rosal, Rafael; Biedma-Velázquez, Lourdes; Rodríguez-Torronteras, Alejandro; Segura-Saint-Gerons, Rafael

2016-01-01

Background The main objective of this paper is to analyze the prevalence of each of the different clinical subtypes of temporomandibular disorders (TMD) in a sample of patients with this pathology. In addition, a second objective was to analyze their distribution according to gender. Material and Methods To this end, the results of 1603 patients who went to the Unit of Temporomandibular Disorders in the Córdoba Healthcare District because they suffered from this pathology were analyzed. In order to diagnose them, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were applied, analyzing the different Axis I subtypes (myopathy, discopathy and arthropathy) and obtaining the combined Axis I for each patient and the relation of all these variables according to gender. The null-hypothesis test confirmed the lack of connection between the gender variable and the different subtypes in the clinical analysis, and between the former and the combined Axis I of the RDC/TMD. Results The prevalence was high for the muscle disorders subtype in general, showing an 88.7% prevalence, while the presence of discopathies or arthropathies was much lower. Among discopathies, the most frequent ones were disc displacements with reduction, with 39.7% and 42.8% for the left and right temporomandibular joints (TMJ), respectively, while the prevalence of arthropathies was 26.3% for the right TMJ and 32.9% for the left TMJ. The bivariate analysis on the connection with gender reveals a p≥ 0.05 value for the muscle and arthralgia subtypes. Conclusions The patients seen at the TMD Unit where mostly middle-aged women whose main clinical axis subtype was the muscle disorder subtype. For their part, both discopathies and arthropathies, although present, are much less prevalent. Key words:RDCTMD, axis I, orofacial pain, temporomandibular disorders, gender. PMID:26615508

Spinal and temporo-mandibular disorders in male workers of the State Police.

Science.gov (United States)

Sancini, Angela; Tomei, Francesco; Tomei, Gianfranco; Caciari, Tiziana; Capozzella, Assunta; Di Famiani, Manuela; Samperi, Ilaria; Scala, Barbara; Fiaschetti, Maria; Cetica, Carlotta; Ciarrocca, Manuela

2013-01-01

The aims of this study are to evaluate the prevalence of disorders of the lumbar region and the temporo-mandibular district co-morbidity in drivers and workers of the State Police employed for different office activities. The study population included 103 drivers as cases and 100 police officers as controls. The study was carried out through questionnaire and clinical evaluation of the spine and temporo-mandibular region. At clinical examination, the drivers were found to have a higher prevalence (p temporo-mandibular joint (TMJ), when compared with the controls. The results also showed a higher prevalence (p < 0.05) of co-morbidity in the two districts among the drivers, when compared with the controls. These results confirm that morbidity related to back and TMJ and increase in co-morbidity between the two districts are higher in professional drivers.

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

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

2014-01-15

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

Bioengineered Temporomandibular Joint Disk Implants: Study Protocol for a Two-Phase Exploratory Randomized Preclinical Pilot Trial in 18 Black Merino Sheep (TEMPOJIMS)

Science.gov (United States)

Monje, Florencio Gil; González-García, Raúl; Little, Christopher B; Mónico, Lisete; Pinho, Mário; Santos, Fábio Abade; Carrapiço, Belmira; Gonçalves, Sandra Cavaco; Morouço, Pedro; Alves, Nuno; Moura, Carla; Wang, Yadong; Jeffries, Eric; Gao, Jin; Sousa, Rita; Neto, Lia Lucas; Caldeira, Daniel; Salvado, Francisco

2017-01-01

Background Preclinical trials are essential to test efficacious options to substitute the temporomandibular joint (TMJ) disk. The contemporary absence of an ideal treatment for patients with severe TMJ disorders can be related to difficulties concerning the appropriate study design to conduct preclinical trials in the TMJ field. These difficulties can be associated with the use of heterogeneous animal models, the use of the contralateral TMJ as control, the absence of rigorous randomized controlled preclinical trials with blinded outcomes assessors, and difficulties involving multidisciplinary teams. Objective This study aims to develop a new, reproducible, and effective study design for preclinical research in the TMJ domain, obtaining rigorous data related to (1) identify the impact of bilateral discectomy in black Merino sheep, (2) identify the impact of bilateral discopexy in black Merino sheep, and (3) identify the impact of three different bioengineering TMJ discs in black Merino sheep. Methods A two-phase exploratory randomized controlled preclinical trial with blinded outcomes is proposed. In the first phase, nine sheep are randomized into three different surgical bilateral procedures: bilateral discectomy, bilateral discopexy, and sham surgery. In the second phase, nine sheep are randomized to bilaterally test three different TMJ bioengineering disk implants. The primary outcome is the histological gradation of TMJ. Secondary outcomes are imaging changes, absolute masticatory time, ruminant time per cycle, ruminant kinetics, ruminant area, and sheep weight. Results Previous preclinical studies in this field have used the contralateral unoperated side as a control, different animal models ranging from mice to a canine model, with nonrandomized, nonblinded and uncontrolled study designs and limited outcomes measures. The main goal of this exploratory preclinical protocol is to set a new standard for future preclinical trials in oromaxillofacial surgery

Head, Neck, and Oral Cancer

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Full Text Available ... Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ... Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ...

Obstructive Sleep Apnea

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Full Text Available ... Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ... Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ...

Corrective Jaw Surgery

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Full Text Available ... Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ... Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ...

Administration of Anesthesia

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Full Text Available ... Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ... Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, headaches and limited ...

Usefulness of quantitative SPECT in unilateral temporomandibular joint disorder: correlation with signs and symptoms

International Nuclear Information System (INIS)

Kim, Ho Sung; Jeong, Jong Cheol; Kim, Keon Jung; Choi, Jae Sun; Sung, Dae Kyung; Lee, Gye Huyk; Kim, Jong Ho

1998-01-01

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

18F-NaF PET/CT for the evaluation of temporomandibular joint disorder.

Science.gov (United States)

Suh, M S; Park, S H; Kim, Y-K; Yun, P-Y; Lee, W W

2018-04-01

To investigate the usefulness of a quantitative parameter (maximum standardised uptake value [SUVmax]) of 18 F-sodium fluoride (NaF) positron-emission tomography (PET)/computed tomography (CT) for the evaluation of temporomandibular joint (TMJ) disorder (TMD). Seventy-six TMD patients (male: female=14:62, age=40.3±17.1 years, bilateral: unilateral=40:36) with 152 TMJs were enrolled. The 18 F-NaF PET/CT parameter (SUVmax) was compared with the presence of TMJ arthralgia (arthralgic=86, non-arthralgic=66) and clinical subtypes based on the Research Diagnostic Criteria for TMD Axis I (TMD osteoarthritis=49, non-TMD osteoarthritis=67, and asymptomatic TMJ=36). Splint therapy was applied to 48 patients for 6 months without considering 18 F-NaF PET/CT findings. Post-splint therapy 18 F-NaF PET/CT was performed in 32 patients and clinical responses to the therapy were classified into improvement (n=33), no change (n=10), or aggravation (n=7) for 50 TMJs excluding asymptomatic TMJs (n=14). SUVmax was significantly greater in arthralgic TMJs than in non-arthralgic TMJs (6.62±3.56 versus 4.32±1.53, pchange in SUVmax was observed in improved (from 6.16±2.68 to 6.09±2.60, p=0.4915) and unchanged (from 6.46±4.19 to 6.77±4.32, p=0.3223) TMJs. 18 F-NaF PET/CT is a useful imaging tool for TMD evaluation because SUVmax showed a fair diagnostic performance for arthralgic TMJ and TMD osteoarthritis, and a correlation with the therapeutic response. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Temporomandibular disorders – validity of clinical diagnostics compared to magnetic resonance imaging

OpenAIRE

BADEL, TOMISLAV; MAROTTI, MILJENKO; SAVIĆ PAVIČIN, IVANA; DULČIĆ, NIKŠA; ZADRAVEC, DIJANA; KERN, JOSIPA

2011-01-01

Background and Purpose: Orthopedic examination techniques of the musculoskeletal system contribute to the successful diagnostics of temporomandibular disorders (TMD). The purpose of this study is to determine the validity of TMD clinical diagnostics by comparing the findings of manual functional analysis (MFA) and the results of MRI of temporomandibular joint (TMJ). The diagnostic significance of limited mouth opening and pain upon passive mouth opening were taken into consideration. M...

A comparative study of the radiobiologic risks from three different TMJ (temporary modular joint) radiographic techniques using a pan-tomographic system

International Nuclear Information System (INIS)

Chilvarquer, Israel.

1992-01-01

The aim of this study was the obtention of the absorbed doses to critical organs for evaluating and comparing the radiobiologic risks from three different TMJ radiographic techniques, using a pantomographic system, utilizing a combination of rare-earth screens to fast films. The compared techniques were the conventional panoramic technique, the Manufacture's recommended technique for TMJ and the Chilvarquer's technique. The absorber doses were measured by exposing a phantom, fitted with fluoride TLD in fourteen sites distributed at the Thyroid, Pituitary, Salivary glands sites distributed at the Thyroid, Pituitary, Salivary glands and at the bone marrow. The radiobiologic risks were calculated using the UNSCEAR 34 (1977), and the fatal cancer incidence for age and sex was calculated using the ICRP 29 (1977). Based on the obtained data, it was concluded that the Chilvarquer's technique induced the lowest absorbed doses and the estimated radiobiologic risks were lower than a cancer per a million of examinations. (author). 108 refs., 19 figs., 14 tabs

Self-Reported Bruxism and Symptoms of Temporomandibular Disorders in Finnish University Students.

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Huhtela, Outi S; Näpänkangas, Ritva; Joensuu, Tiina; Raustia, Aune; Kunttu, Kristina; Sipilä, Kirsi

2016-01-01

To evaluate the prevalence of self-reported bruxism and symptoms of temporomandibular disorders (TMD) and to investigate their association in academic and applied science university students in Finland. The data were gathered from 4,403 Finnish students included in the Finnish Student Health Survey 2012. The comprehensive questionnaire included five questions concerning bruxism and TMD symptoms. Bivariate associations between self-reported bruxism and TMD symptoms were evaluated using chi-square tests, and logistic regression model was used with age and gender as factors. Sleep bruxism was reported by 21.0% of women and by 12.5% of men, awake bruxism by 2.0% of women and by 2.8% of men, and both sleep and awake bruxism by 7.2% of women and by 3.2% of men. TMD pain was reported by 25.9% of women and by 11.4% of men and temporomandibular joint (TMJ) pain on jaw movement by 9.6% of women and by 4.2% of men. Report of sleep bruxism increased the risk for all TMD symptoms in both genders. Among women, report of awake bruxism increased the risk for TMD pain and TMJ pain on jaw movement. Reporting stress as a perpetuating factor for TMD pain increased the risk for both sleep and awake bruxism in both genders. The logistic regression analysis (including age and gender) showed that report of sleep bruxism and/or awake bruxism was associated with TMD pain (Odds Ratio [OR] = 5.71; 95% confidence interval [CI] = 4.86-6.70), TMJ pain on jaw movement (OR = 4.49; 95% CI = 3.54-5.69), and TMJ locking (OR = 2.98; 95% CI = 2.17-4.10). Bruxism and TMD symptoms are frequent in Finnish university students. Self-reported bruxism is associated with TMD symptoms, confirming earlier findings.

Radiation-induced temporo-mandibular joint disorder in post-radiotherapy nasopharyngeal carcinoma patients: assessment and treatment.

Science.gov (United States)

Wu, Vincent W C; Lam, Ying-Na

2016-06-01

Nasopharyngeal carcinoma (NPC) is endemic in southern China, and its incidence in Hong Kong is relatively high. Radiotherapy is the mainstay treatment for NPC due to its relatively high radiosensitivity and deep-seated anatomical position, which is not readily accessible by surgery. Although the technique of radiotherapy in NPC has been advancing and offers promising treatment outcome, complications around the irradiation areas are inevitable and the quality of life of the post-radiotherapy patients is often compromised. Trismus, which is defined as the restricted mouth opening or jaw movement due to the disorder of temporo-mandibular joint (TMJ), is one of the possible late complications for radiotherapy of NPC and is found in 5-17% of the post-radiotherapy (post-RT) patients. Trismus at early stage may only affect the speech, but in severe cases nutritional intake and oral hygiene condition may deteriorate seriously. This article reviewed the possible causes of radiation-induced TMJ damage, the various assessments including imaging modalities and possible treatments. The conclusion is that the availability of simple, yet effective examinations for trismus is essential for delaying the progression and restoring TMJ functions. Although there is no absolutely effective treatment for trismus, many supportive, restorative and palliative management are possible under different clinical situations.

Densities and sizes of the main masticatory muscles in computed tomography compared with clinical findings related to temporo mandibular joint (TMJ) dysfunction

International Nuclear Information System (INIS)

Raustia, A.M.; Pyhtinen, J.; Virtanen, K.K.; Oulu Univ.

1986-01-01

Computed tomography (CT) has a good resolution capacity and is an excellent method for measuring tissue densities. The aim here was to compare the densities and sizes of the main masticatory muscles, the masseter, medial pterygoid and lateral pterygoid muscles, as obtained with CT, with clinical findings in patients with TMJ dysfunction (25) and controls (29). The densities of the masseter muscles and the medial pterygoid muscles showed no statistical difference between the patients and controls, while the lateral pterygoid muscles of the patients had densities that were only almost significantly higher than those of the controls. The masseter muscles on the patients who more often had signs of bruxism in their dentition were statistically significantly thicker than in the controls, but the widths of the medial pterygoid muscles gave no statistical difference between the groups. The results seem to indicate that in addition to the bone density changes associated with functional disorders of the masticatory system, there may be also density and size changes in the masticatory muscles which are detectable by CT. (orig.) [de

Densities and sizes of the main masticatory muscles in computed tomography compared with clinical findings related to temporo mandibular joint (TMJ) dysfunction

Energy Technology Data Exchange (ETDEWEB)

Raustia, A.M.; Pyhtinen, J.; Virtanen, K.K.

1986-03-01

Computed tomography (CT) has a good resolution capacity and is an excellent method for measuring tissue densities. The aim here was to compare the densities and sizes of the main masticatory muscles, the masseter, medial pterygoid and lateral pterygoid muscles, as obtained with CT, with clinical findings in patients with TMJ dysfunction (25) and controls (29). The densities of the masseter muscles and the medial pterygoid muscles showed no statistical difference between the patients and controls, while the lateral pterygoid muscles of the patients had densities that were only almost significantly higher than those of the controls. The masseter muscles on the patients who more often had signs of bruxism in their dentition were statistically significantly thicker than in the controls, but the widths of the medial pterygoid muscles gave no statistical difference between the groups. The results seem to indicate that in addition to the bone density changes associated with functional disorders of the masticatory system, there may be also density and size changes in the masticatory muscles which are detectable by CT.

A clinical and radiological study on the internal derangement of TMJ

International Nuclear Information System (INIS)

Han, Won Jeong; Kim, Eun Kyung

1992-01-01

Internal derangement of the temporomandibular joint can be defined an abnormal relationships of the meniscus relative to the mandibular condyle, articular fossa and dminence. This may cause variable mandibular dysfunctions and pain. For diagnosis, arthrography, computed tomography and amgnetic resonance imaging are used. In this study, the author reviewed 98 TMJs of 88 patients who were diagnosed as internal derangement through inferior joint space arthrography at the department of Oral and Maxillofacial Radiology, Dental Hospital, Dankook university through 1986 to 1992. 98 TMJs consisting of 30 disc displacement with reduction, 48 disc displacement without reduction and 20 perforation were studied about clinical and radiological findings. The results were as follows: 1. Internal derangement was found most frequently in the 2nd, 3rd decades and the average age of perforation was higher than that of disc displacement with higher than that of disc displacement with reduction. The sexual predilection was 2 times higher in females. 2. The most frequent chief complaints were TMJ sound in disc displacement with reduction, pain and limitation of mouth opening in disc displacement without reduction and pain in perforation. The duration of the chief complaints was longer in disc displacement with reduction with than in perforation and disc displacement without reduction. 3. Reciprocal click was the most frequently TMJ sound in disc displacement with reduction. History of joint sound in disc displacement without reduction an crepitus in perforation was the most frequent one. 4. The average maximum opening was 45.4 mm in disc displacement with reduction, 31.4 mm in disc displacement without reduction and 33.8 mm in perforation. 5. In the centric occlusion, posterior condylar position was the most frequent in disc displacement with reduction. Posterior and concentric condylar position was frequent in disc displacement without reduction, concentric and anterior condylar

Quantitative analysis of the TMJ movement with a new mandibular movement tracking and simulation system

International Nuclear Information System (INIS)

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

2008-01-01

The purpose of this study was to develop a system for the measurement and simulation of the TMJ movement and to analyze the mandibular movement quantitatively. We devised patient-specific splints and a registration body for the TMJ movement tracking. The mandibular movements of the 12 subjects with facial deformity and 3 controls were obtained by using an optical tracking system and the patient-specific splints. The mandibular part was manually segmented from the CT volume data of a patient. Three-dimensional surface models of the maxilla and the mandible were constructed using the segmented data. The continuous movement of the mandible with respect to the maxilla could be simulated by applying the recorded positions sequentially. Trajectories of the selected reference points were calculated during simulation and analyzed. The selected points were the most superior point of bilateral condyle, lower incisor point, and pogonion. There were significant differences (P<0.05) between control group and pre-surgical group in the maximum displacement of left superior condyle, lower incisor, and pogonion in vertical direction. Differences in the maximum lengths of the right and the left condyle were 0.59 ± 0.30 mm in pre-surgical group and 2.69 ± 2.63 mm in control group, which showed a significant difference (P<0.005). The maximum of differences between lengths of the right and the left calculated during one cycle also showed a significant difference between two groups (P<0.05). Significant differences in mandibular movements between the groups implies that facial deformity have an effect on the movement asymmetry of the mandible.

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.

Social anxiety disorder and stuttering: current status and future directions.

Science.gov (United States)

Iverach, Lisa; Rapee, Ronald M

2014-06-01

Anxiety is one of the most widely observed and extensively studied psychological concomitants of stuttering. Research conducted prior to the turn of the century produced evidence of heightened anxiety in people who stutter, yet findings were inconsistent and ambiguous. Failure to detect a clear and systematic relationship between anxiety and stuttering was attributed to methodological flaws, including use of small sample sizes and unidimensional measures of anxiety. More recent research, however, has generated far less equivocal findings when using social anxiety questionnaires and psychiatric diagnostic assessments in larger samples of people who stutter. In particular, a growing body of research has demonstrated an alarmingly high rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a prevalent and chronic anxiety disorder characterised by significant fear of humiliation, embarrassment, and negative evaluation in social or performance-based situations. In light of the debilitating nature of social anxiety disorder, and the impact of stuttering on quality of life and personal functioning, collaboration between speech pathologists and psychologists is required to develop and implement comprehensive assessment and treatment programmes for social anxiety among people who stutter. This comprehensive approach has the potential to improve quality of life and engagement in everyday activities for people who stutter. Determining the prevalence of social anxiety disorder among children and adolescents who stutter is a critical line of future research. Further studies are also required to confirm the efficacy of Cognitive Behaviour Therapy in treating social anxiety disorder in stuttering. The reader will be able to: (a) describe the nature and course of social anxiety disorder; (b) outline previous research regarding anxiety and stuttering, including features of social anxiety disorder; (c) summarise research findings regarding the

Efficacy of splint therapy for the management of temporomandibular disorders: a meta-analysis

OpenAIRE

Zhang, Chao; Wu, Jun-Yi; Deng, Dong-Lai; He, Bing-Yang; Tao, Yuan; Niu, Yu-Ming; Deng, Mo-Hong

2016-01-01

Temporomandibular disorders (TMD) are a group of clinical problems affecting temporomandibular joint (TMJ), myofascial muscles and other related structures. Splint therapy is the most commonly used approach to treatment of TMD, but its effectiveness is remains unclear. We therefore conducted a meta-analysis to evaluate the effectiveness of splint therapy for TMD in adults. The electronic databases PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov were searched for reports published up ...

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 < 0.0001). The most frequent painful location in the subjects with PTSD was the left lateral pterygoid site in 88%, and in subjects of the control group the right lateral pterygoid site in 28.26% of cases. The most painful location in the PTSD group was the left lateral pterygoid site in 72%, and in the control group the left posterior digastric in 4.35% of cases. 58% of the subjects with PTSD had TMJ tenderness compared to 3.26% of subjects in the control group (chi2 = 66.23, p < 0.0001). The most frequent painful location of 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.

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.

Efficacy of pumping manipulation treatment for closed lock of the temporomandibular joint disorder. Correlation between arthrographic findings using limited cone beam X-ray CT for dental use and mouth opening distance in 20 cases

International Nuclear Information System (INIS)

Honda, Kazuya; Uehara, Tamotsu; Arai, Yoshinori; Kashima, Masahiro; Tsukimura, Naoki; Honda, Masahiko; Iwai, Kazuo; Terakado, Masaaki; Shinoda, Koji

2002-01-01

A study was conducted to evaluate the efficacy of pumping manipulation treatment for closed lock of the temporomandibular joint (TMJ) disorder using limited cone beam X-ray CT for dental use. The subjects were 20 patients with TMJ closed lock. Arthrography and pumping manipulation treatment were performed, and the correlation between maximal mouth opening and arthrographic findings was examined. Arthrography showed 16 cases of anterior disk displacement, and 4 cases of sideways displacement. Disk configuration showed 15 abnormal cases and 3 cases of disk perforation. Before treatment, mouth opening distance was 24.2 mm and 1 week after treatment it was 34.4 mm. After 3 months this had improved significantly to 41.0 mm. Comparison of mouth opening distance with arthrographic findings showed that disk perforation was significantly different after 3 months. These results suggest that pumping manipulation treatment might be useful in patients with TMJ closed lock without internal derangement or disk perforation. (author)

Pattern analysis of patients with temporomandibular disorders resulting from unilateral mastication due to chronic periodontitis

Science.gov (United States)

2017-01-01

Purpose The purpose of the present study was to perform a pattern analysis in patients with temporomandibular disorder (TMD) resulting from unilateral mastication due to chronic periodontitis. Methods Thirty participants with signs or symptoms of TMD who engaged in unilateral mastication due to periodontitis-related discomfort (test group) were selected. Another 30 subjects exhibiting signs or symptoms of TMD resulting from unilateral mastication not due to chronic periodontitis (control group) were also recruited. An interview-based questionnaire was administered, and an examination of the temporomandibular joint (TMJ) with determination of periodontal status was performed. Results The duration of unilateral mastication was significantly longer in the control group than in the test group. There was a significant negative correlation between the duration of unilateral mastication and the Community Periodontal Index score. Using the Research Diagnostic Criteria for TMD (RDC/TMD) axis I algorithms, all the subjects were assigned to 3 main groups. The test group exhibited significantly a higher diagnostic distribution of group III (arthralgia, osteoarthritis, or osteoarthrosis), and in both the test and control groups, the number of diagnoses was larger for the non-chewing side. The control group showed a significantly higher diagnostic distribution of group I (myofacial pain), and in both the test and control groups, the number of diagnoses was larger for the chewing side. Conclusions The results of the present study indicate that unilateral mastication due to chronic periodontitis could induce not only pain but also structural TMJ changes if adequate treatment is not administered and supported within a short time from the onset of the condition. Therefore, immediate treatment of chronic periodontitis is recommended to prevent not only the primary progress of periodontal disease, but also secondary TMJ-related problems. Furthermore, subjects who have suffered chronic

Clinical Neurotoxic Disorders : Past, Present and Future

Directory of Open Access Journals (Sweden)

Nag Devika

2001-01-01

Full Text Available Neurotoxins have existed on the earth from times immemorial. Old neurotoxic disorders were due to ingestion/ exposure of heavy metals and food like lathyrus sativus over a long period of time. The 20th Century with rapid industrialsation and expanding chemical and drug industry has spawned several new, hitherto unknown disorders. Old disorders continue to exist e.g. fluorosis, arsenicosis, lathyrism, manganism and lead neuropathy, along with new diseases like Minamata disease, subacute myelo optic neuropathy (SMON, MPTP-Parkinsonian syndorme, triorthcresyl phosphate (TOCP neuroparalytic disease, pesticide induced seizures, tremor and neuropathy, solvent encephalopthy, antipileptic drug foetal syndrome and excitotoxin induced behavioural disorders. Studies on pesticides Organochlorine and organophosphates, synthetic pyrethrins, solvents, heavy metals and substances abuse in the Indian context confirm the neurotoxic nature of many synthetic substances. Future problems envisaged are of concern to clinical neurologists as many of these neurotoxic disorders mimic syndromes of well known neurological disease. The new millenium poses a challenge to the clinician as newer compounds in industry, food, drugs and chemical war agents are being developed. Molecular genetics has advanced rapidly with release of the human genome map. Animal cloning and genetically modified plant products have entered the food chain. How safe are these new inventions for the central nervous system is a big question? India cannot afford disasters like Union Carbide′s Bhopal gas leak nor be a silent spectator to manipulative biotechnology. Unless it is proven beyond all doubt to be a safe innovation, Chemicals have to be cautiously introduced in our environment. To Study, ascertain and confirm safety or neurotoxicity is an exciting challenge for the neuroscientists of the 21st century.

How invasive is TMJ double-contrast arthrography in combination with cinematography? Patient discomfort versus known diagnostic gain.

Science.gov (United States)

Engelke, W; Mommaerts, M

1990-04-01

There is no doubt that double-contrast TMJ fluoroscopic tomography enables a differential diagnosis and treatment in internal derangement pathosis. Its indication is, apart from the expected diagnostic gain, also determined by the degree of its invasiveness, and other alternative diagnostics being available (nuclear magnetic resonance). Data on patient discomfort and complications were gathered in 63 arthrotomographies; pain sensations and mandibular mobility, during and after the procedure in particular, were studied. We consider, along with Westesson, the procedure to be less invasive than commonly considered, once the surgeon-radiologist has gained enough experience.

Causes of secondary headache (image)

Science.gov (United States)

Temporomandibular joint, or TMJ, dysfunction, can be a cause of secondary headache. Secondary headaches result from underlying disorders which produce pain as a symptom. The TMJ may become painful and dysfunctional as a result ...

Temporomandibular disorders dysfunction in headache patients.

Science.gov (United States)

Melo, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Quintans, Jullyana-de Souza Siqueira; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

2012-11-01

To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its severity in individuals with headache. 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic questionnaire. The severity of TMD was defined by the temporomandibular index (TMI). The TMD signs and symptoms were always more frequent in individuals with headache, especially report of pain in TMJ area (CDH, n=16; EH, n=12; WH, n=6), pain to palpation on masseter (CDH, n=19; EH, n=16; WH, n=11) which are significantly more frequent in episodic and chronic daily headache. The mean values of temporomandibular and articular index (CDH patients) and muscular index (CDH and EH patients) were statistically higher than in patients of the control group, notably the articular (CDH=0.38; EH=0.25;WH=0.19) and muscular (CDH=0.46; EH=0.51; WH=0.26) indices. These findings allow us to speculate that masticatory and TMJ pain are more common in headache subjects. Besides, it seems that the TMD is more severe in headache patients.

Psychosocial and Physical Assessment of Patients with Temporomandibular Disorders

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Anitha B

2004-01-01

Full Text Available A study was conducted to assess the prevalence of psychosocial disorders in patients with TMD, and to establish correlation between these, and symptoms and physical signs of TMD. Thirty patients were included in the study. TMD history and TMJ examination findings were recorded. Subsequently psychosocial assessment was carried out. Eighteen patients were in psychiatric morbid (PM group and 12 were in psychiatric nonmorbid (PNM group. Symptoms and signs of TMD were compared between PM and PNM group. Strong association was evident between presence of psychiatric morbidity and certain parameters viz. pain duration, VAS, bruxism, mouth opening.

Single-needle temporomandibular joint arthrocentesis with hyaluronic acid injections. Preliminary data after a five-injection protocol.

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Manfredini, D; Guarda-Nardini, L; Ferronato, G

2009-10-01

The classical technique for temporomandibular joint (TMJ) arthrocentesis provides a double access to the joint space, which may lead to patient's postoperatory discomfort. For this reason, a less invasive, single-needle approach has been recently described, and the present investigation reports findings on a case series of patients with TMJ osteoarthritis treated with hyaluronic acid injections following a single needle arthrocentesis. METHODS. Fourteen consecutive patients with a diagnosis of TMJ osteoarthritis according to the Research Diagnostic Criteria for Temporo-mandibular Disorders were treated with a cycle of five weekly injections of hyaluronic acid after arthrocentesis. A number of subjective (pain at rest and mastication, masticatory efficiency, functional limitation, subjective efficacy of treatment, tolerability of treatment) and objective (maximum assisted and unassited mouth opening, protrusive and laterotrusive movements) outcome variables were assessed before and after the treatment period. At the end of the five-injection protocol, significant improvements were showed in almost all the subjective outcome variables. Tolerability of the treatment was good on a four-point ordinal scale since the time of the first injection. The present investigation suggested that the single needle technique for TMJ hyaluronic injection following arthrocentesis in osteoarthritic joints may have promising applications in the clinical setting, which have to be confirmed with future studies.

Clinical phenotype of South-East Asian temporomandibular disorder patients with upper airway resistance syndrome.

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Tay, D K L; Pang, K P

2018-01-01

Clinical and radiographic characteristics of a subset of South East Asian temporomandibular disorder (TMD) patients with comorbid upper airway resistance syndrome (UARS) were documented in a multi-center prospective series of 86 patients (26 men and 60 women / mean age 35.7 years). All had excessive daytime sleepiness, high arousal index and Apnoea-Hypopnoea Index (AHI) temporomandibular joint (TMJ) arthralgia while 90·7% reported sleep bruxism (SB). Unlike patients with obstructive sleep apnoea (OSA), hypertension was uncommon (4·7%) while depression was prevalent at 68·6% with short REM latency of 25% documented in 79·6% and 57·6% of these depressed patients, respectively. 65·1% displayed a posteriorly displaced condyle at maximum intercuspation with or without TMJ clicking. Most exhibited a forward head posture (FHP) characterised by loss of normal cervical lordosis (80·2%), C0-C1 narrowing (38·4%) or an elevated hyoid position (50%), and 91·9% had nasal congestion. We postulate the TMD-UARS phenotype may have originally developed as an adaptive response to 'awake' disordered breathing during growth. Patients with persistent TMD and/or reporting SB should be screened for UARS and chronic nasal obstruction, especially when they also present with FHP. The lateral cephalogram is a useful tool in the differentiation of UARS from other OSA phenotypes. © 2017 John Wiley & Sons Ltd.

A retrospective analysis of the headache associated with temporomandibular joint disorder.

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Ungari, C; Quarato, D; Gennaro, P; Riccardi, E; Agrillo, A; Mitro, V; Cascino, F; Reale, G; Rinna, C; Filiaci, F

2012-11-01

Headache is a common symptom, that can be extremely disabling, affecting 26 million of patients only in Italy. ICHD-II has reported two categories: "primary headaches" and "secondary headaches". Temporomandibular joint disorders can lead to a secondary headaches. We want to evaluate the prevalence and clinical features of headache among a series of patients having temporomandibular joint disorders and we illustrate the evolution of headache following medical treatament of temporomandibular joint (TMJ) disorders. This is a retrospective study carried out on chart review of 426 consecutive patients with various degrees of temporomandibular disorders and treated with medical devices from 2007 to 2011. Headache was reported by 73 patients (17.14%). Headache was observed in 36 of 51 patients with lock and in 32 out of 130 patients with mandibular deflections (Table I). The remaining 5 patients with headache had articular noise. Headache is not a rare finding in a population with temporomandibular dysfunctions and is more often a tension-type rather than trigeminal headache.

Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients

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Park, Ha Na; Kim, Kyoung A; Koh, Kwang Joon [Dept. of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Bioscience, Chonbuk National University, Jeonju (Korea, Republic of)

2014-12-15

This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the chi2 test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (p<0.05). However, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ (G1) was not related to joint effusion in TMD patients (p>0.05). Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain.

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

DEFF Research Database (Denmark)

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 scale...... score for jaw pain intensity, the maximum inter-incisal opening (MK)), 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 (P follow-up. Additionally, a significant...

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

Soft versus hard occlusal splint therapy in the management of temporomandibular disorders (TMDs

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Sameh A Seifeldin

2015-10-01

Conclusions: Both forms of occlusal splints (soft and hard improved TMJ symptoms in patients with MPD or ID of the TMJ. However, the soft occlusal splints exhibited superior results after 4 months of use.

[Temporo-mandibular joints and orthognathic surgery].

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Bouletreau, P

2016-09-01

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

Attention Deficit Hyperactivity Disorder (ADHD) and disordered eating behaviour: A systematic review and a framework for future research.

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Kaisari, Panagiota; Dourish, Colin T; Higgs, Suzanne

2017-04-01

Preliminary findings suggest that Attention Deficit Hyperactivity Disorder (ADHD) may be associated with disordered eating behaviour, but whether there is sufficient evidence to suggest an association between ADHD and specific types of disordered eating behaviour is unclear. Furthermore, it is uncertain whether specific features associated with ADHD are differentially associated with disordered eating behaviour. A systematic review of seventy-five studies was conducted to evaluate the potential association between ADHD symptomatology and disordered eating behaviour and to provide an estimate of the strength of evidence for any association. Overall, a moderate strength of evidence exists for a positive association between ADHD and disordered eating and with specific types of disordered-eating behaviour, in particular, overeating behaviour. There is consistent evidence that impulsivity symptoms of ADHD are positively associated with overeating and bulimia nervosa and more limited evidence for an association between hyperactivity symptoms and restrictive eating in males but not females. Further research is required to assess the potential direction of the relationship between ADHD and disordered eating, the underlying mechanisms and the role of specific ADHD symptoms in the development and/or maintenance of disordered eating behaviour. We propose a framework that could be used to guide the design of future studies. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

APLIKASI SPLIN RELAKSASI PADA GANGGUAN SENDI RAHANG SELAMA PERAWATAN ORTHODONTIK (LAPORAN KASUS)

OpenAIRE

R.A. Donna Pratiwi; Laura Susanti Himawan

2015-01-01

The increase of pain symptoms in the temporomandibular joint (TMJ) challenges the scientists to find a more effective therapy. The popular treatment of the temporomandibular disorders (TMD) are eg oclussal splints, orthodontic treatment, electromyographic biofeedback, medication, etc. Among these, splint therapy is more successful than the others, especially in dealing with pain in the TMJ. Orthodontics as a treatment for the TMD quite often creates new complains on TMJ during and/or after tr...

Monoclonal antibody therapy for neuromyelitis optica spectrum disorder: current and future.

Science.gov (United States)

Lin, Jie; Xue, Binbin; Li, Xiang; Xia, Junhui

2017-08-01

Monoclonal-antibody has been used for patients with autoimmune disorders for several years, and efficacy and safety were appreciated for these patients. Neuromyelitis optica specturm disorder (NMOSD) has been defined as an autoimmune demyelination disorder of the central nervous system (CNS) with a course of relapse-remission. Treatment of prevention is important for patients with NMOSD because of the increased disability after several attacks. Multiple factors were involved in the pathogenesis of NMOSD. Currently, targeting specific factor was favored in the research into the treatment for NMOSD. Previous studies reported the efficacy and tolerance in NMOSD for drugs such as rituximab, tocilizumab, and eculizumab. The aim of this article is to review the current monoclonal therapies for NMOSD patients, and also future alternative options.

Pragmatics and adult language disorders: past achievements and future directions.

Science.gov (United States)

Cummings, Louise

2007-05-01

In this article, the current state of our knowledge of pragmatic disorders in adults with language impairment is assessed. A brief historical background of clinical pragmatics is presented, and the place of adult language pathology within the development of this field is discussed. A comprehensive review is undertaken of pragmatic deficits in adults with language impairments of diverse etiologies. Specifically, pragmatic deficits are examined in adults with left-hemisphere damage, often resulting in aphasia, and in adults with right-hemisphere damage, traumatic brain injury, schizophrenia, and neurodegenerative disorders (principally, Alzheimer's disease). Although many pragmatic phenomena have been examined in these clinical populations, studies have also tended to neglect important areas of pragmatic functioning in adults with these disorders. Several such areas are identified within a wider discussion of how researchers and clinicians can best pursue future investigations of pragmatics in adults with language impairment.

Future Directions in Etiologic, Prevention, and Treatment Research for Eating Disorders

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Stice, Eric; South, Kelsey; Shaw, Heather

2012-01-01

Significant advances have occurred regarding the understanding of etiologic processes that give rise to eating disorders and the design and evaluation of efficacious prevention programs and treatment interventions. Herein we offer suggestions regarding potentially fruitful directions for future research in these areas. We suggest it would be…

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

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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.

Temporomandibular disorders and bruxism. Part I.

Science.gov (United States)

Kevilj, R; Mehulic, K; Dundjer, A

2007-01-01

Correct functioning of the entire stomatognathic system is achieved by a compatible relationship of all its parts. Four determinants, by their mutual harmonious activity, dictate the function of the entire system: the teeth, periodontium with supporting structure, muscles, temporomandibular joint (TMJ) and CNS. In such a complex system a disorder of any integrative part causes disturbances also in other parts of the system. Changed functions can arise through organic disorder, and also iatrogenically by inadequate conservative, prosthetic, surgical or orthodontic therapy. For this reason it is often difficult to recognise the primary cause. The first responses of the system to the disorder are adaptive mechanisms which occur within one or more integrative parts, and depending on their intensity and duration symptoms grow more prominent. Tissue response can be ortho- or parafunctional. Attempts are made to exclude psychoemotional influences and the obstacle eliminated by either abrasion, clenching or grinding of the teeth. If the obstacle is not eliminated by abrasion, the cause of such functional disorder becomes the trigger for parafunctional activity. From a review of the relevant literature it can be concluded that parafunctional activity is caused by changed occlusion, with determined psychological habits of the patient and specific tissue response of the stomatognathic system. Therefore, therapy of these disorders is made more difficult and includes a multidisciplinary approach.

The dental management of patients with severe depression disorder (Literature review

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Nanan Nur’aeny

2016-06-01

Full Text Available World Health Organization (WHO in the year 2000 have identified major depressive disorder ranks as the fourth leading cause of death in the world. WHO also estimates that in 2020, the disorder will increase to second only to ischemic heart disease. People at high risk of first occurrence of depression are those who have a family history. Depression can happen to anyone and at all ages, ranging in age from children, young adults up to old age. This paper will discuss the literature review of an overview of depression and itsmanagement in dentistry. Patients with major depressive disorder may have abnormalities in the oral cavity affected by lack of oral hygiene as well as a manifestation of mental disorder and its treatment. Dental and oral management conducted in accordance with procedures and have to be carried out carefully especially to patients with mental disorders such as depression. Tooth decayed, gingivitis, xerostomia, oral candidiasis, oral lesion, and TMJ disorder are clinical findings in depressed patient, so as dentists may cooperate with psychiatrists in providing comprehensive treatment to improve quality of life of the patients.

Study of the relationship of psychosocial disorders to bruxism in adolescents.

