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Kimoto A, Yamashita J, Ohori H, Negi N, Sekitani T, Komori H, Shioyasono A, Tateishi C, Hasegawa T, Akashi M. A Novel Imaging Technique for Analyzing Condylar Movement During Mastication in Patients With Jaw Deformities: Four-Dimensional Computed Tomography. J Craniofac Surg 2023; 34:1880-1883. [PMID: 37428979 DOI: 10.1097/scs.0000000000009509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/17/2023] [Indexed: 07/12/2023] Open
Abstract
OBJECTIVE This study aimed to reveal characteristic condylar movements in patients with jaw deformities. STUDY DESIGN Thirty patients with jaw deformities before surgery were enrolled and instructed to chew a cookie during 4-dimensional computed tomography (4DCT). The distance between the most anterior and posterior positions of the bilateral condyles on 4DCT images was measured and compared among patients with different skeletal classes. Correlations between the condylar protrusion and cephalometric values were also determined. RESULTS The distances of condylar protrusion during mastication were significantly greater in the skeletal class II group than in the skeletal class III group ( P =0.0002). Significant correlations were found between the distances of condylar protrusion during mastication and the sella-nasion-B point angle ( r =-0.442, P =0.015), A point-nasion-B point angle ( r =0.516, P =0.004), sella-nasion plane to ramus plane angle ( r =0.464, P =0.01), sella-nasion plane to occlusal plane angle ( r =0.367, P =0.047), and condylion-gonion length ( r =-0.366, P =0.048). CONCLUSION Motion analysis with 4DCT images revealed that condylar movement in patients with retrognathism was larger than in patients with mandibular prognathism. Skeletal structure was therefore correlated with condylar movement during mastication.
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Affiliation(s)
- Akira Kimoto
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Junya Yamashita
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hiroaki Ohori
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Noriyuki Negi
- Department of Radiology, Kobe University Hospital, Kobe, Japan
| | - Toshinori Sekitani
- Department of Radiological Technologist, Osaka College of High Technology, Osaka, Japan
| | - Hiroki Komori
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Atsushi Shioyasono
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Chizu Tateishi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Takumi Hasegawa
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masaya Akashi
- Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Sundaram DS, Lal B, Kumar RD, Bhutia O. A rare case of bilateral pseudoaneurysm secondary to mandibular condyle fracture-a case report with review of literature. Oral Maxillofac Surg 2023; 27:527-532. [PMID: 35654988 DOI: 10.1007/s10006-022-01069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 05/01/2022] [Indexed: 11/28/2022]
Abstract
This paper aims to present a rare case report of bilateral pseudoaneurysm secondary to condylar fracture and its management with a brief review of literature. A patient of age 19 years with alleged history of road traffic accident presented 6 weeks lately to our department with slow growing swelling in right preauricular area. History revealed bilateral condylar fracture with right parasymphysis fracture of mandible for which patient underwent maxillomandibular fixation for 4 weeks. The diffuse swelling in preauricular region showed positive signs of pulsation and audible bruit. Ultrasonography and contrast-enhanced computed tomography suggested the bilateral presence of vascular anamoly from the terminal branches of external carotid artery. Diagnostic angiography confirmed presence of pseudoaneurysm at the bifurcation of the internal maxillary artery and superficial temporal artery (STA) on right side whereas on the left side it was at proximal STA. Bilateral endovascular coil and gel foam embolization was done and thrombosis was confirmed with high frequency ultrasound on fourth postintervention day. The swelling completely resolved in a period of 1 month with no evidence of recurrence in the following 2-year follow-up period. Routine investigation revealed presence of pseudoaneurysm on left side which was completely without any clinical signs as repoterd by many cases of condylar fracture in the literature review. Pseudoaneurysm may remain silent and are exposed intraoperatively with massive bleeding which causes significant morbidity. Hence, prompt diagnosis and management is essential to avoid unexpected complication perioperatively.
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Affiliation(s)
- D Shanmuga Sundaram
- Department of Oral and Maxillofacial Surgery, All India Institue of Medical Sciences, New Delhi-110029, India
| | - Babu Lal
- Department of Oral and Maxillofacial Surgery, All India Institue of Medical Sciences, New Delhi-110029, India
| | - Rudra Deo Kumar
- Department of Oral and Maxillofacial Surgery, All India Institue of Medical Sciences, New Delhi-110029, India
| | - Ongkila Bhutia
- Department of Oral and Maxillofacial Surgery, All India Institue of Medical Sciences, New Delhi-110029, India.
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Wu B, Lv K. Control of Mandibular Width With 3D Printed Occlusal Splint in Children With Multiple Mandibular Fractures. J Craniofac Surg 2023; 34:e582-e584. [PMID: 37236625 DOI: 10.1097/scs.0000000000009418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND The fracture of mandibular symphysis combined with bilateral condylar fractures often leads to changes in the width of the mandible, which significantly widens the face of the child. Therefore, it is necessary to reposition the mandible through accurate adduction. METHODS To ensure that the mandible can be accurately repositioned, a 3D printed occlusal splint was used. Bilateral maxillomandibular fixation screws were implanted. The 3D printed occlusal splint was located on the maxillary dentition and fixed to the maxillomandibular fixation screws with wire loops. The reference basis for adduction is to make the mandibular dentition located in the occlusal splint. The absorbable plate was contoured according to the restored model and fixed at the fracture site. The 3D printed occlusal splint was retained in the maxillary dentition for two months. RESULTS AND DISCUSSION Postoperative computed tomography showed that the mandible had been adducted according to the preoperative design. Two months of follow-up showed that the child's facial development, mouth opening type, occlusion, and range of motion were good. It is especially suitable for children with mandibular symphyseal fractures accompanied by bilateral condylar fractures.
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Affiliation(s)
- Benxing Wu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan, People's Republic of China
| | - Kun Lv
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, Wuhan, People's Republic of China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, People's Republic of China
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陈 晓, 陈 萍, 马 善, 梁 远, 徐 琳. [Study of dental arch width in patients with idiopathic condylar resorption]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2023; 37:652-655. [PMID: 37551574 PMCID: PMC10645529 DOI: 10.13201/j.issn.2096-7993.2023.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Indexed: 08/09/2023]
Abstract
Objective:To investigate the relationship between idiopathic condylar resorption (ICR) and arch width disorder. Methods:Thirty-two patients with ICR and twenty patients without condylar resorption were enrolled according to the same inclusion criteria. They were divided into experimental group and control group. The experimental group was divided into unilateral ICR group and bilateral ICR group according to the affected side of condylar resorption, and then experimental group was divided into subgroups ICR Ⅰ, ICRⅡand ICR Ⅲ according to the degree of condylar resorption. Patients with no condylar resorption were used as a control group. The width of anterior, middle and posterior segments of dental arch on cone beam computed tomography(CBCT) was measured and the two groups of measured values were statistically analyzed. Results:Compared with the control group, the width of maxillary anterior, middle and posterior segments in ICR group was significantly reduced, and the difference was statistically significant(P<0.01). But the width of mandibular segment was not significantly different from that in control group(P>0.05). There was no significant difference in the width of anterior, middle and posterior dental arch between subgroups(P>0.05). Conclusion:Almost all patients with ICR have malocclusion of maxillary and mandibular arch width, but there is no significant correlation between the malocclusion width and the severity of condylar resorption.
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Affiliation(s)
- 晓波 陈
- 珠海市口腔医院口腔正畸科(广东珠海,519000)Department of Orthodontics, Zhuhai Dental Hospital, Zhuhai, 519000, China
| | - 萍 陈
- 珠海市口腔医院口腔正畸科(广东珠海,519000)Department of Orthodontics, Zhuhai Dental Hospital, Zhuhai, 519000, China
| | - 善伟 马
- 珠海市口腔医院口腔正畸科(广东珠海,519000)Department of Orthodontics, Zhuhai Dental Hospital, Zhuhai, 519000, China
| | - 远威 梁
- 珠海市第五人民医院口腔科Department of Stomatology, Fifth People's Hospital
| | - 琳 徐
- 珠海市口腔医院口腔正畸科(广东珠海,519000)Department of Orthodontics, Zhuhai Dental Hospital, Zhuhai, 519000, China
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Gross A, Buschang PH, Shakya A, Jing Y. Short-term effects of mechanical loading on the transdifferentiation of condylar chondrocytes. Am J Orthod Dentofacial Orthop 2023; 164:201-214. [PMID: 36922241 PMCID: PMC10659147 DOI: 10.1016/j.ajodo.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Transdifferentiation of chondrocytes into bone cells explains most of the prenatal and early postnatal condylar growth, but its role during later postnatal growth and the mechanisms regulating transdifferentiation remain unknown. This study aimed to quantify the effects of mechanical loading on chondrocyte-derived osteogenesis during late postnatal condylar growth using a short-term mandibular laterotrusion model. METHODS Thirty 4-week-old Aggrecan-CreERT2, R26RtdTomato, and 2.3Col1a1-GFP compound mice received tamoxifen injections and were divided into control and experimental groups. Appliances were bonded to shift the mandibles of the experimental mice for 5 days, causing protrusion and retrusion of the right and left condyles, respectively. Radiographic, microcomputed tomographic, and histomorphometric analyses were performed. RESULTS The experimental and control groups showed substantial transdifferentiation of chondrocytes into bone cells. The experimental mice developed asymmetric mandibles, with the protrusive side significantly longer than the retrusive side. The protrusive condyles showed significantly increased chondrogenesis and greater numbers of chondrocyte-derived osteogenic cells, especially in the posterior third. The opposite effects were seen on the retrusive side. CONCLUSIONS Transdifferentiation of chondrocytes into bone cells occurs during late postnatal condylar growth. Laterotrusion regulates condylar chondrogenesis and chondrocyte transdifferentiation, which alters the amount and direction of condylar growth. Our study demonstrated that chondrocytes are key players in condylar bone formation and should be the focus of studies to control and further understand condylar growth.
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Affiliation(s)
- Amanda Gross
- Department of Orthodontics, Texas A&M University School of Dentistry, Dallas, Tex
| | - Peter H Buschang
- Department of Orthodontics, Texas A&M University School of Dentistry, Dallas, Tex
| | - Ajay Shakya
- Department of Biomedical Sciences, Texas A&M University School of Dentistry, Dallas, Tex
| | - Yan Jing
- Department of Orthodontics, Texas A&M University School of Dentistry, Dallas, Tex.
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Lepidi L, Grande F, Baldassarre G, Suriano C, Li J, Catapano S. Preliminary clinical study of the accuracy of a digital axiographic recording system for the assessment of sagittal condylar inclination. J Dent 2023; 135:104583. [PMID: 37331577 DOI: 10.1016/j.jdent.2023.104583] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/31/2023] [Accepted: 06/06/2023] [Indexed: 06/20/2023] Open
Abstract
OBJECTIVES The aim of this study was to clinically evaluate the accuracy of a digital axiographic recording system in tracing the sagittal condylar inclination. METHODS An axiographic examination that records the sagittal condylar path during protrusive/retrusive movement was performed on ten patients. Each subject was registered five different times by two different systems: 1) the Cadiax Gamma Diagnostic 4 computerized system as the control; 2) the Zebris Jaw Motion Analyser+ Optic System as the tested digital axiographic recording system. The records obtained allow to calculate the kinematic terminal transverse horizontal axis and the sagittal condylar inclination (SCI) at 3 and 5 mm along the pro-retrusive path. A linear mixed model was used to analyze if there was a statistically significant difference between the two systems. RESULTS The mean left SCI value recorded by Zebris system were 49.81 ± 10.64° at 3 mm, 48.10 ± 11.04° at 5 mm, while the values recorded by Gamma system were 55.16° at 3 mm, 52.18° at 5 mm. The mean right SCI value recorded by Zebris system were 54.53 ± 10.26° at 3 mm, 51.85 ± 8.55° at 5 mm, while the values recorded by Gamma system were 49.68° at 3 mm, 48.23° at 5 mm. Linear mixed model showed no significant statistical difference between the two systems. CONCLUSIONS Based on preliminary results, the Zebris Jaw Motion Analyzer+ Optic System demonstrates comparable accuracy to the Cadiax Gamma Diagnostic 4 when measuring sagittal condylar inclination. CLINICAL SIGNIFICANCE The digital axiographic recording system enables to evaluate sagittal condylar inclination and to adjust virtual articulators in a digital workflow.
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Affiliation(s)
- Luca Lepidi
- Department of Translational Medicine and for Romagna, University of Ferrara, Italy.
| | | | | | - Carmela Suriano
- Department of Clinical and Experimental Medicine, University of Foggia School of Dentistry, Foggia, Italy
| | - Junying Li
- Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Santo Catapano
- Department of Translational Medicine and for Romagna, University of Ferrara, Ferrara, Italy
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Luo E. Treatment of dentofacial deformities secondary to condylar hyperplasia. Hua Xi Kou Qiang Yi Xue Za Zhi 2023; 41:369-376. [PMID: 37474468 PMCID: PMC10372531 DOI: 10.7518/hxkq.2023.2023059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/27/2023] [Indexed: 07/22/2023]
Abstract
Dentofacial deformities secondary to condylar hyperplasiais a kind of disease presenting facial asymmetry, malocclusion, temporomandibular joint dysfunction, and other symptoms caused by non-neoplastic hyperplasia of the condyle. The etiology is still unknown, and currently, pre- and post-operative orthodontics accompanied by orthognathic surgery, temporomandibular joint surgery and jawbone contouring surgery are the main treatment methods. A personalized treatment plan was developed, considering the active degree of condyle hyperplasia, the severity of the jaw deformity, and the patient's will, to correct deformity, obtain ideal occlusal relationship, and regain good temporomandibular joint function. Combined with the author's clinical experience, the etiology, clinical and imageological features, treatment aims, and surgical methods of condylar hyperplasia and secondary dentofacial deformities were discussed in this paper.
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Affiliation(s)
- En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Chengdu 610041, China
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Espinosa S, Cortés R, Toro-Ibacache V. Single photon emission computed tomography (SPECT) diagnostic accuracy in active unilateral condylar hyperplasia: Retrospective study. J Craniomaxillofac Surg 2023; 51:467-474. [PMID: 37550116 DOI: 10.1016/j.jcms.2023.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 05/30/2023] [Accepted: 07/30/2023] [Indexed: 08/09/2023] Open
Abstract
The aim of this study was to assess the diagnostic accuracy of single photon emission tomography (SPECT) in unilateral condylar hyperplasia (UCH). To this end, 3D morphometric changes of the mandibles in one year were assessed (T0 vs. T1) and compared over SPECT results in T1, in a sample of 40 patients. A contingency table was constructed based on these results for SPECT diagnostic accuracy evaluation, classifying patients as SPECT true-positive, true-negatives, false positives and false-negatives. Additionally, the morphometric analysis was used to describe the presentation of mandibular changes using principal component analysis (PCA) and non-parametric statistics. We obtained diagnostic accuracy results of sensitivity 81%, specificity 63%, positive predictor value (PPV) 59%, negative predictor value (NPV) 83% and accuracy 70%, showing that SPECT yields poor results regarding accuracy diagnostic performance. The morphometric analysis showed that individuals without progress of asymmetry and those with more progress differ particularly in a group of landmarks representing the mental region and the right mandibular body. Based on these landmarks, difference among the four SPECT-accuracy groups was statistically significant (p < 0.001), where the landmark showing the largest change within a year had a mean increase of 1.13 + 0.66 mm. Within the limitations of the study, it seems that SPECT alone is not suitable for making surgical decisions regarding condylectomy in active UCH. Follow up with morphological assessment methods are recommended for confirming an active UCH in combination with SPECT.
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Affiliation(s)
- S Espinosa
- Department of Oral and Maxillofacial Surgery, Hospital Sótero del Río, Santiago, Chile; Department of Oral and Maxillofacial Surgery, Clinica Indisa, Santiago, Chile.
| | - R Cortés
- Department of Oral Rehabilitation, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - V Toro-Ibacache
- Laboratory for Craniofacial Research and Institute for Research in Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile; Department of Maxillofacial Surgery, Hospital Clínico San Borja Arriarán, Santiago, Chile
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Kumar CD, Selvaraj S, Mohan J, Raju R. Comparison of accuracy of protrusive condylar guidance registration by two interocclusal recording materials in edentulous patients. Ann Afr Med 2023; 22:316-320. [PMID: 37417019 PMCID: PMC10445705 DOI: 10.4103/aam.aam_70_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 05/12/2022] [Accepted: 06/20/2022] [Indexed: 07/08/2023] Open
Abstract
Background and Purpose During complete denture fabrication making Interocclusal records plays an integral role to obtain the condylar guidance value. The study was conducted to compare the protrusive condylar guidance registration by two interocclusal recording materials-Quick setting plaster and Luxabite®(bisacrylic composite) in semi adjustable articulator for completely edentulous patients. Methodology Maxillary and Mandibular casts of the completely edentulous patients were mounted in Hanau®Wide Vue articulator. The Quick setting plaster and Luxabite®(bisacrylic composite) was used as interocclusal recording materials to program the protrusive condylar guidance angles in the articulators. Results The protrusive condylar guidance values registered in the articulator for the different interocclusal records were tabulated and statistically analyzed.. The mean protrusive condylar guidance values registered in the articulator was compared with two parameters obtained from the radiographic tracings -- the protrusive condylar path angle obtained with Quick setting plaster and Luxabite with the inclination of articular eminence to the Frankfort horizontal plane. Conclusion From the study it was concluded that the Luxabite®(bisacrylic composite) material demonstrated better reproducibility of protrusive condylar guidance registration.than the Quick setting plaster.
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Affiliation(s)
- C. Dhinesh Kumar
- Department of Prosthodontics and Crown and Bridge, JKKN Dental College, Namakkal, Tamil Nadu, India
| | - Sunantha Selvaraj
- Department of Prosthodontics and Crown and Bridge, Vinayaka Mission's Sankarachariyar Dental College, Vinyaka Mission's Research Foundation-DU, Salem, Tamil Nadu, India
| | - Jayashree Mohan
- Department of Prosthodontics and Crown and Bridge, Vinayaka Mission's Sankarachariyar Dental College, Vinyaka Mission's Research Foundation-DU, Salem, Tamil Nadu, India
| | - Ramesh Raju
- Department of Prosthodontics and Crown and Bridge, Vinayaka Mission's Sankarachariyar Dental College, Vinyaka Mission's Research Foundation-DU, Salem, Tamil Nadu, India
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McLeod NM, Saeed NR, Gerber B. Remodelling of mandibular condylar head after fixation of fractures with ultrasound activated resorbable pins: A retrospective case series. J Craniomaxillofac Surg 2023; 51:460-466. [PMID: 37553264 DOI: 10.1016/j.jcms.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 05/22/2023] [Accepted: 07/30/2023] [Indexed: 08/10/2023] Open
Abstract
The aim of this study was to assess whether the resorption of poly-lactic acid pins, used for condylar head fracture fixation, adversely affect remodelling of the condylar head. A retrospective review of patients was performed that underwent ORIF of CHF with ultrasound activated resorbable poly-lactic acid pins and had CT/CBCT scans of the condyle at least 18 months after surgery, at which point the fixation material was expected to be resorbed. We reviewed the size, shape and position of the condylar head and compared this to the normal side and compared this to the results of conservative management and ORIF with titanium screws in the literature. Most patients had condylar heads normally positioned and shaped, with minimal bone changes. The position of the condyle in the fossa, its shape and bone changes compare favourably with previous studies on CHF managed conservatively or with titanium screw fixation. There was no radiographic evidence of the pins after 18 months. In conclusion, ultrasound activated resorbable pins can provide suitable fixation for ORIF of condylar head fractures, avoiding the need for screw removal, and there was no evidence that the resorption process adversely affected the remodelling of the condylar head.