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Katayoun, E; Sima, F; Naser, V; Anahita, D

2008-01-01

Bruxism has been defined as a diurnal or nocturnal parafunctional habit. Etiology of bruxism has remained controversial and some investigators believe that psychological factors may play a major role in promoting and perpetuating this habit. The aim of this case-control study was to assess the existence of an association between bruxism and psychosocial disorders in adolescents., Participants were chosen among 114, 12-14 year old students (girls). They were divided into two groups, bruxers and nonbruxers, on the basis of both validated clinical criteria and interview with each patient. A few participants were excluded on the basis of presence of systemic disorders, TMJ disorders, other oral habits, primary teeth, defective restorations and premature contacts. Following matching of two groups in regard to parent's age and education, mother's marital status, child support status, mother's employment status, and socio-economical status, 25 cases and 25 controls were enlisted. A self report validated questionnaire (YSR, 11-18 yr) was then filled out by both groups for the evaluation of 12 psychosocial symptoms. Remarkable differences in certain psychosocial aspects were found between the two groups. Prevalence of psychosocial disorders including Thought Disorders (P bruxism and psychosocial disorders has been provided.

Oral splint for temporomandibular joint disorders with revolutionary fluid system

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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.

Functional disorders of the temporomandibular joints: Internal derangement of the temporomandibular joint.

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Chang, Chih-Ling; Wang, Ding-Han; Yang, Mu-Chen; Hsu, Wun-Eng; Hsu, Ming-Lun

2018-04-01

Temporomandibular joint (TMJ) is one of the most complex joints of the human body. Due to its unique movement, in terms of combination of rotation and translator movement, disc of the joint plays an important role to maintain its normal function. In order to sustain the normal function of the TMJ, disc must be kept in proper position as well as maintain normal shape in all circumstances. Once the disc is not any more in its normal position during function of the joint, disturbance of the joint can be occurred which will lead to subsequent distortion of the disc. Shape of the disc can be influenced by many factors i.e.: abnormal function or composition of the disc itself. Etiology of the internal derangement of the disc remains controversial. Multifactorial theory has been postulated in most of previous manuscripts. Disc is composed of mainly extracellular matrix. Abnormal proportion of collagen type I & III may also leads to joint hypermobility which may be also a predisposing factor of this disorder. Thus it can be recognized as local manifestation of a systemic disorder. Different treatment modalities with from conservative treatment to surgical intervention distinct success rate have been reported. Recently treatment with extracellular matrix injection becomes more and more popular to strengthen the joint itself. Since multifactorial in character, the best solution of the treatment modalities should be aimed to resolve possible etiology from different aspects. Team work may be indication to reach satisfied results. Copyright © 2018. Published by Elsevier Taiwan.

Therapeutic improvements expected in the near future for schizophrenia and schizoaffective disorder

DEFF Research Database (Denmark)

Garay, Ricardo P; Citrome, Leslie; Samalin, Ludovic

2016-01-01

INTRODUCTION: In this review, the authors describe medications in phase III of clinical development for schizophrenia and schizoaffective disorder, and provide an opinion on how current treatment can be improved in the near future. Areas covered: Recent (post 2013) phase III clinical trials...... and schizoaffective disorder. In addition to better-tolerated antipsychotics that treat positive symptoms, we could see the arrival of the first effective drug for negative symptoms and CIAS, which would strongly facilitate the ultimate goal of recovery in persons with schizophrenia....

Temporo-mandibular joint kinetics and chewing cycles in children. A 3-year follow-up.

Science.gov (United States)

Bodin, C; Lodetti, G; Marinone, M G

2002-01-01

To report the temporo-mandibular joint (TMJ) kinetics and masticatory function in healthy children. Temporo-mandibular joint palpation and electrognathographic registrations of chewing cycles were repeated for 3 years in order to evaluate changes. Healthy children without systemic pathologies, decayed cavities and previous dental treatment. Electrognathographic (EGN) registration of masticatory cycles and TMJ palpation were carried out on 52 patients (mean age: 5 years 8 months, range: 5 years 1 month, 6 years 8 months), by two university researchers, once a year for 3 consecutive years. TMJ palpation, differentiated TMJ synchronism (simultaneous bilateral opening movement) and TMJ asynchronism (not simultaneous bilateral opening movement), TMJ subluxation and click were observed. Electrognathographic registrations differentiated normal and abnormal jaw chewing cycles, and narrow and large cycles. Temporo-mandibular joint asynchronism was evident in 34 of 52 patients in the primary dentition, in 42 of 52 patients after the eruption of the first permanent molar, and in 31 of 52 patients after the eruption of the permanent incisors. TMJ subluxation increased during the full period of observation. Three temporomandibular clicks appeared after the eruption of the permanent incisors. Altered mastication was not always associated with TMJ disorders. In children, normal chewing cycles can coexist with occlusal discrepancies, cranio-facial growth and TMJ alterations.

Virtual reality for obsessive-compulsive disorder: past and the future.

Science.gov (United States)

Kim, Kwanguk; Kim, Chan-Hyung; Kim, So-Yeon; Roh, Daeyoung; Kim, Sun I

2009-09-01

The use of computers, especially for virtual reality (VR), to understand, assess, and treat various mental health problems has been developed for the last decade, including application for phobia, post-traumatic stress disorder, attention deficits, and schizophrenia. However, the number of VR tools addressing obsessive-compulsive disorder (OCD) is still lacking due to the heterogeneous symptoms of OCD and poor understanding of the relationship between VR and OCD. This article reviews the empirical literatures for VR tools in the future, which involve applications for both clinical work and experimental research in this area, including examining symptoms using VR according to OCD patients' individual symptoms, extending OCD research in the VR setting to also study behavioral and physiological correlations of the symptoms, and expanding the use of VR for OCD to cognitive-behavioral intervention.

{sup 99m}Tc-labeled-1-thio-{beta}-D-glucose as a new tool to temporomandibular joint inflammatory disorders diagnosis

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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.

[Clinical evaluation and psychological aspects of temporomandibular joint disorders].

Science.gov (United States)

Coessens, P; De Boever, J A

1997-01-01

Establishing the patient's clinical diagnosis depends on gathering as much information of the patient and his or her signs and symptoms as possible. This information can be gathered from history, physical and psychological examination, diagnostic analysis. It is also important to look upon pain as a disorder and to consider the relationship between pain and psychological factors. The differential diagnosis is constructed through a biopsychological model of illness rather than through a more traditional biomedical model of disease. To arrive at a consistently accurate clinical diagnosis in patients with TMJ and craniofacial pain, the technique of clinical diagnosis must be well defined, reliable and include examination of the head and the neck, cranial nerves and the stomatognathic system. The craniomandibular index provides a standardized examination of the stomatognathic system that has been tested on validity and reliability. This chapter focuses on the techniques of history taking clinical and psychological examination and diagnostic criteria for temporomandibular joint disorders and muscle pain.

Temporomandibular joint involvement in a cohort of patients with Juvenile Idiopatic Arthritis and evaluation of the effect induced by functional orthodontic appliance: clinical and radiographic investigation.

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Portelli, M; Matarese, G; Militi, A; Logiudice, G; Nucera, R; Lucchese, A

2014-03-01

The aim of the study was to assess possible correlations between the clinical parameters of temporomandibular joint (TMJ) arthritis and pathologic MRI findings of the TMJ in patients affected by juvenile idiopathic arthritis (JIA), and the effect of a functional orthodontic therapy on the evolution of TMJ disorders. A prospective clinical and nuclear magnetic resonance (NMR) investigation was conducted on a sample of 53 patients (41 female, 12 male) with JIA, treated for 24 months with an Andresen appliance. The involvement of TMJ was defined by clinical and radiological signs. NMR assessments were performed in closed and maximum opening mouth position before (T0) and at the end of functional orthodontic therapy (T1). Fifteen patients showed physical and radiologic TMJ abnormalities. Changes were not uniformly distributed among the different JIA subtypes. Patients with poliarticular JIA (≥5 peripheral joints affected) showed more destructive bony changes. No correlation existed between clinical symptoms and NMR alterations. Approximately one half of the patients experienced significant improvement of the TMJ and muscular pain using the Andresen appliance. The prevalence of TMJ involvement in patients suffering of JIA, and the improvement of TMJ and muscular pain associated with the use of functional appliance found in the present study, suggest an alert for TMJ dysfunction in patients with JIA and demonstrate the utility of functional orthodontic therapy in preventing the morbidities associated with TMJ arthritis in JIA.

Temporomandibular joint MR images: Incidental head and neck findings and pathologies.

Science.gov (United States)

Orhan, Kaan; Avsever, Hakan; Aksoy, Seçil; Seki, Umut; Bozkurt, Poyzan

2017-10-17

To report the number and frequency of incidental findings (IFs) detected during magnetic resonance (MR) imaging screening of the temporomandibular joint (TMJ) and to define related diseases. Bilateral TMJ MR images in the sagittal and coronal sections, from 518 patients with TMJ symptoms were evaluated retrospectively. Patients who were diagnosed with IFs were sent for consultation and clarification of the findings. Patient age, gender, IFs, locations, and diseases were classified and noted.  Results: Seventy-eight (15%) patients were diagnosed with 117 IFs. Of them, 43 were diagnosed with a single IF, and 35 were diagnosed with more than one IF. The most frequent locations were paranasal sinuses and mastoid air cells. The most frequent diseases were inflammatory and cystic lesions.  Discussion: While examining TMJ MR images, it is important to check for evidence of IFs or pathologies that may have mimicked signs and symptoms of TMJ disorders.

Bipolar disorder diagnosis: challenges and future directions

Science.gov (United States)

Phillips, Mary L; Kupfer, David J

2018-01-01

Bipolar disorder refers to a group of affective disorders, which together are characterised by depressive and manic or hypomanic episodes. These disorders include: bipolar disorder type I (depressive and manic episodes: this disorder can be diagnosed on the basis of one manic episode); bipolar disorder type II (depressive and hypomanic episodes); cyclothymic disorder (hypomanic and depressive symptoms that do not meet criteria for depressive episodes); and bipolar disorder not otherwise specified (depressive and hypomanic-like symptoms that do not meet the diagnostic criteria for any of the aforementioned disorders). Bipolar disorder type II is especially difficult to diagnose accurately because of the difficulty in differentiation of this disorder from recurrent unipolar depression (recurrent depressive episodes) in depressed patients. The identification of objective biomarkers that represent pathophysiologic processes that differ between bipolar disorder and unipolar depression can both inform bipolar disorder diagnosis and provide biological targets for the development of new and personalised treatments. Neuroimaging studies could help the identification of biomarkers that differentiate bipolar disorder from unipolar depression, but the problem in detection of a clear boundary between these disorders suggests that they might be better represented as a continuum of affective disorders. Innovative combinations of neuroimaging and pattern recognition approaches can identify individual patterns of neural structure and function that accurately ascertain where a patient might lie on a behavioural scale. Ultimately, an integrative approach, with several biological measurements using different scales, could yield patterns of biomarkers (biosignatures) to help identify biological targets for personalised and new treatments for all affective disorders. PMID:23663952

APLIKASI SPLIN RELAKSASI PADA GANGGUAN SENDI RAHANG SELAMA PERAWATAN ORTHODONTIK (LAPORAN KASUS

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R.A. Donna Pratiwi

2015-08-01

Full Text Available The increase of pain symptoms in the temporomandibular joint (TMJ challenges the scientists to find a more effective therapy. The popular treatment of the temporomandibular disorders (TMD are eg oclussal splints, orthodontic treatment, electromyographic biofeedback, medication, etc. Among these, splint therapy is more successful than the others, especially in dealing with pain in the TMJ. Orthodontics as a treatment for the TMD quite often creates new complains on TMJ during and/or after treatment. The extrusion of the posterior teeth in reducing anterior deep overbite have been proposed as possible cause of TMD. This paper reported that a relaxation splint was an effective solution to relieve the pain in the TMJ for the orthodontic patients where occlusal factors were related. One month after the splint therapy, the pain in the TMJ was slowly disappeared, and the orthodontic treatment can be continued with the splint as an occlusal height guidance.

Muscle disorders and dentition-related aspects in temporomandibular disorders: controversies in the most commonly used treatment modalities

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Jerjes Waseem

2008-10-01

Full Text Available Abstract This review explores the aetiology of temporomandibular disorders and discusses the controversies in variable treatment modalities. Pathologies of the temporomandibular joint (TMJ and its' associated muscles of mastication are jointly termed temporomandibular disorders (TMDs. TMDs present with a variety of symptoms which include pain in the joint and its surrounding area, jaw clicking, limited jaw opening and headaches. It is mainly reported by middle aged females who tend to recognize the symptoms more readily than males and therefore more commonly seek professional help. Several aetiological factors have been acknowledged including local trauma, bruxism, malocclusion, stress and psychiatric illnesses. The Research Diagnostic Criteria of the Temporomandibular Disorders (RDC/TMD is advanced to other criteria as it takes into consideration the socio-psychological status of the patient. Several treatment modalities have been recommended including homecare practices, splint therapy, occlusal adjustment, analgesics and the use of psychotropic medication; as well as surgery, supplementary therapy and cognitive behavioural therapy. Although splint therapy and occlusal adjustment have been extensively used, there is no evidence to suggest that they can be curative; a number of evidence-based trials have concluded that these appliances should not be suggested as part of the routine care. Surgery, except in very rare cases, is discouraged since it is the most invasive alternative; recent studies have shown healthier outcome with cognitive behavioural therapy.

Avaliação da sensibilidade do questionário de triagem para dor orofacial e desordens temporomandibulares recomendado pela Academia Americana de Dor Orofacial The sensibility appreciation of the questionnaire for selection of orofacial pain and temporomandibular disorders recommended by the American Academy of Orofacial Pain

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Ana Paula S. Manfredi

2001-01-01

Full Text Available Introdução: As Desordens Temporomandibulares têm interpretação muito ampla e descrevem uma população geral de pacientes sofrendo de disfunção dos músculos e articulações da mandíbula, usualmente dolorosa¹. Além da queixa de dor nos maxilares, dores de ouvido, cabeça e face, os pacientes com essas desordens muitas vezes têm movimentos mandibulares limitados ou assimétricos, e os sons da Articulação Temporomandibulares (ATM mais descritos são os estalos. Objetivo: Com o intuito de fazer uma análise qualitativa e quantitativa do uso de um instrumento de auxílio diagnóstico, foi aplicado o "Questionário para Triagem para Dor Orofacial e DTM", recomendado pela Academia Americana de Dor Orofacial (Anexo 1, ainda não testado no Brasil. A população alvo foi de pacientes com queixas de dor não-dental na região orofacial, cefaléia, otalgia e/ou nas ATM que procuraram o ambulatório médico e odontológico (CSS/CECOM mantido pela Unicamp para o atendimento de sua comunidade interna. Forma de estudo: Prospectivo clínico randomizado. Método: O questionário foi aplicado em 46 pacientes (40 mulheres e 6 homens, e posteriormente foi realizado um exame clínico específico para diagnóstico das DTM. Resultados: A análise estatística revelou que este questionário apresenta uma sensibilidade de 85.37% e uma especificidade de 80% para pacientes portadores de desordens musculares da região orofacial (Kappa = 0,454 e uma baixa sensibilidade e especificidade para desordens intra-articulares (Kappa = 0,043. Conclusão: O questionário é útil e viável para uma pré-triagem das chamadas DTM, principalmente para os distúrbios miogênicos, mas não deve ser o único recurso utilizado para diagnóstico.Introduction: The Temporomandibular Joint Disorders (TMJ Disorders has very ample interpretation and describes a population of patients suffering from muscles dysfunctions and the muscles and toggles of jaw usually painful 1. Beyond

Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients

International Nuclear Information System (INIS)

Park, Ha Na; Kim, Kyoung A; Koh, Kwang Joon

2014-01-01

This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the chi2 test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (p 0.05). Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain.

Hypersensitivity to mechanical and intra-articular electrical stimuli in persons with painful temporomandibular joints

DEFF Research Database (Denmark)

Ayesh, Emad; Jensen, Troels Staehelin; Svensson, P

2007-01-01

This study tested whether persons with TMJ arthralgia have a modality-specific and site-specific hypersensitivity to somatosensory stimuli assessed by quantitative sensory tests (QST). Forty-three healthy persons and 20 with TMJ arthralgia participated. The QST consisted of: sensory and pain dete...... of sensitization of the TMJs as well as central nociceptive pathways. QST may facilitate a mechanism-based classification of temporomandibular disorders. Udgivelsesdato: 2007-Dec...

Current status of temporomandibular joint disorders and the therapeutic system derived from a series of biomechanical, histological, and biochemical studies

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Kazuo Tanne

2015-01-01

Full Text Available This article was designed to report the current status of temporomandibular joint disorders (TMDs and the therapeutic system on the basis of a series of clinical, biomechanical, histological and biochemical studies in our research groups. In particular, we have focused on the association of degenerative changes of articular cartilage in the mandibular condyle and the resultant progressive condylar resorption with mechanical stimuli acting on the condyle during the stomatognathic function. In a clinical aspect, the nature and prevalence of TMDs, association of malocclusion with TMDs, association of condylar position with TMDs, association of craniofacial morphology with TMDs, and influences of TMDs, TMJ-osteoarthritis (TMJ-OA in particular, were examined. In a biomechanical aspect, the nature of stress distribution in the TMJ from maximum clenching was analyzed with finite element method. In addition, the pattern of stress distribution was examined in association with varying vertical discrepancies of the craniofacial skeleton and friction between the articular disk and condyle. The results demonstrated an induction of large compressive stresses in the anterior and lateral areas on the condyle by the maximum clenching and the subsequent prominent increases in the same areas of the mandibular condyle as the vertical skeletal discrepancy became more prominent. Increase of friction at the articular surface was also indicated as a cause of larger stresses and the relevant disk displacement, which further induced an increase in stresses in the tissues posterior to the disks, indicating an important role of TMJ disks as a stress absorber. In a histological or biological aspect, increase in TMJ loading simulated by vertical skeletal discrepancy, which has already been revealed by the preceding finite element analysis or represented by excessive mouth opening, produced a decrease in the thickness of cartilage layers, an increase in the numbers of

Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

International Nuclear Information System (INIS)

Castro Lopes, Sergio Lucio Pereira; Ferreira Costa, Andre Luiz; Oliveira Gamba, Thiago; Flores, Isadora Luana; Cruz, Adriana Dibo; Min, Li Li

2015-01-01

Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

Lateral pterygoid muscle volume and migraine in patients with temporomandibular disorders

Energy Technology Data Exchange (ETDEWEB)

Castro Lopes, Sergio Lucio Pereira [Dept. of Diagnosis and Surgery, Sao Jose dos Campos Dental School, Sao Paulo (Brazil); Ferreira Costa, Andre Luiz [Dept. of Pediatric Dentistry and Orthodontics, University of Sao Paulo, Sao Paulo (Brazil); Oliveira Gamba, Thiago; Flores, Isadora Luana [Dept. of ral Diagnosis, School of Dentistry, Sao Paulo (Brazil); Cruz, Adriana Dibo [Dept. of Specific Formation, Area of Radiology, Nova Friburgo Dental School, Fluminense Federal University, Rio de Janeiro (Brazil); Min, Li Li [Laboratory of Neuroimaging, Dept. of Neurology, Faculty of Medical Sciences, Sao Paulo (Brazil)

2015-03-15

Lateral pterygoid muscle (LPM) plays an important role in jaw movement and has been implicated in Temporomandibular disorders (TMDs). Migraine has been described as a common symptom in patients with TMDs and may be related to muscle hyperactivity. This study aimed to compare LPM volume in individuals with and without migraine, using segmentation of the LPM in magnetic resonance (MR) imaging of the TMJ. Twenty patients with migraine and 20 volunteers without migraine underwent a clinical examination of the TMJ, according to the Research Diagnostic Criteria for TMDs. MR imaging was performed and the LPM was segmented using the ITK-SNAP 1.4.1 software, which calculates the volume of each segmented structure in voxels per cubic millimeter. The chi-squared test and the Fisher's exact test were used to relate the TMD variables obtained from the MR images and clinical examinations to the presence of migraine. Logistic binary regression was used to determine the importance of each factor for predicting the presence of a migraine headache. Patients with TMDs and migraine tended to have hypertrophy of the LPM (58.7%). In addition, abnormal mandibular movements (61.2%) and disc displacement (70.0%) were found to be the most common signs in patients with TMDs and migraine. In patients with TMDs and simultaneous migraine, the LPM tends to be hypertrophic. LPM segmentation on MR imaging may be an alternative method to study this muscle in such patients because the hypertrophic LPM is not always palpable.

A comparative study of radiographic landmarks of T.M.J. by various techniques

International Nuclear Information System (INIS)

Lee, You Dong; Ahn, Hyung Kyu

1974-01-01

The author has studied roentgenographic images of temporomandibular articulation using various conventional roentgenographies. The roentgenographic images have been obtained by application of the contrast media on the glenoid fossa and condylar head in human dry skull. Comparing the various roentgenograms by Modified Transcranial projection, A-P T.M. articulation projection, Reverse Town projection, Mayer projection, and Bregma-Menton projection; The author has drawn following results. 1. The sharp radiographic details were obtained by all technics used except the Bregma-Menton projection which seemed to be impractical to the study of T.M.J. because of the shortened image of condylar head. 2. The best image of the condyle-fossa relationship was appeared by Modified Transcranial projection and better image w as acquired by Orbito-Ramus projection, but there were all inferior in Reverse Towne projection, Mayer projection, and B regma-Menton projection. 3. In all of the above techniques, the radiograhpic images of condylar head were clear and appeared to be the convex type in Modified Transcranial projection, the angled type in Orbito-Ramus and Reverse Towne projection, the flat type in Mayer projection, and the distorted angled type in Bregma-Menton projection. 4. The radiographic image of condylar head was shortened in Bregma-Menton projection only and was magnified somewhat in other projections.

A comparative study of radiographic landmarks of T.M.J. by various techniques

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Lee, You Dong; Ahn, Hyung Kyu [College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1974-11-15

The author has studied roentgenographic images of temporomandibular articulation using various conventional roentgenographies. The roentgenographic images have been obtained by application of the contrast media on the glenoid fossa and condylar head in human dry skull. Comparing the various roentgenograms by Modified Transcranial projection, A-P T.M. articulation projection, Reverse Town projection, Mayer projection, and Bregma-Menton projection; The author has drawn following results. 1. The sharp radiographic details were obtained by all technics used except the Bregma-Menton projection which seemed to be impractical to the study of T.M.J. because of the shortened image of condylar head. 2. The best image of the condyle-fossa relationship was appeared by Modified Transcranial projection and better image w as acquired by Orbito-Ramus projection, but there were all inferior in Reverse Towne projection, Mayer projection, and B regma-Menton projection. 3. In all of the above techniques, the radiograhpic images of condylar head were clear and appeared to be the convex type in Modified Transcranial projection, the angled type in Orbito-Ramus and Reverse Towne projection, the flat type in Mayer projection, and the distorted angled type in Bregma-Menton projection. 4. The radiographic image of condylar head was shortened in Bregma-Menton projection only and was magnified somewhat in other projections.

Somatosensory Tinnitus: Correlation between Cranio-Cervico-Mandibular Disorder History and Somatic Modulation.

Science.gov (United States)

Ralli, Massimo; Altissimi, Giancarlo; Turchetta, Rosaria; Mazzei, Filippo; Salviati, Massimo; Cianfrone, Francesca; Orlando, Maria Patrizia; Testugini, Valeria; Cianfrone, Giancarlo

2016-01-01

In a subpopulation of patients, tinnitus can be modulated by movements of the jaw or head and neck due to complex somatosensory-auditory interactions. In some of these subjects, tinnitus could be related to an underlying temporomandibular (TMJ) or craniocervical (NECK) dysfunction that, if correctly identified, could streamline treatment and increase chances of tinnitus improvement. However, it is still unclear whether somatic modulation of tinnitus could be used as a screening tool for identifying such patients. In this study, we included 310 tinnitus patients with normal hearing, no psychiatric comorbidities, and a positive history of TMJ and/or NECK dysfunction and/or a positive modulation of tinnitus to evaluate the characteristics of somatic modulation, investigate the relationship between positive history and positive modulation, and identify factors most strongly associated with somatic modulation. Tinnitus modulation was present in 79.67% of the patients. We found a significant association within the same subjects between a positive history and a positive tinnitus modulation for the same region, mainly for TMJ in unilateral tinnitus patients and for TMJ + NECK in bilateral tinnitus patients. A strong correlation between history and modulation in the same somatic region within the same subgroups of subjects was also identified. Most TMJ maneuvers resulted in an increased loudness, while NECK maneuvers showed an increase in tinnitus loudness in about 59% of cases. High-pitched tinnitus and male gender were associated with a higher prevalence of modulation; no differences were found for tinnitus onset, Tinnitus Handicap Inventory score, and age. In this paper, we report a strong association between history and modulation for the same regions within the same patients; such an association should always be investigated to improve chances of a correct diagnosis of somatosensory tinnitus. © 2017 S. Karger AG, Basel.

A European Perspective on Auditory Processing Disorder-Current Knowledge and Future Research Focus

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Vasiliki (Vivian Iliadou

2017-11-01

Full Text Available Current notions of “hearing impairment,” as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other more sophisticated audiometric tests such as speech audiometry in noise or complex non-speech sound perception. This disorder, defined as “Auditory Processing Disorder” (APD or “Central Auditory Processing Disorder” is classified in the current tenth version of the International Classification of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order to further clarify the nature of APD and thus assist in optimum diagnosis and evidence-based management. This European consensus presents the main symptoms, conditions, and specific medical history elements that should lead to auditory processing evaluation. Consensus on definition of the disorder, optimum diagnostic pathway, and appropriate management are highlighted alongside a perspective on future research focus.

Histochemistry for studying structure and function of the articular disc of the human temporomandibular joint

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N. Kiga

2012-02-01

Full Text Available The articular disc of the temporomandibular joint (TMJ is composed of fibrocartilage, and the extracellular matrix of this disc is composed mainly of collagen, glycosaminoglycan and proteoglycans. Research on the changes that occur in the composition of the articular disc of the TMJ is necessary for understanding the basis of the pathological process of internal derangement (ID, and a number of reports have been published in recent years on the application of refined histochemical techniques to investigate the structure and function of the TMJ. The direction of future TMJ disc studies should be towards obtaining more evidence to support previous results, and should hopefully be of practical use in terms of prevention and cure of ID.

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

Science.gov (United States)

Sahebi, Safoora; Moazami, Fariborz; Afsa, Masoomeh; Nabavi Zade, Mohammad Reza

2010-01-01

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 intuba-tion 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. PMID:22991607

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

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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.

A postmortem and future look at the personality disorders in DSM-5.

Science.gov (United States)

Widiger, Thomas A

2013-10-01

It might seem difficult to describe the outcome of the proposals by the American Psychiatric Association's (APA) Personality and Personality Disorders Work Group (PPDWG) to be a success, given that all of the proposals were ultimately rejected. Nevertheless, one can interpret the result as a step forward, because the final outcome might not have been much different if a more conservative approach was adopted at the outset. The PPDWG did provide a significant contribution to the field through the provision of proposals that will likely generate a considerable body of informative research. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) effort and suggestions for the future are discussed with respect to magnitude of change, documentation of empirical support, and addressing opposition. PsycINFO Database Record (c) 2013 APA, all rights reserved.

Temporomandibular joint involvement in rheumatoid arthritis patients: association between clinical and tomographic data

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Cordeiro, Patrícia C. F; Guimaraes, Josemar P; de Souza, Viviane A; Dias, Isabela M; Silva, Jesca N. N; Devito, Karina L; Bonato, Leticia L

2016-01-01

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and synovial hyperplasia, which usually affects multiple joints. The temporomandibular joint (TMJ) becomes susceptible to the development of changes resulting from RA. The aim of this study was to evaluate the presence of TMD and degenerative bone changes in TMJ in patients diagnosed with RA (rheumatoid arthritis). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questio...

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.

Ultrastructure of collagen fibers and distribution of extracellular matrix in the temporomandibular disk of the human fetus and adult.

Science.gov (United States)

Takahashi, H; Sato, I

2001-12-01

We quantitatively examined the distribution of these differences in extracellular matrices (collagen types I, III, and fibronectin) and elastic fibers under confocal laser scanning microscopy and electron scanning microscopy in terms of their contribution to the mechanics of the TMJ during development and in adults. Elastic fibers were found in the anterior and posterior bands in adults aged 40 years, and a few elastic fibers in the anterior band of the disk in adults aged 80 to 90 years. The extracellular matrix contents of the TMJ disk are shown in various detected levels in the anterior, intermediate, posterior bands of TMJ disk. During development, collagen fibers are arranged in a complex fashion from 28 weeks' gestation. These ultrastructures of the embryonic TMJ are resembled to that of adults aged the 40s, however the difference in extracellular matrix distribution found in embryonic stages and adults. They might reflect the differences in function between mastication and sucking or the changes in shape and form as results of functional disorders of the TMJ.

Autism Spectrum Disorders: Is Mesenchymal Stem Cell Personalized Therapy the Future?

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Dario Siniscalco

2012-01-01

Full Text Available Autism and autism spectrum disorders (ASDs are heterogeneous neurodevelopmental disorders. They are enigmatic conditions that have their origins in the interaction of genes and environmental factors. ASDs are characterized by dysfunctions in social interaction and communication skills, in addition to repetitive and stereotypic verbal and nonverbal behaviours. Immune dysfunction has been confirmed with autistic children. There are no defined mechanisms of pathogenesis or curative therapy presently available. Indeed, ASDs are still untreatable. Available treatments for autism can be divided into behavioural, nutritional, and medical approaches, although no defined standard approach exists. Nowadays, stem cell therapy represents the great promise for the future of molecular medicine. Among the stem cell population, mesenchymal stem cells (MSCs show probably best potential good results in medical research. Due to the particular immune and neural dysregulation observed in ASDs, mesenchymal stem cell transplantation could offer a unique tool to provide better resolution for this disease.

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 horses commonly had spherical hypodensities within the mandibular condyles consistent with bone cysts; and hyperdense regions of the intra-articular disc consistent with dystrophic mineralization. Findings indicated that 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.

Borderline Personality Disorder and Oxytocin: Review of Clinical Trials and Future Directions.

Science.gov (United States)

Amad, Ali; Thomas, Pierre; Perez-Rodriguez, M Mercedes

2015-01-01

Borderline personality disorder (BPD) is a common mental disorder characterized by a pervasive pattern of emotional Borderline personality disorder (BPD) is a common mental disorder characterized by a pervasive pattern of emotional lability, impulsivity, interpersonal difficulties, identity disturbances, and disturbed cognition. Traditional pharmacotherapies are effective in treating some of these core symptoms but have only modest effects on the domain of interpersonal dysfunction of BPD. Thus there is a need to develop new, neurobiologically informed pharmacological treatments for BPD. This review focuses on the potential use of intranasal oxytocin (OXT), which has key roles in the regulation of complex social cognition and behaviors, to target symptoms of interpersonal dysfunction in BPD. Surprisingly, despite promising data on the prosocial effects of OXT, only 5 trials in BPD have been published to date. These trials show mixed results with on one hand, a decrease of emotional responses to stress and on the other hand, some "paradoxical" reactions with worsened interpersonal anxiety and decreased cooperative behavior. These mixed results are interpreted according to different theoretical models and also in light of some methodological limitations. Further studies are needed to understand the effect of OXT in patients with BPD and ongoing clinical trials will provide some answers to remaining questions on the use of OXT in BPD. Recommendations for future studies are also proposed in this review.

Relationship between pain and effusion on magnetic resonance imaging in temporomandibular disorder patients

Science.gov (United States)

Park, Ha-Na; Kim, Kyoung-A

2014-01-01

Purpose This study was performed to find the relationship between pain and joint effusion using magnetic resonance imaging (MRI) in temporomandibular disorder (TMD) patients. Materials and Methods The study subjects included 232 TMD patients. The inclusion criteria in this study were the presence of spontaneous pain or provoked pain on one or both temporomandibular joints (TMJs). The provoked pain was divided into three groups: pain on palpation (G1), pain on mouth opening (G2), and pain on mastication (G3). MRI examinations were performed using a 1.5-T MRI scanner. T1- and T2-weighted images with para-sagittal and para-coronal images were obtained. According to the T2-weighted image findings, the cases of effusions were divided into four groups: normal, mild (E1), moderate (E2), and marked effusion (E3). A statistical analysis was carried out using the χ2 test with SPSS (version 12.0, SPSS Inc., Chicago, IL, USA). Results Spontaneous pain, provoked pain, and both spontaneous and provoked pain were significantly related to joint effusion in TMD patients (peffusion in TMD patients (p>0.05). Conclusion Spontaneous pain was related to the MRI findings of joint effusion; however, among the various types of provoked pain, pain on palpation of the masticatory muscles and TMJ was not related to the MRI findings of joint effusion. These results suggest that joint effusion has a significant influence on the prediction of TMJ pain. PMID:25473637

The Yucatan Minipig Temporomandibular Joint Disc Structure-Function Relationships Support Its Suitability for Human Comparative Studies.

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Vapniarsky, Natalia; Aryaei, Ashkan; Arzi, Boaz; Hatcher, David C; Hu, Jerry C; Athanasiou, Kyriacos A

2017-11-01

Frequent involvement of the disc in temporomandibular joint (TMJ) disorders warrants attempts to tissue engineer TMJ disc replacements. Physiologically, a great degree of similarity is seen between humans and farm pigs (FPs), but the pig's rapid growth confers a significant challenge for in vivo experiments. Minipigs have a slower growth rate and are smaller than FPs, but minipig TMJ discs have yet to be fully characterized. The objective of this study was to determine the suitability of the minipig for TMJ studies by extensive structural and functional characterization. The properties of minipig TMJ discs closely reproduced previously reported morphological, biochemical, and biomechanical values of human and FP discs. The width/length dimension ratio of the minipig TMJ disc was 1.95 (1.69 for human and 1.94 for FP). The biochemical evaluation revealed, on average per wet weight, 24.3% collagen (22.8% for human and 24.9% for FP); 0.8% glycosaminoglycan (GAG; 0.5% for human and 0.4% for FP); and 0.03% DNA (0.008% for human and 0.02% for FP). Biomechanical testing revealed, on average, compressive relaxation modulus of 50 kPa (37 kPa for human and 32 kPa for FP), compressive instantaneous modulus of 1121 kPa (1315 kPa for human and 1134 kPa for FP), and coefficient of viscosity of 13 MPa·s (9 MPa·s for human and 3 MPa·s for FP) at 20% strain. These properties also varied topographically in accordance to those of human and FP TMJ discs. Anisotropy, quantified by bidirectional tensile testing and histology, again was analogous among minipig, human, and FP TMJ discs. The minipig TMJ's ginglymoarthrodial nature was verified through cone beam computer tomography. Collectively, the similarities between minipig and human TMJ discs support the use of minipig as a relevant model for TMJ research; considering the practical advantages conferred by its growth rate and size, the minipig may be a preferred model over FP.

Experimental model of temporomandibular joint arthritis induced by zymozan in rats and the study of the role of nitric oxide

OpenAIRE

HellÃada Vasconcelos Chaves

2006-01-01

Temproromandibular disfunction (TMD) is related to a masticatory system disfunction which can include the temporomandibular joint (TMJ), the masticatory muscles and/or other related structures. TMJ inflammatory disorders are one of the major pathology of TMD afecting a great number of patients. Although TMJÂs inflammation and pain are important cinical entities, their mechanisms are poorly understood. The purpose of the study is to propose an experimetnal model of TMJÂs arthritis to study its...

Lifestyle and oral facial disorders associated with sleep bruxism in children.

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Alencar, Nashalie Andrade de; Fernandes, Alline Birra Nolasco; Souza, Margareth Maria Gomes de; Luiz, Ronir Raggio; Fonseca-Gonçalves, Andréa; Maia, Lucianne Cople

2017-05-01

The aim of the study was to investigate the routine, sleep history, and orofacial disorders associated with children aged 3-7 years with nocturnal bruxism. Children (n = 66) were divided into groups of parent reported nocturnal bruxism (n = 34) and those without the disorder (n = 32). Data about the child's routine during the day, during sleep and awakening, headache frequency, temporomandibular joint (TMJ), and hearing impairments were obtained through interviews with parents/caregivers. Electromyography examination was used to assess the activity of facial muscles. Multiple logistic regression (MLR), chi-square test, and t-test analyses were performed. MLR revealed association of nightmares (p = 0.002; OR = 18.09) and snoring (p = 0.013; OR = 0.14) with bruxism. Variables related to awakening revealed an association with bruxism (p bruxism) reported more complaints of orofacial pain, facial appearance, and headache occurrence (p  0.05). Nightmares and snoring are associated with nocturnal bruxism in children. Bruxism in children elicits consequences such as headache, orofacial pain, and pain related to awakening.

[Intra-articular injections of hyaluronic acid for anterior disc displacement of temporomandibular joint].

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Long, X

2017-03-09

Anterior disc displacement (ADD) of temporomandibular joint (TMJ) is regarded as one of the major findings in temporomandibular disorders (TMD). It is related to joint noise, pain, mandibular dysfunction, degenerative change and osteoarthritis. In the mean time, the pathological changes were found in synovial membrane and synovial fluid. Hyaluronic acid is a principal component of the synovial fluid which plays an important role in nutrition, lubrication, anti-inflammation and cartilage repair. The synthesis, molecule weight, and concentration of hyaluronic acid are decreased during TMD and cause TMJ degenerative changes. The clinical conditions, pathological changes, the mechanism of action for hyaluronic acid and the treatment of anterior disc displacement of TMJ are discussed in this article.

Rheumatoid arthritis affecting temporomandibular joint

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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.

Risk perception of future cardiovascular disease in women diagnosed with a hypertensive disorder of pregnancy.

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Traylor, Jessica; Chandrasekaran, Suchitra; Limaye, Meghana; Srinivas, Sindhu; Durnwald, Celeste P

2016-01-01

The objective of this study is to evaluate a woman's risk perception for future cardiovascular disease (CVD) after being diagnosed with a hypertensive disorder of pregnancy. A prospective cohort of women diagnosed with a hypertensive disorder of pregnancy (HDP) was studied. Each woman completed two surveys, one prior to hospital discharge and one 2 weeks later, designed to assess knowledge of and risk perception for future CVD based on their recent diagnosis of a HDP. Rates of postpartum depression were also assessed. Of the 146 subjects included, 28% were diagnosed with preeclampsia with severe features, 52.1% with preeclampsia with mild features, and 19.9% had chronic hypertension. Women with severe features and those delivering preterm were more likely to report a perception of increased risk of both recurrent HDP in a future pregnancy (p = 0.004 and 0.005, respectively) and hypertension later in life (p = 0.01 and 0.03, respectively). Women delivering preterm were more likely to report an accurate perception of increased risk of myocardial infarction and stroke compared to those delivering at term (p = 0.006 and 0.002, respectively). Disease severity and preterm delivery were associated with a higher likelihood of the perception of an increased risk for both recurrent HDP and hypertension in the future. Only preterm delivery was associated with a higher risk perception for stroke and myocardial infarction. Interventions targeted at improved health awareness in women diagnosed with HDP are warranted.

Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms.

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Wiese, Mie; Svensson, Peter; Bakke, Merete; List, Thomas; Hintze, Hanne; Petersson, Arne; Knutsson, Kerstin; Wenzel, Ann

2008-01-01

To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings. Two hundred four adult patients (156 women, 48 men, mean age 40 years) with temporomandibular joint (TMJ) pain/sounds or changes in mandibular motion were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bilateral sagittal corrected TMJ tomograms in closed and open positions were assessed for the presence of flattening, erosion, osteophytes, and sclerosis in the joint components and the range of mandibular motion. Logistic regression analyses were performed with the radiographic findings as the dependent variables and the following clinical variables as independent variables: opening pattern, maximal jaw opening, TMJ sounds, number of painful muscle/TMJ sites, duration of pain, presence of arthritic disease, depression and somatization scores, graded chronic pain, and age and gender. Coarse crepitus on opening/closing (odds ratio [OR] > or = 3.12), on lateral excursions (odds ratio > or = 4.06), and on protrusion (OR > or = 5.30) was associated with increased risk of degenerative findings in tomograms. A clinical diagnosis of osteoarthritis increased the risk of radiographic findings (OR > or = 2.95) and so did increasing age (OR > or = 1.03 per year) and the female gender (OR > or = 2.36). Maximal assisted opening and maximal opening without pain (position (OR > or = 2.60). No other significant associations were observed. Age, gender, and coarse crepitus, but no pain-related variables, were associated with increased risk of degenerative findings in TMJ tomograms. Maximal opening < 40 mm was associated with a posterior condyle-to-articular tubercle relation on opening.

Soft versus hard occlusal splint therapy in the management of temporomandibular disorders (TMDs)

OpenAIRE

Seifeldin, Sameh A; Elhayes, Khaled A.

2015-01-01

Aim: To compare between soft and hard occlusal splint therapy for the management of myofacial pain dysfunction (MPD) or internal derangement (ID) of the temporomandibular joint (TMJ) with reciprocal clicking. Patients and methods: This study included 50 patients (age range: 24–47 years) who had been diagnosed with MPD or ID of the TMJ in the form of reciprocal clicking. Patients were divided into two groups. They were treated for 4 months with either a vacuum-formed soft occlusal splint co...

Surgical treatment for temporomandibular joint osteoarthrosis. Case report.

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Robiony, M; Demitri, V; Costa, F; Politi, M

1998-11-01

TMJ osteoarthrosis and internal derangements are in close connection, representing a substantial portion of temporomandibular disorders. The authors wish to underline the role of surgery in the treatment of this degenerative disease to improve function and to alleviate pain. A 63 year-old woman suffering from closed-lock with reduced opening movements was accepted in our Department in March, 1995. Clinical and radiological evaluations showed bilateral closed lock and severe TMJ osteoarthrosis. Occlusal, pharmacological and physical therapy were performed for one year, without results. Bilateral condylectomy and diskectomy with arthroplasty were carried out. Immediate muscular rehabilitation after surgery was performed by the patient. Follow-up 3, 6, 12 months after surgery were carried out. Full opening movements and reduction of pain were obtained 20 days after surgery. The patient, followed-up one year after surgery, presented effective mandibular movements and adequate amelioration of clinical picture. TMJ surgery in association with physical therapy represents in selected cases an adequate procedure for the treatment of TMJ degenerative disease.

MR findings of facial nerve on oblique sagittal MRI using TMJ surface coil: normal vs peripheral facial nerve palsy

International Nuclear Information System (INIS)

Park, Yong Ok; Lee, Myeong Jun; Lee, Chang Joon; Yoo, Jeong Hyun

2000-01-01

To evaluate the findings of normal facial nerve, as seen on oblique sagittal MRI using a TMJ (temporomandibular joint) surface coil, and then to evaluate abnormal findings of peripheral facial nerve palsy. We retrospectively reviewed the MR findings of 20 patients with peripheral facial palsy and 50 normal facial nerves of 36 patients without facial palsy. All underwent oblique sagittal MRI using a T MJ surface coil. We analyzed the course, signal intensity, thickness, location, and degree of enhancement of the facial nerve. According to the angle made by the proximal parotid segment on the axis of the mastoid segment, course was classified as anterior angulation (obtuse and acute, or buckling), straight and posterior angulation. Among 50 normal facial nerves, 24 (48%) were straight, and 23 (46%) demonstrated anterior angulation; 34 (68%) showed iso signal intensity on T1W1. In the group of patients, course on the affected side was either straight (40%) or showed anterior angulation (55%), and signal intensity in 80% of cases was isointense. These findings were similar to those in the normal group, but in patients with post-traumatic or post-operative facial palsy, buckling, of course, appeared. In 12 of 18 facial palsy cases (66.6%) in which contrast materials were administered, a normal facial nerve of the opposite facial canal showed mild enhancement on more than one segment, but on the affected side the facial nerve showed diffuse enhancement in all 14 patients with acute facial palsy. Eleven of these (79%) showed fair or marked enhancement on more than one segment, and in 12 (86%), mild enhancement of the proximal parotid segment was noted. Four of six chronic facial palsy cases (66.6%) showed atrophy of the facial nerve. When oblique sagittal MR images are obtained using a TMJ surface coil, enhancement of the proximal parotid segment of the facial nerve and fair or marked enhancement of at least one segment within the facial canal always suggests pathology of

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

International Nuclear Information System (INIS)

Sano, Tsukasa; Yamamoto, Mika; Sakuma, Katsuya

2001-01-01

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)

Combining Pharmacological and Psychological Treatments for Binge Eating Disorder: Current Status, Limitations, and Future Directions.

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Grilo, Carlos M; Reas, Deborah L; Mitchell, James E

2016-06-01

Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress about binge eating without the extreme compensatory behaviors for weight control that characterize other eating disorders. BED is prevalent, associated strongly with obesity, and is associated with heightened levels of psychological, psychiatric, and medical concerns. This article provides an overview of randomized controlled treatments for combined psychological and pharmacological treatment of BED to inform current clinical practice and future treatment research. In contrast to the prevalence and significance of BED, to date, limited research has been performed on combining psychological and pharmacological treatments for BED to enhance outcomes. Our review here found that combining certain medications with cognitive behavioral therapy (CBT) or behavioral weight loss (BWL) interventions produces superior outcomes to pharmacotherapy only but does not substantially improve outcomes achieved with CBT/BWL only. One medication (orlistat) has improved weight losses with CBT/BWL albeit minimally, and only one medication (topiramate) has enhanced reductions achieved with CBT in both binge eating and weight. Implications for future research are discussed.

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.

Study of the relationship of psychosocial disorders to bruxism in adolescents

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Katayoun E

2008-12-01

Full Text Available Background and Aim: Bruxism has been defined as a diurnal or nocturnal parafunctional habit. Etiology of bruxism has remained controversial and some investigators believe that psychological factors may play a major role in promoting and perpetuating this habit. The aim of this case-control study was to assess the existence of an association between bruxism and psychosocial disorders in adolescents., Participants were chosen among 114, 12-14 year old students (girls. They were divided into two groups, bruxers and nonbruxers, on the basis of both validated clinical criteria and interview with each patient. A few participants were excluded on the basis of presence of systemic disorders, TMJ disorders, other oral habits, primary teeth, defective restorations and premature contacts. Following matching of two groups in regard to parent′s age and education, mother′s marital status, child support status, mother′s employment status, and socio-economical status, 25 cases and 25 controls were enlisted. A self report validated questionnaire (YSR, 11-18 yr was then filled out by both groups for the evaluation of 12 psychosocial symptoms. Results: Remarkable differences in certain psychosocial aspects were found between the two groups. Prevalence of psychosocial disorders including Thought Disorders (P < 0.005, Conduct Disorders (P < 0.05, Antisocial Disorders (P < 0.06 as identified by YSR was significantly higher in bruxers. Significant differences between the two groups also emerged in total YSR scores (P < 0.005. The results of Odds Ratio revealed that a bruxer adolescent has 16 times greater probability for psychosocial disorders than a non-bruxer one. Fischer exact test and T-test were used and Odds Ratio and Confidence Interval was estimated. Conclusion: Support to the existence of an association between bruxism and psychosocial disorders has been provided.

[Bilateral chronic dislocation of the temporomandibular joints and Meige syndrome].

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Arzul, L; Henoux, M; Marion, F; Corre, P

2015-04-01

Chronic dislocation of the temporo-mandibular joint (TMJ) is rare. It occurs when an acute dislocation is left untreated, in certain situations, including severe illness, neurologic or psychiatric diseases or prolonged oral intubation. A 79 years old woman, with Meige syndrome, suffered from bilateral dislocation of the TMJ for over 1 year. Surgical repositioning of the mandibular condyles and temporal bone eminectomy were performed. At the 18 postoperative months control, no recurrence has been noted. Treatment of chronic TMJ dislocations often requires a surgical procedure. Manual reduction, even under general anaesthesia, often fails because of severe muscular spasm and periarticular fibrotic changes. The management of this disorder is still controversial. We review available surgical procedures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

DSM-5's posttraumatic stress disorder with dissociative symptoms: challenges and future directions.

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Dorahy, Martin J; van der Hart, Onno

2015-01-01

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, formally recognizes a dissociative subtype of posttraumatic stress disorder (PTSD; PTSD with dissociative symptoms). This nomenclative move will boost empirical and theoretical efforts to further understand the links between dissociation, trauma, and PTSD. This article examines the empirical literature showing that patients with PTSD can be divided into 2 different groups based on their neurobiology, psychological symptom profile, history of exposure to early relational trauma, and depersonalization/derealization symptoms. It then explores the conceptual and empirical challenges of conceiving 1 of these types as reflecting a "dissociative" type of PTSD. First, this classification is based on the presence of a limited subset of dissociative symptoms (i.e., depersonalization, derealization). This sets aside an array of positive and negative psychoform and somatoform dissociative symptoms that may be related to PTSD. Second, empirical evidence suggests heightened dissociation in PTSD compared to many other disorders, indicating that dissociation is relevant to PTSD more broadly rather than simply to the so-called dissociative subtype. This article sets out important issues to be examined in the future study of dissociation in PTSD, which needs to be informed by solid conceptual understandings of dissociation.

Diagnostic criteria for headache attributed to temporomandibular disorders.

Science.gov (United States)

Schiffman, Eric; Ohrbach, Richard; List, Thomas; Anderson, Gary; Jensen, Rigmor; John, Mike T; Nixdorf, Donald; Goulet, Jean-Paul; Kang, Wenjun; Truelove, Ed; Clavel, Al; Fricton, James; Look, John

2012-07-01

We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD). In 373 headache subjects with TMD, a TMD headache reference standard was defined as: self-reported temple headache, consensus diagnosis of painful TMD and replication of the temple headache using TMD-based provocation tests. Revised diagnostic criteria for Headache attributed to TMD were selected using the RPART (recursive partitioning and regression trees) procedure, and refined in half of the data set. Using the remaining half of the data, the diagnostic accuracy of the revised criteria was compared to that of the International Headache Society's International Classification of Headache Diseases (ICHD)-II criteria A to C for Headache or facial pain attributed to temporomandibular joint (TMJ) disorder. Relative to the TMD headache reference standard, ICHD-II criteria showed sensitivity of 84% and specificity of 33%. The revised criteria for Headache attributed to TMD had sensitivity of 89% with improved specificity of 87% (p headache that is changed with jaw movement, function or parafunction and (2) provocation of that headache by temporalis muscle palpation or jaw movement. Having significantly better specificity than the ICHD-II criteria A to C, the revised criteria are recommended to diagnose headache secondary to TMD.

Temporomandibular disorders after whiplash injury: a controlled, prospective study.

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Kasch, Helge; Hjorth, Tine; Svensson, Peter; Nyhuus, Lone; Jensen, Troels S

2002-01-01

Whiplash injury to the neck is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies, however, have examined TMD-related pain in acute whiplash patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Prospectively, 19 acute whiplash patients exposed to a motor vehicle accident involving a rear collision participated in a study of TMD. The control group consisted of 20 age- and gender-matched ankle-injury patients. Participants were seen within 4 weeks and again at 6 months post-injury. The masticatory system was examined in accordance with the research diagnostic criteria. Participants underwent structured interviews, filled out the McGill Pain Questionnaire (MPQ), and had their masticatory system examined by a trained dentist, blinded to their diagnosis. Pain detection threshold (PDT) to pressure stimuli, and maximal voluntary occlusal force (MVOF) were obtained at each visit. One whiplash patient and 1 ankle-injury patient had jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ, TMD symptoms and signs, MVOF and PDT were not significantly different in whiplash-injury and ankle-injury patients after 4 weeks and 6 months. TMD pain after whiplash injury and ankle injury is rare, suggesting that whiplash injury is not a major risk factor for the development of TMD problems. Further studies are needed to identify which other factors may contribute to TMD pain.

3-D sonography for diagnosis of disk dislocation of the temporomandibular joint compared with MRI.

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Landes, Constantin A; Goral, Wojciech A; Sader, Robert; Mack, Martin G

2006-05-01

This study determines the value of three-dimensional (3-D) sonography for the assessment of disk dislocation of the temporomandibular joint (TMJ). Sixty-eight patients (i.e.,136 TMJ) with clinical dysfunction were examined by 272 sonographic 3-D scans. An 8- to 12.5-MHz transducer, angulated by step-motor, was used after picking a volume box on 2-D scan; magnetic resonance imaging followed immediately. Every TMJ was scrutinized in closed- and open-mouth position for normal or dislocated disk position. Fifty-three patients had complete data sets, i.e., 106 TMJ, 212 examinations. Sonographic examination took 5 min, with 74% specificity (62% closed-mouth; 85% open-mouth); sensitivity 53% (62/43%); accuracy 70% (62/77%); positive predictive value 49% (57/41%); and negative predictive value 77% (67/86%). This study encourages more research on the diagnostic capacity of 3-D TMJ sonography, with the advantage of multidimensional joint visualization. Although fair in specificity and negative predictive value, sensitivity and accuracy may ameliorate with future higher-sound frequency, real-time 3-D viewing and automated image analysis.

Prevention of Mental Health Disorders Using Internet- and Mobile-Based Interventions: A Narrative Review and Recommendations for Future Research.

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Ebert, David Daniel; Cuijpers, Pim; Muñoz, Ricardo F; Baumeister, Harald

2017-01-01

Although psychological interventions might have a tremendous potential for the prevention of mental health disorders (MHD), their current impact on the reduction of disease burden is questionable. Possible reasons include that it is not practical to deliver those interventions to the community en masse due to limited health care resources and the limited availability of evidence-based interventions and clinicians in routine practice, especially in rural areas. Therefore, new approaches are needed to maximize the impact of psychological preventive interventions. Limitations of traditional prevention programs could potentially be overcome by providing Internet- and mobile-based interventions (IMIs). This relatively new medium for promoting mental health and preventing MHD introduces a fresh array of possibilities, including the provision of evidence-based psychological interventions that are free from the restraints of travel and time and allow reaching participants for whom traditional opportunities are not an option. This article provides an introduction to the subject and narratively reviews the available evidence for the effectiveness of IMIs with regard to the prevention of MHD onsets. The number of randomized controlled trials that have been conducted to date is very limited and so far it is not possible to draw definite conclusions about the potential of IMIs for the prevention of MHD for specific disorders. Only for the indicated prevention of depression there is consistent evidence across four different randomized trial trials. The only trial on the prevention of general anxiety did not result in positive findings in terms of eating disorders (EDs), effects were only found in post hoc subgroup analyses, indicating that it might be possible to prevent ED onset for subpopulations of people at risk of developing EDs. Future studies need to identify those subpopulations likely to profit from preventive. Disorders not examined so far include substance use

Orofacial features of subjects aged 18-30 years in the northern part of Kosovo and Metohija territory

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Todić Jelena

2016-01-01

Full Text Available Introduction: Temporomandibular disorder (TMD is a universal term referred to herein to collectively denote a series of functional disorders of orofacial structures, the temporomandibular joint (TMJ and the masticatory muscles in particular. Objectives: The aim of our study was to determine the prevalence of temporomandibular disorders within the observed sample population of the northern part of Kosovo and Metohija, as well as the frequency of signs and symptoms of this type of disorder. Methods: The study involved a sample of 300 subjects, aged 18-30 years. The sample comprised the target student population attending the University of Pristina, Kosovska Mitrovica. A random sample, intended for sampling without replacement, was drawn from the target population. All subjects underwent the Helkimo clinical dysfunction index analysis. Results of the analysis were quantified and expressed numerically, based on severity, as the Helkimo anamnestic dysfunction index (Ai and the clinical dysfunction index (Di with specific values assigned thereto accordingly. Results: The prevalence of temporomandibular disorders within the observed sample population totaled 50.7% (Di> 0. In the majority of patients a mild form of TMP (67% was reported. Temporomandibular disorders were more common in women than in men, who appear to be three times as likely to develop the respective condition, demonstrating the ratio of 3:1. The most common TMD signs and symptoms implied mandibular kinetics disturbances (46% and TMJ sounds (45%. The prevalence of pain during mandibular movements amounted to 9%, the palpable TMJ sensitivity to 20% and the palpable sensitivity of masticatory muscles 18%. Headache and otalgia were represented with 13%, that is, 3% in the observed sample. Conclusion: Temporomandibular disorder analysis demonstrates high incidence in the population of the northern part of Kosovo and Metohija. These findings indicate the need for an extensive prevention

[Diagnosis and treatment of temporo-mandibular disorders in orthodontics].

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Bocquet, Emmanuelle; Moreau, Alexis; Danguy, Michel; Danguy, Chantal

2010-03-01

Orthodontists are fully prepared to treat the problems of occlusion that they are called upon to deal with every day. On the other hand temporo-mandibular joint disorders present more obscure difficulties from the point of view of detection and diagnosis as well the management of their treatment. That is why a profound understanding of the anatomical and physiological functioning of the temporo-mandibular joint has become indispensable for today's orthodontists who are now asked to detect and diagnose an assortment of TMJ disturbances whose etiology may vary greatly. By performing a rigorous diagnostic procedure, based on a thorough clinical examination supported by careful axiographic and radiological studies, of temporo-mandibular malfunctioning and its underlying etiological causes, which are primarily dento-alveolar and occlusal in nature, orthodontists will be able to adopt an appropriate therapeutic approach that might be purely orthodontic or multi-disciplinary and carried out with the collaboration of specialists in occlusion, oral surgery, and even osteopathy. EDP Sciences, SFODF, 2010.

Risk factors associated with incidence and persistence of signs and symptoms of temporomandibular disorders.

Science.gov (United States)

Marklund, Susanna; Wänman, Anders

2010-09-01

To analyze whether gender, self-reported bruxism, and variations in dental occlusion predicted incidence and persistence of temporomandibular disorder (TMD) during a 2-year period. The study population comprised 280 dental students at Umeå University in Sweden. The study design was that of a case-control study within a 2-year prospective cohort. The investigation comprised a questionnaire and a clinical examination at enrolment and at 12 and 24 months. Cases (incidence) and controls (no incidence) were identified among those without signs and symptoms of TMD at the start of the study. Cases with 2-year persistence of signs and symptoms of TMD were those with such signs and symptoms at all three examinations. Clinical registrations of baseline variables were used as independent variables. Odds ratio estimates and 95% confidence intervals of the relative risks of being a case or control in relation to baseline registrations were calculated using logistic regression analyses. The analyses revealed that self-reported bruxism and crossbite, respectively increased the risk of the 2-year cumulative incidence and duration of temporomandibular joint (TMJ) signs or symptoms. Female gender was related to an increased risk of developing and maintaining myofascial pain. Signs of mandibular instability increased the risk of maintained TMD signs and symptoms during the observation period. This 2-year prospective observational study indicated that self-reported bruxism and variations in dental occlusion were linked to the incidence and persistence of TMJ signs and symptoms to a higher extent than to myofascial pain.

Work-related reproductive, musculoskeletal and mental disorders among working women--history, current issues and future research directions.

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Kishi, Reiko; Kitahara, Teruyo; Masuchi, Ayumi; Kasai, Setsuko

2002-04-01

According to the recent changes of working environments and socio-economical conditions, the proportion of working women are increasing in Japan. Characteristics of occupational workload and stress of Japanese working women are consistent with those in many industrialized countries except man-dominant culture. In this review we describe the history, current issues, and future research directions on occupational health of working women, especially focused on reproductive health, work-related musculo-skeletal disorders (WMSDs), and mental disorders. In the reproductive health survey, traditionally main concern was about pregnancy outcomes, then fecundity studies, such as time to pregnancy, became topics recently. Future research will be shifted to outcomes not only during pregnancy but also disorders of hormonal balance and climacterium or health conditions after menopause. WMSDs are reviewed on mainly gender difference and its causative factors. Historically, mental health of working women in Japan has focused on the job stress of nurses. We compare results with a lot of recent researches in Europe and U.S.A., where interaction between occupational stress and family roles were studied. It is not easy to predict the prospective status of female workers in Japan, but social, workplace and familial supports will enhance their health promotion.

Impalement of an unusual foreign body on the temporomandibular joint causing severe trismus.

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Ito, Ryohei; Kubota, Kosei; Furudate, Ken; Nakagawa, Hiroshi; Kon, Takao; Tamura, Yoshihiro; Kobayashi, Wataru

2016-12-01

A penetrating injury by a foreign body is comparatively common in the oral and maxillofacial region. On the other hand, injury to the temporomandibular joint (TMJ) by a foreign object is very rare. The TMJ is an anatomically narrow space surrounded by hard bony processes. An unusual case of trauma with severe trismus caused by a foreign body that impaled the TMJ is reported. A 55-year-old man presented with a 5 × 1-cm laceration to the right cheek caused by a flying object propelled during the use of a lawn mower. The edge of the foreign body had a metallic wire, which became imbedded in the wound. His jaw opening was severely limited. Computed tomography revealed that the foreign body was 3 mm in diameter and was impaled on the articular capsule. The object was successfully removed, and the wound and interior of the TMJ were irrigated. Rehabilitation of mouth opening was started on postoperative day 3. On day 9, mouth opening had improved to 35 mm, and he was discharged. After 1 year, mouth opening was 45 mm with no sign of any TMJ disorders. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prolotherapy: A new hope for temporomandibular joint pain

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A Vijay Kumar

2013-01-01

Full Text Available The most common cause of orofacial pain is the Temporomandibular Joint Disorder (TMD, a collective term used to describe a group of medical disorders causing temporomandibular joint (TMJ pain and dysfunction. As the causes of TMD are varied and run the gamut from mechanical issues, such as disc degeneration and dislocation or erosion of the fibrocartilaginous surfaces of the condyle, fossa, and articular eminence, the treatment approaches for the chronic TMJ case are also quite varied. As surgery is considered a last resort for TMD, it is common for sufferers to seek out alternatives and one of the alternative treatments is ′Prolotherapy,′ which is also known as Regenerative Injection Therapy. This article provides an overview of this new alternative therapy.

Comparison between human and rat TMJ: anatomic and histopathologic features Comparação entre a ATM humana e de ratos: achados anatômicos e histopatológicos

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Gabriela Granja Porto

2010-06-01

Full Text Available PURPOSE: To describe and evaluate normal rat temporomandibular joints from anatomic and histopathologic point of view and make a comparison between this joint in rats and humans. METHODS: Twelve male adult Wistar rats (12 same side joints were used in this procedure. The following anatomical structures were histologically evaluated in a qualitative fashion: condyle, disc, temporal bone, retrodiscal tissue and synovia. The macroscopical and microscopic study of the human TMJ was based on the current literature. RESULTS: The TMJ is surrounded by a thin capsule, consisting of fibrous tissue, and a synovial lining. The mandibular angle has a prominent shape. The glenoid fossa is flat, with no eminences. Histologically, the TMJ is composed of different tissues that comprise the mandibular head, mandibular fossa and fibrocartilaginous disc. A layer of hyaline cartilage covers the articulating cortical condyle and temporal bone. CONCLUSION:Morphologically and histologically, the articular structure of rats is, on the whole, similar to that of humans. In these animals there is no articular eminence.OBJETIVO: Descrever e avaliar a articulação temporomandibular de ratos sob o aspecto anatômico e histológico e realizar uma comparação entre esta articulação e a de humanos. MÉTODOS: Foram utilizados doze ratos adultos Wistar (12 articulações do mesmo lado. As seguintes estruturas anatômicas foram avaliadas de forma qualitativa: côndilo, disco, osso temporal, tecido retrodiscal e sinóvia. O estudo macroscópico e o microscópico da ATM humana foram baseados na literatura atual. RESULTADOS: A ATM é envolvida por uma fina cápsula, formada por tecido fibroso e cobertura sinovial. O ângulo mandibular é proeminente. A fossa glenoide é rasa, sem eminência articular. De acordo com os achados histológicos, a ATM é composta por diferentes tecidos, são eles a cabeça da mandíbula, a fossa mandibular e o disco fibrocartilaginoso. Uma camada de

A test of the vulnerability model: temperament and temperament change as predictors of future mental disorders - the TRAILS study.

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Laceulle, Odilia M; Ormel, Johan; Vollebergh, Wilma A M; van Aken, Marcel A G; Nederhof, Esther

2014-03-01

This study aimed to test the vulnerability model of the relationship between temperament and mental disorders using a large sample of adolescents from the TRacking Adolescents Individual Lives' Survey (TRAILS). The vulnerability model argues that particular temperaments can place individuals at risk for the development of mental health problems. Importantly, the model may imply that not only baseline temperament predicts mental health problems prospectively, but additionally, that changes in temperament predict corresponding changes in risk for mental health problems. Data were used from 1195 TRAILS participants. Adolescent temperament was assessed both at age 11 and at age 16. Onset of mental disorders between age 16 and 19 was assessed at age 19, by means of the World Health Organization Composite International Diagnostic Interview (WHO CIDI). Results showed that temperament at age 11 predicted future mental disorders, thereby providing support for the vulnerability model. Moreover, temperament change predicted future mental disorders above and beyond the effect of basal temperament. For example, an increase in frustration increased the risk of mental disorders proportionally. This study confirms, and extends, the vulnerability model. Consequences of both temperament and temperament change were general (e.g., changes in frustration predicted both internalizing and externalizing disorders) as well as dimension specific (e.g., changes in fear predicted internalizing but not externalizing disorders). These findings confirm previous studies, which showed that mental disorders have both unique and shared underlying temperamental risk factors. © 2013 The Authors. Journal of Child Psychology and Psychiatry © 2013 Association for Child and Adolescent Mental Health.

Feasibility of differential quantification of 3D temporomandibular kinematics during various oral activities using a cone-beam computed tomography-based 3D fluoroscopic method

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Chien-Chih Chen

2013-06-01

Conclusion: A new CBCT-based 3D fluoroscopic method was proposed and shown to be capable of quantitatively differentiating TMJ movement patterns among complicated functional activities. It also enabled a complete description of the rigid-body mandibular motion and descriptions of as many reference points as needed for future clinical applications. It will be helpful for dental practice and for a better understanding of the functions of the TMJ.

Chiropractic care of a patient with vertebral subluxation and Bell's palsy.

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Alcantara, Joel; Plaugher, Gregory; Van Wyngarden, Darwin L

2003-05-01

To describe the chiropractic care of a patient medically diagnosed with Bell's palsy and discuss issues clinically relevant to this disorder, such as its epidemiology, etiology, diagnosis, care, and prognosis. A 49-year-old woman with a medical diagnosis of Bell's palsy sought chiropractic care. Her symptoms included right facial paralysis, extreme phonophobia, pain in the right temporomandibular joint (TMJ), and neck pain. Signs of cervical vertebral and TMJ subluxations included edema, tenderness, asymmetry of motion and posture, and malalignment detected from plain film radiographs. The patient was cared for with full spine contact-specific, high-velocity, low-amplitude adjustments (Gonstead Technique) to sites of vertebral and occipital subluxations. The patient's left TMJ was also adjusted. The initial symptomatic response to care was positive, and the patient made continued improvements during the 6 months of care. There are indications that patients suffering from Bell's palsy may benefit from a holistic chiropractic approach that not only includes a focus of examination and care of the primary regional areas of complaint (eg, face, TMJ) but also potentially from significant vertebral subluxation concomitants.

Advance statements for borderline personality disorder: a qualitative study of future crisis treatment preferences.

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Borschmann, Rohan; Trevillion, Kylee; Henderson, R Claire; Rose, Diana; Szmukler, George; Moran, Paul

2014-06-01

Little is known about the crisis treatment preferences of people with borderline personality disorder. Clinicians may also question service users' ability to make considered decisions about their treatment when in crisis. Therefore, this qualitative study aimed to investigate crisis treatment preferences of a sample of community-dwelling adults with borderline personality disorder. Participants were 41 adults with borderline personality disorder who had created joint crisis plans during a randomized controlled trial. Data from all 41 joint crisis plans were analyzed iteratively via a thematic analysis framework. Participants gave clear statements in their crisis plans relating to the desire to recover from the crisis and to improve their social functioning. Key themes included the desire to be treated with dignity and respect and to receive emotional and practical support from clinicians. Many participants spoke of the importance of connecting with others during periods of crisis, but several reported a clear desire to be left alone during a future crisis. Other themes concerned preferences for specific treatment refusals during crises, including particular types of psychotropic medication and involuntary treatment. The variation of participants' preferences underscores the importance of developing individually tailored crisis plans for people with borderline personality disorder. The need to be treated with dignity and respect and to be given autonomy in decision making--also identified in global surveys of people with severe mental illness--is important to people with borderline personality disorder. Key messages for clinicians, service users, and policy makers, in addition to staff training issues, are discussed.

An ex vivo study on immunohistochemical localization of MMP-7 and MMP-9 in temporomandibular joint discs with internal derangement

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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.

Prevention of Mental Health Disorders Using Internet- and Mobile-Based Interventions: A Narrative Review and Recommendations for Future Research

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David Daniel Ebert

2017-08-01

Full Text Available Although psychological interventions might have a tremendous potential for the prevention of mental health disorders (MHD, their current impact on the reduction of disease burden is questionable. Possible reasons include that it is not practical to deliver those interventions to the community en masse due to limited health care resources and the limited availability of evidence-based interventions and clinicians in routine practice, especially in rural areas. Therefore, new approaches are needed to maximize the impact of psychological preventive interventions. Limitations of traditional prevention programs could potentially be overcome by providing Internet- and mobile-based interventions (IMIs. This relatively new medium for promoting mental health and preventing MHD introduces a fresh array of possibilities, including the provision of evidence-based psychological interventions that are free from the restraints of travel and time and allow reaching participants for whom traditional opportunities are not an option. This article provides an introduction to the subject and narratively reviews the available evidence for the effectiveness of IMIs with regard to the prevention of MHD onsets. The number of randomized controlled trials that have been conducted to date is very limited and so far it is not possible to draw definite conclusions about the potential of IMIs for the prevention of MHD for specific disorders. Only for the indicated prevention of depression there is consistent evidence across four different randomized trial trials. The only trial on the prevention of general anxiety did not result in positive findings in terms of eating disorders (EDs, effects were only found in post hoc subgroup analyses, indicating that it might be possible to prevent ED onset for subpopulations of people at risk of developing EDs. Future studies need to identify those subpopulations likely to profit from preventive. Disorders not examined so far include

Use of chondroitin sulphate and glucosamine sulphate in degenerative changes in TMJ: a systematic review Utilização de sulfato de condroitina e sulfato de glicosamina nas alterações degenerativas da ATM: uma revisão sistematica

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Eduardo Machado

2012-08-01

Full Text Available INTRODUCTION: Degenerative changes in Temporomandibular Joint (TMJ have increased in prevalence and severity over the years. Within this context, it's necessary to obtain safe and effective therapies for control and management of the patient in cases of osteoarthritis and osteoarthrosis of the TMJ. Therapeutic options range from intra-articular infiltration protocols, occlusal splints, pharmacological therapies and physiotherapy and educational measures. The alternative treatment with structure-modifying agents, like as chondroitin and glucosamine sulphates, showed promising results, and especially safety. Thus, through a systematic literature review, this study aimed to analyze and discuss effectiveness and safety of chondroitin and glucosamine in degenerative changes of the TMJ. METHODS: Survey in research bases MEDLINE, Cochrane, EMBASE, Pubmed, Lilacs and BBO, between the years of 1966 and January 2009, with focus in randomized clinical trial (RCTs and quasi-randomized clinical trials, systematic reviews and meta-analysis. RESULTS: After application of the inclusion criteria 2 articles were selected, both randomized controlled double-blind clinical trials, which evaluated the effectiveness of chondroitin and glucosamine in degenerative changes of the TMJ. CONCLUSIONS: There is the necessity of further RCT, with representative samples and long follow-up time, to obtainment more precise cause-effect relationships and to achieve an effective and objective protocol involving chondroitin and glucosamine in cases of degenerative changes of the TMJ.INTRODUÇÃO: as alterações degenerativas da Articulação Temporomandibular (ATM têm aumentado em prevalência e em severidade ao longo dos anos. Dentro desse contexto, surge a necessidade de se obter terapêuticas efetivas e seguras para o controle e o manejo do paciente em situações de osteoartrite e osteoartrose da ATM. As opções terapêuticas variam desde protocolos de infiltra

Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?

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Walczyńska-Dragon, Karolina; Baron, Stefan; Nitecka-Buchta, Aleksandra; Tkacz, Ewaryst

2014-01-01

Temporomandibular dysfunction (TMD) is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM) and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD) and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function (P > 0.05), cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility. PMID:25050363

Correlation between TMD and Cervical Spine Pain and Mobility: Is the Whole Body Balance TMJ Related?

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Karolina Walczyńska-Dragon

2014-01-01

Full Text Available Temporomandibular dysfunction (TMD is considered to be associated with imbalance of the whole body. This study aimed to evaluate the influence of TMD therapy on cervical spine range of movement (ROM and reduction of spinal pain. The study group consisted of 60 patients with TMD, cervical spine pain, and limited cervical spine range of movements. Subjects were interviewed by a questionnaire about symptoms of TMD and neck pain and had also masticatory motor system physically examined (according to RDC-TMD and analysed by JMA ultrasound device. The cervical spine motion was analysed using an MCS device. Subjects were randomly admitted to two groups, treated and control. Patients from the treated group were treated with an occlusal splint. Patients from control group were ordered to self-control parafunctional habits. Subsequent examinations were planned in both groups 3 weeks and 3 months after treatment was introduced. The results of tests performed 3 months after the beginning of occlusal splint therapy showed a significant improvement in TMJ function (P>0.05, cervical spine ROM, and a reduction of spinal pain. The conclusion is that there is a significant association between TMD treatment and reduction of cervical spine pain, as far as improvement of cervical spine mobility.

Episodic and semantic components of autobiographical memories and imagined future events in post-traumatic stress disorder.

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Brown, Adam D; Addis, Donna Rose; Romano, Tracy A; Marmar, Charles R; Bryant, Richard A; Hirst, William; Schacter, Daniel L

2014-01-01

Individuals with post-traumatic stress disorder (PTSD) tend to retrieve autobiographical memories with less episodic specificity, referred to as overgeneralised autobiographical memory. In line with evidence that autobiographical memory overlaps with one's capacity to imagine the future, recent work has also shown that individuals with PTSD also imagine themselves in the future with less episodic specificity. To date most studies quantify episodic specificity by the presence of a distinct event. However, this method does not distinguish between the numbers of internal (episodic) and external (semantic) details, which can provide additional insights into remembering the past and imagining the future. This study employed the Autobiographical Interview (AI) coding scheme to the autobiographical memory and imagined future event narratives generated by combat veterans with and without PTSD. Responses were coded for the number of internal and external details. Compared to combat veterans without PTSD, those with PTSD generated more external than internal details when recalling past or imagining future events, and fewer internal details were associated with greater symptom severity. The potential mechanisms underlying these bidirectional deficits and clinical implications are discussed.

A critical appraisal of neuroimaging studies of bipolar disorder: toward a new conceptualization of underlying neural circuitry and roadmap for future research

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Phillips, Mary L; Swartz, Holly A.

2014-01-01

Objective This critical review appraises neuroimaging findings in bipolar disorder in emotion processing, emotion regulation, and reward processing neural circuitry, to synthesize current knowledge of the neural underpinnings of bipolar disorder, and provide a neuroimaging research “roadmap” for future studies. Method We examined findings from all major studies in bipolar disorder that used fMRI, volumetric analyses, diffusion imaging, and resting state techniques, to inform current conceptual models of larger-scale neural circuitry abnormalities in bipolar disorder Results Bipolar disorder can be conceptualized in neural circuitry terms as parallel dysfunction in bilateral prefrontal cortical (especially ventrolateral prefrontal cortical)-hippocampal-amygdala emotion processing and emotion regulation neural circuitries, together with an “overactive” left-sided ventral striatal-ventrolateral and orbitofrontal cortical reward processing circuitry, that result in characteristic behavioral abnormalities associated with bipolar disorder: emotional lability, emotional dysregulation and heightened reward sensitivity. A potential structural basis for these functional abnormalities are gray matter decreases in prefrontal and temporal cortices, amygdala and hippocampus, and fractional anisotropy decreases in white matter tracts connecting prefrontal and subcortical regions. Conclusion Neuroimaging studies of bipolar disorder clearly demonstrate abnormalities in neural circuitries supporting emotion processing, emotion regulation and reward processing, although there are several limitations to these studies. Future neuroimaging research in bipolar disorder should include studies adopting dimensional approaches; larger studies examining neurodevelopmental trajectories in bipolar disorder and at-risk youth; multimodal neuroimaging studies using integrated systems approaches; and studies using pattern recognition approaches to provide clinically useful, individual

Eosinophilic granuloma of the skull base: patient with unique clinical moreover, radiographic presentation.

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Hosein Dalili

2015-01-01

Full Text Available This case report presents an eight-year-old girl having periauricular swelling and severe pain during mouth opening on the right-side temporomandibular joint (TMJ. CBCT showed extensive destruction of the base of the skull and the roof of the glenoid fossa on the right side. The findings based on CT and MRI images with and without contrast are discussed herein. This report highlights a skull base eosinophilic granuloma that mimics TMJ disorder and the importance of proper evaluation of CBCT images to make an early diagnosis.

The "at-home LLLT" in temporo-mandibular disorders pain control: a pilot study.

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Fornaini, C; Pelosi, A; Queirolo, V; Vescovi, P; Merigo, E

2015-03-31

The Temporo-Mandibular Disorders (TMD) are a set of dysfunctional patterns concerning the temporo-mandibular joints (TMJ) and the masticatory muscles; its main symptom is pain, probably caused by inflammatory changes in the synovial membrane, alterations in the bone marrow of the mandibular condyle and impingement and compression. The aim of this preliminary study was to investigate the effectiveness in the TMD pain reduction of a new laser device recently proposed by the commerce that, due to its reduced dimensions and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Twenty-four patients with TMD were randomly selected: the inclusion criteria for the sample was the diagnosis of mono- or bi-lateral TMD, with acute pain restricted to the joint area, associated with the absence of any muscle tenderness during palpation. The patients were randomly assigned to two groups: Group 1 (12 patients): patients receiving real LLLT (experimental group). Group 2 (12 patients): patients receiving inactive laser (placebo group). The treatment was performed once a day for two weeks with an 808 nm diode laser by the patient himself with irradiation of the cutaneous zone corresponding to the TMJ for 15 minutes each side. Each patient was instructed to express its pain in a visual analogue scale (VAS) making a perpendicular line between the two extremes representing the felt pain level. Statistical analysis was realized with GraphPad Instat Software, where Ptemporo-mandibular diseases by an at home self administered laser device. RESULTS are encouraging but they will have to be confirmed by greater studies.

Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients

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Di Paolo, Carlo; D'Urso, Anna; Di Sabato, Francesco; Pompa, Giorgio

2017-01-01

Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs). The aim of this study was to evaluate, retrospectively, if headache influences TMD's symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH) and Group without Headache (GwoH). Descriptive statistics and Chi-square index were performed. Results. Sociodemographic (gender, marital status, and occupation) and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities), and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion. This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity. PMID:28420942

Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients.

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Di Paolo, Carlo; D'Urso, Anna; Papi, Piero; Di Sabato, Francesco; Rosella, Daniele; Pompa, Giorgio; Polimeni, Antonella

2017-01-01

Aim . Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs). The aim of this study was to evaluate, retrospectively, if headache influences TMD's symptoms. Material and Methods . A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH) and Group without Headache (GwoH). Descriptive statistics and Chi-square index were performed. Results . Sociodemographic (gender, marital status, and occupation) and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities), and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion . This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity.

Temporomandibular Disorders and Headache: A Retrospective Analysis of 1198 Patients

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Carlo Di Paolo

2017-01-01

Full Text Available Aim. Headache is one of the most common diseases associated with Temporomandibular Disorders (TMDs. The aim of this study was to evaluate, retrospectively, if headache influences TMD’s symptoms. Material and Methods. A total sample of 1198 consecutive TMD patients was selected. After a neurological examination, a diagnosis of headache, according to the latest edition of the International Classification of Headache Disorders, was performed in 625 subjects. Patients were divided into two groups based on presence/absence of headache: Group with Headache (GwH and Group without Headache (GwoH. Descriptive statistics and Chi-square index were performed. Results. Sociodemographic (gender, marital status, and occupation and functional factors, occlusion (occlusal and skeletal classes, dental formula, and occlusal abnormalities, and familiar pain did not show a statistically significant correlation in either group. Intensity and frequency of neck pain, arthralgia of TMJ, and myalgia showed higher correlation values in GwH. Conclusion. This study is consistent with previous literature in showing a close relationship between headache and TMD. All data underlines that headache makes pain parameters more intense and frequent. Therefore, an early and multidisciplinary treatment of TMDs should be performed in order to avoid the overlay of painful events that could result in pain chronicity.

Sleep Disorders in Childhood Neurogenetic Disorders

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Laura Beth Mann Dosier

2017-09-01

Full Text Available Genetic advances in the past three decades have transformed our understanding and treatment of many human diseases including neurogenetic disorders. Most neurogenetic disorders can be classified as “rare disease,” but collectively neurogenetic disorders are not rare and are commonly encountered in general pediatric practice. The authors decided to select eight relatively well-known neurogenetic disorders including Down syndrome, Angelman syndrome, Prader–Willi syndrome, Smith–Magenis syndrome, congenital central hypoventilation syndrome, achondroplasia, mucopolysaccharidoses, and Duchenne muscular dystrophy. Each disorder is presented in the following format: overview, clinical characteristics, developmental aspects, associated sleep disorders, management and research/future directions.

Update on Psychological Trauma, Other Severe Adverse Experiences and Eating Disorders: State of the Research and Future Research Directions.

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Trottier, Kathryn; MacDonald, Danielle E

2017-08-01

This paper provides an updated review of the literature on the relationship between psychological trauma exposure, other severe adverse experiences, and eating disorders. Trauma exposure and other severe adverse experiences (e.g., emotional abuse) in both childhood and adulthood are associated with eating disorders. The relationship between traumatic and other adverse experiences and eating disorders appears to be mediated by emotional and behavioral dysregulation, as well as by cognitive factors such as self-criticism. Biological vulnerabilities may also be relevant to this relationship. Overall, the literature is limited by predominantly cross-sectional designs. There is clear evidence of a correlational relationship between trauma exposure and other severe adverse events, and eating disorders. Both risk and maintenance factor hypotheses have been put forth; however, prospective research testing these hypotheses remains limited. Future research should use prospective designs and focus on trauma-related symptoms (rather than trauma exposure) in order to advance research on risk and maintaining factors for eating disorders and inform treatment directions.

Temporomandibular joint formation requires two distinct hedgehog-dependent steps.

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Purcell, Patricia; Joo, Brian W; Hu, Jimmy K; Tran, Pamela V; Calicchio, Monica L; O'Connell, Daniel J; Maas, Richard L; Tabin, Clifford J

2009-10-27

We conducted a genetic analysis of the developing temporo-mandibular or temporomandi-bular joint (TMJ), a highly specialized synovial joint that permits movement and function of the mammalian jaw. First, we used laser capture microdissection to perform a genome-wide expression analysis of each of its developing components. The expression patterns of genes identified in this screen were examined in the TMJ and compared with those of other synovial joints, including the shoulder and the hip joints. Striking differences were noted, indicating that the TMJ forms via a distinct molecular program. Several components of the hedgehog (Hh) signaling pathway are among the genes identified in the screen, including Gli2, which is expressed specifically in the condyle and in the disk of the developing TMJ. We found that mice deficient in Gli2 display aberrant TMJ development such that the condyle loses its growth-plate-like cellular organization and no disk is formed. In addition, we used a conditional strategy to remove Smo, a positive effector of the Hh signaling pathway, from chondrocyte progenitors. This cell autonomous loss of Hh signaling allows for disk formation, but the resulting structure fails to separate from the condyle. Thus, these experiments establish that Hh signaling acts at two distinct steps in disk morphogenesis, condyle initiation, and disk-condyle separation and provide a molecular framework for future studies of the TMJ.

Gambling Disorder in Veterans: A Review of the Literature and Implications for Future Research.

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Levy, Lauren; Tracy, J Kathleen

2018-02-09

To review the scientific literature examining gambling behavior in military veterans in order to summarize factors associated with gambling behavior in this population. Database searches were employed to identify articles specifically examining gambling behavior in military veterans. Cumulative search results identified 52 articles (1983-2017) examining gambling behavior in veteran populations. Articles generally fell into one or more of the following categories: prevalence, psychological profiles and psychiatric comorbidities, treatment evaluations, measurement, and genetic contributions to gambling disorder. Results from reviewed articles are presented and implications for future research discussed. Research to date has provided an excellent foundation to inform potential screening, intervention and research activities going forward. The authors suggest that a public health approach to future research endeavors would strengthen the evidence base regarding gambling in veteran populations and better inform strategies for screening, prevention and treatment.

Prevalence of temporomandibular joint disorders and neck pain in musicians: a sytematic review

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Bennatan Ferreira dos Santos

Full Text Available Abstract Introduction: The instrumental practice for a long time, the high performance level, the strict technique and the specific shape of each musical instrument can take musicians to overcome their physiological limits, giving a high prevalence of musculoskeletal injuries. Objective: Investigate the prevalence of temporomandibular joint disorder and neck pain in musicians. Methods: Between August and September 2015 were reviewed five databases: LILACS, SciELO, Medline / PubMed, Scopus and Web of Science. The articles were read and evaluated by the criteria of the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE, items, that obtained a percentage above of 50 percent, were considered in the analysis of this work. Results: 15 articles attended the inclusion criteria. Among all musicians the prevalence of TMJ pain ranged from 10 - 81% and the prevalence of neck pain ranged from 29 - 80%. Conclusion: In this study was observed that the musicians showed both, temporomandibular joint disorders and neck pain, watching a high prevalence especially in violinists and the horn players. In the risk factors identified in the literature for the emergence of painful symptoms in musicians, stand out the biomechanical factors involved in maintaining anti-physiologic postures.

Temporomandibular disorders: Old ideas and new concepts.

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List, Thomas; Jensen, Rigmor Højland

2017-06-01

Background Temporomandibular disorders (TMD) is an umbrella term for pain and dysfunction involving the masticatory muscles and the temporomandibular joints (TMJs). TMD is the most common orofacial pain condition. Its prominent features include regional pain in the face and preauricular area, limitations in jaw movement, and noise from the TMJs during jaw movements. TMD affects up to 15% of adults and 7% of adolescents. Chronic pain is the overwhelming reason that patients with TMD seek treatment. TMD can associate with impaired general health, depression, and other psychological disabilities, and may affect the quality of life of the patient. Assessment Evaluations indicate that the recently published Diagnostic Criteria for TMD (DC/TMD) are reliable and valid. These criteria cover the most common types of TMD, which include pain-related disorders (e.g., myalgia, headache attributable to TMD, and arthralgia) as well as disorders associated with the TMJ (primarily disc displacements and degenerative disease). As peripheral mechanisms most likely play a role in the onset of TMD, a detailed muscle examination is recommended. The persistence of pain involves more central factors, such as sensitization of the supraspinal neurons and second-order neurons at the level of the spinal dorsal horn/trigeminal nucleus, imbalanced antinociceptive activity, and strong genetic predisposition, which also is included in DC/TMD. Conclusion The etiology is complex and still not clearly understood, but several biological and psychosocial risk factors for TMD have been identified. Several studies indicate that patients with TMD improve with a combination of noninvasive therapies, including behavior therapy, pharmacotherapy, physical therapy, and occlusal appliances. More stringently designed studies, however, are needed to assess treatment efficacy and how to tailor treatment to the individual patient.

The validity of clinical findings for diagnosing temporomandibular disorders in patients from different age and gender groups

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Igarashi, Chinami

2008-01-01

This study was to clarify the diagnostic accuracy of clinical findings for internal derangement of the temporomandibular joint (TMJ) compared with that of magnetic resonance imaging. A series of 4559 patients (879 male and 3680 female, mean age 32.7 years; range 8-85 years;) with temporomandibular disorders were clinically examined by un unspecified number of dentists. All patients underwent magnetic resonance imaging (MRI). The clinical findings that characterize disc displacement, anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) are pain, clicking sound and limitation of maximum mouth opening. These clinical findings were compared to the MRI interpretation, which was used as the gold standard for diagnosis of temporomandibular disorders to define the diagnostic accuracy, specificity, sensitivity, positive predictive value and negative predictive value of clinical findings. The prevalence of clinical finding was 3990 joints (43%) with pain, 2775 joints (30%) with clicking sound and 1731 patients (38%) with limitation of opening. Three thousands forty seven joints were diagnosed as having a normal disc position, 510 joints with sideways disc displacement, 2312 joints with ADDwR, 3239 joints with ADDwoR on MR image. The sensitivity of clinical findings was considerably low: sensitivity was 0.48 for pain versus internal derangement, 0.51 for clicking sound versus ADDwR, 0.62 for limitation of opening versus ADDwoR. The sensitivity was higher in the younger group for clicking sound versus ADDwR, but sensitivity was higher in the older group for limitation of opening versus ADDwoR. The diagnostic accuracy based on clinical findings of internal derangement of TMJ was found to be correlated with age. This study has been that the overall diagnostic accuracy of the clinical findings to determine the status of the joint is about 50-60%. The status of the joint could not be accurately determined by clinical findings

Qualitative analysis of interviews of future non-affective psychotic disorder patients and non-psychiatric controls: preliminary results

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Katya Rubinstein

2014-03-01

Conclusions: The findings of this unique historical-prospective qualitative analysis of interviews performed before the onset of psychosis, confirmed previous findings of premorbid abnormality of future non-affective psychosis patients. Using qualitative analysis enabled obtaining a more in-depth understanding of the real-life experience of the premorbid period among patients with non-affective psychotic disorders.

Functional anatomy of the equine temporomandibular joint: Collagen fiber texture of the articular surfaces.

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Adams, K; Schulz-Kornas, E; Arzi, B; Failing, K; Vogelsberg, J; Staszyk, C

2016-11-01

In the last decade, the equine masticatory apparatus has received much attention. Numerous studies have emphasized the importance of the temporomandibular joint (TMJ) in the functional process of mastication. However, ultrastructural and histological data providing a basis for biomechanical and histopathological considerations are not available. The aim of the present study was to analyze the architecture of the collagen fiber apparatus in the articular surfaces of the equine TMJ to reveal typical morphological features indicating biomechanical adaptions. Therefore, the collagen fiber alignment was visualized using the split-line technique in 16 adult warmblood horses without any history of TMJ disorders. Within the central two-thirds of the articular surfaces of the articular tubercle, the articular disc and the mandibular head, split-lines ran in a correspondent rostrocaudal direction. In the lateral and medial aspects of these articular surfaces, the split-line pattern varied, displaying curved arrangements in the articular disc and punctual split-lines in the bony components. Mediolateral orientated split-lines were found in the rostral and caudal border of the articular disc and in the mandibular fossa. The complex movements during the equine chewing cycle are likely assigned to different areas of the TMJ. The split-line pattern of the equine TMJ is indicative of a relative movement of the joint components in a preferential rostrocaudal direction which is consigned to the central aspects of the TMJ. The lateral and medial aspects of the articular surfaces provide split-line patterns that indicate movements particularly around a dorsoventral axis. Copyright © 2016 Elsevier Ltd. All rights reserved.

Group-based social skills interventions for adolescents with higher-functioning autism spectrum disorder: a review and looking to the future

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McMahon, Camilla M; Lerner, Matthew D; Britton, Noah

2013-01-01

In this paper, we synthesize the current literature on group-based social skills interventions (GSSIs) for adolescents (ages 10–20 years) with higher-functioning autism spectrum disorder and identify key concepts that should be addressed in future research on GSSIs. We consider the research participants, the intervention, the assessment of the intervention, and the research methodology and results to be integral and interconnected components of the GSSI literature, and we review each of these components respectively. Participant characteristics (eg, age, IQ, sex) and intervention characteristics (eg, targeted social skills, teaching strategies, duration and intensity) vary considerably across GSSIs; future research should evaluate whether participant and intervention characteristics mediate/moderate intervention efficacy. Multiple assessments (eg, parent-report, child-report, social cognitive assessments) are used to evaluate the efficacy of GSSIs; future research should be aware of the limitations of current measurement approaches and employ more accurate, sensitive, and comprehensive measurement approaches. Results of GSSIs are largely inconclusive, with few consistent findings across studies (eg, high parent and child satisfaction with the intervention); future research should employ more rigorous methodological standards for evaluating efficacy. A better understanding of these components in the current GSSI literature and a more sophisticated and rigorous analysis of these components in future research will lend clarity to key questions regarding the efficacy of GSSIs for individuals with autism spectrum disorder. PMID:23956616

The “at-home LLLT” in temporo-mandibular disorders pain control: a pilot study

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Pelosi, A; Queirolo, V; Vescovi, P; Merigo, E

2015-01-01

Objectives: The Temporo-Mandibular Disorders (TMD) are a set of dysfunctional patterns concerning the temporo-mandibular joints (TMJ) and the masticatory muscles; its main symptom is pain, probably caused by inflammatory changes in the synovial membrane, alterations in the bone marrow of the mandibular condyle and impingement and compression. The aim of this preliminary study was to investigate the effectiveness in the TMD pain reduction of a new laser device recently proposed by the commerce that, due to its reduced dimensions and to be a class I laser according the ANSI classification, may be used at home by the patient himself. Material and methods: Twenty-four patients with TMD were randomly selected: the inclusion criteria for the sample was the diagnosis of mono- or bi-lateral TMD, with acute pain restricted to the joint area, associated with the absence of any muscle tenderness during palpation. The patients were randomly assigned to two groups: Group 1 (12 patients): patients receiving real LLLT (experimental group). Group 2 (12 patients): patients receiving inactive laser (placebo group). The treatment was performed once a day for two weeks with an 808 nm diode laser by the patient himself with irradiation of the cutaneous zone corresponding to the TMJ for 15 minutes each side. Each patient was instructed to express its pain in a visual analogue scale (VAS) making a perpendicular line between the two extremes representing the felt pain level. Statistical analysis was realized with GraphPad Instat Software, where Ptemporo-mandibular diseases by an at home self administered laser device. Results are encouraging but they will have to be confirmed by greater studies. PMID:25941425

The potential of induced pluripotent stem cells in models of neurological disorders: implications on future therapy.

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Crook, Jeremy Micah; Wallace, Gordon; Tomaskovic-Crook, Eva

2015-03-01

There is an urgent need for new and advanced approaches to modeling the pathological mechanisms of complex human neurological disorders. This is underscored by the decline in pharmaceutical research and development efficiency resulting in a relative decrease in new drug launches in the last several decades. Induced pluripotent stem cells represent a new tool to overcome many of the shortcomings of conventional methods, enabling live human neural cell modeling of complex conditions relating to aberrant neurodevelopment, such as schizophrenia, epilepsy and autism as well as age-associated neurodegeneration. This review considers the current status of induced pluripotent stem cell-based modeling of neurological disorders, canvassing proven and putative advantages, current constraints, and future prospects of next-generation culture systems for biomedical research and translation.

Signs and symptoms of temporomandibular disorders and oral parafunctions in urban Saudi arabian adolescents: a research report

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Feteih Rabab M

2006-08-01

Full Text Available Abstract Background The aim of this study was to evaluate the prevalence of signs and symptoms of temporomandibular disorders (TMD and oral parafunction habits among Saudi adolescents in the permanent dentition stage. Methods A total of 385 (230 females and 155 males school children age 12–16, completed a questionnaire and were examined clinically. A stratified selection technique was used for schools allocation. Results The results showed that 21.3% of the subjects exhibited at least one sign of TMD and females were generally more affected than males. Joint sounds were the most prevalent sign (13.5% followed by restricted opening (4.7% and opening deviation (3.9%. The amplitude of mouth opening, overbite taken into consideration, was 46.5 mm and 50.2 mm in females and males respectively. TMJ pain and muscle tenderness were rare (0.5%. Reported symptoms were 33%, headache being the most frequent symptom 22%, followed by pain during chewing 14% and hearing TMJ noises 8.7%. Difficulty during jaw opening and jaw locking were rare. Lip/cheek biting was the most common parafunction habit (41% with females significantly more than males, followed by nail biting (29%. Bruxism and thumb sucking were only 7.4% and 7.8% respectively. Conclusion The prevalence of TMD signs were 21.3% with joint sounds being the most prevalent sign. While TMD symptoms were found to be 33% as, with headache being the most prevalent. Among the oral parafunctions, lip/cheek biting was the most prevalent 41% followed by nail biting 29%.

The future of tic disorder treatment.

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Bennett, Shannon M; Keller, Alex E; Walkup, John T

2013-11-01

Competing theories on the etiology and treatment of chronic tic disorders and Tourette syndrome have long made the search for efficacious intervention more challenging for patients and families seeking to reduce functional impairment related to tic symptoms. These symptoms were historically posited to be either psychological in origin, leading to the long tradition of psychoanalytic psychotherapy for tics, or biological in nature, particularly since the advent of successful treatments using neuroleptic medications. Current thinking about the phenomenology of tic disorders comes from growing empirical evidence as well as advances in neuroscience and genetics research and reveals a biological vulnerability that is exacerbated by physiological arousal related to environmental or interpersonal stress. This manuscript summarizes the evolution of this knowledge base and describes current best-practice recommendations for patients, families, and clinicians. © 2013 New York Academy of Sciences.

Effect of Surgery First Orthognathic Approach on the Temporomandibular Joint.

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

2018-05-01

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.

Effectiveness of Gaalas Phototherapy According to Diagnostic Criteria for Tемрoromandibular Disorders

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Nencheva-Sveshtarova Savina

2015-11-01

Full Text Available The objective of this study was to test the clinical effectiveness of the combined gallium-aluminum-arsenide laser (GaAlAs; 785 nm and superluminiscent diods (SLD; 633 nm phototherapy (MedX 1100 device for the treatment of 62 patients with 7 of the most common pain-related temporomandibular disorders with highest sensitivity and specificity according to diagnostic criteria DC/TMD. Using paired samples t-test a positive effect in the pain relief for all tested conditions was demonstrated. The most manifested and statistically significant reduction of pain was found in arthralgia attributed to osteoarthritis and systemic (rheumatoid arthritis (p = 0.0000001, and disc displacement without reduction with limited opening (p = 0.0000002. Similar levels of pain reduction were found in arthralgia attributed to subluxation, myofascial pain with referral, local myalgia (p values vary between 0.000001 and 0.000284; the lowest values were recorded for myofascial pain (p = 0.001789 and hypermobility-related myalgia (p = 0.018443. The combined laser and SLD phototherapy can be defined as very effective treatment option particularly in pain reduction of internal derangement disorders as well as in some myogenic-related pain conditions affected by TMJ dysfunction.

Childhood Attention-Deficit/Hyperactivity Disorder and Future Substance Use Disorders: Comparative Meta-Analyses

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Charach, Alice; Yeung, Emanuela; Climans, Troy; Lillie, Erin

2011-01-01

Objective: In recent years cohort studies have examined childhood attention-deficit/hyperactivity disorder (ADHD) as a risk factor for substance use disorders (SUDs) in adolescence and young adulthood. The long-term risk is estimated for development of alcohol, cannabis, combined alcohol and psychoactive SUDs, combined SUDs (nonalcohol), and…

Occlusal Grinding Pattern during Sleep Bruxism and Temporomandibular Disorder

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Yeni Wijaya

2013-09-01

Full Text Available Sleep Bruxism is a significant etiology of temporomandibular disorder (TMD and causes many dental or oral problems such as tooth wear or facet. There is no study analyzing the relationship between sleep bruxism and TMD. Objective: To investigate any relationship between occlusal grinding pattern during sleep bruxism and temporomandibular disorder. Methods: A cross-sectional study involving 30 sleep bruxism patients attended the Faculty Dentistry Universitas Indonesia Teaching Hospital (RSGMP FKG UI. Completion of 2 forms of ID-TMD index and questionnaire from American Academy of Sleep Medicine were done. BruxChecker was fabricated and used for two nights to record the occlusal grinding pattern. The occlusal grinding pattern was categorized into laterotrusive grinding (LG and mediotrusive side. Further divisons of LG were: incisor-canine (IC, incisor-caninepremolar (ICP and incisor-canine-premolar-molar (ICPM. Mediotrusive side was classified as mediotrusive contact (MC and mediotrusive grinding (MG. Results: It was found that occlusal grinding pattern in non-TMD subjects were IC+MC, in subjects with mild TMD were ICP+MG and in subjects with moderate TMD were ICP+MG and ICPM+MG. TMJ was more significantly affected by ICP and ICPM grinding pattern than that of IC. Conclusion: There was a significant relationship between occlusal grinding pattern during sleep bruxism and TMD.DOI: 10.14693/jdi.v20i2.149

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

International Nuclear Information System (INIS)

You, Dong Soo

1981-01-01

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

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

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

1981-11-15

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

MRI and CBCT image registration of temporomandibular joint: a systematic review.

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Al-Saleh, Mohammed A Q; Alsufyani, Noura A; Saltaji, Humam; Jaremko, Jacob L; Major, Paul W

2016-05-10

The purpose of the present review is to systematically and critically analyze the available literature regarding the importance, applicability, and practicality of (MRI), computerized tomography (CT) or cone-beam CT (CBCT) image registration for TMJ anatomy and assessment. A systematic search of 4 databases; MEDLINE, EMBASE, EBM reviews and Scopus, was conducted by 2 reviewers. An additional manual search of the bibliography was performed. All articles discussing the magnetic resonance imaging MRI and CT or CBCT image registration for temporomandibular joint (TMJ) visualization or assessment were included. Only 3 articles satisfied the inclusion criteria. All included articles were published within the last 7 years. Two articles described MRI to CT multimodality image registration as a complementary tool to visualize TMJ. Both articles used images of one patient only to introduce the complementary concept of MRI-CT fused image. One article assessed the reliability of using MRI-CBCT registration to evaluate the TMJ disc position and osseous pathology for 10 temporomandibular disorder (TMD) patients. There are very limited studies of MRI-CT/CBCT registration to reach a conclusion regarding its accuracy or clinical use in the temporomandibular joints.

Magnetic resonance in temporomandibular articulations

International Nuclear Information System (INIS)

Duarte Filho, D.L.; Ferreira, R.

1994-01-01

Dysfunction of temporomandibular joint (TMJ) is extremely common, mainly in women. The indication of imaging study of TMJ is the evaluation of its internal derangements, since disc dislocation is treated by different way than other intrinsic mechanical conditions and of the painful myofacial dysfunction, as well where there is no anatomic lesion. The patients, who do not improve with the clinical approach, should be referred to imaging evaluation, in order to rule out mechanical disorder. When the patient is supposed to be operated upon, imaging of the contralateral TMJ is necessary. The presence of a thick and stiff disc perforated with adhesion to the mandibular condyle will change the surgical management. The plain x-ray film is able to demonstrate the bone outlines and joint space but it is not able to show the soft articular tissues. Arthrography is very reliable to demonstrate perforation. However it is an invasive method and demands skilled radiographer radiologist. MRI has shown to be reliable method and it is becoming to be progressively used in routine investigation of TMJ. Nevertheless, MRI still has some limitations concerning to disc perforation. (author). 16 refs, 9 figs

Prescription for antidepressant in reducing future alcohol-related readmission in patients suffering from depression and alcohol use disorder: a retrospective medical record review.

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Chan, Patrick; Yomen, Katie; Turcios, Jennifer; Richman, Mark

2015-12-21

Patients suffering from major depressive disorder are more likely to suffer from alcohol use disorder. The data is inconclusive for the effectiveness of antidepressant treatment of patients suffering from both illnesses in regards to improving sobriety and reducing alcohol-related healthcare expenses such as hospitalizations. The objective of this study is to determine if a new prescription of an antidepressant upon inpatient discharge is associated with a reduction in the number of future acute alcohol-related hospital readmissions to the same institution in patients suffering from major depressive disorder and alcohol-use disorder. A retrospective, medical record review study was conducted at a publicly-supported hospital in Sylmar, CA. A query was performed for adult patients admitted between 1/1/2005-12/31/2013 who had ICD-9 codes for both alcohol-use disorder and depression. Index admission was the first hospitalization in which the patient was currently consuming alcohol and had depression as identified by physician documentation as a problem. Acute alcohol-related admissions were those for alcohol intoxication or withdrawal (indicating current alcohol use). Patients were excluded if they were receiving an antidepressant on index admission, depressive disorder with a prescription for an antidepressant is not associated with a reduction in future readmissions, nor significantly increase the number of days to readmission. The study does not support the concept of antidepressants in reducing acute alcohol-related readmissions.

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

Principal direction of inertia for 3D trajectories from patient-specific TMJ movement.

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

2013-03-01

Accurate simulation and evaluation of mandibular movement is fundamental for the analysis of functional changes and effects of the mandible and maxilla before and after surgical treatments. We applied principal axes of inertia to the three-dimensional (3D) trajectories generated by patient-specific simulations of TMJ movements for the functional evaluations of mandible movement. Three-dimensional movements of the mandible and the maxilla were tracked based on a patient-specific splint and an optical tracking system. The dental occlusion recorded on the sprint provided synchronization for initial movement in the tracking and the simulation phases. The translation and rotation recorded during movement tracking was applied sequentially to the mandibular model in relation to a fixed maxilla model. The sequential 3D positions of selected landmarks on the mandible were calculated based on the reference coordinate system. The landmarks selected for analysis were bilateral condyles and pogonion points. The moment of inertia tensor was calculated with respect to the 3D trajectory points. Using the unit vectors along the principal axes derived from the tensor matrix, α, β and γ rotations around z-, y- and x-axes were determined to represent the principal directions as principal rotations respectively. The γ direction showed the higher standard deviation, variation of directions, than other directions at all the landmarks. The mandible movement has larger kinematic redundancy in the γ direction than α and β during mouth opening and closing. Principal directions of inertia would be applied to analyzing the changes in angular motion of trajectories introduced by mandibular shape changes from surgical treatments and also to the analysis of the influence of skeletal deformities on mandibular movement asymmetry. Copyright © 2012 Elsevier Ltd. All rights reserved.

Psychiatric and medical disorders in the after math of the uttarakhand disaster: assessment, approach, and future challenges.

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Channaveerachari, Naveen Kumar; Raj, Aneel; Joshi, Suvarna; Paramita, Prajna; Somanathan, Revathi; Chandran, Dhanya; Kasi, Sekar; Bangalore, N Roopesh; Math, Suresh Bada

2015-01-01

To present the descriptive data on the frequency of medical and psychiatric morbidity and also to discuss various pertinent issues relevant to the disaster management, the future challenges and psychosocial needs of the 2013 floods in Uttarakhand, India. Observation was undertaken by the disaster management team of National Institute of Mental Health and Neurosciences in the worst affected four districts of Uttarakhand. Qualified psychiatrists diagnosed the patients using the International Classification of Diseases-10 criteria. Data were collected by direct observation, interview of the survivors, group sessions, individual key-informant interview, individual session, and group interventions. Patients with physical health problems formed the majority of treatment seekers (39.6%) in this report. Only about 2% had disaster induced psychiatric diagnoses. As was expected, minor mental disorders in the form of depressive disorders and anxiety disorders formed majority of the psychiatric morbidity. Substance use disorders appear to be very highly prevalent in the community; however, we were not able to assess the morbidity systematically. The mental health infrastructure and manpower is abysmally inadequate. There is an urgent need to implement the National Mental Health Program to increase the mental health infrastructure and services in the four major disaster-affected districts.

Formal thought disorder in autism spectrum disorder predicts future symptom severity, but not psychosis prodrome

NARCIS (Netherlands)

Eussen, M.L.J.M.; de Bruin, E.I.; van Gool, A.R.; Louwerse, E.S.; van der Ende, J.; Verheij, F.; Verhulst, F.C.; Greaves-Lord, K.

2015-01-01

Formal thought disorder (FTD) is a disruption in the flow of thought, which is inferred from disorganisation of spoken language. FTD in autism spectrum disorders (ASD) might be a precursor of psychotic disorders or a manifestation of ASD symptom severity. The current longitudinal study is a

Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain.

Science.gov (United States)

Anderson, Gary C; John, Mike T; Ohrbach, Richard; Nixdorf, Donald R; Schiffman, Eric L; Truelove, Edmond S; List, Thomas

2011-04-01

The relationship of the frequency of temple headache to signs and symptoms of temporomandibular joint (TMJ) disorders (TMD) was investigated in a subset of a larger convenience sample of community TMD cases. The study sample included 86 painful TMD, nonheadache subjects; 309 painful TMD subjects with varied frequency of temple headaches; and 149 subjects without painful TMD or headache for descriptive comparison. Painful TMD included Research Diagnostic Criteria for Temporomandibular Disorders diagnoses of myofascial pain, TMJ arthralgia, and TMJ osteoarthritis. Mild to moderate-intensity temple headaches were classified by frequency using criteria based on the International Classification of Headache Disorder, 2nd edition, classification of tension-type headache. Outcomes included TMD signs and symptoms (pain duration, pain intensity, number of painful masticatory sites on palpation, mandibular range of motion), pressure pain thresholds, and temple headache resulting from masticatory provocation tests. Trend analyses across the painful TMD groups showed a substantial trend for aggravation of all of the TMD signs and symptoms associated with increased frequency of the temple headaches. In addition, increased headache frequency showed significant trends associated with reduced PPTs and reported temple headache with masticatory provocation tests. In conclusion, these findings suggest that these headaches may be TMD related, as well as suggesting a possible role for peripheral and central sensitization in TMD patients. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

Magnetic Resonance Imaging-Based Prediction of the Relationship between Whiplash Injury and Temporomandibular Disorders.

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Lee, Yeon-Hee; Lee, Kyung Mi; Auh, Q-Schick; Hong, Jyung-Pyo

2017-01-01

Whiplash injury can cause internal derangement of the temporomandibular joint (TMJ) and lead to temporomandibular disorders (TMDs). Our aim was to evaluate whether the initial clinical findings in TMD patients with whiplash injury are correlated with their magnetic resonance imaging (MRI) characteristics. This case-control study involved 219 patients (135 women, 84 men; mean age: 37.84 years) who visited our orofacial pain clinic with TMD; TMD was diagnosed using the diagnostic criteria for TMD Axis I. Patients were categorized into three groups based on the presence and type of macrotrauma: in the "wTMD" group, patients had suffered whiplash injury; patients in the "pTMD" group had post-traumatic TMD; the "iTMD" group comprised patients who had presented with TMD symptoms and had sustained no macrotrauma. We investigated the presence of disk displacement, effusion, disk deformity, and condylar degeneration, and changes in the lateral pterygoid muscle (LPM). To evaluate the severity of TMD pain and objectively analyze symptoms, we used a visual analog scale (VAS), palpation index (PI), neck PI, dysfunction index, and craniomandibular index (CMI). The VAS scores, and the severity indexes of the TMD including PI, neck PI, and CMI were highest in the wTMD patients. Atrophy of the LPM was most commonly seen in the wTMD group, as was disk deformity. In wTMD patients only, VAS score was significantly correlated with stress; it was correlated with headache in wTMD and iTMD patients. The clinical symptoms of TMD were not correlated with MRI findings in the wTMD group. However, alterations in the LPM were strongly correlated with disk displacement. If clinicians recognize alterations in the LPM and disk displacement in the TMJ, they will better understand the clinical symptoms and pathophysiology of TMD with whiplash injury. Whiplash injury may lead to TMD via different mechanisms from other macrotraumas.

Pigmented villonodular synovitis of the temporomandibular joint with intracranial extension: A case series and systematic review.

Science.gov (United States)

Safaee, Michael; Oh, Taemin; Sun, Matthew Z; Parsa, Andrew T; McDermott, Michael W; El-Sayed, Ivan H; Bloch, Orin

2015-08-01

Pigmented villonodular synovitis (PVNS) is a rare proliferative disorder of the synovial membrane. PVNS generally affects large joints but occasionally involves the temporomandibular joint (TMJ), with occasional extension into the middle cranial fossa. The purpose of this study was to report our experience with PVNS along with a focused literature review. Patients with PVNS of the TMJ treated at the University of California - San Francisco from 2007 to 2013 were reviewed. A PubMed search was performed to identify additional cases. Five patients underwent surgical resection, with 1 recurrence at 61 months. A literature review identified 58 patients, 19 of which had intracranial involvement. Interestingly, intracranial extension was more common in men. Intracranial extension was not associated with an increased rate of recurrence. PVNS of the TMJ is a rare entity associated with excellent outcomes, even with intracranial extension. Management should consist of maximal resection, with radiotherapy reserved for extensive or recurrent lesions. © 2014 Wiley Periodicals, Inc.

PERAWATAN PRA PROSTODONTIK DENGAN SPLIN OKLUSAL PADA KASUS KEHILANGAN GIGI YANG DISERTAI GANGGUAN SENDI TEMPOROMANDIBULA

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Ira S Wardani

2015-08-01

Full Text Available Pre-prosthetic treatment is very important step to get a successful prosthodontic treatment. This study reported a case of patient with missing teeth on left and right lower first and second molar, with TMJ symptoms. Other symptoms felt by the patients were ear pain, and shoulder pain. After detailed examination, pre-prosthetic treatment needed by the patient was the TMJ treatment. The usage of occlusal splint as one of the methods to treat the TMD were i.e. to eliminate the occlusal disorder, to reduce the neuromuscular activity, and to regain a stable centric relation. After splint treatment, an open bite on the posterior teeth appeared. To solve this problem, a removable frame prosthesis enhanced with overlay rest was fabricated. With this prosthesis, the TMJ symptoms stopped recurring. It was concluded that to achieve a successful prosthesis, a detailed and comprehensive treatment was needed, including the pre-prosthetic treatment, along with the patient’s motivation and cooperation.

High-resolution ultrasonography in assessing temporomandibular joint disc position.

Science.gov (United States)

Talmaceanu, Daniel; Lenghel, Lavinia Manuela; Bolog, Nicolae; Popa Stanila, Roxana; Buduru, Smaranda; Leucuta, Daniel Corneliu; Rotar, Horatiu; Baciut, Mihaela; Baciut, Grigore

2018-02-04

The purpose of this study was to determine the diagnostic value of high-resolution ultrasonography (US) in temporomandibular joint (TMJ) disc displacements. A number of 74 patients (148 TMJs) with signs and symptoms of TMJ disorders, according to the Research Diagnostic Criteria for Temporomandibular Disorders, were included in this study. All patients received US and magnetic resonance imaging (MRI) of both TMJs 1 to 5 days after the clinical examination. MRI examinations were performed using 1.5 T MRI equipment (Siemens Avanto, Siemens, Erlangen). Ultrasonographic examination was performed on a Hitachi EUB 8500 (Hitachi Medical Corp., Tokyo, Japan) scanner with L 54 M6.5-13 MHz linear transducer. MRI depicted 68 (45.95%) normal joints, 47 (31.76%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 34 (22.97%) with degenerative changes. US detected 78 (52.7%) normal joints, 37 (25%) with disc displacement with reduction, 33 (22.3%) with disc displacement without reduction and 21 (14.19%) with degenerative changes. Compared to MRI, US showed a sensitivity of 93.1%, specificity of 87.88%, accuracy of 90.32%, a positive predictive value of 87.1% and a negative predictive value of 93.55% for overall diagnosis of disc displacement. The Youden index was 0.81. Based on our results, high-resolution ultrasonography showed high sensitivity, specificity and accuracy in the diagnosis of TMJ disc displacement. It could be a valuable imaging technique in assessing TMJ disc position. The diagnostic value of high-resolution ultrasonography depends strictly on the examiner's skills and on the equipment used.

MR imaging of the juvenile temporomandibular joint before orthodontic treatment

International Nuclear Information System (INIS)

Lieberman, J.M.; Hans, M.G.; Rozencweig, G.; Goldberg, J.S.; Bellon, E.M.

1990-01-01

This paper determines the prevalence of internal derangement (ID) of the temporomandibular joint (TM) in a population of children prior to orthodontic therapy. Thirty-two children, aged 7-15 years, with a variety of orthodontic disorders underwent both MR imaging and physical examination to assess ID of the TMJ. With MR imaging, the disks were graded as normal, borderline anterior displaced, or anterior displaced. Fifty-nine TMJs in 32 patients were successfully imaged. Five TMJ MR examinations could not be interpreted because of patient motion. Fifty seven of the 59 joints (97%) were normal. One disk (1.7%) was anterior displaced, and one (1.7%) was considered borderline

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.

2015-01-01

Purpose 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. Materials and Methods 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. Results 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 < .05). The total magnitude of the maximum distance between the points on the condyle and fossa decreased from 3.6 ± 0.8 mm to 3.1 ± 0.6 mm for the working condyle and 2.8 ± 0.4 mm to 2.5 ± 0.4 mm for the balancing condyle (P < .05). The largest decreases were seen in the anteroposterior direction for both condyles. Conclusion Determining the changes in condylar movement might lead to a better understanding of the early predictors in the development of TMJ-OA and determining when the symptoms become a chronic, irreversible problem. PMID:25889371

Long-Term Symptoms Onset and Heterotopic Bone Formation around a Total Temporomandibular Joint Prosthesis: a Case Report

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Luca Guarda-Nardini

2014-04-01

Full Text Available Background: The literature on total alloplastic temporomandibular joint (TMJ reconstructions is encouraging, and studies on total alloplastic TMJ replacements outcomes showed acceptable improvements in terms of both pain levels and jaw function. Nevertheless, some adverse events, such as heterotopic bone formation around the implanted prosthesis, may occur. In consideration of that, the present manuscript describes a case of heterotopic bone formation around a total temporomandibular joint prosthesis, which occurred several years after the implant. Methods: The present manuscript describes a case of heterotopic bone formation around a total TMJ prosthesis, which occurred several years after the implant in patients, who previously underwent multiple failed TMJ surgeries. Results: Ten years after the surgical TMJ replacement to solve an ankylotic bone block, the patient came to our attention again referring a progressive limitation in mouth opening. A computerized tomography showed evidence of marked heterotopic bone formation in the medial aspects of the joint, where a new-born ankylotic block occupied most part of the gap created by resecting the coronoid process at the time of the TMJ prosthesis insertion. Conclusions: Despite this adverse event has been sometimes described in the literature, this is the first case in which its occurrence happened several years after the temporomandibular joint replacement. It can be suggested that an accurate assessment of pre-operative risk factors for re-ankylosis (e.g., patients with multiple failed temporomandibular joint surgeries and within-intervention prevention (e.g., strategies to keep the bone interfaces around the implant separated should be better standardized and define in future studies.

Integration of Nanobots Into Neural Circuits As a Future Therapy for Treating Neurodegenerative Disorders.

Science.gov (United States)

Saniotis, Arthur; Henneberg, Maciej; Sawalma, Abdul-Rahman

2018-01-01

Recent neuroscientific research demonstrates that the human brain is becoming altered by technological devices. Improvements in biotechnologies and computer based technologies are now increasing the likelihood for the development of brain augmentation devices in the next 20 years. We have developed the idea of an "Endomyccorhizae like interface" (ELI) nanocognitive device as a new kind of future neuroprosthetic which aims to facilitate neuronal network properties in individuals with neurodegenerative disorders. The design of our ELI may overcome the problems of invasive neuroprosthetics, post-operative inflammation, and infection and neuroprosthetic degradation. The method in which our ELI is connected and integrated to neuronal networks is based on a mechanism similar to endomyccorhizae which is the oldest and most widespread form of plant symbiosis. We propose that the principle of Endomyccorhizae could be relevant for developing a crossing point between the ELI and neuronal networks. Similar to endomyccorhizae the ELI will be designed to form webs, each of which connects multiple neurons together. The ELI will function to sense action potentials and deliver it to the neurons it connects to. This is expected to compensate for neuronal loss in some neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease.

Cocoa Enriched Diets Enhance Expression of Phosphatases and Decrease Expression of Inflammatory Molecules in Trigeminal Ganglion Neurons

Science.gov (United States)

Cady, Ryan J.; Durham, Paul L.

2010-01-01

Activation of trigeminal nerves and release of neuropeptides that promote inflammation are implicated in the underlying pathology of migraine and temporomandibular joint (TMJ) disorders. The overall response of trigeminal nerves to peripheral inflammatory stimuli involves a balance between enzymes that promote inflammation, kinases, and those that restore homeostasis, phosphatases. The goal of this study was to determine the effects of a cocoa-enriched diet on the expression of key inflammatory proteins in trigeminal ganglion neurons under basal and inflammatory conditions. Rats were fed a control diet or an isocaloric diet enriched in cocoa for 14 days prior to an injection of noxious stimuli to cause acute or chronic excitation of trigeminal neurons. In animals fed a cocoa-enriched diet, basal levels of the mitogen-activated kinase (MAP) phosphatases MKP-1 and MKP-3 were elevated in neurons. Importantly, the stimulatory effects of acute or chronic peripheral inflammation on neuronal expression of the MAPK p38 and extracellular signal-regulated kinases (ERK) were significantly repressed in response to cocoa. Similarly, dietary cocoa significantly suppressed basal neuronal expression of calcitonin gene-related peptide (CGRP) as well as stimulated levels of the inducible form of nitric oxide synthase (iNOS), proteins implicated in the underlying pathology of migraine and TMJ disorders. To our knowledge, this is first evidence that a dietary supplement can cause upregulation of MKP, and that cocoa can prevent inflammatory responses in trigeminal ganglion neurons. Furthermore, our data provide evidence that cocoa contains biologically active compounds that would be beneficial in the treatment of migraine and TMJ disorders. PMID:20138852

Association between clinical and cone-beam computed tomography findings in patients with temporomandibular disorders

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Mahrokh Imanimoghaddam

2017-08-01

Full Text Available BACKGROUND AND AIM: The aim of this study was to assess the association between the clinical and cone-beam computed tomography (CBCT findings in relation to bony changes in patients with temporomandibular disorders (TMD. METHODS: According to the research diagnostic criteria for temporomandibular disorder (RDC/TMD, forty-one patients with type II TMD (42 TM joints and type III TMD (40 TM joints were recruited for this study. Condylar position and bony changes including flattening, sclerosis, osteophytes, resorption, and erosion of joint were evaluated by CBCT and compared with clinical findings. Data were analyzed by SPSS software. RESULTS: Condylar flattening, sclerosis, resorption, and erosion were not significantly associated with joint/masticatory muscles pain or crepitus sound. The vertical or horizontal position of the condyle showed no significant relationship with the clinical findings. Condylar osteophyte was significantly associated with pain in masticatory muscles and crepitus (P = 0.030 and P = 0.010, respectively. There was no association between the condylar range of motion and pain in joint or masticatory muscles. CONCLUSION: Condylar osteophyte was significantly associated with both masticatory muscles pain and crepitus sound. No significant relationship was found between the other temporomandibular joint (TMJ radiographic and clinical findings in patients with TMD.

Skin picking disorder with co-occurring body dysmorphic disorder

DEFF Research Database (Denmark)

Grant, Jon E; Redden, Sarah A; Leppink, Eric W

2015-01-01

There is clinical overlap between skin picking disorder (SPD) and body dysmorphic disorder (BDD), but little research has examined clinical and cognitive correlates of the two disorders when they co-occur. Of 55 participants with SPD recruited for a neurocognitive study and two pharmacological st...... unique clinical and cognitive aspects of SPD may be more pronounced. Future work should explore possible subgroups in SPD and whether these predict different treatment outcomes....

Gene x environment interactions in conduct disorder: Implications for future treatments.

Science.gov (United States)

Holz, Nathalie E; Zohsel, Katrin; Laucht, Manfred; Banaschewski, Tobias; Hohmann, Sarah; Brandeis, Daniel

2016-08-18

Conduct disorder (CD) causes high financial and social costs, not only in affected families but across society, with only moderately effective treatments so far. There is consensus that CD is likely caused by the convergence of many different factors, including genetic and adverse environmental factors. There is ample evidence of gene-environment interactions in the etiology of CD on a behavioral level regarding genetically sensitive designs and candidate gene-driven approaches, most prominently and consistently represented by MAOA. However, conclusive indications of causal GxE patterns are largely lacking. Inconsistent findings, lack of replication and methodological limitations remain a major challenge. Likewise, research addressing the identification of affected brain pathways which reflect plausible biological mechanisms underlying GxE is still very sparse. Future research will have to take multilevel approaches into account, which combine genetic, environmental, epigenetic, personality, neural and hormone perspectives. A better understanding of relevant GxE patterns in the etiology of CD might enable researchers to design customized treatment options (e.g. biofeedback interventions) for specific subgroups of patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

UPAYA PENINGKATAN KUALITAS PELAYANAN JALAN TOL SEMARANG-BAWEN DENGAN INTEGRASI METODE IMPORTANCE PERFORMANCE GAP ANALYSIS, LEAN, DAN SIX SIGMA

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Diana Puspita Sari

2017-07-01

Abstract PT Trans Marga Jateng (TMJ is a company engaged in service sector, which is managing Semarang-Bawen toll road. The result of preliminary surveyconducted by PT TMJ showed that service quality of PT TMJ is still unsatisfactory, so it is necessary to do research on improving service quality. Service quality can be measured from two perspectives, i.e., internal perspective and external perspective. The external perspective can be measured with Importance Performance Gap Analysis (IPGA method, while the internal perspective can be measured with Lean and Six Sigma method. Thus, this study will use the integration method of IPGA, lean, and six sigma in effort to improve service quality of PT TMJ. Based on the research result, service quality attributes considered the most influential is road lighting, road surface smoothness, driving safety, and accident handling. Suggested improvements for each attribute are road lighting installation at vulnerable points of accidents,asphalt layer installation on bumpy roads, paying particular attention to the implementation of safety driving indicator, and improving value stream of accident handling. Based on future state value stream mapping, total lead time is 150 minutes and value added activity percentage is 72,6%.

Metrical analysis of disc-condyle relation with different splint treatment positions in patients with TMJ disc displacement

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Mu-Qing Liu

Full Text Available Abstract Objective: To evaluate the effect of bite positions characterizing different splint treatments (anterior repositioning and stabilization splints on the disc-condyle relation in patients with TMJ disc displacement with reduction (DDwR, using magnetic resonance imaging (MRI. Material and Methods: 37 patients, with a mean age of 18.8±4.3 years (7 male and 30 females and diagnosed with DDwR based on the RDC/TMD, were recruited. MRI metrical analysis of the spatial changes of the disc/condyle, as well as their relationships, was done in three positions: maximum intercuspation (Position 1, anterior repositioning splint position (Position 2, and stabilization splint position (Position 3. Disc/condyle coordinate measurements and disc condyle angles were determined and compared. Results: In Position 1, the average disc-condyle angle was 53.4° in the 60 joints with DDwR, while it was −13.3° with Position 2 and 30.1° with Position 3. The frequency of successful "disc recapture" with Position 2 was significantly higher (58/60, 96.7% than Position 3 (20/60, 33.3%. In Positions 2 and 3, the condyle moved forward and downward while the disc moved backward. The movements were, however, more remarkable with Position 2. Conclusions: Anterior repositioning of the mandible improves the spatial relationship between the disc and condyle in patients with DDwR. In addition to anterior and inferior movement of the condyle, transitory posterior movement of the disc also occurred.

Group-based social skills interventions for adolescents with higher-functioning autism spectrum disorder: a review and looking to the future

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McMahon CM

2013-01-01

Full Text Available Camilla M McMahon,1 Matthew D Lerner,2,3 Noah Britton41Department of Curriculum and Instruction, Indiana University Bloomington, Bloomington, IN, USA; 2Department of Psychology, University of Virginia, Charlottesville, VA, USA; 3Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA; 4Behavorial Sciences Department, Bunker Hill Community College, Charleston, MA, USAAbstract: In this paper, we synthesize the current literature on group-based social skills interventions (GSSIs for adolescents (ages 10–20 years with higher-functioning autism spectrum disorder and identify key concepts that should be addressed in future research on GSSIs. We consider the research participants, the intervention, the assessment of the intervention, and the research methodology and results to be integral and interconnected components of the GSSI literature, and we review each of these components respectively. Participant characteristics (eg, age, IQ, sex and intervention characteristics (eg, targeted social skills, teaching strategies, duration and intensity vary considerably across GSSIs; future research should evaluate whether participant and intervention characteristics mediate/moderate intervention efficacy. Multiple assessments (eg, parent-report, child-report, social cognitive assessments are used to evaluate the efficacy of GSSIs; future research should be aware of the limitations of current measurement approaches and employ more accurate, sensitive, and comprehensive measurement approaches. Results of GSSIs are largely inconclusive, with few consistent findings across studies (eg, high parent and child satisfaction with the intervention; future research should employ more rigorous methodological standards for evaluating efficacy. A better understanding of these components in the current GSSI literature and a more sophisticated and rigorous analysis of these components in future research will lend clarity to key questions

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.

Comparison of planar images and SPECT with bayesean preprocessing for the demonstration of facial anatomy and craniomandibular disorders

International Nuclear Information System (INIS)

Kircos, L.T.; Ortendahl, D.A.; Hattner, R.S.; Faulkner, D.; Taylor, R.L.

1984-01-01

Craniomandiublar disorders involving the facial anatomy may be difficult to demonstrate in planar images. Although bone scanning is generally more sensitive than radiography, facial bone anatomy is complex and focal areas of increased or decreased radiotracer may become obscured by overlapping structures in planar images. Thus SPECT appears ideally suited to examination of the facial skeleton. A series of patients with craniomandibular disorders of unknown origin were imaged using 20 mCi Tc-99m MDP. Planar and SPECT (Siemens 7500 ZLC Orbiter) images were obtained four hours after injection. The SPECT images were reconstructed with a filtered back-projection algorithm. In order to improve image contrast and resolution in SPECT images, the rotation views were pre-processed with a Bayesean deblurring algorithm which has previously been show to offer improved contrast and resolution in planar images. SPECT images using the pre-processed rotation views were obtained and compared to the SPECT images without pre-processing and the planar images. TMJ arthropathy involving either the glenoid fossa or the mandibular condyle, orthopedic changes involving the mandible or maxilla, localized dental pathosis, as well as changes in structures peripheral to the facial skeleton were identified. Bayesean pre-processed SPECT depicted the facial skeleton more clearly as well as providing a more obvious demonstration of the bony changes associated with craniomandibular disorders than either planar images or SPECT without pre-processing

Epidemiologia dos transtornos alimentares: estado atual e desenvolvimentos futuros Epidemiology of eating disorders: current status and future developments

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Phillipa J Hay

2002-12-01

disorders, with a focus on community-based studies of risk factors and nosology; and to point to future areas for study, notably the social and economic burden and general population "mental health literacy" of people with eating disorders. In spite of problems in identifying and recruiting sufficient numbers of people with anorexia nervosa and variable methods of case-ascertainment, studies of incidence and prevalence of eating disorders have reached a general consensus and do not in general support a current rising incidence, except possibly a small increase in anorexia nervosa in young women. The application of analytic epidemiologic methods has lead to a greater understanding of environmental and genetic factors, as compared with social and economic factors, to the risk of developing eating disorders, and as well aided the refinement of eating disorder nosology. In the future analytic epidemiology has the potential to answer key questions about the nature and determinants of eating disorders, and to help to decide how to help those who need it most.

Dentists' knowledge of occlusal splint therapy for bruxism and ...

African Journals Online (AJOL)

2015-10-28

Oct 28, 2015 ... bruxism, and temporomandibular joint (TMJ) disorders and to assessment of treatment modalities. Materials ... While the dentists' with sufficient knowledge soft splint application rates were 11.6% ... might result in disease progression or the development of a different ... software “SPSS” version 15.0. (Inc.

Study on the effectiveness of the kinetic method in patients with rheumatic diseases and temporomandibular joint dysfunction.

Science.gov (United States)

Havriş, Maria Daniela; Ancuţa, Codrina; Iordache, Cristina; Chirieac, Rodica Marieta

2012-01-01

Selecting the appropriate treatment decision is essential for achieving optimal results in the management of algo-dysfunctional syndrome of the temporo-mandibular joint (TMJD). The study aims to decide on the most effective (symptomatic control, preserved motility) kinetic program in patients with TMJ involvement. prospective observational study on 83 consecutive patients with rheumatic diseases and TMJ dysfunction. Clinical assessment (pain, noises, muscle spasm, range of motion, ROM) was performed at baseline and after 3 months of specific kinetic rehabilitation program. Change in clinical parameters and TM3 index was reported, pposture (head, neck and trunk), normal mastication, swallowing and respiration, as well as correction of neuromuscular imbalances in patients with TMJD secondary to rheumatic disorders.

Integration of Nanobots Into Neural Circuits As a Future Therapy for Treating Neurodegenerative Disorders

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Arthur Saniotis

2018-03-01

Full Text Available Recent neuroscientific research demonstrates that the human brain is becoming altered by technological devices. Improvements in biotechnologies and computer based technologies are now increasing the likelihood for the development of brain augmentation devices in the next 20 years. We have developed the idea of an “Endomyccorhizae like interface” (ELI nanocognitive device as a new kind of future neuroprosthetic which aims to facilitate neuronal network properties in individuals with neurodegenerative disorders. The design of our ELI may overcome the problems of invasive neuroprosthetics, post-operative inflammation, and infection and neuroprosthetic degradation. The method in which our ELI is connected and integrated to neuronal networks is based on a mechanism similar to endomyccorhizae which is the oldest and most widespread form of plant symbiosis. We propose that the principle of Endomyccorhizae could be relevant for developing a crossing point between the ELI and neuronal networks. Similar to endomyccorhizae the ELI will be designed to form webs, each of which connects multiple neurons together. The ELI will function to sense action potentials and deliver it to the neurons it connects to. This is expected to compensate for neuronal loss in some neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease.

A European Perspective on Auditory Processing Disorder-Current Knowledge and Future Research Focus

DEFF Research Database (Denmark)

IIiadou, Vasiliki; Ptok, Martin; Grech, Helen

2017-01-01

Current notions of "hearing impairment," as reflected in clinical audiological practice, do not acknowledge the needs of individuals who have normal hearing pure tone sensitivity but who experience auditory processing difficulties in everyday life that are indexed by reduced performance in other...... of diseases as H93.25 and in the forthcoming beta eleventh version. APDs may have detrimental effects on the affected individual, with low esteem, anxiety, and depression, and symptoms may remain into adulthood. These disorders may interfere with learning per se and with communication, social, emotional......, and academic-work aspects of life. The objective of the present paper is to define a baseline European APD consensus formulated by experienced clinicians and researchers in this specific field of human auditory science. A secondary aim is to identify issues that future research needs to address in order...

Autistic disorder : Current psychopharmacological treatments and areas of interest for future developments

NARCIS (Netherlands)

Nikolov, R; Jonker, Jacob Jan; Scahill, L

Autistic disorder and the group of related conditions defined as pervasive developmental disorders are chronic neurodevelopmental disorders starting in early childhood and affecting a significant number of children and families. Although the causes and much of the pathophysiology of the disorder

Paediatric Anxiety Disorders

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Beena Johnson

2017-07-01

Full Text Available Anxiety disorders are highly prevalent among children and are associated with serious morbidity. Lifetime prevalence of paediatric anxiety disorders is about fifteen percent. Social phobia, generalized anxiety disorder and separation anxiety disorder are included in the triad of paediatric anxiety disorders. Specific phobia, obsessive compulsive disorder and post-traumatic stress disorder are also commonly seen in children. Overprotection by parents, parental death or separation, female sex, low educational status, family history of anxiety disorder, financial stress in family and adverse childhood experiences are risk factors for the development of anxiety disorders. If not diagnosed and managed at the earliest, paediatric anxiety disorders can cause life threatening problems in the future. Hence early and scientific management of anxiety disorders is essential. Cognitive behavioural therapy is the effective evidence based treatment for paediatric anxiety disorders.

Splint therapy for disc displacement with reduction of the temporomandibular joint. Part I: Modified mandibular splint therapy

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I-Yueh Huang

2011-08-01

Full Text Available The aims of this preliminary study were to present a modified mandibular splint together with a treatment regimen and to evaluate their effects on the treatment of reciprocal joint sounds of the temporomandibular joint (TMJ. The study participants were recruited from 312 consecutive patients in the temporomandibular disorder clinic of a medical center in Taiwan from January 2003 to December 2003. From among these, 59 cases with typical reciprocal clicking were selected for this study. All participants were treated with a modified mandibular splint and then followed up for 6 months. Successful treatment was defined as leading to the disappearance of the joint sounds of TMJ, as described by patients. Based on clinical evaluation, the overall success rate was 71.2% (42/59 with minimal temporary complications. Patients with clicking at less than 3.5 cm of interincisal opening had a success rate of 92.5%, which was higher than the success rate of patients with clicking at a mouth opening of 3.5 cm or more. This study showed that a modified mandibular splint can be used to treat reciprocal clicking of the TMJ effectively and encouraged us to conduct further study on the efficacy of this splint to treat disc displacement with reduction of TMJ using magnetic resonance imaging examination.

EFEKTIFITAS HARD DAN SOFT OCCLUSAL SPLINT PADA GANGGUAN SENDI TEMPOROMANDIBULA (Kajian klinis pada seri kasus berdasarkan keluhan nyeri sendi temporomandibula

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R.A Donna Pratiwi

2015-08-01

Full Text Available Occlusal splint is commonly used for treatment of the temporomandibular joint disorder (TMD. It can be made of hard and soft material. Hard occlusal splint (HOS which was known earlier had been recognized more effective than soft occlusal splint (SOS which recently gained some popularity. This clinical study based on case series was to determined which type of occlusal splint was more effective for TMD. This study involved 20 subjects and they were divided into HOS and SOS group with 10 subjects in each group. HOS was processed with heat curing acrylic and SOS with vacuum former. Before and after 4 weeks of treatment, 5 TMD symptoms (impaired range of movement, impaired TMJ function, muscle pain, TMJ pain and pain on movement of mandible were measured using Helkimo diagnostic index. The results were analyzed with Kolmogorov-Smirnov Z's test. The findings showed statistically significant improvement in impaired range of movement and muscle pain in favor of HOS group (p<0.05. Although they were not statistically significant, HOS group showed better improvement than SOS group in TMJ pain and pain on movement of the mandible. In TMJ's function, no changes were found in both groups. IN general, HOS was more effective than SOS for treating TMD in relatively short period of time. Despite of the phenomena, the popularity of SOS was not followed with its effectiveness.

Alterações da articulação temporomandibular e suas repercussões orofaciais em pacientes portadores de artrite idiopática juvenil Temporomandibular joint alterations and their orofacial complications in patients with juvenile idiopathic arthritis

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Renata Teixeira de Carvalho

2012-12-01

arthritis (JIA can have alterations in bone metabolism and skeletal growth, as well as damage to the temporomandibular joint (TMJ, which can generate extra and/or intraoral alterations, resulting in craniofacial disorders. Our goal is to carry out a review of the literature on orofacial alterations in patients with JIA. Among the orofacial disorders in patients with JIA, alterations in mandibular growth, caused by dysfunctions in the TMJ region, seem highly prevalent in these patients. The most often found alterations are: retrognathia, micrognathia, anterior open bite, dental crowding, facial asymmetry and mouth opening limitation. Thus, the rheumatologist becomes a key agent in the early detection of these disorders, helping with patient referral to a dentist. The diagnosis, in turn, should be performed by the orthodontist, using clinical examination and imaging methods, allowing early treatment and a favorable prognosis. TMJ disorders should be treated by a multidisciplinary team, including pharmacological treatment for pain control and dental care through functional appliance and/or orthodontic therapy, physical therapy and sometimes, speech therapy. We conclude that among the orofacial disorders in patients with JIA, alterations in mandibular growth generated by dysfunctions in the TMJ region seem highly prevalent. Such dysfunctions can cause mainly open bite, mandibular retrusion, micrognathia, dental crowding and facial asymmetry. The rheumatologist can detect these alterations at an early stage, with immediate patient referral to a team that should preferably be a multidisciplinary one, consisting of an orthodontist, physical therapist and speech therapist, to reduce future occlusal and mandibular growth complications.

The future of psychiatry as clinical neuroscience.

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Reynolds, Charles F; Lewis, David A; Detre, Thomas; Schatzberg, Alan F; Kupfer, David J

2009-04-01

Psychiatry includes the assessment, treatment, and prevention of complex brain disorders, such as depression, bipolar disorder, anxiety disorders, schizophrenia, developmental disorders (e.g., autism), and neurodegenerative disorders (e.g., Alzheimer dementia). Its core mission is to prevent and alleviate the distress and impairment caused by these disorders, which account for a substantial part of the global burden of illness-related disability. Psychiatry is grounded in clinical neuroscience. Its core mission, now and in the future, is best served within this context because advances in assessment, treatment, and prevention of brain disorders are likely to originate from studies of etiology and pathophysiology based in clinical and translational neuroscience. To ensure its broad public health relevance in the future, psychiatry must also bridge science and service, ensuring that those who need the benefits of its science are also its beneficiaries. To do so effectively, psychiatry as clinical neuroscience must strengthen its partnerships with the disciplines of public health (including epidemiology), community and behavioral health science, and health economics.The authors present a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of psychiatry and identify strategies for strengthening its future and increasing its relevance to public health and the rest of medicine. These strategies encompass new approaches to strengthening the relationship between psychiatry and neurology, financing psychiatry's mission, emphasizing early and sustained multidisciplinary training (research and clinical), bolstering the academic infrastructure, and reorganizing and refinancing mental health services both for preventive intervention and cost-effective chronic disease management.

The Future of Psychiatry as Clinical Neuroscience

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Reynolds, Charles F.; Lewis, David A.; Detre, Thomas; Schatzberg, Alan F.; Kupfer, David J.

2009-01-01

Psychiatry includes the assessment, treatment, and prevention of complex brain disorders, such as depression, bipolar disorder, anxiety disorders, schizophrenia, developmental disorders (e.g., autism), and neurodegenerative disorders (e.g., Alzheimer dementia). Its core mission is to prevent and alleviate the distress and impairment caused by these disorders, which account for a substantial part of the global burden of illness-related disability. Psychiatry is grounded in clinical neuroscience. Its core mission, now and in the future, is best served within this context because advances in assessment, treatment, and prevention of brain disorders are likely to originate from studies of etiology and pathophysiology based in clinical and translational neuroscience. To ensure its broad public health relevance in the future, psychiatry must also bridge science and service, ensuring that those who need the benefits of its science are also its beneficiaries. To do so effectively, psychiatry as clinical neuroscience must strengthen its partnerships with the disciplines of public health (including epidemiology), community and behavioral health science, and health economics. The authors present a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of psychiatry and identify strategies for strengthening its future and increasing its relevance to public health and the rest of medicine. These strategies encompass new approaches to strengthening the relationship between psychiatry and neurology, financing psychiatry’s mission, emphasizing early and sustained multidisciplinary training (research and clinical), bolstering the academic infrastructure, and reorganizing and refinancing mental health services both for preventive intervention and cost-effective chronic disease management. PMID:19318776

Voz e disfunção temporomandibular em professores Voice and temporomandibular joint disorders in teachers

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Ilza Maria Machado

2009-12-01

-reported speech pathological, medical and dental evaluation data. METHODS: 29 public school teachers from the city of Sorocaba - SP took part in this study. The teachers filled out a questionnaire about vocal disorders and on TMJD. The four following assessments were performed: auditory-perceptive, ENT medical assessment, oral-facial mobility, and a dental assessment. The mentioning about three or more symptoms in the questionnaire determined 'presence' of vocal and TMJD complaint. Both auditory-perceptive and ENT evaluations concluded whether there was 'presence' of voice and laryngeal disorders. TMJD was considered present when three or more signs or symptoms, necessarily including pain, were registered during oral-facial mobility and dental assessments. For statistical analysis of the data the following tests were applied: Two Proportions Equality Test, Fischer's Exact Test and Kappa Agreement Test. RESULTS: among the participating subjects, 82.8% reported having a vocal disorder, and 62.1% reported TMJD symptoms; 51.7% showed vocal disorders in ENT evaluation, and 65.5% had TMJD according to dental assessments. When comparing vocal and TMJ disorder assessments, a significant correlation was present for auditory-perceptual and oral-facial mobility for TMJD, with a tendency towards significance also when applying the questionnaire. CONCLUSION: the results point towards confirming the presence of TMJ and vocal disorders in the group of teachers in this research, as well as positive correlations between these two disorders.

Magnetic Resonance Imaging-Based Prediction of the Relationship between Whiplash Injury and Temporomandibular Disorders

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Yeon-Hee Lee

2018-01-01

Full Text Available PurposeWhiplash injury can cause internal derangement of the temporomandibular joint (TMJ and lead to temporomandibular disorders (TMDs. Our aim was to evaluate whether the initial clinical findings in TMD patients with whiplash injury are correlated with their magnetic resonance imaging (MRI characteristics.Materials and methodsThis case–control study involved 219 patients (135 women, 84 men; mean age: 37.84 years who visited our orofacial pain clinic with TMD; TMD was diagnosed using the diagnostic criteria for TMD Axis I. Patients were categorized into three groups based on the presence and type of macrotrauma: in the “wTMD” group, patients had suffered whiplash injury; patients in the “pTMD” group had post-traumatic TMD; the “iTMD” group comprised patients who had presented with TMD symptoms and had sustained no macrotrauma. We investigated the presence of disk displacement, effusion, disk deformity, and condylar degeneration, and changes in the lateral pterygoid muscle (LPM. To evaluate the severity of TMD pain and objectively analyze symptoms, we used a visual analog scale (VAS, palpation index (PI, neck PI, dysfunction index, and craniomandibular index (CMI.ResultsThe VAS scores, and the severity indexes of the TMD including PI, neck PI, and CMI were highest in the wTMD patients. Atrophy of the LPM was most commonly seen in the wTMD group, as was disk deformity. In wTMD patients only, VAS score was significantly correlated with stress; it was correlated with headache in wTMD and iTMD patients. The clinical symptoms of TMD were not correlated with MRI findings in the wTMD group. However, alterations in the LPM were strongly correlated with disk displacement.ConclusionIf clinicians recognize alterations in the LPM and disk displacement in the TMJ, they will better understand the clinical symptoms and pathophysiology of TMD with whiplash injury. Whiplash injury may lead to TMD via different mechanisms from other macrotraumas.

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

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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 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

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

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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.

Radiographic evaluation of cervical spine of subjects with temporomandibular joint internal disorder Avaliação radiográfica da coluna cervical de indivíduos com distúrbios internos da articulação temporomandibular

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Wagner Cesar Munhoz

2004-12-01

Full Text Available 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 submitted to clinical and radiographic evaluation. Clinical evaluation comprised anamnesis and stomatognathic system physical examination. Radiographic evaluation comprised analysis of lateral cervical spine X-rays by three physical therapists and tracing on the same im ages. The test group presented twice as much cervical spine hyperlordosis as the control group (20.7% versus 10.5%, but almost half of rectification prevalence (41.4 versus 79.0%, p = 0.03. After that, the test group was divided into three subgroups according to TMJ dysfunction severity, evaluated by Helkimo's index. These subgroups were not significantly different, but the subgroup with more severe TMD showed a tendency to cervical spine hyperlordosis prevalence. Results showed a tendency for subjects with more severe TMD to exhibit cervical spine hyperlordosis. Nevertheless, studies with a larger number of subjects suffering from severe TMD are encouraged in order to corroborate the present findings.Apesar de a etiofisiopatologia dos distúrbios internos (DI da articulação temporomandibular (ATM ser ainda desconhecida, sugere-se que as posturas de cabeça e corpo estariam associadas a seu desencadeamento, desenvolvimento e sua perpetuação. O objetivo deste estudo foi verificar a relação entre alterações radiográficas de coluna cervical e distúrbios internos da ATM. Este estudo avaliou 30 indivíduos com distúrbios da ATM (grupo teste e 20 saudáveis (grupo controle. Os indiv

Analyzing Menton Deviation in Posteroanterior Cephalogram in Early Detection of Temporomandibular Disorder

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Trelia Boel

2017-01-01

Full Text Available Introduction. Some clinicians believed that mandibular deviation leads to facial asymmetry and it also had a correlation with temporomandibular disorders (TMDs. Posteroanterior (PA cephalogram was widely reported as a regular record in treating facial asymmetry and craniofacial anomalies. The objective of this study was to analyze the relationship of menton deviation in PA cephalogram with temporomandibular disorders (TMDs symptoms. Materials and Methods. TMJ function was initially screened based on TMD-DI questionnaire. PA cephalogram of volunteer subjects with TMDs (n=37 and without TMDs (n=33 with mean age of 21.61±2.08 years was taken. The menton deviation was measured by the distance (mm from menton point to midsagittal reference (MSR horizontally, using software digitized measurement, and categorized as asymmetric if the value is greater than 3 mm. The prevalence and difference of menton deviation in both groups were evaluated by unpaired t-test. Result. The prevalence of symmetry group showed that 65.9% had no TMDs with mean of 1,815 ± 0,71 mm; in contrast, the prevalence of asymmetry group showed that 95.5% reported TMDs with mean of 3,159 ± 1,053 mm. There was a significant difference of menton deviation to TMDs (p=0.000 in subjects with and without TMDs. Conclusion. There was a significant relationship of menton deviation in PA cephalogram with TMDs based on TMD-DI index.

Surgical treatment of chronic mandibular dislocation--report of a case.

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Bakardjiev, Angel G; Atanasov, Dimitar T

2002-01-01

Chronic dislocation of the temporomandibular jaw (TMJ) can result from lax joint ligaments and parafunctioning joints; it can also be a consequence of a systemic connective tissue disorder. The authors report a case of hypermobile joint syndrome in combination with mitral valve prolapse. The case was managed by osteosynthesis using modified titanium plate.

Assessing behavioural and cognitive domains of autism spectrum disorders in rodents: current status and future perspectives.

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Kas, Martien J; Glennon, Jeffrey C; Buitelaar, Jan; Ey, Elodie; Biemans, Barbara; Crawley, Jacqueline; Ring, Robert H; Lajonchere, Clara; Esclassan, Frederic; Talpos, John; Noldus, Lucas P J J; Burbach, J Peter H; Steckler, Thomas

2014-03-01

The establishment of robust and replicable behavioural testing paradigms with translational value for psychiatric diseases is a major step forward in developing and testing etiology-directed treatment for these complex disorders. Based on the existing literature, we have generated an inventory of applied rodent behavioural testing paradigms relevant to autism spectrum disorders (ASD). This inventory focused on previously used paradigms that assess behavioural domains that are affected in ASD, such as social interaction, social communication, repetitive behaviours and behavioural inflexibility, cognition as well as anxiety behaviour. A wide range of behavioural testing paradigms for rodents were identified. However, the level of face and construct validity is highly variable. The predictive validity of these paradigms is unknown, as etiology-directed treatments for ASD are currently not on the market. To optimise these studies, future efforts should address aspects of reproducibility and take into account data about the neurodevelopmental underpinnings and trajectory of ASD. In addition, with the increasing knowledge of processes underlying ASD, such as sensory information processes and synaptic plasticity, phenotyping efforts should include multi-level automated analysis of, for example, representative task-related behavioural and electrophysiological read-outs.

TMJ

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... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

Post-traumatic stress disorder and opioid use disorder: A narrative review of conceptual models.

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Danovitch, Itai

2016-01-01

Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed.

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

International Nuclear Information System (INIS)

Lee, Sang Mi; Lee, Won Woo; Yun, PiI Young; Kim, Young Kyun; Kim, Sang Eun

2007-01-01

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 invovle ) were defined as; TMJ uptake ratio of involved/non-involved joint. Asymmetric indices for greater TMJ uptake regardless of disease involvement (AI 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 invovle (1.16±0.22 vs. 1.10±0.12) (p>0.05, t-test). However, AI 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

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

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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.

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

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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

Variations of the attachment of the superior head of human lateral pterygoid muscle.

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Antonopoulou, Maria; Iatrou, Ioannis; Paraschos, Alexandros; Anagnostopoulou, Sophia

2013-09-01

The superior head of the lateral pterygoid muscle (LPM), is closely related to the temporomandibular joint (TMJ) and plays a role in the aetiology of temporomandibular disorders. Increased activity of this muscle has been implicated in the anterior displacement of the TMJ disc. However, there is uncertainty about the manner of the LPM attachment to the disc-condyle complex. The aim of this study was to investigate the exact anatomy of the attachment of the superior head of the LPM (SLPM) to the disc-condyle complex of the TMJ. Thirty-six TMJs were examined - both sides of 18 Greek cadavers (eight males and 10 females, mean age 79.6 years). Examination of the attachment of the SLPM was undertaken viewed under the dissecting microscope. Variation in the attachment of the SLPM was categorized into three types: in type I, the SLPM inserted into the condyle and the disc-capsule complex (55.5%). In type II, the SLPM only inserted into the condyle (27.8%). In type III, the SLPM inserted purely into the disc-capsule complex (16.7%). This study demonstrates that there are three different attachment types of the SLPM to the disc-condyle complex. The type III variation could be involved in the TMJ pathology. The knowledge of the variations of the SLPM attachment could be useful for precise surgical and pharmaceutical approaches. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Generalized Anxiety Disorder and Social Anxiety Disorder, but Not Panic Anxiety Disorder, Are Associated with Higher Sensitivity to Learning from Negative Feedback: Behavioral and Computational Investigation

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Khdour, Hussain Y.; Abushalbaq, Oday M.; Mughrabi, Ibrahim T.; Imam, Aya F.; Gluck, Mark A.; Herzallah, Mohammad M.; Moustafa, Ahmed A.

2016-01-01

Anxiety disorders, including generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic anxiety disorder (PAD), are a group of common psychiatric conditions. They are characterized by excessive worrying, uneasiness, and fear of future events, such that they affect social and occupational functioning. Anxiety disorders can alter behavior and cognition as well, yet little is known about the particular domains they affect. In this study, we tested the cognitive correlates of me...

Future Directions in Parent Education Research.

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Aaronson, May

This paper suggests goals for future research programs in parent education. Suggestions include: (1) developing and replicating long-term studies of the effects of parent education, (2) examining the antecedents of adult behavior disorders to plan parenting programs that aim at preventing such disorders, (3) replacing deficit models of parenting…

[Analysis of factors related to the number of mesenchymal stem cells derived from synovial fluid of the temporomandibular joint].

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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.

Activation of voltage-gated KCNQ/Kv7 channels by anticonvulsant retigabine attenuates mechanical allodynia of inflammatory temporomandibular joint in rats

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Xu Wen

2010-08-01

Full Text Available Abstract Background Temporomandibular disorders (TMDs are characterized by persistent orofacial pain and have diverse etiologic factors that are not well understood. It is thought that central sensitization leads to neuronal hyperexcitability and contributes to hyperalgesia and spontaneous pain. Nonsteroidal anti-inflammatory drugs (NSAIDs are currently the first choice of drug to relieve TMD pain. NSAIDS were shown to exhibit anticonvulsant properties and suppress cortical neuron activities by enhancing neuronal voltage-gated potassium KCNQ/Kv7 channels (M-current, suggesting that specific activation of M-current might be beneficial for TMD pain. Results In this study, we selected a new anticonvulsant drug retigabine that specifically activates M-current, and investigated the effect of retigabine on inflammation of the temporomandibular joint (TMJ induced by complete Freund's adjuvant (CFA in rats. The results show that the head withdrawal threshold for escape from mechanical stimulation applied to facial skin over the TMJ in inflamed rats was significantly lower than that in control rats. Administration of centrally acting M-channel opener retigabine (2.5 and 7.5 mg/kg can dose-dependently raise the head withdrawal threshold of mechanical allodynia, and this analgesic effect can be reversed by the specific KCNQ channel blocker XE991 (3 mg/kg. Food intake is known to be negatively associated with TMJ inflammation. Food intake was increased significantly by the administration of retigabine (2.5 and 7.5 mg/kg, and this effect was reversed by XE991 (3 mg/kg. Furthermore, intracerebralventricular injection of retigabine further confirmed the analgesic effect of central retigabine on inflammatory TMJ. Conclusions Our findings indicate that central sensitization is involved in inflammatory TMJ pain and pharmacological intervention for controlling central hyperexcitability by activation of neuronal KCNQ/M-channels may have therapeutic potential for

Difference or disorder? Cultural issues in understanding neurodevelopmental disorders.