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Affiliation(s)
- Niall Mh McLeod
- University Hospitals Coventry and Warwickshire NHS Trust, Department of Oral & Maxillofacial Surgery, University Hospital, Clifford Bridge Road, Coventry, CV2 2DX, UK.
| | - Nadeem R Saeed
- Oxford University Hospitals NHS Trust, Department of Oral & Maxillofacial Surgery, The John Radcliffe, Headley Way, Oxford, OX3 9DU, UK
| | - Barbara Gerber
- Oxford University Hospitals NHS Trust, Department of Oral & Maxillofacial Surgery, The John Radcliffe, Headley Way, Oxford, OX3 9DU, UK
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Peker Öztürk H, Avsever İsmail H, Şenel B, Özgedik HS, Kurt MH. retrospective evaluation of condylar morphology using panoramic radiography in a sample of Turkish population. Folia Morphol (Warsz) 2023; 83:192-199. [PMID: 37345390 DOI: 10.5603/fm.a2023.0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 05/12/2023] [Accepted: 06/11/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND The temporomandibular joint is one of the most complex anatomic structures. It takes a great role in masticatory system and helps to make possible some functions such as speaking, chewing and swallowing. Clinicians should have sufficient anatomical knowledge to assess relationships of the hard and soft tissues, including the mandibular condyle, glenoid fossa, articular eminence of the temporal bone, the articular disc and its attachments. The aim of this study was to evaluate the frequency of different types of mandibular condyles and its distribution according to the age and gender. It was also evaluated whether the condyle types were bilaterally symmetrical or not. MATERIALS AND METHODS A total of 1315 digital panoramic images which obtained from the patients suffering from the dental problems were assessed. Demographic data, condylar morphology were noted. All obtained data were analysed by using descriptive statistics. Morphology of mandibular condyles were classified into four shapes as identified in other studies, namely: type I - oval shape, type II - diamond shape, type III - bird beak shape, type IV - crooked finger shape. Two independent examiners, who have 19 and 7 years of experience in oral and dentomaxillofacial radiology, made a consensus and evaluated all images. RESULTS A total of 1315 digital panoramic images were assessed. Seven hundred sixty-seven [58.3%] the patients were female and 548 [41.6%] were male. The age range of patients was from 18 to 84 years. Right-left condyle types were found to be symmetrical in the range of 67% of the subpopulation examined in the study. For the consensus, 'oval' condyle was common on both the right and left, while 'crooked finger' condyle was the rarest. CONCLUSIONS The temporomandibular joint is the most important structure for all jaw functions such as speech, swallowing. In order for all these functions to continue in a healthy way, the anatomical structure should be known very well down to the finest detail. Identification of anatomical structures and their variations can play an important role in implant dentistry. Clinicians commonly prefer conventional radiologic methods to evaluate dentomaxillofacial region. Although the most of the variations are asymptomatic and require no treatment,correct identification of these findings will reduce unnecessary further diagnostic assessments and will provide more appropriate treatment plans.
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Affiliation(s)
- Hilal Peker Öztürk
- Department of Dentomaxillofacial Radiology, Gulhane Dentistry Faculty, University of Health Sciences, Ankara, Turkey.
| | - Hakan Avsever İsmail
- Dentomaxillofacial Radiology Department, Ankara University, Dentistry Faculty, Ankara, Turkey
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of East Mediterranean, Gazi Mağusa, Cyprus
| | - Buğra Şenel
- Department of Dentomaxillofacial Radiology, Gulhane Dentistry Faculty, University of Health Sciences, Ankara, Turkey
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of East Mediterranean, Gazi Mağusa, Cyprus
| | - Hatice Seda Özgedik
- Department of Dentomaxillofacial Radiology, Gulhane Dentistry Faculty, University of Health Sciences, Ankara, Turkey
| | - Mehmet Hakan Kurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
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Görürgöz C, İçen M, Kurt MH, Aksoy S, Bakırarar B, Rozylo-Kalinowska I, Orhan K. Degenerative changes of the mandibular condyle in relation to the temporomandibular joint space, gender and age: A multicenter CBCT study. Dent Med Probl 2023; 60:127-135. [PMID: 37023340 DOI: 10.17219/dmp/147514] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 03/03/2022] [Accepted: 03/21/2022] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Cone-beam computed tomography (CBCT) is used to provide multiplanar views of the temporomandibular joint (TMJ) bone components as well as TMJ pathologies without superposition, magnification or distortion. OBJECTIVES The study aimed to analyze degenerative changes in the condylar surface, and their relationship with patient age and gender, and the TMJ space measurements by using CBCT images. MATERIAL AND METHODS A total of 258 individuals were retrospectively analyzed. The degenerative bone changes of the condylar head were evaluated and classified on the right and left sides. The shortest distances from the anterior, superior and posterior parts of the condylar head to the glenoid fossa were measured to represent the TMJ space. Univariate and multivariate logistic regression analyses then evaluated the effect of age and gender on the presence of degenerative changes. RESULTS Condylar flattening was most frequently observed (413 TMJs, 53.5%). However, the presence or absence of the change types did not differ according to the sides. The mean values of the TMJ space measurements on the right and left sides were narrower in the group with changes than in the group without changes. Nonetheless, no statistically significant difference in the TMJ space was found between the groups (p > 0.05). CONCLUSIONS An increased risk of radiographically detectable degenerative alterations in left TMJs was detected for males and for increasing age. Degenerative changes in the condylar surface may affect the dimensions of the TMJ space.
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Affiliation(s)
- Cansu Görürgöz
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Bursa Uludağ University, Turkey
| | - Murat İçen
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Nevşehir Hacı Bektaş Veli University, Turkey
| | - Mehmet Hakan Kurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University,Turkey
| | - Seçil Aksoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Mersin, Turkey
| | - Batuhan Bakırarar
- Department of Biostatistics, School of Medicine, Ankara University, Turkey
| | | | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University,Turkey
- Department of Dental and Maxillofacial Radiodiagnostics, Medical University of Lublin, Poland
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Abdelazeem MH, Aboelela S, Erdogan O. Transoral Endoscopic-Assisted Reduction and Internal Fixation of Mandibular Condylar Fractures in Children. J Oral Maxillofac Surg 2023; 81:566-574. [PMID: 36809851 DOI: 10.1016/j.joms.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 02/20/2023]
Abstract
PURPOSE Extraoral approaches for open reduction and fixation of condylar fractures in children are associated with serious risks of complications, including facial nerve injury, facial scarring, parotid fistula, and auriculotemporal nerve injury. The purpose of this study was to retrospectively evaluate the outcomes of transoral endoscopic-assisted open reduction and internal fixation of condylar fractures and hardware removal in pediatric patients. MATERIAL AND METHODS This study was designed as a retrospective case series. The study included pediatric patients admitted with condylar fractures that were indicated for treatment with open reduction and internal fixation. The patients were clinically and radiographically evaluated with regard to occlusion, mouth opening, lateral and protrusive movement of the mandible, pain, chewing and speech difficulties, and bone healing at the fracture site. Computed tomography images were used to assess the reduction of the fractured segment, the stability of fixation and progress of healing of the condylar fracture at follow-up visits. The same surgical treatment approach was applied to all patients. The data from the study were analyzed for a single group without any comparison to other groups. RESULTS The technique was used for the treatment of 14 condylar fractures in 12 patients between the ages of 3 to 11 years. A total of 28 transoral endoscopic-assisted approaches to the condylar region either for reduction and internal fixation or hardware removal were applied. The mean operating time was 53.1 (±11.3) minutes for the fracture repair and 20 (±2.6) minutes for hardware removal, respectively. The mean follow-up time of the patients was 17.8 (±2.7) months (median: 18) months. All patients regained stable occlusion, satisfactory mandibular motion, stable fixation, and complete bone healing at the fracture site at the end of their follow-up period. There was no transient of permanent facial nerve or trigeminal nerve injury in any of the patients. CONCLUSIONS Endoscopically assisted transoral approach is a reliable technique for reduction and internal fixation of condylar fracture and hardware removal in pediatric patients. The serious risks of extraoral approaches including facial nerve injury, facial scar, and parotid fistula can be eliminated by using this technique.
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Affiliation(s)
- Mohamed Hazem Abdelazeem
- Associate Professor, Department of General Surgery, Plastic Surgery Division, Cairo University, Cairo, Egypt
| | - Salma Aboelela
- Research Assistant, Electron Microscopy Unit, Cancer Biology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Ozgur Erdogan
- Professor, Department of Oral and Maxillofacial Surgery, Istanbul Okan University, Faculty of Dentistry, Istanbul, Turkey.
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Li CX, Liu X, Gong ZC, Liu H, Jumatai S. Effects of condyle on disc status of the reducing and nonreducing anterior disc displacement of the temporomandibular joint based on 3D reconstructive imaging: a pilot study. Quintessence Int 2023; 54:156-166. [PMID: 36421045 DOI: 10.3290/j.qi.b3512027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
OBJECTIVES Morphologic study is a common approach in the field of anterior disc displacement (ADD) pathology; however, analysis based on 3D reconstructive imaging has not been investigated. This study investigated the association between ADD and the status of the mandibular condyle and articular fossa. METHOD AND MATERIALS Thirty-four patients were divided into a normal articular disc position (NADP) group, an ADD with reduction (ADDwR) group, and an ADD without reduction (ADDwoR) group. Images reconstructed were used to determine multiple grouped comparisons of these three different types of disc position, and the diagnostic efficacy for the morphologic parameters with significant grouped difference was analyzed to assess. RESULTS The condylar volume and condylar superficial area of the NADP, ADDwR, and ADDwoR groups exhibited obvious changes (P < .05). A multivariate logistic ordinal regression model showed that the condylar volume (odds ratio [OR], 1.011; regression coefficient [RC] = .011, P = .018), superior joint space (OR, 8.817; RC = 2.177; P < .001), and medial joint space (OR, 1.492; RC = 0.400; P = .047) had a significantly positive impact on the groups. CONCLUSION The mandibular condyle and articular fossa in temporomandibular joint ADD exhibited altered dimensions. The condylar volume, condylar superficial area, superior joint space, and medial joint space could be considered as promising biometric markers for assessing ADD, and were investigated in this current pilot study. (Quintessence Int 2023;54:156-166; doi: 10.3290/j.qi.b3512027).