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Norbury, Courtenay Frazier; Sparks, Alison

2013-01-01

Developmental disorders, such as autism spectrum disorder and specific language impairment, are biologically based disorders that currently rely on behaviorally defined criteria for diagnosis and treatment. Specific behaviors that are included in diagnostic frameworks and the point at which individual differences in behavior constitute abnormality are largely arbitrary decisions. Such decisions are therefore likely to be strongly influenced by cultural values and expectations. This is evident in the dramatically different prevalence rates of autism spectrum disorder across countries and across different ethnic groups within the same country. In this article, we critically evaluate the understanding of developmental disorders from a cultural perspective. We specifically consider the challenges of applying diagnostic methods across cultural contexts, the influence of cultural values and expectations on the identification and treatment of children with suspected disorders, and how cross-cultural studies can help to refine cognitive theories of disorder that have been derived exclusively from Western North American and European investigations. Our review synthesizes clinical, cultural, and theoretical work in this area, highlighting potential universals of disorder and concluding with recommendations for future research and practice.

Predicting Future Antisocial Personality Disorder in Males from a Clinical Assessment in Childhood

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Lahey, Benjamin B.; Loeber, Rolf; Burke, Jeffrey D.; Applegate, Brooks

2005-01-01

It is essential to identify childhood predictors of adult antisocial personality disorder (APD) to target early prevention. It has variously been hypothesized that APD is predicted by childhood conduct disorder (CD), attention-deficit/hyperactivity disorder (ADHD), or both disorders. To test these competing hypotheses, the authors used data from a…

Enhancing self-efficacy improves episodic future thinking and social-decision making in combat veterans with posttraumatic stress disorder.

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Brown, Adam D; Kouri, Nicole A; Rahman, Nadia; Joscelyne, Amy; Bryant, Richard A; Marmar, Charles R

2016-08-30

Posttraumatic Stress Disorder (PTSD) is associated with maladaptive changes in self-identity, including impoverished perceived self-efficacy. This study examined if enhancing perceptions of self-efficacy in combat veterans with and without symptoms of PTSD promotes cognitive strategies associated with positive mental health outcomes. Prior to completing a future thinking and social problem-solving task, sixty-two OEF/OIF veterans with and without symptoms of PTSD were randomized to either a high self-efficacy (HSE) induction in which they were asked to recall three autobiographical memories demonstrating self-efficacy or a control condition in which they recalled any three autobiographical events. An interaction between HSE and PTSD revealed that individuals with symptoms of PTSD in the HSE condition generated future events with more self-efficacious statements than those with PTSD in the control condition, whereas those without PTSD did not differ in self-efficacy content across the conditions. In addition, individuals in the HSE condition exhibited better social problem solving than those in the control condition. Increasing perceptions of self-efficacy may promote future thinking and problem solving in ways that are relevant to overcoming trauma and adversity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Eating Disorders in Adolescents

Directory of Open Access Journals (Sweden)

Beena Johnson

2015-10-01

Full Text Available According to International Classification of Diseases by World Health Organization, eating disorders are behavioural syndromes associated with physiological disturbances [1]. Eating disorders include anorexia nervosa, atypical anorexia nervosa, bulimia nervosa, atypical bulimia nervosa, overeating associated with other psychological disturbances and vomiting associated with other psychological disturbances [1]. Maladaptive eating pattern and inadequate physical activity are seen in adolescents with eating disorders and obesity [2]. Those with comorbid eating disorder and obesity have a poorer prognosis and are at higher risk for future medical problems.

The cerebellum and psychiatric disorders

Directory of Open Access Journals (Sweden)

Joseph ePhillips

2015-05-01

Full Text Available The cerebellum has been considered for a long time to play a role solely in motor coordination. However, studies over the past two decades have shown that the cerebellum also plays a key role in many motor, cognitive, and emotional processes. In addition, studies have also shown that the cerebellum is implicated in many psychiatric disorders including attention deficit hyperactivity disorder, autism spectrum disorders, schizophrenia, bipolar disorder, major depressive disorder and anxiety disorders. In this review, we discuss existing studies reporting cerebellar dysfunction in various psychiatric disorders. We will also discuss future directions for studies linking the cerebellum to psychiatric disorders.

Is Clinical Assessment of Addiction Severity of Individuals with Substance Use Disorder, Using the Addiction Severity Index, A Predictor of Future Inpatient Mental Health Hospitalization? A Nine-Year Registry Study.

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Padyab, Mojgan; Armelius, Bengt-Åke; Armelius, Kerstin; Nyström, Siv; Blom, Björn; Grönlund, Ann-Sofie; Lundgren, Lena

2018-04-23

In Sweden, the Addiction Severity Index (ASI) is the Swedish National Board of Health and Welfare's recommended substance use disorder assessment tool and used routinely for patient intakes. Our study of 213 individuals assessed for substance use disorder with the ASI used nine years of the National Patient Register and examined whether clinical social workers' assessments of addiction severity at baseline were associated with later hospitalizations for mental health disorder (MHD). ASI composite scores and interviewer severity rating were used to measure clients' problems in seven areas (mental health, family and social relationships, employment, alcohol, drug use, health, and legal) at baseline. A stepwise regression method was used to assess the relative importance of ASI composite scores, MHD hospitalization two years prior to baseline, age, and gender for MHD hospitalization seven years post-baseline. Almost two-thirds of the individuals (63%) were hospitalized at least once for MHD in the seven years post-baseline. At the multivariable level, MHD hospitalization prior to baseline was the strongest predictor of future MHD hospitalization, followed by ASI composite scores for drug use, employment, mental health and, last, male gender. A key finding is that higher ASI composite scores for drug use and mental health are predictors of future need for MHD treatment. Future studies will replicate this effort with a national population of individuals with substance use disorder.

Normal personality, personality disorder and psychosis: current views and future perspectives.

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Balaratnasingam, Sivasankaran; Janca, Aleksandar

2015-01-01

The purpose of this article is to review recent literature examining the occurrence of psychotic experiences in normal population and those with personality disorders. Up to 15% of individuals in the general population report some type or degree of psychotic experience. Most of these individuals function adequately, do not require psychiatric treatment and do not receive diagnosis of a psychotic illness. A significant number of individuals diagnosed with borderline personality disorder (25-50%) also report psychotic symptoms. These are not easily differentiated from the psychotic symptoms reported by individuals with schizophrenia, nor are they always transient. However, emerging research has confirmed that individuals with schizotypal personality disorder are dimensionally related to those with schizophrenia and are at an increased risk of transition to psychosis. Psychotic symptoms are best considered as 'trans-diagnostic' entities on a continuum from normal to pathological. There is a large body of evidence for a dimensional relationship between schizotypal personality disorder and schizophrenia. There is also a significant amount of research showing that psychotic symptoms in borderline personality disorder are frequent, nontransient and represent a marker of illness severity. This review highlights the need to move beyond traditional assumptions and categorical boundaries when evaluating psychotic experiences and psychopathological phenomena.

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.

Touching the Future Technology for Autism

DEFF Research Database (Denmark)

Mintz, Joseph; Gyori, Miklos; Aagaard, Morten

2012-01-01

apps designed to develop social and daily life skills in young people with autism spectrum disorders (ASD), should be developed and implemented in the future. We also set out a roadmap for a future research agenda, indicating further promising lines of enquiry that could potentially lead...

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

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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 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 < 0.05). As a result of the present study, for patients with internal derangement of the TMJ an additional examination of the craniocervical system should be recommended.

A comparative study of three-dimensional reconstructive images of temporomandibular joint using computed tomogram

International Nuclear Information System (INIS)

Lim, Suk Young; Koh, Kwang Joon

1993-01-01

The purpose of this study was to clarify the spatial relationship of temporomandibular joint and to an aid in the diagnosis of temporomandibular disorder. For this study, three-dimensional images of normal temporomandibular joint were reconstructed by computer image analysis system and three-dimensional reconstructive program integrated in computed tomography. The obtained results were as follows : 1. Two-dimensional computed tomograms had the better resolution than three dimensional computed tomograms in the evaluation of bone structure and the disk of TMJ. 2. Direct sagittal computed tomograms and coronal computed tomograms had the better resolution in the evaluation of the disk of TMJ. 3. The positional relationship of the disk could be visualized, but the configuration of the disk could not be clearly visualized on three-dimensional reconstructive CT images. 4. Three-dimensional reconstructive CT images had the smoother margin than three-dimensional images reconstructed by computer image analysis system, but the images of the latter had the better perspective. 5. Three-dimensional reconstructive images had the better spatial relationship of the TMJ articulation, and the joint space were more clearly visualized on dissection images.

Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

Science.gov (United States)

Costa, Yuri-Martins; Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

2016-01-01

The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (pbruxism.

Caffeine Use Disorder: A Review of the Evidence and Future Implications.

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Addicott, Merideth A

2014-09-01

The latest edition of the Diagnostic and Statistical Manual (DSM-5) has introduced new provisions for caffeine-related disorders. Caffeine Withdrawal is now an officially recognized diagnosis, and criteria for caffeine use disorder have been proposed for additional study. caffeine use disorder is intended to be characterized by cognitive, behavioral, and physiological symptoms indicative of caffeine use despite significant caffeine-related problems, similar to other Substance Use Disorders. However, since nonproblematic caffeine use is so common and widespread, it may be difficult for some health professionals to accept that caffeine use can result in the same types of pathological behaviors caused by alcohol, cocaine, opiates, or other drugs of abuse. Yet there is evidence that some individuals are psychologically and physiologically dependent on caffeine, although the prevalence and severity of these problems is unknown. This article reviews the recent changes to the DSM, the concerns regarding these changes, and some potential impacts these changes could have on caffeine consumers.

Treatment of Cannabis Use Disorder: Current Science and Future Outlook

Science.gov (United States)

Sherman, Brian J.; McRae-Clark, Aimee L.

2016-01-01

Cannabis is the most commonly used illicit substance in the United States. Rates of cannabis use and cannabis use disorder have increased in the past decade, paralleling changes in the legal and political climate favoring legalization. Almost 20 million people aged 12 years or older report past-month cannabis use, and 8 million report daily or near-daily use. Concurrently, the perception that cannabis use poses a significant risk of negative consequences has decreased. Contrary to this perception, heavy cannabis use is associated with cognitive impairment, increased risk for psychotic disorders and other mental health problems, lower education attainment, and unemployment. Clinical trials of various treatments for cannabis use disorder have likewise increased, focusing primarily on psychotherapy treatments, specifically, motivational enhancement therapy, cognitive behavioral therapy, and contingency management. Their findings suggest that a combination of these three modalities produces the best abstinence outcomes, although abstinence rates remain modest and decline after treatment. More recently, pharmacotherapy trials have been conducted as adjunctive interventions to psychosocial treatment. N-acetylcysteine and gabapentin are two of the most promising medications, although no pharmacologic treatment has emerged as clearly efficacious. In this review, we provide a detailed summary of clinical trials that evaluated psychotherapy and pharmacotherapy for treating cannabis use disorder and discuss emerging areas of clinical research and cannabis-specific barriers to treatment. PMID:27027272

N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects.

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Minarini, Alessandro; Ferrari, Silvia; Galletti, Martina; Giambalvo, Nina; Perrone, Daniela; Rioli, Giulia; Galeazzi, Gian Maria

2017-03-01

N-acetylcysteine (NAC) is widely known for its role as a mucolytic and as an antidote to paracetamol overdose. There is increasing interest in the use of NAC in the treatment of several psychiatric disorders. The rationale for the administration of NAC in psychiatric conditions is based on its role as a precursor to the antioxidant glutathione, and its action as a modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways. Areas covered: This study reviews the available data regarding the use of NAC in different psychiatric disorders including substance use disorders, autism, obsessive-compulsive spectrum disorders, schizophrenia, depression, bipolar disorder. Promising results were found in trials testing the use of NAC, mainly as an add-on treatment, in cannabis use disorder in young people, depression in bipolar disorder, negative symptoms in schizophrenia, and excoriation (skin-picking) disorder. Despite initial optimism, recent findings regarding NAC efficacy in autism have been disappointing. Expert opinion: These preliminary positive results require further confirmation in larger samples and with longer follow-ups. Given its high tolerability and wide availability, NAC represents an important target to investigate in the field of new adjunctive treatments for psychiatric conditions.

Synovial chondromatosis and osteochondroma in TMJ with CBCT images

Energy Technology Data Exchange (ETDEWEB)

Seo, Yo Seob; Lee, Gun Sun; Kim, Jin Soo; Kim, Jae Duk [Department of Oral and Maxilloficial Radiology, School of Dentistry, Oral Biology Research Institute, Chosun University, Gwangju (Korea, Republic of)

2010-03-15

Synovial chondromatosis is an uncommon disorder characterized by metaplastic formation of multiple cartilaginous and osteocartilaginous nodules within connective tissue of the synovial membrane of joints. Osteochondroma is a benign lesion of osseous and cartilagenous origin. It is frequently found in the general skeleton, but is rare in the mandibular condyle. We experienced 2 patients with abnormal appearance of temporomandibular joint. Histologic diagnoses were not obtained, because surgery was unwarranted in view of the lack of symptoms and the benign differential diagnosis. We describes 2 cases that show the characteristics of both disease simultaneously.

The Relationship between Osseous Changes of the Temporomandibular Joint and RDC/TMD Groups in CBCT Images

Directory of Open Access Journals (Sweden)

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

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

Science.gov (United States)

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

2014-06-01

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

Cervical flexion-rotation test and physiological range of motion - A comparative study of patients with myogenic temporomandibular disorder versus healthy subjects.

Science.gov (United States)

Greenbaum, Tzvika; Dvir, Zeevi; Reiter, Shoshana; Winocur, Ephraim

2017-02-01

Temporomandibular Disorders (TMD) refer to several common clinical disorders which involve the masticatory muscles, the temporomandibular joint (TMJ) and the adjacent structures. Although neck signs and symptoms are found with higher prevalence in TMD patients compared to the overall population, whether limitation of cervical mobility is an additional positive finding in this cohort is still an open question. To compare the physiological cervical range of motion (CROM) and the extent of rotation during cervical flexion (flexion-rotation test, FRT) in people with TMD (muscular origin) and healthy control subjects. The range of motion of the neck and FRT was measured in 20 women with myogenic TMD and 20 age matched healthy controls. Women with myogenic TMD had significantly lower FRT scores compared to their matched healthy women. No difference was found between groups in CROM in any of the planes of movement. The FRT was positive (less than 32°) in 90% of the TMD participants versus 5% in the healthy control but the findings were not correlated with TMD severity. The results point out a potential involvement of the upper cervical joints (c1-c2) in women with myogenic TMD. Copyright © 2016 Elsevier Ltd. All rights reserved.

A tomographic study of the condyle position in temporomandibular disorders

International Nuclear Information System (INIS)

Choi, Sung Youn; Ryu, Young Kyu

1988-01-01

The aim of this study was to determine whether T.M.J. tomographic examination yielded significant difference in condyle positions among asymptomatic, myalgia, derangement, and arthrosis group of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows: 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substance range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P< .05). Also that of left central section existed between derangement and myalgia group, and that of left medial section existed between derangement and myalgia groups (P< . 05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement and group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main symptom side, and only between derangement and myalgia groups in central section of contra-lateral sides (P< .05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia group (P< .05

A tomographic study of the condyle position in temporomandibular disorders

Energy Technology Data Exchange (ETDEWEB)

Choi, Sung Youn; Ryu, Young Kyu [Dept. of Oral Radiology, College of Dentistry, Yonsei University, Seoul (Korea, Republic of)

1988-11-15

The aim of this study was to determine whether T.M.J. tomographic examination yielded significant difference in condyle positions among asymptomatic, myalgia, derangement, and arthrosis group of T.M.J. disorders. The author obtained sagittal linear tomograms of right and left T.M.Js. of 36 asymptomatic, 22 myalgia, 54 derangement, and 31 arthrosis patients taken at serial lateral, central, and medial sections in the intercuspal position after submentovertex radiographs analyzed. With the dual linear measurements of the posterior and anterior interarticular space, condyle positions were mathematically expressed as proportion. All data from these analysis was recorded and processed statistically. The results were obtained as follows: 1. In asymptomatic group, radiographically concentric condyle position was found in 50.0% to 65.4% of subjects, with a substance range of variability. No significant differences existed between men and women and also between right and left T.M.Js. for condyle position. 2. In women, significant difference for mean condyle position of left lateral section of each diagnostic category existed between derangement and myalgia groups (P< .05). Also that of left central section existed between derangement and myalgia group, and that of left medial section existed between derangement and myalgia groups (P< . 05). 3. In main-symptom side, condyle position in myalgia group was more concentric, and condyle position in derangement and group was more posterior. This showed significant differences between derangement and myalgia groups in lateral, central, and medial sections of main symptom side, and only between derangement and myalgia groups in central section of contra-lateral sides (P< .05). Condyle position in arthrosis group was broadly distributed among all positions. 4. In contra-lateral side, significant difference for mean condyle position of central section of each symptomatic group existed between derangement and myalgia group (P< .05

Oro-facial pain and temporomandibular disorders classification systems: A critical appraisal and future directions.

Science.gov (United States)

Klasser, G D; Manfredini, D; Goulet, J-P; De Laat, A

2018-03-01

It is a difficult undertaking to design a classification system for any disease entity, let alone for oro-facial pain (OFP) and more specifically for temporomandibular disorders (TMD). A further complication of this task is that both physical and psychosocial variables must be included. To augment this process, a two-step systematic review, adhering to PRISMA guidelines, of the classification systems published during the last 20 years for OFP and TMD was performed. The first search step identified 190 potential citations which ultimately resulted in only 17 articles being included for in-depth analysis and review. The second step resulted in only 5 articles being selected for inclusion in this review. Five additional articles and four classification guidelines/criteria were also included due to expansion of the search criteria. Thus, in total, 14 documents comprising articles and guidelines/criteria (8 proposals of classification systems for OFP; 6 for TMD) were selected for inclusion in the systematic review. For each, a discussion as to their advantages, strengths and limitations was provided. Suggestions regarding the future direction for improving the classification process with the use of ontological principles rather than taxonomy are discussed. Furthermore, the potential for expanding the scope of axes included in existing classification systems, to include genetic, epigenetic and neurobiological variables, is explored. It is therefore recommended that future classification system proposals be based on combined approaches aiming to provide archetypal treatment-oriented classifications. © 2017 John Wiley & Sons Ltd.

Temporomandibular joint dislocation in an epileptic and mentally ...

African Journals Online (AJOL)

Theories regarding the pathogenesis of TMJ dislocation propose laxity of TMJ ligaments or capsule, excessive activity of the lateral pterygoid muscle (LPM)and erosion of the eminence'. TMJ dislocation can occur in an anterior, posterior, lateral and superior direction'. Clinical presentation of dislocated TMJ includes inability ...

An electrochemical investigation of TMJ implant metal alloys in an artificial joint fluid environment: the influence of pH variation.

Science.gov (United States)

Royhman, Dmitry; Radhakrishnan, Rashmi; Yuan, Judy Chia-Chun; Mathew, Mathew T; Mercuri, Louis G; Sukotjo, Cortino

2014-10-01

To investigate the corrosion behaviour of commonly used TMJ implants alloys (CoCrMo and Ti6Al4V) under simulated physiological conditions. Corrosion behaviour was evaluated using standard electrochemical corrosion techniques and galvanic corrosion techniques as per ASTM standards. Standard electrochemical tests (E(corr), I(corr), R(p) and C(f)) were conducted in bovine calf serum (BCS), as a function of alloys type and different pHs. Galvanic corrosion tests were conducted in BCS at a pH of 7.6. Alloy surfaces were characterized using white-light interferometry (WLI) and scanning electron microscopy (SEM). The potentiodynamic test results exhibited the enhanced passive layer growth and a better corrosion resistance of Ti6Al4V compared to CoCrMo. Electrochemical impedance spectroscopy measurements demonstrated the influence of protein as a function of pH on corrosion mechanisms/kinetics. Galvanic coupling was not a major contributor to corrosion. SEM and WLI images demonstrated a significantly higher in surface roughness in CoCrMo after corrosion. The results of this study suggest that Ti6Al4V shows superior corrosion behaviour to CoCrMo due to its strong passive layer, simulated joint fluid components can affect the electrochemical nature of the metal/electrolyte interface as a function of pH, and the galvanic effect of coupling CoCrMo and Ti6Al4V in a single joint is weak. Published by Elsevier Ltd.

Neuroimaging of neurotic disorders

International Nuclear Information System (INIS)

Okubo, Yoshiro; Yahata, Noriaki

2006-01-01

Neuroimaging has been involved in recent biological approaches with evidence for neurotic disorders in place of diagnostic criteria on Freud theory hitherto. This review describes the present states of brain imaging in those disorders. Emotion has such three bases for environmental stimuli as recognition/evaluation of causable factors, manifestation, and its control, each of which occurs in various different regions connected by neuro-net work in the brain. The disorders are regarded as abnormality of the circuit that can be imaged. Documented and discussed are the actual regions imaged by MRI and PET in panic disorder, social phobia, phobias to specified things, posttraumatic stress disorder and obsessive-compulsive disorder. The approach is thought important for elucidating not only the pathogenesis of the disorders but also the human emotional functions and mechanism of the mind, which may lead to a better treatment of the disorders in future. (T.I)

Effect of intracapsular steroid injection in combination with arthrocentesis followed by mouth opening exercises and nonsteroidal anti-inflammatory drug treatment for closed lock

International Nuclear Information System (INIS)

Wakita, Takeshi; Kurita, Kenichi; Nakatsuka, Kensuke

2010-01-01

Recent biochemical studies of synovial fluids indicate that temporomandibular joint (TMJ) symptoms are caused by intra-articular inflammation. There are various ways to manage such disorders. Arthrocentesis is one effective treatment for closed lock. The aim of this study was to evaluate the efficacy of arthrocentesis (steroid injection) followed by mouth opening exercises during non-steroidal anti-inflammatory drug (NSAID) therapy as a primary treatment for closed lock. The ultimate goal was to increase the improvement rate and the number of patients with no TMJ dysfunction. Subjects were selected from a series of patients with newly diagnosed closed lock who presented at Aichi-Gakuin University Hospital between January 2003 and December 2004. Sixty-two patients were confirmed to have closed lock with MRI. The patients underwent two consecutive sessions of arthrocentesis at a 2 week interval and were followed up every 2 weeks for 12 weeks. NSAID administration and mouth opening exercises were performed daily until the patient's symptoms improved. The improvement rate was calculated as the percentage of improved cases among the total number of cases in each group. The improvement rates were 27%, 43%, 56%, 62%, 65%, and 71% after 2, 4, 6, 8, 10, and 12 weeks, respectively. Improvement to a TMJ classification of no dysfunction was achieved in 11% of the patients. This combination therapy (steroid injection) is an effective primary treatment because the improvement rate was as higher as 71%, and 11% of all patients had improved to a TMJ classification of no dysfunction. (author)

Bipolar disorder in the postpartum period: management strategies and future directions.

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Pope, Carley J; Sharma, Verinder; Mazmanian, Dwight

2014-07-01

Bipolar I and II disorder are chronic and severe psychiatric illnesses that affect many women. Furthermore, women are at increased risk for mood episodes during the postpartum period compared with non-postpartum periods. Unfortunately, identification of clinically significant depressive or (hypo)manic episodes can be challenging. Delays in detection, as well as misdiagnosis, put women at risk of many negative consequences, such as symptom exacerbation and treatment refractoriness. Early and accurate detection of bipolar I or II disorder in the postpartum period is critical to improve prognosis. At this time, limited recommendations can be made due to a paucity of research. Further research on postpartum bipolar I or II disorder focusing on its identification, consequences and treatment is urgently needed to allow for empirically informed clinical decision-making.

Annual Research Review: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision making in attention-deficit/hyperactivity disorder, conduct disorder, depression, and anxiety.

Science.gov (United States)

Sonuga-Barke, Edmund J S; Cortese, Samuele; Fairchild, Graeme; Stringaris, Argyris

2016-03-01

Ineffective decision making is a major source of everyday functional impairment and reduced quality of life for young people with mental disorders. However, very little is known about what distinguishes decision making by individuals with different disorders or the neuropsychological processes or brain systems underlying these. This is the focus of the current review. We first propose a neuroeconomic model of the decision-making process with separate stages for the prechoice evaluation of expected utility of future options; choice execution and postchoice management; the appraisal of outcome against expectation; and the updating of value estimates to guide future decisions. According to the proposed model, decision making is mediated by neuropsychological processes operating within three domains: (a) self-referential processes involved in autobiographical reflection on past, and prospection about future, experiences; (b) executive functions, such as working memory, inhibition, and planning, that regulate the implementation of decisions; and (c) processes involved in value estimation and outcome appraisal and learning. These processes are underpinned by the interplay of multiple brain networks, especially medial and lateralized cortical components of the default mode network, dorsal corticostriatal circuits underpinning higher order cognitive and behavioral control, and ventral frontostriatal circuits, connecting to brain regions implicated in emotion processing, that control valuation and learning processes. Based on clinical insights and considering each of the decision-making stages in turn, we outline disorder-specific hypotheses about impaired decision making in four childhood disorders: attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), depression, and anxiety. We hypothesize that decision making in ADHD is deficient (i.e. inefficient, insufficiently reflective, and inconsistent) and impulsive (biased toward immediate over delayed

Cognitive behavioural therapy in pain and psychological disorders: Towards a hybrid future.

Science.gov (United States)

Tang, Nicole K Y

2017-03-08

Cognitive Behavioural Therapy (CBT) is a form of evidence-based talking therapy that emphasises the importance of behaviour and conscious thoughts in shaping our emotional experiences. As pain becomes increasingly accepted as not only a sensory but also an emotional experience, success in using CBT to treat emotional disorders has resulted in the incorporation of cognitive-behavioural principles into the management of chronic pain. Outcomes of CBT-informed interdisciplinary pain management programmes are modest at best, despite rapid methodological improvements in trial design and implementation. Whilst the field searches for new treatment directions, a hybrid CBT approach that seeks to simultaneously tackle pain and its comorbidities shows promise in optimising treatment effectiveness and flexibility. This article provides a brief description of the core characteristics of CBT and the transformation this therapeutic model has brought to our understanding and management of chronic pain. Current evidence on efficacy of CBT for chronic pain is then reviewed, followed by a critical consideration of the advantages and disadvantages of the new hybrid treatment approach that conceptualises and treats chronic pain in connection with its comorbidities. Recent progress made in the area of pain and insomnia is highlighted as an example to project therapeutic innovations in the near future. Copyright © 2017 Elsevier Inc. All rights reserved.

Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders.

Science.gov (United States)

Yoo, Ji Youn; Kim, Sung Soo

2016-03-18

Metabolic disorders, including type 2 diabetes (T2DM) and cardiovascular disease (CVD), present an increasing public health concern and can significantly undermine an individual's quality of life. The relative risk of CVD, the primary cause of death in T2DM patients, is two to four times higher in people with T2DM compared with those who are non-diabetic. The prevalence of metabolic disorders has been associated with dynamic changes in dietary macronutrient intake and lifestyle changes over recent decades. Recently, the scientific community has considered alteration in gut microbiota composition to constitute one of the most probable factors in the development of metabolic disorders. The altered gut microbiota composition is strongly conducive to increased adiposity, β-cell dysfunction, metabolic endotoxemia, systemic inflammation, and oxidative stress. Probiotics and prebiotics can ameliorate T2DM and CVD through improvement of gut microbiota, which in turn leads to insulin-signaling stimulation and cholesterol-lowering effects. We analyze the currently available data to ascertain further potential benefits and limitations of probiotics and prebiotics in the treatment of metabolic disorders, including T2DM, CVD, and other disease (obesity). The current paper explores the relevant contemporary scientific literature to assist in the derivation of a general perspective of this broad area.

Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders

Directory of Open Access Journals (Sweden)

Ji Youn Yoo

2016-03-01

Full Text Available Metabolic disorders, including type 2 diabetes (T2DM and cardiovascular disease (CVD, present an increasing public health concern and can significantly undermine an individual’s quality of life. The relative risk of CVD, the primary cause of death in T2DM patients, is two to four times higher in people with T2DM compared with those who are non-diabetic. The prevalence of metabolic disorders has been associated with dynamic changes in dietary macronutrient intake and lifestyle changes over recent decades. Recently, the scientific community has considered alteration in gut microbiota composition to constitute one of the most probable factors in the development of metabolic disorders. The altered gut microbiota composition is strongly conducive to increased adiposity, β-cell dysfunction, metabolic endotoxemia, systemic inflammation, and oxidative stress. Probiotics and prebiotics can ameliorate T2DM and CVD through improvement of gut microbiota, which in turn leads to insulin-signaling stimulation and cholesterol-lowering effects. We analyze the currently available data to ascertain further potential benefits and limitations of probiotics and prebiotics in the treatment of metabolic disorders, including T2DM, CVD, and other disease (obesity. The current paper explores the relevant contemporary scientific literature to assist in the derivation of a general perspective of this broad area.

Probiotics and Prebiotics: Present Status and Future Perspectives on Metabolic Disorders

Science.gov (United States)

Yoo, Ji Youn; Kim, Sung Soo

2016-01-01

Metabolic disorders, including type 2 diabetes (T2DM) and cardiovascular disease (CVD), present an increasing public health concern and can significantly undermine an individual’s quality of life. The relative risk of CVD, the primary cause of death in T2DM patients, is two to four times higher in people with T2DM compared with those who are non-diabetic. The prevalence of metabolic disorders has been associated with dynamic changes in dietary macronutrient intake and lifestyle changes over recent decades. Recently, the scientific community has considered alteration in gut microbiota composition to constitute one of the most probable factors in the development of metabolic disorders. The altered gut microbiota composition is strongly conducive to increased adiposity, β-cell dysfunction, metabolic endotoxemia, systemic inflammation, and oxidative stress. Probiotics and prebiotics can ameliorate T2DM and CVD through improvement of gut microbiota, which in turn leads to insulin-signaling stimulation and cholesterol-lowering effects. We analyze the currently available data to ascertain further potential benefits and limitations of probiotics and prebiotics in the treatment of metabolic disorders, including T2DM, CVD, and other disease (obesity). The current paper explores the relevant contemporary scientific literature to assist in the derivation of a general perspective of this broad area. PMID:26999199

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

Alternative dimensional models of personality disorder

DEFF Research Database (Denmark)

Widiger, Thomas A; Simonsen, Erik

2005-01-01

The recognition of the many limitations of the categorical model of personality disorder classification has led to the development of quite a number of alternative proposals for a dimensional classification. The purpose of this article is to suggest that future research work toward the integration...... of these alternative proposals within a common hierarchical structure. An illustration of a potential integration is provided using the constructs assessed within existing dimensional models. Suggestions for future research that will help lead toward a common, integrative dimensional model of personality disorder...

Stigmatizing attitudes differ across mental health disorders: a comparison of stigma across eating disorders, obesity, and major depressive disorder.

Science.gov (United States)

Ebneter, Daria S; Latner, Janet D

2013-04-01

The aim of the current article was to compare stigmatizing attitudes toward eating disorders (EDs), including anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED), with stigma toward another weight-related condition (obesity) and a non-weight-related mental disorder (major depressive disorder [MDD]). Participants (N = 447) read five vignettes describing a woman with AN, BN, BED, obesity, or MDD and responded to questionnaires examining stigmatizing attitudes. The targets with EDs were blamed more for their condition than the targets with MDD, whereas persons with obesity were held more responsible for their condition than any other target. On the other hand, the target with MDD was perceived as more impaired than any other target. Lack of self-discipline was attributed more to the development of BED and obesity than to any other condition. Stigmatizing attitudes vary across mental health disorders, and future research should aim to specifically target stigmatizing beliefs to reduce and prevent discrimination toward mental health disorders and obesity.

A review of attention-deficit/hyperactivity disorder complicated by symptoms of oppositional defiant disorder or conduct disorder.

Science.gov (United States)

Connor, Daniel F; Steeber, Jennifer; McBurnett, Keith

2010-06-01

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent disorder with significant functional impairment. ADHD is frequently complicated by oppositional symptoms, which are difficult to separate from comorbidity with oppositional defiant disorder, conduct disorder, and aggressive symptoms. This review addresses the impact of oppositional symptoms on ADHD, disease course, functional impairment, clinical management, and treatment response. Oppositional defiant disorder or conduct disorder may be comorbid in more than half of ADHD cases and are more common with the combined than with the inattentive ADHD subtype. Comorbid symptoms of oppositional defiant disorder and conduct disorder in patients with ADHD can have a significant impact on the course and prognosis for these patients and may lead to differential treatment response to both behavioral and pharmacologic treatments. Assessment of oppositional symptoms is an essential part of ADHD screening and diagnosis and should include parental, as well as educator, input. Although clinical evidence remains limited, some stimulant and nonstimulant medications have shown effectiveness in treating both core ADHD symptoms and oppositional symptoms. Oppositional symptoms are a key consideration in ADHD management, although the optimum approach to treating ADHD complicated by such symptoms remains unclear. Future research should focus on the efficacy and safety of various behavioral and medication regimens, as well as longitudinal studies to further clarify the relationships between ADHD, oppositional defiant disorder, and conduct disorder.

Results of Combined, Single-Session Arthrocentesis and Dextrose Prolotherapy for Symptomatic Temporomandibular Joint Syndrome: A Case Series.

Science.gov (United States)

Cezairli, Burak; Sivrikaya, Efe Can; Omezli, Mehmet Melih; Ayranci, Ferhat; Seyhan Cezairli, Neslihan

2017-10-01

Arthrocentesis and prolotherapy are nonsurgical treatments for temporomandibular joint (TMJ) diseases. This study aimed to evaluate the treatment of hypermobility, pain, and displacement of the TMJ by consecutively performing arthrocentesis and prolotherapy in the same session. In this study, 10 adults with disc displacement and painful, hypermobile TMJ were selected. Arthrocentesis and prolotherapy were consecutively performed using a 30% dextrose solution that was simultaneously injected into five areas: posterior disc attachment, superior joint space, superior and inferior capsular attachments, and stylomandibular ligament. Paired t-test, McNemar test, and chi-square test were used to assess the maximum mouth opening, clicking sounds, pain, and subluxation of the TMJ. Patients with rheumatoid arthritis and parafunctional habits such as teeth clenching and grinding and biting of the cheeks or any other objects and those who had undergone surgery were excluded from this study. A total of 10 participants (36.20 ± 7.06 years old, 7 women and 3 men) received a single treatment session of combined arthrocentesis and prolotherapy at the same office visit. Subluxation frequency and pain significantly decreased after the first week of treatment (p < 0.05). Subluxation also decreased at the 3-month follow-up (p < 0.05). Clicking sound values did not significantly change at any of the follow-up time points. Maximum mouth opening values decreased at all follow-up time points compared to baseline (p < 0.05). A single session of combined arthrocentesis and prolotherapy to treat symptomatic TMJ safely and significantly improved the subluxation and pain after 1 week and subluxation after 3 months compared to baseline status. The maximum mouth opening significantly decreased at all follow-up time points. Future studies assessing multiple treatment sessions are warranted.

Celiac Disease Is Associated with Childhood Psychiatric Disorders: A Population-Based Study.

Science.gov (United States)

Butwicka, Agnieszka; Lichtenstein, Paul; Frisén, Louise; Almqvist, Catarina; Larsson, Henrik; Ludvigsson, Jonas F

2017-05-01

To determine the risk of future childhood psychiatric disorders in celiac disease, assess the association between previous psychiatric disorders and celiac disease in children, and investigate the risk of childhood psychiatric disorders in siblings of celiac disease probands. This was a nationwide registry-based matched cohort study in Sweden with 10 903 children (aged celiac disease and 12 710 of their siblings. We assessed the risk of childhood psychiatric disorders (any psychiatric disorder, psychotic disorder, mood disorder, anxiety disorder, eating disorder, psychoactive substance misuse, behavioral disorder, attention-deficit hyperactivity disorder [ADHD], autism spectrum disorder [ASD], and intellectual disability). HRs of future psychiatric disorders in children with celiac disease and their siblings was estimated by Cox regression. The association between previous diagnosis of a psychiatric disorder and current celiac disease was assessed using logistic regression. Compared with the general population, children with celiac disease had a 1.4-fold greater risk of future psychiatric disorders. Childhood celiac disease was identified as a risk factor for mood disorders, anxiety disorders, eating disorders, behavioral disorders, ADHD, ASD, and intellectual disability. In addition, a previous diagnosis of a mood, eating, or behavioral disorder was more common before the diagnosis of celiac disease. In contrast, siblings of celiac disease probands were at no increased risk of any of the investigated psychiatric disorders. Children with celiac disease are at increased risk for most psychiatric disorders, apparently owing to the biological and/or psychological effects of celiac disease. Copyright © 2017 Elsevier Inc. All rights reserved.

Visual processing in anorexia nervosa and body dysmorphic disorder: similarities, differences, and future research directions

Science.gov (United States)

Madsen, Sarah K.; Bohon, Cara; Feusner, Jamie D.

2013-01-01

Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are psychiatric disorders that involve distortion of the experience of one’s physical appearance. In AN, individuals believe that they are overweight, perceive their body as “fat,” and are preoccupied with maintaining a low body weight. In BDD, individuals are preoccupied with misperceived defects in physical appearance, most often of the face. Distorted visual perception may contribute to these cardinal symptoms, and may be a common underlying phenotype. This review surveys the current literature on visual processing in AN and BDD, addressing lower- to higher-order stages of visual information processing and perception. We focus on peer-reviewed studies of AN and BDD that address ophthalmologic abnormalities, basic neural processing of visual input, integration of visual input with other systems, neuropsychological tests of visual processing, and representations of whole percepts (such as images of faces, bodies, and other objects). The literature suggests a pattern in both groups of over-attention to detail, reduced processing of global features, and a tendency to focus on symptom-specific details in their own images (body parts in AN, facial features in BDD), with cognitive strategy at least partially mediating the abnormalities. Visuospatial abnormalities were also evident when viewing images of others and for non-appearance related stimuli. Unfortunately no study has directly compared AN and BDD, and most studies were not designed to disentangle disease-related emotional responses from lower-order visual processing. We make recommendations for future studies to improve the understanding of visual processing abnormalities in AN and BDD. PMID:23810196

Association Between Prenatal Acetaminophen Exposure and Future Risk of Attention Deficit/Hyperactivity Disorder in Children.