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Tran TTN, Wang DH, Yang MC, Chen JC, Wu PH, Yang CC, Hsu WE, Hsu ML. Effects of food hardness on temporomandibular joint osteoarthritis: Qualitative and quantitative micro-CT analysis of rats in vivo. Ann Anat 2023; 246:152029. [PMID: 36435414 DOI: 10.1016/j.aanat.2022.152029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 11/12/2022] [Accepted: 11/15/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Temporomandibular joint osteoarthritis (TMJ-OA) is a degenerative joint disease in which quantitative analysis based on magnetic resonance image (MRI) or cone-beam computed tomography (CBCT) remains limited. Moreover, the long-term effects of soft food on the adaptive condylar remodeling process in TMJ-OA remain unclear. This study aimed to assess the effects of food hardness on adaptive condylar remodeling in a healthy TMJ, TMJ-OA, and controlled TMJ-OA. METHODS Complete Freund's adjuvant (CFA) was used for TMJ-OA induction and Link-N (LN) for TMJ repair. Eighteen mature rats were randomly divided into six groups: (1) control/normal diet (Ctrl-N); (2) control/soft diet (Ctrl-S); (3) TMJ-OA/normal diet (CFA-N); (4) TMJ-OA/soft diet (CFA-S); (5) Link-N-controlled TMJ-OA/normal diet (LN-N); and (6) Link-N-controlled TMJ-OA/soft diet (LN-S). Micro-CT was performed 14, 21, and 28 days after CFA injection to analyze the bone volume, bone volume fraction (BVF), bone mineral density (BMD), and trabecular bone number and thickness (Tb.N, Tb.Th). MRI and histological imaging were performed to support the analysis. RESULTS Under CFA treatment, the BVF and BMD decreased significantly (p < 0.01) and later recovered to normal. However, more significant improvements occurred in normal-diet groups than soft-diet groups. Additionally, bone volume changes were more predictable in the normal-diet groups than in the soft-diet groups. The normal-diet groups presented a significant decrease and increase in the Tb.N and Tb.Th, respectively (p < 0.05), while the Tb.N and Tb.Th in the soft-diet groups remained largely unchanged. Furthermore, a significantly higher frequency of irregularities on the condylar articular surface was found in the soft-diet groups. CONCLUSIONS Compared with a soft diet, a normal diet may be beneficial for preserving condyle articular surface and directing bone remodeling in TMJ-OA rats.
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Affiliation(s)
- Trang Thi-Ngoc Tran
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Ding-Han Wang
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Mu-Chen Yang
- Division of Craniofacial Development and Tissue Biology, Tohoku University Graduate School of Dentistry, Sendai, Japan.
| | - Jyh-Cheng Chen
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Medical Imaging, Xuzhou Medical University, Jiangsu, China.
| | - Po-Han Wu
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Cheng-Chieh Yang
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Wun-Eng Hsu
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
| | - Ming-Lun Hsu
- College of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Sun CK, Li YB, Ma HS, Li G, Sun ZP, Sun LS. Natural course of severe temporomandibular joint osteoarthrosis evaluated by a novel condylar remodelling scoring system and quantitative volumetric analysis. Int J Oral Maxillofac Surg 2023; 52:227-236. [PMID: 35970695 DOI: 10.1016/j.ijom.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 01/11/2023]
Abstract
Temporomandibular joint osteoarthrosis (TMJ-OA) frequently causes mild, moderate, or severe condylar morphological changes. A novel condylar remodelling scoring system (CRSS) based on three-dimensional cone beam computed tomography images is proposed, which is used to grade condylar morphological changes. In the CRSS, the condyle is divided into 10 regions by 11 reference points. For each increase in the number of regions involved in TMJ-OA, one point is subtracted from the full score of 10. The intra-class correlation coefficients for intra- and inter-observer agreement (range 0.656-0.898 and 0.841-0.906, respectively) indicated that the CRSS had good reliability. Cephalometric analysis showed that the condyles with severe morphological changes were prone to present with a retrognathic and clockwise rotating mandible, shorter ramus height, reduced mandibular length, larger mandibular angle, and maxillary retrusion. Qualitative CRSS evaluation and quantitative volumetric analysis were performed to evaluate the stability of severe TMJ-OA in its natural course (343 condyles). The continuous cortex group showed no remarkable changes with an average follow-up of 2 years. In the discontinuous cortex group, most (74.4%) converted into a continuous cortex during follow-up (mean 2 years).
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Affiliation(s)
- C-K Sun
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - Y-B Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - H-S Ma
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - G Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - Z-P Sun
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - L-S Sun
- National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China; Key Laboratory of Oral Pathology, School and Hospital of Stomatology, Peking University, Haidian District, Beijing, PR China.
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Diwakar R, Bucci R, Kaushik A, Bansal A, Bucci P, Kochhar AS, Spagnuolo G. Three-Dimensional Assessment of Temporomandibular Joint Morphology and Facial Asymmetry in Individuals with Different Vertical Skeletal Growth Patterns. Int J Environ Res Public Health 2023; 20:1437. [PMID: 36674193 PMCID: PMC9859447 DOI: 10.3390/ijerph20021437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 06/17/2023]
Abstract
The aim of the current study was to investigate, by means of Cone-Beam Computed Tomography (CBCT), condyle−fossa relationship, temporomandibular joint (TMJ) morphology and facial asymmetry in subjects with different vertical skeletal growth patterns. CBCT of 56 patients (112 TMJs) were categorized into three groups according to the mandibular plane angle (MP): Hypodivergent (MP ≤ 23°), Normodivergent (23° < MP < 30°), and Hyperdivergent (MP ≥ 30°). TMJ spaces, width and depth of the condyle and thickness of the fossa were measured. Horizontal and vertical measurements were used to assess facial asymmetry. One-way Analysis of Variance (ANOVA) and post-hoc Turkey tests were computed for the between-groups comparison. Statistical significance was set at p < 0.05. Larger anterior joint space and smaller condylar dimensions (medio-lateral diameter and medio-lateral thickness) were observed in the hyperdivergent group compared to the normodivergent and hypodivergent groups. Right condylar distances to midsagittal plane were significantly larger than left distances in all the three groups. A vertical pattern of growth in healthy individuals seems to be associated with condylar position and dimension, while facial asymmetry values do not differ among different vertical groups.
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Affiliation(s)
- Rohan Diwakar
- Department of Orthodontics, PDM Dental College, Bahadurgarh 124507, India
| | - Rosaria Bucci
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Ankur Kaushik
- Department of Orthodontics, PDM Dental College, Bahadurgarh 124507, India
| | - Anubhav Bansal
- Department of Orthodontics, PDM Dental College, Bahadurgarh 124507, India
| | - Paolo Bucci
- Department of Public Health, University of Naples Federico II, 80131 Naples, Italy
| | | | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, 80131 Naples, Italy
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, 119991 Moscow, Russia
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Ermolin VI, Chkadua TZ, Staricov NA, Babunashvili GB, Mashkina AA, Romanovsky MA. [The effects of a total TMJ endoprosthesis on the contralateral condyle]. Stomatologiia (Mosk) 2023; 102:9-15. [PMID: 37997307 DOI: 10.17116/stomat20231020619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
OBJECTIVE To correlate the magnitude of the amount of translation of prosthesis and the native joint, and the postoperative change in the volume of the contralateral condylar process after unilateral total joint replacement. MATERIAL AND METHODS The study examined 16 patients with post-traumatic jaw deformation treated with unilateral TMJ replacement using total endoprosthesis. The mandible kinematics was recorded using the Cadiax Diagnostic system and correlated with the remodeling of the native joint. RESULT On average, the group showed an 8.5% decrease in the volume of the native condylar process. In 13 patients, the amplitude of the native joint movement in the mouth opening and the mandible pro- and laterotrusion markedly deviated quantitatively that combined with the translational movement of the TMJ endoprosthesis in all types of mandibular abduction in all the patients. Correlation analysis showed a moderate negative relationship (r= -0.43) in opening the mouth between the amplitude of movement of the native joint and of the endoprosthesis, as well as a noticeable negative strength of relationship. Also, the correlation analysis showed a moderate positive relationship between the change in the native condylar process volume and movement amplitude when opening the mouth, and an inverse correlation of the high strength of relationship between the change in the native condylar process volume and movement amplitude of the TMJ endoprosthesis. CONCLUSION Electronic axiography found that patients in the postoperative period could restore some of the translational movements even with the attachment of the lateral pterygoid muscle cut off. The main factor influencing the magnitude of the endoprosthesis translational movement is the design of the fossa component: the ratio of the circumferential surface of the fossa to the diameter of the head of the endoprosthesis, as well as the presence of lateral stoppers. The study showed that unilateral TMJ reconstruction provides changes in the volume of the native joint directly related to the amplitude of the movement of the joint itself and inversely correlated with the amplitude of the movement of the endoprosthesis.
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Affiliation(s)
- V I Ermolin
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - T Z Chkadua
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - N A Staricov
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - G B Babunashvili
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - A A Mashkina
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
| | - M A Romanovsky
- Central Research Institute of Dental and Maxillofacial Surgery, Moscow, Russia
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Nussi AD, de Castro Lopes SLP, De Rosa CS, Gomes JPP, Ogawa CM, Braz-Silva PH, Costa ALF. In vivo study of cone beam computed tomography texture analysis of mandibular condyle and its correlation with gender and age. Oral Radiol 2023; 39:191-197. [PMID: 35585223 DOI: 10.1007/s11282-022-00620-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/24/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Texture analysis is an image processing method that aims to assess the distribution of gray-level intensity and spatial organization of the pixels in the image. The purpose of this study was to investigate whether the texture analysis applied to cone beam computed tomography (CBCT) images could detect variation in the condyle trabecular bone of individuals from different age groups and genders. METHODS The sample consisted of imaging exams from 63 individuals divided into three groups according to age groups of 03-13, 14-24 and 25-34. For texture analysis, the MaZda® software was used to extract the following parameters: second angular momentum, contrast, correlation, sum of squares, inverse difference moment, sum entropy and entropy. Statistical analysis was performed using Mann-Whitney test for gender and Kruskal-Wallis test for age (P = 5%). RESULTS No statistically significant differences were found between age groups for any of the parameters. Males had lower values for the parameter correlation than those of females (P < 0.05). CONCLUSION Texture analysis proved to be useful to discriminate mandibular condyle trabecular bone between genders.