Science.gov (United States)

Hoover, Rebecca M; Hayes, V Autumn Gombert; Erramouspe, John

2015-12-01

To evaluate the effect of prenatal acetaminophen exposure on the future development of attention deficit/hyperactivity disorder (ADHD) in children. Literature searches of MEDLINE (1975 to June 2015), International Pharmaceutical Abstracts (1975 to June 2015), and Cochrane Database (publications through June 2015) for prospective clinical trials assessing the relationship of prenatal acetaminophen exposure and the development of attention deficit disorders or hyperactivity. Studies comparing self-reported maternal acetaminophen use during pregnancy to development of ADHD or ADHD-like behaviors in offspring between the ages of 3 and 12 years. Four studies examining the effects of prenatal acetaminophen exposure on subsequent ADHD behaviors were identified. Of these, one early study found no link to ADHD behaviors while the other studies found statistically significant correlations with the most prominent being a study finding a higher risk for using ADHD medications (hazard ratio = 1.29; 95% CI, 1.15-1.44) or having ADHD-like behaviors at age 7 years as determined by the Strengths and Difficulties Questionnaire (risk ratio = 1.13; 95% CI, 1.01-1.27) in children whose mothers used acetaminophen during pregnancy. While there does appear to be a mild correlation between prenatal acetaminophen use and the development of ADHD symptoms in children, current data do not provide sufficient evidence that prenatal acetaminophen exposure leads to development of ADHD symptoms late in life. Acetaminophen is a preferred option for pain management during pregnancy when compared with other medications such as nonsteroidal anti-inflammatory drugs or opioids for pyretic or pain relief. © The Author(s) 2015.

Imaging of the temporomandibular joint: An update

Institute of Scientific and Technical Information of China (English)

Asim; K; Bag; Santhosh; Gaddikeri; Aparna; Singhal; Simms; Hardin; Benson; D; Tran; Josue; A; Medina; Joel; K; Curé

2014-01-01

Imaging of the temporomandibular joint(TMJ) is continuously evolving with advancement of imaging technologies. Many different imaging modalities are currently used to evaluate the TMJ. Magnetic resonance imaging is commonly used for evaluation of the TMJ due to its superior contrast resolution and its ability to acquire dynamic imaging for demonstration of the functionality of the joint. Computed tomography and ultrasound imaging have specific indication in imaging of the TMJ. This article focuses on state of the art imaging of the temporomandibular joint. Relevant normal anatomy and biomechanics of movement of the TMJ are discussed for better understanding of many TMJ pathologies. Imaging of internal derangements is discussed in detail. Different arthropathies and commontumors are also discussed in this article.

[Dysfunctional pathology from "true" and "de facto" mutilation of the dental arches].

Science.gov (United States)

Garino, G B; Capurso, U

1989-01-01

The mutilations of the dental arches for agenesia, extractions or trauma and because of ankylosis, caries can be the cause of the disorders of the stomatognatic system. These problems are in relation with the time of the disfunction, the skeletal type and the interarches relationship. The pathogenetic factors are secondary to the amount and the direction of the dislocations or the entrapment of the lower jaw. The treatment planning can provide the closure of the spaces or the reopening. These procedures are demonstrated by two treated cases with TMJ disorders.

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.

EFFECTIVENESS OF ROCABADO'S TECHNIQUE FOR SUBJECTS WITH TEMPOROMANDIBULAR JOINT DYSFUNCTION - A SINGLE BLIND STUDY

Directory of Open Access Journals (Sweden)

Niha Siraj Mulla

2015-02-01

Full Text Available Background:A temporo-mandibular joint dysfunction or TMD is a group of conditions characterized by pain in the muscles of mastication, the temporo-mandiblar joint or both. Rocabado has described techniques includes the Rocabado’s manipulation and Rocabado’s exercises which have both been individually advocated for treatment of TMD. The purpose of study is to determine the effectiveness of Rocabado’s techniques on TMJ dysfunction symptoms, pain, TMJ Range of Motion (ROM and jaw functional limitation for subjects with temporo-mandibular joint dysfunction. Method: Pre to post test experimental study design, subjects with temporo-mandibular joint dysfunction randomized into two groups with 15 subjects into each group with total of 30 subjects in Study and control group, respectively. The study group received the Rocabado’s technique which consisted of Rocabado’s non-thrust TMJ manipulation and Rocabado’s exercises along with conventional TMJ exercises and the control group received only conventional TMJ exercises. The exercises were performed for 6 times per each session, six times in a day, one session under supervision and remaining five sessions by the subject at home for 6 days in a week for duration of 2 weeks. The outcome measurements such as VAS for pain, TMJ ROM, Fonseca’s questionnaire rating for TMJ dysfunction symptoms and jaw function limitation score (JFLS was measured before and after two weeks of intervention. Results: Comparative analysis, using Independent ‘t’ test and Mann Whitney U- test found that the means of VAS, TMJ ROM, Fonseca’s questionnaire and JFLS scores showed statistically significant difference (p <0.05 when the pre-intervention means and post-intervention means were compared between two groups. Conclusion: It is concluded that Rocabado’s technique found to have statistically and clinically significant added effect with conventional TMJ exercises shown greater percentage of improvements obtained

Does Temporomandibular Joint Pathology With or Without Surgical Management Affect the Stability of Counterclockwise Rotation of the Maxillomandibular Complex in Orthognathic Surgery? A Systematic Review and Meta-Analysis.

Science.gov (United States)

Al-Moraissi, Essam Ahmed; Wolford, Larry M

2017-04-01

This study was designed to determine the stability of counterclockwise rotation (CCWR) of the maxillomandibular complex (MMC) in orthognathic surgery with or without surgical correction of coexisting temporomandibular joint (TMJ) pathology. The authors implemented a systematic review and meta-analysis. A search of major databases through PubMed, EMBASE, and Cochrane CENTRAL was performed. Inclusion criteria were studies that analyzed CCWR of the MMC in regard to skeletal stability after orthognathic surgery in patients with or without pre-existing TMJ pathology that was or was not surgically corrected concomitantly. The predictor variables were patients who underwent CCWR of the MMC in the following subgroups: 1) healthy TMJs (presumed healthy based on history, clinical evaluation, and radiographic analysis but without magnetic resonance imaging [MRI] confirmation), 2) no TMJ assessment, 3) untreated TMJ disc displacement (confirmed by MRI), 4) TMJ disc displacement (confirmed by MRI) repositioned using Mitek anchors, and 5) reconstruction with TMJ total joint prosthesis. Outcome variables were surgical relapse for angular and linear measurements. Postsurgical mean changes for the occlusal plane (OP) and linear measurements using a fixed-effects model with a 95% confidence interval were analyzed. A total of 345 patients enrolled in 12 studies were included in this study. There was significant OP relapse and horizontal relapse at the B point and menton for studies with untreated TMJ disc displacement and studies without TMJ assessment (P < .005). There was significant horizontal relapse at the A point for studies with healthy TMJs, without assessment of the TMJs, and with TMJ reconstruction with total joint prostheses (P < .005). There was no significant vertical relapse at the B and A points for all subgroup analyses (P < .005). The result of the meta-analysis suggests that CCWR of the MMC is a stable procedure for patients with healthy TMJs, patients undergoing

Comparison between cone beam computed tomography and magnetic resonance imaging of the temporomandibular joint

Energy Technology Data Exchange (ETDEWEB)

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.

The Science Behind the Academy for Eating Disorders' Nine Truths About Eating Disorders.

Science.gov (United States)

Schaumberg, Katherine; Welch, Elisabeth; Breithaupt, Lauren; Hübel, Christopher; Baker, Jessica H; Munn-Chernoff, Melissa A; Yilmaz, Zeynep; Ehrlich, Stefan; Mustelin, Linda; Ghaderi, Ata; Hardaway, Andrew J; Bulik-Sullivan, Emily C; Hedman, Anna M; Jangmo, Andreas; Nilsson, Ida A K; Wiklund, Camilla; Yao, Shuyang; Seidel, Maria; Bulik, Cynthia M

2017-11-01

In 2015, the Academy for Eating Disorders collaborated with international patient, advocacy, and parent organizations to craft the 'Nine Truths About Eating Disorders'. This document has been translated into over 30 languages and has been distributed globally to replace outdated and erroneous stereotypes about eating disorders with factual information. In this paper, we review the state of the science supporting the 'Nine Truths'. The literature supporting each of the 'Nine Truths' was reviewed, summarized and richly annotated. Most of the 'Nine Truths' arise from well-established foundations in the scientific literature. Additional evidence is required to further substantiate some of the assertions in the document. Future investigations are needed in all areas to deepen our understanding of eating disorders, their causes and their treatments. The 'Nine Truths About Eating Disorders' is a guiding document to accelerate global dissemination of accurate and evidence-informed information about eating disorders. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Dreams and Nightmares in Personality Disorders.

Science.gov (United States)

Schredl, Michael

2016-02-01

Although the relationship between dreaming and psychopathology has been studied quite extensively, research on dreaming in patients with personality disorders has been very scarce. In patients with borderline personality disorder, negatively toned dreams and heightened nightmare frequency have been found-characteristics not determined by co-morbid depression or posttraumatic stress disorder. The review includes suggestions for future studies as the existing results clearly indicate that this line of research is most interesting. Lastly, clinical recommendations especially regarding the treatment of the often found co-morbid nightmare disorder will be given.

Cognitive-behavioral therapy for childhood repetitive behavior disorders: tic disorders and trichotillomania.

Science.gov (United States)

Flessner, Christopher A

2011-04-01

This article provides an overview of cognitive-behavioral therapy (CBT) for repetitive behavior disorders. Because tic disorders and trichotillomania are the most often studied and most debilitating of these conditions, this article focuses on the efficacy of CBT for these 2 conditions. An overview of CBT for children presenting with these concerns is provided. This review focuses particularly on habit reversal training, which is at the core of most CBT-based interventions. Two recent empirical studies on the immense potential of CBT in treating childhood repetitive behavior disorders and future areas of research are also discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

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

OpenAIRE

Jitka Levorová; Vladimír Machoň; Anasuya Guha; René Foltán

2016-01-01

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 (1...

Noninvasive brain stimulation to suppress craving in substance use disorders: Review of human evidence and methodological considerations for future work.

Science.gov (United States)

Hone-Blanchet, Antoine; Ciraulo, Domenic A; Pascual-Leone, Alvaro; Fecteau, Shirley

2015-12-01

Substance use disorders (SUDs) can be viewed as a pathology of neuroadaptation. The pharmacological overstimulation of neural mechanisms of reward, motivated learning and memory leads to drug-seeking behavior. A critical characteristic of SUDs is the appearance of craving, the motivated desire and urge to use, which is a main focus of current pharmacological and behavioral therapies. Recent proof-of-concept studies have tested the effects of noninvasive brain stimulation on craving. Although its mechanisms of action are not fully understood, this approach shows interesting potential in tuning down craving and possibly consumption of diverse substances. This article reviews available results on the use of repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (tES) in SUDs, specifically tobacco, alcohol and psychostimulant use disorders. We discuss several important factors that need to be addressed in future works to improve clinical assessment and effects of noninvasive brain stimulation in SUDs. Factors discussed include brain stimulation devices and parameters, study designs, brain states and subjects' characteristics. Copyright © 2015 Elsevier Ltd. All rights reserved.

[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.

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

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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.

Radiographic analysis of the temporomandibular joint by the standardized projection technique

International Nuclear Information System (INIS)

Choe, Han Up; Park, Tae Won

1983-01-01

The purpose of this study was to investigate the radiographic images of the condylar head in clinically normal subjects and the TMJ patients using standardized projection technique. 45 subjects who have not clinical evidence of TMJ problems and 96 patients who have the clinical evidence of TMJ problems were evaluated, but the patients who had fracture, trauma and tumor on TMJ area were discluded in this study. For the evaluation of radiographic images, the author has observed the condylar head positions in closed mouth and 2.54 cm open mouth position taken by the standardized transcranial oblique lateral projection technique. The results were as follow: 1. In closed mouth position, the crest of condylar head took relatively posterior position to the deepest point of the glenoid fossa in 8.9% of the normals and in 26.6% of TMJ patients. 2. In 2.54 cm open mouth position, condylar head took relatively posterior position to the articular eminence in 2 .2% of TMJ patients and 39.6% of the normals. 3. In open mouth position, the horizontal distance from the deepest point of the glenoid fossa to the condylar head was 13.96 mm in the normals and 10.68 mm in TMJ patients. 4. The distance of true movement of condylar head was 13.49 mm in the normals and 10.27 mm in TMJ patients. 5. The deviation of mandible in TMJ patients was slightly greater than of the normals.

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

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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.

Roentgenographic study of the temporomandibular joint in rheumatoid arthritis

International Nuclear Information System (INIS)

Yun, Ho Jung; You, Dong Soo

1984-01-01

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.

Symptoms of conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, and callous-unemotional traits as unique predictors of psychosocial maladjustment in boys: advancing an evidence base for DSM-V.

Science.gov (United States)

Pardini, Dustin A; Fite, Paula J

2010-11-01

The incremental utility of symptoms of conduct disorder (CD), oppositional defiant disorder (ODD), attention-deficit/hyperactivity disorder (ADHD), and callous-unemotional (CU) traits for predicting psychosocial outcomes across multiple domains was examined in a community sample of 1,517 boys. Several outcomes were assessed semiannually across a 2-year follow-up, including antisocial behavior, internalizing problems, peer conflict, and academic difficulties. Official criminal charges were also examined across adolescence. CD symptoms emerged as the most robust predictor of future antisocial outcomes. However, ODD symptoms predicted later criminal charges and conduct problems, and CU traits were robustly associated with serious and persistent criminal behavior in boys. Attention-deficit/hyperactivity disorder symptoms predicted increases in oppositional defiant behavior and conduct problems over time and were uniquely related to future academic difficulties. Both ADHD and ODD symptoms predicted social and internalizing problems in boys, whereas CU traits were associated with decreased internalizing problems over time. The current findings have implications for revisions being considered as part of the DSM-V. Specifically, incorporating CU traits into the diagnostic criteria for Disruptive Behavior Disorders (DBD) may help to further delineate boys at risk for severe and persistent delinquency. Although currently prohibited, allowing a diagnosis of ODD when CD is present may provide unique prognostic information about boys who are at risk for future criminal behavior, social problems, and internalizing problems. Copyright © 2010 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Vitamin D Status at Birth and Future Risk of Attention Deficit/Hyperactivity Disorder (ADHD).

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Gustafsson, Peik; Rylander, Lars; Lindh, Christian H; Jönsson, Bo A G; Ode, Amanda; Olofsson, Per; Ivarsson, Sten A; Rignell-Hydbom, Anna; Haglund, Nils; Källén, Karin

2015-01-01

To investigate whether children with Attention Deficit/Hyperactivity Disorder have lower levels of Vitamin D3 at birth than matched controls. Umbilical cord blood samples collected at birth from 202 children later diagnosed with Attention Deficit/Hyperactivity Disorder were analysed for vitamin D content and compared with 202 matched controls. 25-OH vitamin D3 was analysed by liquid chromatography tandem mass spectrometry. No differences in cord blood vitamin D concentration were found between children with Attention Deficit/Hyperactivity Disorder (median 13.0 ng/ml) and controls (median 13.5 ng/ml) (p = 0.43). In a logistic regression analysis, Attention Deficit/Hyperactivity Disorder showed a significant association with maternal age (odds ratio: 0.96, 95% confidence interval: 0.92-0.99) but not with vitamin D levels (odds ratio: 0.99, 95% confidence interval: 0.97-1.02). We found no difference in intrauterine vitamin D levels between children later developing Attention Deficit/Hyperactivity Disorder and matched control children. However, the statistical power of the study was too weak to detect an eventual small to medium size association between vitamin D levels and Attention Deficit/Hyperactivity Disorder.

Post-traumatic stress disorder

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... of the event Feeling like you have no future 3. Hyperarousal Always scanning your surroundings for signs ... disorders in medical practice. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: ...

Are we missing an opportunity to teach future physicians about female pelvic floor disorders?

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Mueller, Elizabeth R; Kenton, Kimberly; Rogers, Rebecca G; Fenner, Dee E

2009-12-01

Many physicians in primary care and medical/surgical specialties will care for female patients with pelvic floor disorders (PFD). A survey was mailed to 266 United States and Canadian clerkship directors that queried how medical students were being educated in PFD. Forty-four percent of clerkship directors responded. The mean clerkship size was 105 medical students. Over 97% of third year medical students received lectures on hypertension in pregnancy, normal labor, and abnormal uterine bleeding and at least 90% received lectures on obstetric hemorrhage, placenta previa, and menstruation. Forty percent to 85% of medical students received lectures in PFD depending on the topic. Eighty percent of medical students had no exposure to PFD during their first 2 years of medical school. During their third year, 95% of the students were exposed to PFD topics but only 60% had an opportunity to spend at least a day in an urogynecology practice. Clerkship directors indicate that PFD are relevant to medical student training, however, they have limited time in the clerkship to cover all of the required topics. We are missing an important opportunity to educate future clinicians about PFD, which dramatically impact women's quality of life.

Head, Neck, and Oral Cancer

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Full Text Available ... Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ... more. TMJ and Facial Pain TMJ and Facial ... Teeth Management Wisdom Teeth Management An impacted wisdom tooth can ...

Corrective Jaw Surgery

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Full Text Available ... Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ... more. TMJ and Facial Pain TMJ and Facial ... Teeth Management Wisdom Teeth Management An impacted wisdom tooth can ...

Obstructive Sleep Apnea

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Full Text Available ... Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ... more. TMJ and Facial Pain TMJ and Facial ... Teeth Management Wisdom Teeth Management An impacted wisdom tooth can ...

Administration of Anesthesia

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Full Text Available ... Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ... more. TMJ and Facial Pain TMJ and Facial ... Teeth Management Wisdom Teeth Management An impacted wisdom tooth can ...

Histaminergic system in brain disorders: lessons from the translational approach and future perspectives.

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Baronio, Diego; Gonchoroski, Taylor; Castro, Kamila; Zanatta, Geancarlo; Gottfried, Carmem; Riesgo, Rudimar

2014-01-01

Histamine and its receptors were first described as part of immune and gastrointestinal systems, but their presence in the central nervous system and importance in behavior are gaining more attention. The histaminergic system modulates different processes including wakefulness, feeding, and learning and memory consolidation. Histamine receptors (H1R, H2R, H3R, and H4R) belong to the rhodopsin-like family of G protein-coupled receptors, present constitutive activity, and are subjected to inverse agonist action. The involvement of the histaminergic system in brain disorders, such as Alzheimer's disease, schizophrenia, sleep disorders, drug dependence, and Parkinson's disease, is largely studied. Data obtained from preclinical studies point antagonists of histamine receptors as promising alternatives to treat brain disorders. Thus, clinical trials are currently ongoing to assess the effects of these drugs on humans. This review summarizes the role of histaminergic system in brain disorders, as well as the effects of different histamine antagonists on animal models and humans.

Evaluation of the relation between the horizontal condylar angle and the internal derangement of the TMJ - a magnetic resonance imaging study

International Nuclear Information System (INIS)

Crusoe-Rebello, Ieda Margarida Rocha; Campos, Paulo Sergio Flores; Rubira, Izabel Regina Fischer; Panella, Jurandyr; Mendes, Carlos Mauricio Cardeal

2003-01-01

This research aimed at assessing the relation between the horizontal condylar angle (HCA) and the internal derangement (ID) of the temporomandibular joint (TMJ), as a result of interference by the T MJ disk, in individuals undergoing magnetic resonance (MR) scans. The sample included a total of 144 TMJs (sagittal and coronal views) of 72 subjects, 15 of whom were male and 57 female, with ages ranging from 15 to 70. The scans were made in a Signa system model at a magnetic field magnitude of 1.5 T. Sixty-eight TMJs were found to be normal, while 46 showed anterior displacement with reduction. Of these, 41 had some kind of adaptive change in the condyle, while 5 showed degenerative changes. Anterior displacement without reduction was found in 29 joints, 12 of which showed adaptive changes in the condyle, while 17 showed degenerative changes. Only one posterior displacement of the articular disk was recorded. For the TMJs in which disk displacement was found, such values achieved 24.69 deg on the right side, and 22.94 deg on the left side. Hence, it was possible for us to conclude that the HCA tends to increase in those TMJs where ID is present. For contralateral TMJs, a strong association was observed between HCA values (57.8%), state of normality (69.7%), and ID (66.7%). To corroborate such findings, a correlation between contralateral HCA values (63.31%) and the diagnosis for contralateral TMJs (68.05%) was determined. Thus, we could infer that there is a tendency between contralateral TMJs to share characteristics and conditions. (author)

Evaluation of the relation between the horizontal condylar angle and the internal derangement of the TMJ - a magnetic resonance imaging study

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Crusoe-Rebello, Ieda Margarida Rocha [Fundacao de Amparo a Pesquisa do Estado da Bahia (FAPESB), Salvador (Brazil); Campos, Paulo Sergio Flores; Rubira, Izabel Regina Fischer [Sao Paulo Univ., SP (Brazil). Faculdade de Odontologia. Dept. of Propedeutica e Clinica Integrada; Panella, Jurandyr [Sao Paulo Univ., SP (Brazil). Faculdade de Odontologia. Dept. de Radiologia; Mendes, Carlos Mauricio Cardeal [Bahia Univ., Salvador, BA (Brazil). Faculdade de Medicine

2003-06-01

This research aimed at assessing the relation between the horizontal condylar angle (HCA) and the internal derangement (ID) of the temporomandibular joint (TMJ), as a result of interference by the T MJ disk, in individuals undergoing magnetic resonance (MR) scans. The sample included a total of 144 TMJs (sagittal and coronal views) of 72 subjects, 15 of whom were male and 57 female, with ages ranging from 15 to 70. The scans were made in a Signa system model at a magnetic field magnitude of 1.5 T. Sixty-eight TMJs were found to be normal, while 46 showed anterior displacement with reduction. Of these, 41 had some kind of adaptive change in the condyle, while 5 showed degenerative changes. Anterior displacement without reduction was found in 29 joints, 12 of which showed adaptive changes in the condyle, while 17 showed degenerative changes. Only one posterior displacement of the articular disk was recorded. For the TMJs in which disk displacement was found, such values achieved 24.69 deg on the right side, and 22.94 deg on the left side. Hence, it was possible for us to conclude that the HCA tends to increase in those TMJs where ID is present. For contralateral TMJs, a strong association was observed between HCA values (57.8%), state of normality (69.7%), and ID (66.7%). To corroborate such findings, a correlation between contralateral HCA values (63.31%) and the diagnosis for contralateral TMJs (68.05%) was determined. Thus, we could infer that there is a tendency between contralateral TMJs to share characteristics and conditions. (author)

Trauma-related self-defining memories and future goals in Dissociative Identity Disorder.

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Huntjens, Rafaële J C; Wessel, Ineke; Ostafin, Brian D; Boelen, Paul A; Behrens, Friederike; van Minnen, Agnes

2016-12-01

This study examined the content of self-defining autobiographical memories in different identities in patients with Dissociative Identity Disorder (DID) and comparison groups of patients with PTSD, healthy controls, and DID simulators. Consistent with the DID trauma model, analyses of objective ratings showed that DID patients in trauma identities retrieved more negative and trauma-related self-defining memories than DID patients in avoidant identities. Inconsistent with the DID trauma model, DID patients' self-rated trauma-relatedness of self-defining memories and future life goals did not differ between trauma identities and trauma avoidant identities. That is, the DID patients did not seem to be "shut off" from their trauma while in their avoidant identity. Furthermore, DID patients in both identities reported a higher proportion of avoidance goals compared to PTSD patients, with the latter group scoring comparably to healthy controls. The simulators behaved according to the instructions to respond differently in each identity (i.e., to report memories and goals consistent with the identity tested). The discrepant task behavior by DID patients and simulators indicated that DID patients did not seem to intentionally produce the hypothesized differences in performance between identities. In conclusion, for patients with DID (i.e., in both identities) and patients with PTSD, trauma played a central role in the retrieval of self-defining memories and in the formulation of life goals. Copyright © 2016 Elsevier Ltd. All rights reserved.

Episodic memory and episodic future thinking impairments in high-functioning autism spectrum disorder: an underlying difficulty with scene construction or self-projection?

Science.gov (United States)

Lind, Sophie E; Williams, David M; Bowler, Dermot M; Peel, Anna

2014-01-01

There appears to be a common network of brain regions that underlie the ability to recall past personal experiences (episodic memory) and the ability to imagine possible future personal experiences (episodic future thinking). At the cognitive level, these abilities are thought to rely on "scene construction" (the ability to bind together multimodal elements of a scene in mind--dependent on hippocampal functioning) and temporal "self-projection" (the ability to mentally project oneself through time--dependent on prefrontal cortex functioning). Although autism spectrum disorder (ASD) is characterized by diminished episodic memory, it is unclear whether episodic future thinking is correspondingly impaired. Moreover, the underlying basis of such impairments (difficulties with scene construction, self-projection, or both) is yet to be established. The current study therefore aimed to elucidate these issues. Twenty-seven intellectually high-functioning adults with ASD and 29 age- and IQ-matched neurotypical comparison adults were asked to describe (a) imagined atemporal, non-self-relevant fictitious scenes (assessing scene construction), (b) imagined plausible self-relevant future episodes (assessing episodic future thinking), and (c) recalled personally experienced past episodes (assessing episodic memory). Tests of narrative ability and theory of mind were also completed. Performances of participants with ASD were significantly and equally diminished in each condition and, crucially, this diminution was independent of general narrative ability. Given that participants with ASD were impaired in the fictitious scene condition, which does not involve self-projection, we suggest the underlying difficulty with episodic memory/future thinking is one of scene construction.

Surgical Management of Obesity Among People with Schizophrenia and Bipolar Disorder: a Systematic Review of Outcomes and Recommendations for Future Research.

Science.gov (United States)

Kouidrat, Youssef; Amad, Ali; Stubbs, Brendon; Moore, Suzan; Gaughran, Fiona

2017-07-01

People with schizophrenia or bipolar disorder (BD) exhibit very high levels of obesity. Little is known about the potential benefits/risks of obesity surgery. We conducted a narrative review to summarize the available knowledge on bariatric surgery in people with schizophrenia or BD. A systematic search was conducted of major electronic databases from inception to October 2016 for studies investigating bariatric surgery among people with schizophrenia or BD. Data were presented in a narrative synthesis and future research strategies proposed. The electronic database searches identified 44 records. Eight studies (BD, n = 265; schizophrenia: n = 14) were included with a mean study length of 15.7 months (12-24). Seven found that bariatric surgery resulted in weight loss in those with psychiatric disorders with an excess weight loss ranging -31 to -70%. Six studies found that weight loss from bariatric surgery was similar in people with schizophrenia or BD versus controls. However, most of the studies limited their outcomes to only weight loss and did not measure whether obesity surgery affected the status and treatment of psychiatric symptoms. Although few adverse events were reported among patients with BD, data from two studies demonstrated no significant deterioration of psychiatric symptoms post-surgery in people with schizophrenia. Growing evidence suggests that bariatric surgery may improve short-term weight status among people with BD. However, given the paucity of studies for schizophrenia, and the lack of information on medium-to long-term results, future large-scale high-quality studies are required.

Computed tomography and treatment of chronic temporomandibular joint arthritis in a sheep

International Nuclear Information System (INIS)

Warmerdam, E.P.L.; Weeren, P.R. van

1996-01-01

Diagnostic imaging and treatment of destructive right temporomandibular joint (TMJ) arthritis in a sheep are discussed. Computed tomography (CT) appears to be an attractive technique for imaging TMJ lesions in sheep. Surgical curettage of a deformed TMJ can result in functional recovery

Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

Science.gov (United States)

Lewinsohn, Peter M.; Holm-Denoma, Jill M.; Small, Jason W.; Seeley, John R.; Joiner, Thomas E.

2008-01-01

A study to examine the association between childhood separation anxiety disorder (SAD) and the risk of the development of psychopathology during young adulthood was conducted. Results showed that SAD contributed to the risk for the development of internalizing disorders, which are panic and depression, but decreased the risk for externalizing…

Temporomandibular joint arthrocentesis for internal derangement with disc displacement without reduction.

Science.gov (United States)

Bhargava, Darpan; Jain, Megha; Deshpande, Ashwini; Singh, Ajita; Jaiswal, Jagdish

2015-06-01

Temporomandibular joint (TMJ) disc derangement is defined as a malpositioning of the articular disc relative to the condyle and eminence. Arthrocentesis of the TMJ is a minimally invasive chair side procedure for the patients with TMJ internal derangement. This case report presents convincing results to keep arthrocentesis as an imperative procedure to relieve such patients of their acute symptoms. TMJ dynamics has also been discussed for an in-depth understanding of the pathology in cases with internal derangement.

Radikal Bebas pada Gangguan Sendi Rahang

Directory of Open Access Journals (Sweden)

Antonia Chriestedy Tanzil

2013-07-01

Full Text Available In human, the temporomandibular joint (TMJ has been proven as a stress-bearing joint, especially during mastication. Overload of shear stress on the joint can cause degenerative diseases of the joint, such as osteoarthrosis or TMJ osteoarthritis (TMJ-OA. Free radicals have been assumed to be associated in the pathogenesis of various degenerative diseases of the joint and oxidative stress is important in the mechanism of TMJ dysfunction. Free radicals are superoxide (O2-, hydrogen peroxide (H2O2 and hydroxyl (OH-, and are called reactive oxygen species (ROS. Hydroxyl is most destructive in patients with TMJ dysfunction. ROS exert their effects on TMJ by reducing the viscosity of synovial fluid, decreasing joint surface lubrication, breakdown of collagen and proteoglycan, and increasing the activity of cartilage degradation enzymes such as metalloproteinases.DOI: 10.14693/jdi.v15i1.88

Prevalence of temporomandibular joint disfunction in children

Directory of Open Access Journals (Sweden)

Siti Masitoh

2007-07-01

Full Text Available The aim of this study is to get the description on TMJ dysfunction as well as its symptoms including clicking, crepitation, jaw opening restriction and muscle pain in children. Thus the result can be used as an input to the program of TMJ dysfunction prevention and treatment for the children in SDN Sirnasari Village, Ciptasari Pamulihan Subdistrict, Sumedang District. This study is descriptive study using survey technique. The samples for the study are 79 children in elementary school taken by random sampling technique with stratification. TMJ dysfunctions with clicking and crepitation symptoms were detected by palpating and using a stethoscope. Deviation, deflection, and jaw opening restriction symptoms were found out by visual examination. Whereas pain in TMJ supporting muscles was also detected by palpating. The result of the study shows that the number of children developing TMJ dysfunction with symptom of clicking is 34 children (43.03%, crepitation are 4 children (5.06%, deviation are 13 children (16.45%, deflection are 17 children (21.51%, jaw opening restriction are 49 children (62.02%, and pain in TMJ supporting muscles are 69 children (87.34%. From the study, it can be concluded that the highest frequency of TMJ dysfunction symptom in SDN Sirnasari children is a pain in TMJ supporting muscles. It is followed by jaw opening restriction, clicking, deflection, deviation, and the last is crepitation.

Evaluation of the Efficacy of Different Concentrations of Dextrose Prolotherapy in Temporomandibular Joint Hypermobility Treatment.

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Mustafa, Rawand; Güngörmüş, Metin; Mollaoğlu, Nur

2018-03-12

The aim of this study was to compare and evaluate the efficacy of different concentrations of dextrose prolotherapy for the treatment of temporomandibular joint (TMJ) hypermobility. A prospective, randomized clinical trial including patients with subluxation or dislocation was performed. The study comprised 40 patients. Patients were randomly divided into 4 groups: control group, 10% dextrose, 20% dextrose, and 30% dextrose group. Patients in all groups received injections into 4 different areas of each TMJ in 4 sessions at monthly intervals. Visual analog scale of TMJ pain intensity, maximum mouth opening (MMO), joint sounds, and frequency of luxations were recorded preoperatively and postoperatively after 1 month of last injection. The collected data were then statistically analyzed. Each group showed postoperatively significant improvement in TMJ pain, significant decrease in both MMO and joint sound. Besides that, TMJ locking was not observed in any patient during the follow-up period. There were no statistically significant differences throughout the study intervals between the groups. It was concluded that there was no significant difference between control group and dextrose groups and there is no superiority of any concentration of dextrose over the others in TMJ prolotherapy, and all treatment procedures were efficient in improvement of clinical symptoms related to TMJ hypermobility. If dextrose is used as a proliferant, it can be said that 10% dextrose can be sufficient in TMJ hypermobility treatment.

Clarifying the convergence between obsessive compulsive personality disorder criteria and obsessive compulsive disorder.

Science.gov (United States)

Eisen, Jane L; Coles, Meredith E; Shea, M Tracie; Pagano, Maria E; Stout, Robert L; Yen, Shirley; Grilo, Carlos M; Rasmussen, Steven A

2006-06-01

In this study we examined the convergence between obsessive-compulsive personality disorder (OCPD) criteria and obsessive-compulsive disorder (OCD). Baseline assessments of 629 participants of the Collaborative Longitudinal Personality Disorders Study were used to examine the associations between OCPD criteria and diagnoses of OCD. Three of the eight OCPD criteria--hoarding, perfectionism, and preoccupation with details--were significantly more frequent in subjects with OCD (n = 89) than in subjects without OCD (n = 540). Logistic regressions were used to predict the probability of each OCPD criterion as a function of Axis I diagnoses (OCD, additional anxiety disorders, and major depressive disorder). Associations between OCD and these three OCPD criteria remained significant in the logistic regressions, showing unique associations with OCD and odds ratios ranging from 2.71 to 2.99. In addition, other anxiety disorders and major depressive disorder showed few associations with specific OCPD criteria. This study suggests variability in the strength of the relationships between specific OCPD criteria and OCD. The findings also support a unique relationship between OCPD symptoms and OCD, compared to other anxiety disorders or major depression. Future efforts to explore the link between Axis I and Axis II disorders may be enriched by conducting analyses at the symptom level.

Sleep disorders and chronic kidney disease.

Science.gov (United States)

Maung, Stephanie C; El Sara, Ammar; Chapman, Cherylle; Cohen, Danielle; Cukor, Daniel

2016-05-06

Sleep disorders have a profound and well-documented impact on overall health and quality of life in the general population. In patients with chronic disease, sleep disorders are more prevalent, with an additional morbidity and mortality burden. The complex and dynamic relationship between sleep disorders and chronic kidney disease (CKD) remain relatively little investigated. This article presents an overview of sleep disorders in patients with CKD, with emphasis on relevant pathophysiologic underpinnings and clinical presentations. Evidence-based interventions will be discussed, in the context of individual sleep disorders, namely sleep apnea, insomnia, restless leg syndrome and excessive daytime sleepiness. Limitations of the current knowledge as well as future research directions will be highlighted, with a final discussion of different conceptual frameworks of the relationship between sleep disorders and CKD.

[Diagnosis of temporo-mandibular joint dysfunction caused by occlusion pathology and treatment of such patients].

Science.gov (United States)

Semkin, V A; Rabukhina, N A; Kravchenko, D V

2007-01-01

Patients with temporo-mandibular joint (TMJ) dysfunction need complex treatment that includes prosthetic treatment in intrajoint relation stabilization. In cases of TMJ pathology it is necessary to examine patients and make axiography, function analysis, MPI-analysis, magnetic resonance tomography and zonography of TMJ, electromyography of the masticatory muscles. The authors examined 47 patients with TMJ dysfunction, 43 of them had occlusion pathology. We managed to eliminate the dysfunction symptoms and to receive stable result of the treatment in all the patients.

The Genetics of Stress-Related Disorders: PTSD, Depression, and Anxiety Disorders

Science.gov (United States)

Smoller, Jordan W

2016-01-01

Research into the causes of psychopathology has largely focused on two broad etiologic factors: genetic vulnerability and environmental stressors. An important role for familial/heritable factors in the etiology of a broad range of psychiatric disorders was established well before the modern era of genomic research. This review focuses on the genetic basis of three disorder categories—posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and the anxiety disorders—for which environmental stressors and stress responses are understood to be central to pathogenesis. Each of these disorders aggregates in families and is moderately heritable. More recently, molecular genetic approaches, including genome-wide studies of genetic variation, have been applied to identify specific risk variants. In this review, I summarize evidence for genetic contributions to PTSD, MDD, and the anxiety disorders including genetic epidemiology, the role of common genetic variation, the role of rare and structural variation, and the role of gene–environment interaction. Available data suggest that stress-related disorders are highly complex and polygenic and, despite substantial progress in other areas of psychiatric genetics, few risk loci have been identified for these disorders. Progress in this area will likely require analysis of much larger sample sizes than have been reported to date. The phenotypic complexity and genetic overlap among these disorders present further challenges. The review concludes with a discussion of prospects for clinical translation of genetic findings and future directions for research. PMID:26321314

Can palpation-induced muscle pain pattern contribute to the differential diagnosis among temporomandibular disorders, primary headaches phenotypes and possible bruxism?

Science.gov (United States)

Porporatti, André-Luís; Calderon, Patrícia-dos-Santos; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

2016-01-01

Background The evaluation of possible differences in the distribution or characteristics of palpation-induced pain in the masticatory muscles could be valuable in terms of diagnostic assessment. The aim of this study was to evaluate the impact of different combinations of anterior temporalis (AT) and masseter palpation-induced pain in the diagnostic of temporomandibular disorder (TMD), primary headaches and bruxism. Material and Methods A total of 1200 dental records of orofacial pain adult patients were analyzed. The outcomes were dichotomously classified (presence/absence) as following: a) AT and/or masseter palpation-induced pain; b) myogenous TMD; c) temporomandibular joint (TMJ) arthralgia (arthrogenous TMD); d) migraine; e) tension-type headache (TTH); f) self-reported bruxism. Binomial logistic regression model (α = 5%) was applied to the data considering the palpation-induced muscle pain as the dependent variable. Results Mean age (SD) were 35.7 years (13.4) for 635 included dental records (83% females). Myogenous and arthrogenous TMD, migraine, TTH and bruxism were mainly associated with, respectively, masseter palpation-induced pain (ppain (ppain (ppain (p=0.009 - OR=1.62, 95%CI 1.12-2.33) and bilateral masseter palpation-induced pain (p=0.01 - OR=1.74, 95%CI 1.13-2.69). Conclusions Palpation-induced pain in the masticatory muscles may play a role in the differential diagnosis among painful TMD, primary headaches and bruxism. Key words:Diagnosis, temporomandibular joint disorders, migraine, tension-type headache, bruxism. PMID:26615507

Sleep disorders and an increased risk of Parkinson's disease in individuals with non-apnea sleep disorders: a population-based cohort study.

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Hsiao, Yi-Han; Chen, Yung-Tai; Tseng, Ching-Ming; Wu, Li-An; Perng, Diahn-Warng; Chen, Yuh-Min; Chen, Tzeng-Ji; Chang, Shi-Chuan; Chou, Kun-Ta

2017-10-01

Sleep disorders are common non-motor symptoms in patients with Parkinson's disease. Our study aims to explore the relationship between non-apnea sleep disorders and future Parkinson's disease. This is a cohort study using a nationwide database. The participants were recruited from the Taiwan National Health Insurance Research Database between 2000 and 2003. A total of 91 273 adult patients who had non-apnea sleep disorders without pre-existing Parkinson's disease were enrolled. An age-, gender-, income-, urbanization- and Charlson comorbidity index score-matched control cohort consisting of 91 273 participants was selected for comparison. The two cohorts were followed for the occurrence of Parkinson's disease, death or until the end of 2010, whichever came first. The Kaplan-Meier analyses revealed patients with non-apnea sleep disorders tended to develop Parkinson's disease (log-rank test, P sleep disorders was an independent risk factor for the development of Parkinson's disease [crude hazard ratio: 1.63, 95% confidence interval (CI): 1.54-1.73, P sleep disorders, especially chronic insomnia, are associated with a higher risk for future Parkinson's disease. © 2017 European Sleep Research Society.