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Affiliation(s)
- Amanda Drumstas Nussi
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade, São Paulo, SP, 01506-000, Brazil
| | - Sérgio Lucio Pereira de Castro Lopes
- Department of Diagnosis and Surgery, Science and Technology Institute, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Catharina Simioni De Rosa
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, SP, Brazil
| | - João Pedro Perez Gomes
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Celso Massahiro Ogawa
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade, São Paulo, SP, 01506-000, Brazil
| | - Paulo Henrique Braz-Silva
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, SP, Brazil
- Laboratory of Virology, Institute of Tropical Medicine of São Paulo, School of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Andre Luiz Ferreira Costa
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), Rua Galvão Bueno, 868, Liberdade, São Paulo, SP, 01506-000, Brazil.
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Weinberg FM, Rosenberg AJWP, Muller BS, Speksnijder CM. Long-term masticatory performance and ability following closed treatment for unilateral mandibular condylar neck or base fractures: a cross-sectional study. Oral Maxillofac Surg 2023; 27:141-149. [PMID: 35066649 PMCID: PMC9938014 DOI: 10.1007/s10006-021-01027-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 12/10/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of this study was to find explanatory variables for objective and patient-reported long-term masticatory functioning in patients treated with maxillomandibular fixation for unilateral condylar neck or base fractures. These outcomes were compared to healthy control subjects. METHODS Patients treated between 1996 and 2013 were enrolled in the study. Objective measurements included the mixing ability test (MAT) for masticatory performance, and range of motion of the mandible. Patient-reported measurements included the mandibular function impairment questionnaire (MFIQ) for masticatory ability, and the visual analogue scale for pain. Healthy subjects were recruited between October 2018 and January 2019, and performed the MAT and MFIQ. RESULTS Twenty-one patients and 30 healthy subjects were included. The average follow-up period was 11.67 years. In adjusted regression analysis, the amount of occlusal units (OU) was associated with the MAT (P = 0.020; R2 = 0.253) and MFIQ (P = 0.001, R2 = 0.454). The MAT outcome was similar in both groups when correcting for OU (P = 0.001; R2 = 0.201). The MFIQ was inferior in the patient group (P = 0.001). CONCLUSION Long-term masticatory performance was similar in patients with a history of condylar neck or base fracture and healthy subjects; however, masticatory ability was inferior in patients compared to healthy subjects.
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Affiliation(s)
- Florine M Weinberg
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, G05.122, P.O. Box 85.500, 3508 GA, Utrecht, The Netherlands.
| | - Antoine J W P Rosenberg
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, G05.122, P.O. Box 85.500, 3508 GA, Utrecht, The Netherlands
| | - Barbara S Muller
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, G05.122, P.O. Box 85.500, 3508 GA, Utrecht, The Netherlands
| | - Caroline M Speksnijder
- Department of Oral and Maxillofacial Surgery and Special Dental Care, University Medical Center Utrecht, Utrecht University, G05.122, P.O. Box 85.500, 3508 GA, Utrecht, The Netherlands
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Qin X, He Y, Zhang S, Jin N, Yang Z. Comparison of two different therapeutic approaches for skeletal Class II patients with temporomandibular degenerative joint disease. Angle Orthod 2023; 93:49-56. [PMID: 36223213 PMCID: PMC9797142 DOI: 10.2319/042822-321.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/01/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To compare two different therapeutic approaches for skeletal Class II patients with temporomandibular degenerative joint disease. MATERIALS AND METHODS A total of 47 patients were included in this study. Group anterior repositioning splint (ARS) was treated with temporomandibular joint (TMJ) disc surgery followed by an ARS and camouflage orthodontic treatment. Group stabilization splint (SS) was treated with an SS followed by orthodontic treatment combined with orthognathic surgery. Cephalometric analysis of lateral radiographs and measurements of condylar height were evaluated before and after splints. RESULTS In group ARS, mandibular advancement was observed after treatment in 21 of 24 patients (87.5%). The SNB angle increased by an average of 1.40 ± 1.01°. The ANB angle, overjet, Wits, and convexity decreased. Facial angle and soft tissue N Vert to pogonion increased. Vertically, MP-FH, MP-SN, y-axis, and vertical ratio decreased and ANS-Me/N-Me and S-Go/N-Me increased, suggesting a counterclockwise rotation of the mandible. In group SS, 18 of 23 patients (78.3%) showed a backward change tendency. The SNB angle reduced by 0.90 ± 0.93°. The ANB angle, overjet, Wits, convexity, and y-axis increased. The facial angle and soft tissue N Vert to soft tissue pogonion (ST N Vert to ST pogonion) decreased. Magnetic resonance imaging showed condylar height increased by 1.45 ± 3.05 mm (P = .002) in group ARS. In group SS, condylar height change was not consistent. CONCLUSIONS TMJ disc surgery followed by ARS promoted condylar bone remodeling and regeneration. The SNB angle increased, and the severity of skeletal Class II was improved. The SS enabled the mandible to withdraw backward and revealed a retrognathic but true mandible position.
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Wei Y, Zhang GR, Liu YN, Chen WYF, Zhang XZ, Cao BC. [Cone-beam CT analysis of vertical control of mandible and changes of temporomandibular joint in adult patients with skeletal class Ⅱ malocclusion with high angle]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:1147-1155. [PMID: 36379894 DOI: 10.3760/cma.j.cn112144-20220301-00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To investigate the shape and position changes of temporomandibular joint (TMJ) in adult skeletal class Ⅱ malocclusion with high angle patients after vertical mandibular control, and the correlation between vertical mandibular changes and condylar position changes. Methods: Twenty adult skeletal class Ⅱ malocclusion with high angle patients [6 males and 14 females, aged (21.4±2.4) years] who underwent extraction treatment and active vertical control in the Department of Orthodontics, Lanzhou University Stomatological Hospital from October 2017 to November 2020 were selected. Cone-beam CT data of the patient before and after treatment were imported into Invivo Dental 5.0 software for three-dimensional reconstruction and correction, and the vertical index of mandible in reconstructed lateral cephalogram (mandibular plane angle, posterior anterior height ratio, mandibular true rotation angle) were measured. Incisal angle and variables of condyle shape, position and articular fossa shape were measured. Paired t test was performed on the results before and after treatment, and the correlation between mandibular vertical changes and condylar position changes was determined by Pearson correlation coefficient calculation. Results: After treatment, the overbite and overjet were within normal range, and the vertical height of the molars was controlled. Compared with the measurement before treatment, mandibular plane angle and mandibular true rotation angle were decreased by 2.05°±1.22° (t=7.60, P<0.001) and 1.42°±1.92° (t=3.54, P=0.002), respectively. The posterior anterior height ratio was increased by (1.89±3.32)% (t=2.56, P=0.019). After treatment, the mediolateral diameter of condyle, the anteroposterior diameter of condyle, the maximum cross-sectional area of condyle, the height of condyle head, the width of articular fossa, the depth of articular fossa and the articular nodular angle were increased by (0.55±0.76) mm (t=-2.73, P=0.015), (0.27±3.51) mm (t=-3.23, P=0.006), (6.01±7.36) mm2 (t=-2.80, P=0.013), (0.33±0.72) mm (t=-2.14, P=0.046), (0.56±0.93) mm (t=-2.37, P=0.032), 0.33 (0.14, 0.51) mm (Z=-2.76, P=0.006) and 1.50°±2.40° (t=-2.44, P=0.028), respectively. The internal condylar space and the external condylar space were decreased by (0.33±0.49) mm (t=2.31, P=0.035) and (0.20±0.23) mm (t=3.58, P=0.003), respectively. Before orthodontic treatment, 6 patients were with anterior displacement of the condyle, 7 patients with central position of the condyle, and 7 patients with posterior displacement of the condyle. After correction, patients who were with central position of the condyle have not changed much. The posterior displaced condyle in 2 patients and anterior displaced condyle in 3 patients became in central position after treatment. The joint space index was closer to the central position in 3 patients with anterior displacement and 3 patients with posterior displacement. The position of condyle in 1 patient with posterior displacement and 1 patient with anterior displacement remained basically unchanged. There was a significant negative correlation between the change of the posterior-anterior height ratio and the change of the internal condylar space in patients (r=-0.52, P=0.019), and a low correlation with the contral condylar space and the external condylar space(r=-0.48, P=0.031; r=-0.47, P=0.035). Conclusions: Skeletal class Ⅱ malocclusion with high angle adult patients achieved normal overbite and overjet and remodeling of condyle and articular fossa occurred after orthodontic treatmnet and vertical control. There was a certain negative correlation between the change of posterior-anterior height ratio and the change of condylar position.
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Affiliation(s)
- Y Wei
- Department of Orthodontics, Lanzhou University Stomatological Hospital, Lanzhou 730000, China
| | - G R Zhang
- Department of Orthodontics, Lanzhou University Stomatological Hospital, Lanzhou 730000, China
| | - Y N Liu
- Department of Orthodontics, Lanzhou University Stomatological Hospital, Lanzhou 730000, China
| | - W Y F Chen
- Department of Orthodontics, Lanzhou University Stomatological Hospital, Lanzhou 730000, China
| | - X Z Zhang
- Department of Orthodontics, Lanzhou University Stomatological Hospital, Lanzhou 730000, China
| | - B C Cao
- Department of Orthodontics, Lanzhou University Stomatological Hospital, Lanzhou 730000, China
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Shu J, Li A, Shao B, Chong DYR, Yao J, Liu Z. Descriptions of the dynamic joint space of the temporomandibular joint. Comput Methods Programs Biomed 2022; 226:107149. [PMID: 36179656 DOI: 10.1016/j.cmpb.2022.107149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Clinical diagnosis and treatment depended heavily on the motion analysis of the human joints. Although the dynamic joint space (DJS) of other organs was widely used in academic investigations, they were not universally used in the temporomandibular joint (TMJ) field, which was also important for the motion evaluation of the TMJ. The objectives of this study are to introduce the DJS of the TMJ and characterize the DJS regulars of mandibular movements. METHODS Ten asymptomatic subjects were selected to instruct this application. The mouth opening and closing, mandibular protrusion, and left and right protrusions, were tracked by the optical motion tracking system. According to trajectories of markers and reconstructed models from computed tomography, the motions of the mandibles could be obtained. The DJSes, which were described as the minimum Euclidian distances, were subsequently calculated based on the geometrical surfaces between the condyle and fossa during the motions. Then, the DJS map could be drawn based on the calculated values. RESULTS The DJS map manifested a decreasing trend when the condyle crossed the glenoid fossa, while it generally increased after the condyle crossed the fossa during the mouth opening. The results showed that the average maximum and minimum anterior joint spaces were 5.39 mm and 2.07 mm during mouth opening respectively with a great discrepancy existing among the subjects. The average maximum and minimum anterior joint spaces were 4.74 mm and 2.19 mm during mandibular protrusion. As for left and right protrusions, the DJS of the contralateral side was greater than that of the ipsilateral side. CONCLUSION In comparison to morphological analyses or only mandibular motions, the DJS provides more dynamic and interactive information about the TMJ. The research and methodology may help us comprehend TMJ motions and temporomandibular disorders.
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Affiliation(s)
- Jingheng Shu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, 644600, China
| | - Annan Li
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, 644600, China
| | - Bingmei Shao
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, 644600, China; Basic Mechanics Lab, Sichuan University, Chengdu, 610065, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Singapore, 138683, Singapore
| | - Jie Yao
- School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China
| | - Zhan Liu
- Key Lab for Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin, 644600, China.
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Schulz KL, Kesting MR, Nobis CP, Matta R, Lutz R. Three-dimensional evaluation of condylar position after mandibular reconstruction with a fibula free flap—comparison of different surgical techniques. Int J Oral Maxillofac Surg 2022; 52:648-655. [PMID: 36274023 DOI: 10.1016/j.ijom.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/18/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
Three-dimensional positional changes of the temporomandibular joint after mandible reconstruction using microvascular fibula flaps were investigated in 58 patients. The results of preoperative virtually planned surgery, intraoperative resection- and cutting-guided surgery, and non-guided surgery were compared. Pre- and postoperative computed tomography data of each patient were processed and superimposed digitally. The condyle deviations and rotations along the axes and planes of the skull, as well as Euclidean distances, were determined. Reliability analyses, descriptive statistics, and non-parametric tests were performed with the alpha level set at P = 0.05. Reliability proved to be excellent for all variables. The median Euclidean distance was 2.07 mm for the left condyle and 2.11 mm for the right condyle. Deviations of ≥ 10 mm occurred in nine (16%) cases. The maximum deviation occurred in the horizontal plane and the least deviation in the sagittal plane. Median rotation was ≤ 1.4° around all axes. The condylar displacements did not differ significantly between the different surgical techniques investigated. The three-dimensional measurement method applied is highly reliable for evaluating the three-dimensional condylar position after mandibular reconstruction.
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Affiliation(s)
- K L Schulz
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - M R Kesting
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - C-P Nobis
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - R Matta
- Department of Prosthodontics, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - R Lutz
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany.
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Ertugrul BY, Veli İ. Evaluating the effects of orthodontic treatment with clear aligners and conventional brackets on mandibular condyle bone quality using fractal dimension analysis of panoramic radiographs. J Stomatol Oral Maxillofac Surg 2022; 123:538-545. [PMID: 35688416 DOI: 10.1016/j.jormas.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/24/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Orthodontic treatment carried out with clear aligners has become a method that is preferred by patients. In this study, the effect following orthodontic treatment with clear aligners and with conventional brackets, on the mandibular condyle trabecular bone formation is aimed to be examined. MATERIALS AND METHODS Thirty two individuals (16 females and 16 males) with a mean age of 16.80 ± 3,10 years who received orthodontic treatment with clear aligners and conventional brackets were included in the study. Individuals included in the study from the archive data were divided into two groups according to treatment types. The mandibular condyle bone quality in the panoramic images taken from the patients before orthodontic treatment (T0) and after orthodontic treatment (T1) has been compared retrospectively. This examination is carried out via the fractal analysis method. RESULT The mandibular condyle bone density in individuals that have undergone orthodontic treatment with clear aligners, has been reduced following orthodontic treatment. In individuals that have undergone orthodontic treatment with conventional brackets however the mandibular condyle bone density has increased following treatment (T0) in comparison to before being treated (T1). The mandibular condyle bone density change according to different treatment groups has been found to be statistically different. CONCLUSION Orthodontic treatment with clear aligners provides several advantages to patients. However, besides determining the effectiveness of the treatment, complications must also be examined. Application of clear aligners in orthodontic treatment may cause a decrease in bone density in the mandibular condyle. When evaluating orthodontic treatments carried out with clear aligners, the change of the mandibular condyle head bone should be taken into consideration.
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Affiliation(s)
| | - İlknur Veli
- Izmir Katip Celebi University Faculty of Dentistry, Department of Orthodontics, Izmir, Turkey
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Chen KN, Wang J, Chen JP, Wang JL, Sun YC, Xu XL, Guo CB. Comparative Study of Temporomandibular Articular Fossa Bone Surface and the Envelope Surface of the Condyle Movement. Chin J Dent Res 2022; 25:179-187. [PMID: 36102887 DOI: 10.3290/j.cjdr.b3317993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the differences between temporomandibular articular fossa bone surface and the envelope surface of the mandibular condyle movement. METHODS Thirty-four healthy adults underwent skull base and mandible scans using CBCT and performed mandibular border movement using the mandibular movement recording system. Landmarks of the fossa and tubercle were indicated and distance and angle parameters were measured on the 3D models reconstructed from the CBCT. The condyle movement envelope surfaces were formed according to models reconstructed from CBCT and the mandibular movement trajectory using computer simulation. The highest and lowest points of the envelope surface were indicated to create parameters. The data were analysed using a paired t test in SPSS (version 24.0, IBM, Armonk, NY, USA). RESULTS The mandibular fossa bone surface was statistically different to the envelope surface for the height of the first peak of the envelope surface (3.280 ± 1.319 mm) and depth of the mandibular fossa (6.338 ± 2.389 mm) (the ratio was 51.75%), the height of the second peak of the envelope surface (1.463 ± 0.745 mm) and the height of the tubercle (2.000 ± 0.968 mm) (the ratio was 73.15%), and the downwards angle of the envelope surface (25.933 ± 7.539 degrees) and the posterior slope angle of the articular tubercle (35.059 ± 5.224 degrees) (the ratio was 73.97%). CONCLUSION The downwards angle of the envelope surface was statistically significantly smaller than the posterior slope angle of the articular tubercle, suggesting that the condyle movement is flatter than the mandibular fossa bone surface.
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Zhang L, Shen L, Zhang L, Zhang C, Wang H. Dynamic 3D images fusion of the temporomandibular joints: A novel technique. J Dent 2022; 126:104286. [PMID: 36096297 DOI: 10.1016/j.jdent.2022.104286] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To demonstrate a procedure for fusing images from cone-beam computed tomography (CBCT), magnetic resonance imaging (MRI) and optical positioning tracking system to dynamically evaluate the relative motion of the temporomandibular joint (TMJ) for the diagnosis of temporomandibular disorders (TMD). METHODS CBCT data was collected from a patient wearing a fixation device with markers in the intercuspal position. The patient's mandibular movements were recorded using an optical positioning tracking system. The CBCT data were imported into a virtual simulation system to reproduce the mandibular movement. Five jaw positions were selected for 3D printing of the occlusal plate that the patient wore to undergo MRI. MRI scans were registered with the CBCT image for fusion and reconstruction. RESULTS The anatomical structures of the articular fossa, articular disc, and condyle were clearly displayed in the CBCT-MRI fused images. The spatial posture and relative position of the fossa-disc-condyle during mandibular movement could be reproduced dynamically using the 3D reconstruction model. CONCLUSIONS This method can visually display mandibular motion trajectories and the relative TMJ positions. Virtual reproduction provides a comprehensive understanding of the articular disc's morphology and position in different states from a 3D perspective. CLINICAL SIGNIFICANCE This method can be used in clinical studies of TMJ as an adjunct to the 3D dynamic diagnosis and assessment for complex patients with TMD and provide relevant data for doctors.
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Affiliation(s)
- Lu Zhang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Lin Shen
- College of Artificial Intelligence, Nankai University, Tianjin 300350, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen 518081, China
| | - Linkun Zhang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Chunxiang Zhang
- Department of Orthodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China
| | - Hongpeng Wang
- College of Artificial Intelligence, Nankai University, Tianjin 300350, China; Central Laboratory, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China; Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, Tianjin 300041, China; Institute of Intelligence Technology and Robotic Systems, Shenzhen Research Institute of Nankai University, Shenzhen 518081, China.