Shared and unique mechanisms underlying binge eating disorder and addictive disorders

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Schulte, Erica M.; Grilo, Carlos M.; Gearhardt, Ashley N.

2018-01-01

Scientific interest in “food addiction” is growing, but the topic remains controversial. One critique of “food addiction” is its high degree of phenotypic overlap with binge eating disorder (BED). In order to examine associations between problematic eating behaviors, such as binge eating and “food addiction,” we propose the need to move past examining similarities and differences in symptomology. Instead, focusing on relevant mechanisms may more effectively determine whether “food addiction” contributes to disordered eating behavior for some individuals. This paper reviews the evidence for mechanisms that are shared (i.e., reward dysfunction, impulsivity) and unique for addiction (i.e., withdrawal, tolerance) and eating disorder (i.e., dietary restraint, shape/weight concern) frameworks. This review will provide a guiding framework to outline future areas of research needed to evaluate the validity of the “food addiction” model and to understand its potential contribution to disordered eating. PMID:26879210

A cross-sectional study of the relationship between serum sexual hormone levels and internal derangement of temporomandibular joint.

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Madani, A S; Shamsian, A A; Hedayati-Moghaddam, M R; Fathi-Moghadam, F; Sabooni, M R; Mirmortazavi, A; Golmohamadi, M

2013-08-01

Temporomandibular disorders (TMD) are defined as clinical conditions that involve the masticatory muscles, temporomandibular joint (TMJ) or both. The aim of this study was to evaluate serum 17β-oestradiol and progesterone levels in menstruating women affected by internal derangement of the TMJ. A total of 142 women (mean age 30·2 ± 6·7) who referred to medical diagnostic laboratory of Iranian Academic Centre for Education, Culture and Research (ACECR), Mashhad Branch, were enrolled during 2007 and 2008. Forty-seven individuals had disc displacement with reduction (Group IIa) according to Research Diagnostic Criteria (RDC)/TMD Axis I diagnosis. Radioimmunoassay was used for the detection of serum 17β-oestradiol and progesterone levels in all 142 subjects. The mean progesterone level was significantly higher in control group (11·6 ± 10·4 ng mL(-1) ) compared to women with TMD (8·4 ± 6·8 ng mL(-1) , P = 0·03). No significant difference was found in two groups regarding 17β-oestradiol level. Lower progesterone level in women with TMD can suggest the more important role of this hormone in the development of the disorder. © 2013 John Wiley & Sons Ltd.

Temporomandibular joint ankylosis as part of the clinical spectrum of Carey-Fineman-Ziter syndrome?

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Pasetti, Martina; Mazzoleni, Fabio; Novelli, Giorgio; Iascone, Maria; Bozzetti, Alberto; Selicorni, Angelo

2016-08-01

The Carey-Finema-Ziter syndrome (CFZS, MIM 254940) is an apparently autosomal recessively inherited disorder consisting of the combination of non-progressive congenital myopathy with Moebius and Pierre Robin sequence, facial anomalies and growth delay. Mental development has been described as normal or delayed. Temporomandibular joint (TMJ) ankylosis is the immobility of the joint caused by ankylotic fusion of the mandible to the cranial base or zygoma. It is a serious and disabling condition that may cause problems in mastication, digestion, speech, appearance, and oral hygiene. Most often is a true ankylosis of the TMJ but other pathological mechanisms are described (i.e., the fusion of the coronoid process to temporal bone or with the zygoma, or a variety of soft tissues disorders like Fibrodysplasia Ossificans Progressiva). Here we report a 2-year-old girl fitting with a clinical diagnosis of CFZS associated with a limited mouth opening in which temporomandibular joint ankylosis was suspected. Because it has been postulated that many clinical features in CFZS may only be secondary effects of brainstem anomalies and muscle weakness during development, the limited opening of the mouth observed in our patient could represent a rare clinical feature of CFZS itself. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Future of brain stimulation: new targets, new indications, new technology.

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Hariz, Marwan; Blomstedt, Patric; Zrinzo, Ludvic

2013-11-01

In the last quarter of a century, DBS has become an established neurosurgical treatment for Parkinson's disease (PD), dystonia, and tremors. Improved understanding of brain circuitries and their involvement in various neurological and psychiatric illnesses, coupled with the safety of DBS and its exquisite role as a tool for ethical study of the human brain, have unlocked new opportunities for this technology, both for future therapies and in research. Serendipitous discoveries and advances in structural and functional imaging are providing abundant "new" brain targets for an ever-increasing number of pathologies, leading to investigations of DBS in diverse neurological, psychiatric, behavioral, and cognitive conditions. Trials and "proof of concept" studies of DBS are underway in pain, epilepsy, tinnitus, OCD, depression, and Gilles de la Tourette syndrome, as well as in eating disorders, addiction, cognitive decline, consciousness, and autonomic states. In parallel, ongoing technological development will provide pulse generators with longer battery longevity, segmental electrode designs allowing a current steering, and the possibility to deliver "on-demand" stimulation based on closed-loop concepts. The future of brain stimulation is certainly promising, especially for movement disorders-that will remain the main indication for DBS for the foreseeable future-and probably for some psychiatric disorders. However, brain stimulation as a technique may be at risk of gliding down a slippery slope: Some reports indicate a disturbing trend with suggestions that future DBS may be proposed for enhancement of memory in healthy people, or as a tool for "treatment" of "antisocial behavior" and for improving "morality." © 2013 International Parkinson and Movement Disorder Society.

Mood disorders in childhood and adolescence

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Thiago Botter Maio Rocha

2013-01-01

Full Text Available The identification and treatment of mood disorders in children and adolescents has grown over the last decades. Major depression is one of the most common and debilitating disorders worldwide, imposing a massive burden to the youth population. Bipolar disorder is being increasingly recognized as having its roots early in life, and its presentation during childhood and adolescence has been submitted to extensive research. This review aims to highlight clinical aspects of the current knowledge on mood disorders in the pediatric population, presenting updated information on epidemiology, diagnostic procedures, and management strategies. Limitations of available evidence and future directions of research in the field are also discussed.

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

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

2012-09-15

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

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

International Nuclear Information System (INIS)

Nah, Kyung Soo

2012-01-01

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

Quantitative and qualitative comparison of MR imaging of the temporomandibular joint at 1.5 and 3.0 T using an optimized high-resolution protocol.

Science.gov (United States)

Manoliu, Andrei; Spinner, Georg; Wyss, Michael; Erni, Stefan; Ettlin, Dominik A; Nanz, Daniel; Ulbrich, Erika J; Gallo, Luigi M; Andreisek, Gustav

2016-01-01

To quantitatively and qualitatively compare MRI of the temporomandibular joint (TMJ) using an optimized high-resolution protocol at 3.0 T and a clinical standard protocol at 1.5 T. A phantom and 12 asymptomatic volunteers were MR imaged using a 2-channel surface coil (standard TMJ coil) at 1.5 and 3.0 T (Philips Achieva and Philips Ingenia, respectively; Philips Healthcare, Best, Netherlands). Imaging protocol consisted of coronal and oblique sagittal proton density-weighted turbo spin echo sequences. For quantitative evaluation, a spherical phantom was imaged. Signal-to-noise ratio (SNR) maps were calculated on a voxelwise basis. For qualitative evaluation, all volunteers underwent MRI of the TMJ with the jaw in closed position. Two readers independently assessed visibility and delineation of anatomical structures of the TMJ and overall image quality on a 5-point Likert scale. Quantitative and qualitative measurements were compared between field strengths. The quantitative analysis showed similar SNR for the high-resolution protocol at 3.0 T compared with the clinical protocol at 1.5 T. The qualitative analysis showed significantly better visibility and delineation of clinically relevant anatomical structures of the TMJ, including the TMJ disc and pterygoid muscle as well as better overall image quality at 3.0 T than at 1.5 T. The presented results indicate that expected gains in SNR at 3.0 T can be used to increase the spatial resolution when imaging the TMJ, which translates into increased visibility and delineation of anatomical structures of the TMJ. Therefore, imaging at 3.0 T should be preferred over 1.5 T for imaging the TMJ.

Mental disorders across the adult life course and future coronary heart disease: evidence for general susceptibility

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Gale, Catharine R; Batty, G David; Osborn, David P J; Tynelius, Per; Rasmussen, Finn

2014-01-01

Background Depression, anxiety and psychotic disorders have been associated with an increased risk of coronary heart disease (CHD). It is unclear whether this association between mental health and CHD is present across a wider range of mental disorders. Methods and Results Participants were 1,107,524 Swedish men conscripted at mean age 18.3 years. Mental disorders were assessed by psychiatric interview on conscription and data on hospital admissions for mental disorder and CHD were obtained from national registers during 22.6 years of follow-up. Increased risk of incident CHD was evident across a range of mental disorders whether diagnosed at conscription or on later hospital admission. Age-adjusted hazard ratios (95% confidence intervals) according to diagnoses at conscription ranged from 1.30 (1.05, 1.60) (depressive disorders) to 1.92 (1.60, 2.31) (alcohol-related disorders). The equivalent figures according to diagnoses during hospital admission ranged from 1.49 (1.24, 1.80) (schizophrenia) to 2.82 (2.53, 3.13) (other substance use disorders). Associations were little changed by adjustment for parental socioeconomic status, or body mass index, diabetes and blood pressure measured at conscription, but were partially attenuated by adjustment for smoking, alcohol intake, and intelligence measured at conscription, and for education and own socioeconomic position. Conclusions Increased risk of incident CHD is present across a range of mental disorders and is observable when disorders are diagnosed at a young age. PMID:24190959

Mental disorders across the adult life course and future coronary heart disease: evidence for general susceptibility.

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Gale, Catharine R; Batty, G David; Osborn, David P J; Tynelius, Per; Rasmussen, Finn

2014-01-14

Depression, anxiety, and psychotic disorders have been associated with an increased risk of coronary heart disease (CHD). It is unclear whether this association between mental health and CHD is present across a wider range of mental disorders. Participants were 1 107 524 Swedish men conscripted at a mean age of 18.3 years. Mental disorders were assessed by psychiatric interview on conscription, and data on hospital admissions for mental disorder and CHD were obtained from national registers during 22.6 years of follow-up. An increased risk of incident CHD was evident across a range of mental disorders whether diagnosed at conscription or on later hospital admission. Age-adjusted hazard ratios (95% confidence intervals) according to diagnoses at conscription ranged from 1.30 (1.05, 1.62) (depressive disorders) to 1.90 (1.58, 2.38) (alcohol-related disorders). [corrected]. The equivalent figures according to diagnoses during hospital admission ranged from 1.49 (1.24-1.80) (schizophrenia) to 2.82 (2.53-3.13) (other substance use disorders). Associations were little changed by adjustment for parental socioeconomic status, or body mass index, diabetes mellitus, and blood pressure measured at conscription, but they were partially attenuated by the adjustment for smoking, alcohol intake, and intelligence measured at conscription, and for education and own socioeconomic position. Increased risk of incident CHD is present across a range of mental disorders and is observable when the disorders are diagnosed at a young age.

Pathologic gambling disorder. How to help patients curb risky behavior when the future is at stake.

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Sumitra, Leena M; Miller, Shannon C

2005-07-01

Pathologic gambling disorder and problem gambling are becoming increasingly common in the United States as more states legalize gambling. Although gambling-related disorders can cause devastating consequences, well-studied treatments are few. Fortunately, clinical experience suggests that pathologic gambling disorder is highly treatable. In this article, Drs Sumitra and Miller briefly summarize gambling-related disorders and discuss available, effective treatments.

Temporomandibular joint arthrography: normal anatomy and technique of examination

International Nuclear Information System (INIS)

Duvoisin, B.; Schnyder, P.; Klaus, E.; Jacques, B.

1990-01-01

Temporomandibular joint (TMJ) dysfunction is common. This entity is most often consecutive to internal derangements of the TMJ, which are not recognizable on plain films and tomograms. TMJ arthrography has proved a valuable tool in diagnosing these abnormalities. The technique of examination and normal arthrographic anatomy are reviewed. (author) [pt

Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions

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Mitchell, John T.; Zylowska, Lidia; Kollins, Scott H.

2015-01-01

Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Two case study examples are provided to demonstrate relevant clinical issues for practitioners interested in this approach. Directions for future research, including mindfulness meditation as a standalone treatment and as a complementary approach to cognitive-behavioral therapy, are provided. PMID:25908900

Impairment in delay discounting in schizophrenia and schizoaffective disorder but not primary mood disorders.

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Brown, Hannah E; Hart, Kamber L; Snapper, Leslie A; Roffman, Joshua L; Perlis, Roy H

2018-05-28

A measure of planning and impulse control, the delay-discounting (DD) task estimates the extent to which an individual decreases the perceived value of a reward as the reward is delayed. We examined cross-disorder performance between healthy controls (n = 88), individuals with bipolar disorder (n = 23), major depressive disorder (n = 43), and primary psychotic disorders (schizophrenia and schizoaffective disorder; n = 51) on the DD task (using a $10 delayed larger reward), as well as the interaction of DD scores with other symptom domains (cognition, psychosis, and affect). We found that individuals with schizophrenia and schizoaffective disorder display significantly greater rates of discounting compared to healthy controls, while individuals with a primary mood disorder do not differ from healthy controls after adjustment for IQ. Further, impairment in working memory is associated with higher discounting rates among individuals with schizophrenia and schizoaffective disorder, but cognitive dysfunction alone does not account for the extent of impairment in DD. Taken together, these results suggest an impaired ability to plan for the future and make adaptive decisions that are specific to individuals with psychotic disorders, and likely related to adverse functional outcomes. More generally, this work demonstrates the presence of variation in impulsivity across major psychiatric illnesses, supporting the use of a trans-diagnostic perspective.

Functional disorders of the anus and rectum

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Whitehead, W; Wald, A; Diamant, N; Enck, P; Pemberton, J; Rao, S

1999-01-01

In this report the functional anorectal disorders, the etiology of which is currently unknown or related to the abnormal functioning of normally innervated and structurally intact muscles, are discussed. These disorders include functional fecal incontinence, functional anorectal pain, including levator ani syndrome and proctalgia fugax, and pelvic floor dyssynergia. The epidemiology of each disorder is defined and discussed, their pathophysiology is summarized and diagnostic approaches and treatment are suggested. Some suggestions for the direction of future research on these disorders are also given.


Keywords: fecal incontinence; pelvic floor dyssynergia; anismus; proctalgia fugax; levator ani syndrome; constipation; Rome II PMID:10457046

Pharmacological Treatment Of Body Dysmorphic Disorder.

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Hong, Kevin; Nezgovorova, Vera; Uzunova, Genoveva; Schlussel, Danya; Hollander, Eric

2018-04-26

Body dysmorphic disorder is a challenging disorder that manifests as erroneously perceived flaws in one's physical appearance and repetitive behaviors in response to appearance concerns. This disorder is also frequently comorbid with other psychiatric disorders, including major depressive disorder and autism spectrum disorder. It is currently understood to arise from a combination of biological, psychological, and environmental factors. Treatment of body dysmorphic disorder typically consists of a combination of pharmacotherapy and cognitive behavioral therapy. However, not all patients respond to treatment, and BDD symptoms remain even in those who do respond. This review outlines current pharmacological and neuromodulation treatments for body dysmorphic disorder, and suggests directions for future studies of novel treatments such as augmentation with atypical antipsychotics and the use of intranasal oxytocin in cases of body dysmorphic disorder that show residual symptomatology even with tailored monotherapy. There is emerging evidence suggesting that non-invasive neurostimulatory techniques, such as repetitive transcranial magnetic stimulation, may be of value in treatment-resistant cases. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Clinical neurogenetics: autism spectrum disorders.

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Mehta, Sunil Q; Golshani, Peyman

2013-11-01

Autism spectrum disorders are neurodevelopmental disorders characterized by deficits in social interactions, communication, and repetitive or restricted interests. There is strong evidence that de novo or inherited genetic alterations play a critical role in causing Autism Spectrum Disorders, but non-genetic causes, such as in utero infections, may also play a role. Magnetic resonance imaging based and autopsy studies indicate that early rapid increase in brain size during infancy could underlie the deficits in a large subset of subjects. Clinical studies show benefits for both behavioral and pharmacological treatment strategies. Genotype-specific treatments have the potential for improving outcome in the future. Published by Elsevier Inc.

Efficacy of Arthrocentesis with Injection of Hyaluronic Acid in the Treatment of Internal Derangement of Temporomandibular Joint

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Pramila Shakya

2010-07-01

Full Text Available This cross-sectional study was designed to find out the effect of arthrocentesis with injection hyaluronic acid in thetreatment of internal derangement of temporomandibular joint (TMJ ID for the restoration of TMJ function. The studyincluded 25 patients, aged 13 to 50 years with symptoms of TMJ pain and clicking during function and limited mouthopening. TMJ ID was assessed with clinical examination and conformed with MRI. Arthrocentesis was done withinsertion of two 21gauze needles in the upper joint compartment and joint lavaged with 200 ml of ringer’s lactate solutionand at the end 1ml of hyaluronic acid was injected. Intensity of TMJ pain and clicking was assessed using visual analogscale, maximum mouth opening, lateral jaw movement and protrusion were assessed with millimeter scale. All theparameters were measured before the procedure , immediately after the procedure then after 2 weeks, 1 month , 3 monthsand 6 months procedure. During 6 months follow-up, clinical examination and comparison of the results showed 84%reduction in TMJ pain, 92% improvement in mouth opening and clicking disappear in 80% of patients.Key words: TMJ pain; clicking; internal derangement; arthrocentesis; hyaluronic acid.DOI: 10.3329/bsmmuj.v3i1.5509BSMMU J 2010; 3(1: 18-22

Psychoneuroimmunology of mental disorders.

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Soria, Virginia; Uribe, Javiera; Salvat-Pujol, Neus; Palao, Diego; Menchón, José Manuel; Labad, Javier

The immune system is a key element in the organism's defence system and participates in the maintenance of homeostasis. There is growing interest in the aetiopathogenic and prognostic implications of the immune system in mental disorders, as previous studies suggest the existence of a dysregulation of the immune response and a pro-inflammatory state in patients with mental disorders, as well as an increased prevalence of neuropsychiatric symptoms in patients suffering from autoimmune diseases or receiving immune treatments. This study aims to conduct a narrative review of the scientific literature on the role of Psychoneuroimmunology in mental disorders, with special focus on diagnostic, prognostic and therapeutic issues. The development of this body of knowledge may bring in the future important advances in the vulnerability, aetiopathogenic mechanisms, diagnosis and treatment of some mental disorders. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

Differences in latency to first pharmacological treatment (duration of untreated illness) in anxiety disorders: a study on patients with panic disorder, generalized anxiety disorder and obsessive-compulsive disorder.

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Dell'Osso, Bernardo; Camuri, Giulia; Benatti, Beatrice; Buoli, Massimiliano; Altamura, A Carlo

2013-11-01

The latency to first pharmacological treatment (duration of untreated illness or 'DUI') is supposed to play a major role in terms of outcome in psychotic conditions. Interest in the field of affective disorders and, in particular, of duration of untreated anxiety, has been recently registered as well. However, a preliminary epidemiologic investigation of the phenomenon is necessary. The present study was aimed to investigate and compare age at onset, age at first pharmacological treatment and DUI in a sample of patients affected by different anxiety disorders. DUI was defined as the interval between the onset of the specific anxiety disorder and the administration of the first adequate pharmacological treatment in compliant subjects. Study sample included 350 patients, of both sexes, with a DSM-IV-TR diagnosis of panic disorder (n = 138), generalized anxiety disorder (n = 127) and obsessive-compulsive disorder (n = 85). Panic disorder was associated with the shortest DUI (39.5 months), whereas obsessive-compulsive disorder was associated with the longest latency to treatment (94.5 months) (F = 13.333; P anxiety disorder showed a mean DUI of 81.6 months. Present results indicate that patients with different anxiety disorders may wait for years (from 3 up to 8) before receiving a first adequate pharmacological treatment. Differences in terms of age at onset, age at the first pharmacological treatment and, ultimately, in DUI in specific anxiety disorders may depend on multiple clinical and environmental factors. Latency to non-pharmacological interventions (e.g. psychoeducation and different forms of psychotherapy) needs to be addressed and correlated with DUI in future studies. © 2013 Wiley Publishing Asia Pty Ltd.

Interventions for High School Students with Attention-Deficit/Hyperactivity Disorder: Considerations for Future Directions

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Fabiano, Gregory A.

2014-01-01

Attention-deficit/hyperactivity disorder is now widely conceptualized as a life course-persistent disorder, present from early childhood, and it results in pronounced impairment in functioning within educational settings, including high school. Current intervention approaches are briefly reviewed, and an approach to framing interventions within a…

Errors of logic and scholarship concerning dissociative identity disorder.

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Ross, Colin A

2009-01-01

The author reviewed a two-part critique of dissociative identity disorder published in the Canadian Journal of Psychiatry. The two papers contain errors of logic and scholarship. Contrary to the conclusions in the critique, dissociative identity disorder has established diagnostic reliability and concurrent validity, the trauma histories of affected individuals can be corroborated, and the existing prospective treatment outcome literature demonstrates improvement in individuals receiving psychotherapy for the disorder. The available evidence supports the inclusion of dissociative identity disorder in future editions of the Diagnostic and Statistical Manual of Mental Disorders.

Quantitative and qualitative comparison of MR imaging of the temporomandibular joint at 1.5 and 3.0 T using an optimized high-resolution protocol

Science.gov (United States)

Spinner, Georg; Wyss, Michael; Erni, Stefan; Ettlin, Dominik A; Nanz, Daniel; Ulbrich, Erika J; Gallo, Luigi M; Andreisek, Gustav

2016-01-01

Objectives: To quantitatively and qualitatively compare MRI of the temporomandibular joint (TMJ) using an optimized high-resolution protocol at 3.0 T and a clinical standard protocol at 1.5 T. Methods: A phantom and 12 asymptomatic volunteers were MR imaged using a 2-channel surface coil (standard TMJ coil) at 1.5 and 3.0 T (Philips Achieva and Philips Ingenia, respectively; Philips Healthcare, Best, Netherlands). Imaging protocol consisted of coronal and oblique sagittal proton density-weighted turbo spin echo sequences. For quantitative evaluation, a spherical phantom was imaged. Signal-to-noise ratio (SNR) maps were calculated on a voxelwise basis. For qualitative evaluation, all volunteers underwent MRI of the TMJ with the jaw in closed position. Two readers independently assessed visibility and delineation of anatomical structures of the TMJ and overall image quality on a 5-point Likert scale. Quantitative and qualitative measurements were compared between field strengths. Results: The quantitative analysis showed similar SNR for the high-resolution protocol at 3.0 T compared with the clinical protocol at 1.5 T. The qualitative analysis showed significantly better visibility and delineation of clinically relevant anatomical structures of the TMJ, including the TMJ disc and pterygoid muscle as well as better overall image quality at 3.0 T than at 1.5 T. Conclusions: The presented results indicate that expected gains in SNR at 3.0 T can be used to increase the spatial resolution when imaging the TMJ, which translates into increased visibility and delineation of anatomical structures of the TMJ. Therefore, imaging at 3.0 T should be preferred over 1.5 T for imaging the TMJ. PMID:26371077

Trachlight management of succinylcholine-induced subluxation of the Temporo-mandibular joint: a case report and review of the literature.

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Roze des Ordons, Amanda; Townsend, Derek R

2008-09-01

We present a case of spontaneous subluxation of the Temporo-mandibular joint (TMJ) induced by succinylcholine, to compare our experience with previous cases reported in the literature, and to review the pathophysiology, preoperative screening, and intraoperative management of TMJ instability. A 39-yr-old female with primary hyperparathyroidism and a normal airway examination presented for elective parathyroidectomy. Following induction of anesthesia and the administration of succinylcholine prior to jaw manipulation, her mouth could not be opened, and we suspected spontaneous subluxation of the TMJ. We secured the airway with the use of a Trachlight and, subsequently, reduced the joint. Postoperatively, a history of mild TMJ-related symptoms was elicited. Instability of the TMJ is not uncommon, and has several implications for airway management, highlighting the importance of preoperative screening. Limited mouth opening, due to spontaneous subluxation of the TMJ following succinylcholine-induced muscle relaxation in the absence of airway manipulation, has only twice been reported in the literature. This report highlights how tracheal intubation may be accomplished using the Trachlight, in order to secure the airway prior to reduction of the subluxed joint.

Treatment of Functional Gastrointestinal Disorders in Children and Future Challenges

Directory of Open Access Journals (Sweden)

K Eftekhari

2014-04-01

Full Text Available Functional gastrointestinal disorders (FGIDs are a common problem in children. These disorders in children are classified into the following categories according to the ROME III classification: Functional Dyspepsia, Irritable bowel syndrome (IBS, Abdominal Migraines, Childhood Functional abdominal pain (FAP, Childhood functional abdominal pain syndrome and functional constipation. FGIDs are diagnosed based on history and normal physical examination provided that there is no evidence of underlying disease such as anatomical abnormalities, infectious, inflammatory and malignancies. This group of poorly defined diseases represent a huge treatment challenge to the specialist, because, until now there is no therapy that has been effective in improving the symptoms. FGIDs also cause deep family problems as the disease interrupts their routine and positive response to treatment is rarely seen. On the other hand there is no objective document of the disease neither endoscopic, radiologic nor pathologic. Therapeutic strategies of FGIDs are: education and parent's assurance, detection and modifying physical and psychological stress, dietary intervention, pharmacological treatment, psychotherapy and other complementary medical treatments. Some foods may trigger the illness such as coffee, fatty foods and spicy foods, therefore they should be avoided. Lactose-free diet cannot improve symptoms of FGIDs, except in children with lactose intolerance. The beneficial effect of fiber supplement in children with FGIDs remains unknown but it has been useful in adults with IBS. Probiotics have potential efficacy in treating IBS but the efficacy in children with FGIDs remains uncertain and needs to be further studied. In patients with severe symptoms, pharmacological agents can be effective. These drugs include Antacids, Prokinetics, Anticholinergic, Tricyclic antidepressants (TCAS and Serotonergic agents (Agonists and anti agonists. Psychotherapy in FAP and IBS is

Overexpression of Indian hedgehog partially rescues short stature homeobox 2-overexpression-associated congenital dysplasia of the temporomandibular joint in mice.

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Li, Xihai; Liang, Wenna; Ye, Hongzhi; Weng, Xiaping; Liu, Fayuan; Lin, Pingdong; Liu, Xianxiang

2015-09-01

The role of short stature homeobox 2 (shox2) in the development and homeostasis of the temporomandibular joint (TMJ) has been well documented. Shox2 is known to be expressed in the progenitor cells and perichondrium of the developing condyle. A previous study by our group reported that overexpression of shox2 leads to congenital dysplasia of the TMJ via downregulation of the Indian hedgehog (Ihh) signaling pathway, which is essential for embryonic disc primordium formation and mandibular condylar growth. To determine whether overexpression of Ihh may rescue the overexpression of shox2 leading to congenital dysplasia of the TMJ, a mouse model in which Ihh and shox2 were overexpressed (Wnt1-Cre; pMes-stop shox2; pMes-stop Ihh mice) was utilized to assess the consequences of this overexpression on TMJ development during post-natal life. The results showed that the developmental process and expression levels of runt-related transcription factor 2 and sex determining region Y-box 9 in the TMJ of the Wnt1-Cre; pMes-stop shox2; pMes-stop Ihh mice were similar to those in wild‑type mice. Overexpression of Ihh rescued shox2 overexpression-associated reduction of extracellular matrix components. However, overexpression of Ihh did not inhibit the shox2 overexpression-associated increase of matrix metalloproteinases (MMPs) MMP9, MMP13 and apoptosis in the TMJ. These combinatory cellular and molecular defects appeared to account for the observed congenital dysplasia of TMJ, suggesting that overexpression of Ihh partially rescued shox2 overexpression‑associated congenital dysplasia of the TMJ in mice.

Temporomandibular Joint Involvement in Association With Quality of Life, Disability, and High Disease Activity in Juvenile Idiopathic Arthritis.

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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.

Posttraumatic stress disorder in the wake of heart disease

DEFF Research Database (Denmark)

Spindler, Helle; Pedersen, Susanne S.

2014-01-01

There is increasing recognition that patients after a cardiac event may be at risk of posttraumatic stress disorder (PTSD). The present article reviews studies looking at PTSD as a sequel of heart disease with a focus on prevalence, risk factors, and future research directions.......There is increasing recognition that patients after a cardiac event may be at risk of posttraumatic stress disorder (PTSD). The present article reviews studies looking at PTSD as a sequel of heart disease with a focus on prevalence, risk factors, and future research directions....

Osseous osteoarthritic-like changes and joint mobility of the temporomandibular joints and upper cervical spine

DEFF Research Database (Denmark)

Sonnesen, Liselotte; Petersson, Arne; Wiese, Mie

2017-01-01

OBJECTIVES: 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. STUDY DESIGN: 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...

THE CORRELATION OF PARENTING STYLE WITH COGNITIVE DEVELOPMENT IN CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER

OpenAIRE

Fitri Genisti; Ni Komang Sukra Andini; Ni Luh Gede Puspita Yanti

2018-01-01

Background: Child development is a very important phase, which children learn various skills as future generations in the future. Disorders that can impede child development process of Attention Deficit Hyperactivity Disorder (ADHD). Children with ADHD have problems with cognitive abilities, of which about 20-60% of them have learning disorders. The efforts to support cognitive development in ADHD children is to approach the child's environment through parenting parents. Objective: This s...

Role of Auriculotherapy in the Treatment of Temporomandibular Disorders with Anxiety in University Students

Directory of Open Access Journals (Sweden)

Denise Hollanda Iunes

2015-01-01

Full Text Available Introduction. The aim of this study was to evaluate the role of auriculotherapy with mustard seeds in the treatment of temporomandibular disorders (TMDs, anxiety, and electromyographic (EMG activity in university students. Methodology. The State Trait Anxiety Inventory (STAI, Research Diagnostic Criteria (RDC for TMDs (RDC/TMDs, and electromyography were used in this study of 44 college students with high levels of anxiety and TMDs. The subjects were divided into two groups: an auriculotherapy (AA group (n=31 and an AA sham group (n=13. The mustard seeds were applied to the shenmen, rim, sympathetic, brain stem, and temporomandibular joint (TMJ points in the AA group and to sham points in the external ear and wrist in the AA sham group. The treatment protocol was 10 sessions (two treatments per week. Results. Anxiety (p<0.01 was significantly reduced in the AA group. This group also showed a decrease in tender points in the mandibular posterior region (p=0.04 and in the right side of the submandibular region (p=0.02. Complaints of bilateral pain were reduced in the temporal tendon (p≤0.01 and in the left side of the ATM (p<0.01. In addition, electromyographic (EMG activity was reduced during temporal muscle contraction (p=0.03.  Conclusion. Auriculotherapy was effective in the treatment of students with anxiety and TMDs.

Functions of intrinsic disorder in transmembrane proteins

DEFF Research Database (Denmark)

Kjaergaard, Magnus; Kragelund, Birthe B.

2017-01-01

Intrinsic disorder is common in integral membrane proteins, particularly in the intracellular domains. Despite this observation, these domains are not always recognized as being disordered. In this review, we will discuss the biological functions of intrinsically disordered regions of membrane...... receptors. The functions of the disordered regions are many and varied. We will discuss selected examples including: (1) Organization of receptors, kinases, phosphatases and second messenger sources into signaling complexes. (2) Modulation of the membrane-embedded domain function by ball-and-chain like...... mechanisms. (3) Trafficking of membrane proteins. (4) Transient membrane associations. (5) Post-translational modifications most notably phosphorylation and (6) disorder-linked isoform dependent function. We finish the review by discussing the future challenges facing the membrane protein community regarding...

Temporomandibular Joint: MRT Diagnostics; Temporomandibulargelenk: MRT-Diagnostik

Energy Technology Data Exchange (ETDEWEB)

Kress, B. [Universitaetsklinikum Heidelberg (Germany). Abteilung Neuroradiologie; Universitaetsklinikum Heidelberg (Germany). Neurologische Klinik; Schmitter, M. [Universitaetsklinikum Heidelberg (Germany). Poliklinik fuer zahnaerztliche Prothetik; Universitaetsklinikum Heidelberg (Germany). Abteilung Neuroradiologie

2005-09-01

MRI of the temporomandibular joint (TMJ) requires 1.5 T. The radiologist must be familiar with the anatomy and pathology of the TMJ. This review gives a description of MRI protocols for the TMJ, and MRI anatomy and pathology of the TMJ (open and closed mouth) by means of MR images and drawings. Diagnosing of the TMJ related diseases depends on standardized clinical and MR examinations. Therefore close interdisciplinary cooperation between dentist and radiologist is necessary. (orig.) [German] Magnetresonanztomographie bei Kiefergelenkbeschwerden erfordert neben guter technischer Ausstattung Kenntnisse der Anatomie und Pathologie des Kiefergelenks. Diese Uebersicht stellt neben MRT-Protokollen die Anatomie und die pathologischen Befunde des Kiefergelenks bei geoeffnetem und geschlossenem Mund anhand von Abbildungen und Graphiken systematisch dar. Bildgebende Diagnostik des Kiefergelenks gruendet sich auf eine standardisierte klinische und magnetresonanztomographische Untersuchung und erfordert eine enge interdisziplinaere Kooperation zwischen Zahnmedizin und Radiologie. (orig.)

Splint therapy for disc displacement with reduction of the temporomandibular joint. Part I: Modified mandibular splint therapy

OpenAIRE

Huang, I-Yueh; Wu, Ju-Hui; Kao, Yu-Hsun; Chen, Chao-Ming; Chen, Chun-Ming; Yang, Yi-Hsin

2011-01-01

The aims of this preliminary study were to present a modified mandibular splint together with a treatment regimen and to evaluate their effects on the treatment of reciprocal joint sounds of the temporomandibular joint (TMJ). The study participants were recruited from 312 consecutive patients in the temporomandibular disorder clinic of a medical center in Taiwan from January 2003 to December 2003. From among these, 59 cases with typical reciprocal clicking were selected for this study. All pa...

Antisocial Personality as a Neurodevelopmental Disorder.

Science.gov (United States)

Raine, Adrian

2018-05-07

Although antisocial personality disorder (APD) is one of the most researched personality disorders, it is still surprisingly resistant to treatment. This lack of clinical progress may be partly due to the failure to view APD as a neurodevelopmental disorder and to consider early interventions. After first defining what constitutes a neurodevelopmental disorder, this review evaluates the extent to which APD meets neurodevelopmental criteria, covering structural and functional brain imaging, neurocognition, genetics and epigenetics, neurochemistry, and early health risk factors. Prevention and intervention strategies for APD are then outlined, focusing on addressing early biological and health systems, followed by forensic and clinical implications. It is argued both that APD meets criteria for consideration as a neurodevelopmental disorder and that consideration should be given both to the possibility that early onset conduct disorder is neurodevelopmental in nature, and also to the inclusion of psychopathy as a specifier in future Diagnostic and Statistical Manual revisions of APD.

Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†.

Science.gov (United States)

Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond; Look, John; Anderson, Gary; Goulet, Jean-Paul; List, Thomas; Svensson, Peter; Gonzalez, Yoly; Lobbezoo, Frank; Michelotti, Ambra; Brooks, Sharon L; Ceusters, Werner; Drangsholt, Mark; Ettlin, Dominik; Gaul, Charly; Goldberg, Louis J; Haythornthwaite, Jennifer A; Hollender, Lars; Jensen, Rigmor; John, Mike T; De Laat, Antoon; de Leeuw, Reny; Maixner, William; van der Meulen, Marylee; Murray, Greg M; Nixdorf, Donald R; Palla, Sandro; Petersson, Arne; Pionchon, Paul; Smith, Barry; Visscher, Corine M; Zakrzewska, Joanna; Dworkin, Samuel F

2014-01-01

The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project-the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0.98) and for one intra

Self-reported aural symptoms, headache and temporomandibular disorders in Japanese young adults.

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Akhter, Rahena; Morita, Manabu; Ekuni, Disuke; Hassan, Nur Mohammad Monsur; Furuta, Michiko; Yamanaka, Reiko; Matsuka, Yoshizo; Wilson, David

2013-02-06

To investigate the associations of aural symptoms, headache and depression with the presence of temporomandibular disorder (TMD) symptoms in a young adult population in Japan. A personal interview survey was conducted on first-year university students (n = 1,930) regarding symptoms of TMD, aural problems, headache, shoulder pain and depression. Logistic regression was applied to assess the associations of these problems with the presence of TMD symptoms after controlling for age and gender. Among the 1,930 students, 543 students exhibited TMD symptoms and were classified into 7 groups: clicking only (Group I, n = 319), pain in the TMJ only (Group II, n = 21), difficulty in mouth opening only (Group III, n = 18), clicking and pain (Group IV, n = 29), clicking and difficulty in mouth opening (Group V, n = 48), difficulty in mouth opening and pain (Group VI, n = 11), and combination of three symptoms (Group VII, n = 97). The control group (n = 1,387) were subjects without any TMD symptoms. After adjusting for age and gender, a strong association was observed between TMD symptoms (Group II and IV) and tinnitus (OR = 12.1 and 13.2, respectively). TMD symptoms (Group I, II and III) were also associated with vertigo and headache. Otalgia and depression were significantly associated with the presence of clicking only. TMD symptoms were significantly correlated to aural symptoms and headache. A functional evaluation of the stomatognathic system should be considered in subjects with unexplained aural symptoms and headache.

Eating disorders in women

Science.gov (United States)

Sharan, Pratap; Sundar, A. Shyam

2015-01-01

Eating disorders, especially anorexia nervosa and bulimia nervosa have been classically described in young females in Western population. Recent research shows that they are also seen in developing countries including India. The classification of eating disorders has been expanded to include recently described conditions like binge eating disorder. Eating disorders have a multifactorial etiology. Genetic factor appear to play a major role. Recent advances in neurobiology have improved our understanding of these conditions and may possibly help us develop more effective treatments in future. Premorbid personality appears to play an important role, with differential predisposition for individual disorders. The role of cultural factors in the etiology of these conditions is debated. Culture may have a pathoplastic effect leading to non-conforming presentations like the non fat-phobic form of anorexia nervosa, which are commonly reported in developing countries. With rapid cultural transformation, the classical forms of these conditions are being described throughout the world. Diagnostic criteria have been modified to accommodate for these myriad presentations. Treatment of eating disorders can be quite challenging, given the dearth of established treatments and poor motivation/insight in these conditions. Nutritional rehabilitation and psychotherapy remains the mainstay of treatment, while pharmacotherapy may be helpful in specific situations. PMID:26330646