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Maurer M, Gottsauner JM, Meier JK, Reichert TE, Ettl T. CAD/CAM and conventional reconstruction of the mandibular condyle by fibula free flap: a clinical and radiological evaluation. Int J Oral Maxillofac Surg 2022; 52:531-538. [PMID: 36088184 DOI: 10.1016/j.ijom.2022.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/07/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022]
Abstract
The aim of this study was to analyse the radiological and clinical outcomes of condylar reconstruction by fibula free flap (FFF), comparing conventional freehand and CAD/CAM techniques. Fifteen patients (nine CAD/CAM, six freehand) who underwent condylar reconstruction with a FFF were reviewed retrospectively regarding pre- and postoperative computed tomography/cone beam computed tomography scans and clinical function. After surgery, all patients were free of temporomandibular joint pain. Mean postoperative mouth opening was 30.80 mm, with no significant difference between the freehand and CAD/CAM groups. In all patients, laterotrusion was decreased to the contralateral side (P = 0.002), with no difference between freehand and CAD/CAM, while the axis of mouth opening deviated to the side of surgery (P < 0.001). All patients showed significant radiological deviation of the fibular neocondyle in the laterocaudal direction (lateral: P = 0.015; caudal: P = 0.001), independent of the technique. In conclusion, reconstruction of the mandibular condyle by FFF provided favourable functional results in terms of mouth opening, reduction of pain, and mandibular excursions. Radiological deviation of the neocondyle and deviation of laterotrusion and mouth opening did not impair clinical function. CAD/CAM planning facilitated surgery, decreased the surgery time, and improved the fit of the neocondyle in the fossa.
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Affiliation(s)
- M Maurer
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - J M Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - J K Meier
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - T E Reichert
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany
| | - T Ettl
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany.
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Fischer J, Halbig J, Augdal T, Angenete O, Stoustrup PB, Dahl Kristensen K, Slåttelid Skeie M, Tylleskär K, Rosén A, Shi X, Rosendahl K. Observer agreement of imaging measurements used for evaluation of dentofacial deformity in juvenile idiopathic arthritis. Dentomaxillofac Radiol 2022; 51:20210478. [PMID: 35466687 PMCID: PMC10043626 DOI: 10.1259/dmfr.20210478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 03/02/2022] [Accepted: 03/17/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To examine the precision of imaging measures commonly used to assess mandibular morphology in children and adolescents with juvenile idiopathic arthritis (JIA). Secondly, to compare cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) in the measurement of condylar height. METHODS Those included were children diagnosed with JIA during 2015-18 who had had an MRI, a CBCT of the temporomandibular joints (TMJs) and a lateral cephalogram (ceph) of the head within one month of each other. Agreement within and between observers and methods was examined using Bland-Altman mean-difference plots and 95% limits of agreement (LOA). A 95% LOA within 15% of the sample mean was considered acceptable. Minimal detectable change (MDC) within and between observers was estimated. RESULTS 90 patients (33 males) were included, with a mean age of 12.8 years. For MRI, intra- and interobserver 95% LOA were relatively narrow for total mandibular length: 9.6% of the sample mean. For CBCT, condylar height, both intra- and interobserver 95% LOA were wide: 16.0 and 28.4% of the sample mean, respectively. For ceph, both intra- and interobserver 95% LOA were narrow for the SNA-angle and gonion angle: 5.9 and 8% of the sample mean, and 6.2 and 6.8%, respectively. CONCLUSIONS We have identified a set of precise measurements for facial morphology assessments in JIA, including one MRI-based (total mandibular length), one CBCT-based (condylar height), and three ceph-based. Condylar height was higher for MRI than for CBCT; however, the measurement was too imprecise for clinical use. MDC was also determined for a series of measurements.
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Affiliation(s)
- Johannes Fischer
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Josefine Halbig
- Public Dental Service Competence Centre of Northern-Norway (TkNN), Tromsø, Norway
| | | | | | | | | | | | - Karin Tylleskär
- The Children’s Clinic at Haukeland University Hospital, Bergen, Norway
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Huang C, Xu X, Li L, Sun Y, Guo C. Study on the reconstruction of a four-dimensional movement model and the envelope surface of the condyle in normal adults. Br J Oral Maxillofac Surg 2022; 60:884-889. [PMID: 35853791 DOI: 10.1016/j.bjoms.2021.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/19/2021] [Indexed: 11/30/2022]
Abstract
The objective of this study was to reconstruct the envelope surface of the condyle and the four-dimensional trajectory model in mandibular border movement in normal adults. Eleven healthy subjects were selected as volunteers. Cone-beam computed tomographic (CBCT) scanning was performed on the volunteers. The three-dimensional (3D) movement path of the mandible was recorded using a virtual articulator (PN-300), which was based on a 3D model of the mandible. We used Proplan CMF 3.0 (Materialise) software to perform this from the DICOM data generated by CBCT scans. The distance of condylar movement was measured in this model during volunteers' mouth opening, protrusion, and lateral excursions. The envelope surface of the condyle was reconstructed by merging a functional condylar surface at each recording moment during the movement of the whole border. In the mandibular digital models, the condyle moved downward firstly, and moved upward to the position of maximum mouth opening. The condyle moved forward and downward during protrusion. The working condyle rotated slightly and the non-working condyle moved forward, downward, and inward during lateral excursions. The mean (SD) movement distance of 11 subjects was 19.04 (4.37) mm during mouth opening (including downward and upward) and 9.75 (2.38) mm during protrusion. During lateral excursions the mean (SD) movement distance of the working condyle was 2.87 (1.13) mm, the mean (SD) movement distance of the non-working condyle was 10.85 (3.25) mm. The envelope surface of healthy volunteers showed a double-peak pattern. The envelope surface of the condyle and four-dimensional movement model can be reconstructed by merging the trajectory of the mandible recorded from the novel virtual articulator PN300 and a 3D image of the mandible.
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Affiliation(s)
- Chao Huang
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, P. R. China
| | - Xiangliang Xu
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, P. R. China
| | - Linlin Li
- Center of Digital Dentistry, Faculty of Prosthodontics, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Peking University School and Hospital of Stomatology, Beijing, P. R. China
| | - Yuchun Sun
- Center of Digital Dentistry, Faculty of Prosthodontics, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, Peking University School and Hospital of Stomatology, Beijing, P. R. China.
| | - Chuanbin Guo
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, P. R. China.
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Li F, Xu X, Rong Q, Wang J, Zhang J, Zhou W, Zhang W, Guo C. Three-dimensional radiological anatomy of condyle trabecular bone based on a Volume-of-Interest analysis. Dentomaxillofac Radiol 2022; 51:20220138. [PMID: 35731780 PMCID: PMC10043617 DOI: 10.1259/dmfr.20220138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Three-dimensional radiological anatomic characteristics of condyle trabeculae was obtained quantitatively based on a volume-of-interest (VOI) analysis. METHODS Nine human mandibular condyle specimens were scanned by micro-computed tomography (micro-CT). A total of 34 VOIs were selected from each condyle specimen, which were divided into six layers and four parts to analyze the morphological characteristics of trabeculae based on cylindrical VOIs with a diameter and height of 2 mm. One-way analysis of variance was used to compare the regional differences of morphological parameters among each layer and part. RESULTS Values for bone mineral density, bone volume/total volume, trabecular thickness, and trabecular bone number were greater in the anterior part compared with the posterior part; and the lateral part was larger than the medial part in the first, second, and third layers, while the medial part was larger in the fourth and fifth layers; these values in the first and sixth layers were much larger, while those in the third and fourth layers were smaller. Bone surface area/bone volume, trabecular spacing, and trabecular bone pattern factor were larger in the posterior part than in the anterior part; and the lateral part was larger than the medial part in the fourth and fifth layers, while the medial part was larger in the first and second layers. CONCLUSIONS The morphological distribution of VOIs was anisotropic within trabecular bone of human mandibular condyles. The upper and lower ends of trabecular bone were much more compact, with higher bone density, trabecular thickness, and trabecular number than in the middle layers.
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Affiliation(s)
| | - Xiangliang Xu
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, China
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Jianwei Wang
- Department of Human Anatomy& Histology and Embryology, Peking University Health Science Center, Beijing, China
| | - Jiwu Zhang
- Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Wen Zhou
- Department of Central Laboratory, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, China
| | - Weiguang Zhang
- Department of Human Anatomy& Histology and Embryology, Peking University Health Science Center, Beijing, China
| | - Chuanbin Guo
- Department of Oral and Maxillofacial Surgery, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Peking University School and Hospital of Stomatology, Beijing, China
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Tun Oo L, Miyamoto JJ, Takada JI, Moriyama K. Correlation between the position of the glenoid fossa and condylar translational movement in skeletal Class III mandibular asymmetry patients. Eur J Orthod 2022; 44:294-302. [PMID: 34546345 PMCID: PMC9127719 DOI: 10.1093/ejo/cjab060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Understanding the mechanism of mandibular asymmetry (MA) is important to provide suggestions for occlusal treatment and to know the developmental process of masticatory dysfunction. To investigate the morphological and functional effects on MA, we evaluated the three-dimensional position of the glenoid fossa and its relationship to asymmetrical condylar translational movement. METHODS In this retrospective study, 50 subjects who previously underwent computed tomography for surgical purposes were divided into MA and control groups according to a menton deviation of at least 4 mm from the mid-sagittal plane. The glenoid fossae positions were evaluated using a three-dimensional analysis program. Condylar translational movements were recorded and measured by computerized axiography on protrusion. Side-to-side asymmetry was measured for each parameter. Asymmetry index value was calculated to assess the correlation between glenoid fossa position and condylar movement. Wilcoxon's signed-ranked test, Mann-Whitney U-test, and Spearman's rank correlation were used for the statistical analysis. RESULTS In the MA group, glenoid fossa position on the shifted side was significantly inferior and posterior as compared to that on the non-shifted side and of the control group. Condylar path length and sagittal condylar inclination were significantly greater on the shifted side versus non-shifted side, while no significant difference was found in transverse condylar inclination. The asymmetry index of the anterior-posterior glenoid fossa position was significantly correlated with that of condylar path length and bilateral transverse condylar inclination. In the control group, there were no significant correlations among the morphological and functional parameters. LIMITATIONS This study did not consider muscle activity and disc position, which may affect condylar movement. CONCLUSIONS Functional asymmetry of condylar translational movements is closely related to asymmetry of glenoid fossa position in MA patients.
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Affiliation(s)
- Lin Tun Oo
- Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Jun J Miyamoto
- Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Jun-Ichi Takada
- Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
| | - Keiji Moriyama
- Department of Maxillofacial Orthognathics, Division of Maxillofacial and Neck Reconstruction, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Japan
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Shakya S, Li KD, Huang D, Liu ZQ, Zhang X, Liu L. Virtual surgical planning is a useful tool in the surgical management of mandibular condylar fractures. Chin J Traumatol 2022; 25:151-155. [PMID: 35034763 PMCID: PMC9125724 DOI: 10.1016/j.cjtee.2021.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 11/24/2021] [Accepted: 12/03/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The aim of this study is to evaluate the application value of virtual surgical planning in the management of mandibular condylar fractures and to provide a reliable reference. METHODS This was a prospective randomized controlled study and recruited 50 patients requiring surgical treatment for their mandibular condylar fractures. The inclusion criteria were patients (1) diagnosed with a condylar fracture by two clinically experienced doctors and required surgical treatment; (2) have given consent for the surgical treatment; and (3) had no contraindications to the surgery. Patients were excluded from this study if: (1) they were diagnosed with a non-dislocated or only slightly dislocated condylar fracture; (2) the comminuted condylar fracture was too severe to be treated with internal reduction and fixation; or (3) patients could not complete follow-up for 3 months. There were 33 male and 17 female patients with 33 unilateral condylar fractures and 17 bilateral condylar fractures included. The 50 patients were randomly (random number) divided into control group (25 patients with 35 sides of condylar fractures) and experimental group (25 patients with 32 sides of condylar fractures). Virtual surgical planning was used in the experimental group, but only clinical experience was used in the control group. The patients were followed up for 1, 3, 6 and 12 months after operation. Variables including the rate of perfect reduction by radiological analysis, the average distance of deviation between preoperative and postoperative CT measurements using Geomagic software and postoperative clinical examinations (e.g., mouth opening, occlusion) were investigated for outcome measurement. SPSS 19 was adopted for data analysis. RESULTS The average operation time was 180.60 min in the experimental group and 223.2 min in the control group. One week postoperatively, CT images showed that the anatomic reduction rate was 90.63% (29/32) in the experimental group and 68.57% (24/35) in the control group, revealing significant difference (X2 = 4.919, p = 0.027). Geomagic comparative analysis revealed that the average distance of deviation was also much smaller in the experimental group than that in the control group (0.639 mm vs. 0.995 mm; t = 3.824, p < 0.001). CONCLUSION These findings suggest that virtual surgical planning can assist surgeons in surgical procedures, reduce operative time, and improve the anatomic reduction rate & accuracy, and thus of value in the diagnosis and treatment of condylar fractures.
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Affiliation(s)
- Shubhechha Shakya
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Kai-De Li
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Dou Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Zuo-Qiang Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Xiao Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China
| | - Lei Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Dept. of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
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84
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Lee JD, Becker JI, Larkin LM, Almarza AJ, Kapila SD. Morphologic and histologic characterization of sheep and porcine TMJ as large animal models for tissue engineering applications. Clin Oral Investig 2022; 26:5019-5027. [PMID: 35359187 PMCID: PMC9276584 DOI: 10.1007/s00784-022-04472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/21/2022] [Indexed: 11/26/2022]
Abstract
Objective The aim of this study was to compare and characterize the structural and ultrastructural organization of the temporomandibular joint (TMJ) between two large animal models for use in the development of tissue engineering strategies. Materials and methods Whole TMJs from sheep and pigs were evaluated with micro-computed tomography (μCT) for morphology and quantitative analyses of bone parameters. Histological examination was performed on the TMJ disc and its attachments to investigate regional distribution of collagen, elastin, and glycosaminoglycans (GAGs). Results μCT analyses demonstrate higher bone mineral density (BMD) in the temporal fossa compared to the mandibular condyle in both species, with this variable being significantly higher in sheep than pig. Quantitative morphometry of the trabecular condyle reveals no statistical differences between the species. Histology demonstrates similar structural organization of collagen and elastin between species. Elastin staining was nearly twofold greater in sheep than in the pig disc. Finally, Safranin-O staining for GAGs in the TMJ disc was localized to the intermediate zone in the sheep but was absent from the porcine disc. Conclusions Our findings show some important differences in the pig and sheep TMJ μCT variables and histology and composition of the disc and discal attachment. These disparities likely reflect differences in masticatory and TMJ functional loading patterns between the two species and provide insights into large animal models towards human applications. Clinical relevance As with the established pig model, the sheep is a suitable large animal model for TMJ research such as regenerative strategies, with specific considerations for design parameters appropriate for human-analog applications.
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Affiliation(s)
- Jonah D Lee
- Department of Molecular & Integrative Physiology, University of Michigan School of Medicine, Ann Arbor, MI, 48109, USA
- Animal Care and Use Office, Office of Research, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Josh I Becker
- Department of Molecular & Integrative Physiology, University of Michigan School of Medicine, Ann Arbor, MI, 48109, USA
| | - Lisa M Larkin
- Department of Molecular & Integrative Physiology, University of Michigan School of Medicine, Ann Arbor, MI, 48109, USA
| | - Alejandro J Almarza
- Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, 15261, USA
- Center of Craniofacial Regeneration, University of Pittsburgh, Pittsburgh, PA, 15261, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Sunil D Kapila
- Section of Orthodontics, School of Dentistry, University of California Los Angeles School of Dentistry, 10833 Le Conte Avenue, CHS 33-089, Box 951668, Los Angeles, CA, 90095, USA.
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85
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Chang MS, Choi JH, Yang IH, An JS, Heo MS, Ahn SJ. Association between Condylar Bone Density and Disk Displacement in the Temporomandibular Joint. J Clin Densitom 2022; 25:215-222. [PMID: 34391639 DOI: 10.1016/j.jocd.2021.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/22/2022]
Abstract
Measuring bone density (BD) is a common method of determining bone quality; however, the relationship between condylar BD and the occurrence of temporomandibular joint (TMJ) disorders has not been investigated. To address this knowledge gap, we aimed to investigate condylar BD in terms of TMJ disk displacement (TMJ DD) using computed tomography (CT) and magnetic resonance imaging (MRI). We classified TMJ MRI results according to the position of the disk: normal disk position (Normal), anterior disk displacement with reduction (ADDR), and anterior disk displacement without reduction (ADDNR). After retrospectively evaluating 86 female condyles, we determined the total, cortical, and trabecular BD in the upper-joint portion of the condyle and the whole condyle using CT data. To standardize condylar BD, we calculated the BD ratios by dividing the condylar BD by the cervical axis BD. The Kruskal-Wallis test analyzed the differences in BD measurements in the TMJ DD patient groups and showed significant between-group differences in condylar BD. The total and trabecular BD was significantly higher in ADDNR condyles than in Normal or ADDR condyles (Normal = ADDR < ADDNR). However, there was no significant difference in the cortical BD among the three TMJ DD groups. The BD ratios showed a similar tendency with condylar BD. These results suggest that increased condylar BD - specifically total and trabecular BD - may be significantly associated with ADDNR condyles. Our findings will help clinicians determine the course of treatment for patients with disk-related TMJ disorders.
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Affiliation(s)
- Min-Seok Chang
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jeong-Ho Choi
- Department of Orthodontics, Seoul National University Dental Hospital, Seoul, Korea
| | - Il-Hyung Yang
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jung-Sub An
- Department of Orthodontics, Seoul National University Dental Hospital, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sug-Joon Ahn
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
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86
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Taheri F, Farrokhi M. To the Editor: Changes in Condylar Position Within 12 Months After Bilateral Sagittal Split Ramus Osteotomy. J Oral Maxillofac Surg 2022; 80:581. [PMID: 35032439 DOI: 10.1016/j.joms.2021.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/19/2022]
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Yin K, Pang H, Guo Z, Guo H, Qi X, Che X. A comparative study of audiology and cone beam computed tomography in TMD patients with otological symptoms through occlusal splint therapy. Ann Ital Chir 2022; 93:210-216. [PMID: 34290153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION To investigate the changes of audiological tests and the cone beam computed tomography (CBCT) measurements of temporomandibular joint (TMJ) and middle-inner ear structure after occlusal splint therapy in temporomandibular disorders (TMD) patients with otological symptoms, and explore the etiological mechanism between TMD and otological symptoms. METHODS The 25 subjects aged 18 to 40 years who diagnosed with TMD combined the otological symptoms enrolled in the study.They all had received orthodontic treatment in the outpatient clinic of the orthodontic department in Beijing Stomatological Hospital. All the subjects underwent the audiological tests of pure tone audiometry (PTA) and CBCT before and after the occlusal splint therapy. RESULTS After the stabilization occlusal splint therapy, subjects with improvement or complete remission in TMD and otological symptoms accounted for 84% and 80% in all subjects respectively. There were statistically differences in the distances between condylar center (CoC) and sella (S) in sagittal and vertical directions before and after treatment, and statistically difference between ATM and S in sagittal direction. The threshold of PTA at 8000Hz were negatively correlated with the sagittal displacement of condyle and positively correlated with the coronal displacement of condyle. The thickness of top 1/3 of anterior wall of tympanum in sagittal were positively correlated with the threshold of PTA at 4000Hz. CONCLUSION The changes in the TMJ position through occlusal splint therapy might cause the changes in structure of middle-inner ear, which might be one of the reasons for the improvement in otological symptoms. KEY WORDS Audiology, CBCT, Otological symptoms, TMD.
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88
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Ryakhovsky AN, Losev FF, Altynbekov KD, Vykhodtseva MA. [3D analysis of anatomical and functional parameters of TMJ and their correlation]. Stomatologiia (Mosk) 2022; 101:49-60. [PMID: 35640180 DOI: 10.17116/stomat202210103149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
THE AIM OF THE STUDY Was determination of TMJ anatomical and functional parameters in patients without clinical manifestations of TMJ dysfunction and analysis of possible relationships between them. MATERIAL AND METHODS TMJ anatomical parameters of 25 volunteers (22-27 years old) without TMJ dysfunction, malocclusion and more than one tooth adentia were determined on CT scans and lab teeth scans: inclination of the distal slopes of the articular eminence (DS AE), height and width of the condyles, height of AE, inclination of the longitudinal axes of the condyles; as well as functional parameters of LJ movements: horizontal condylar inclination (HCI) during protrusion and laterotrusion, lateral condylar inclination during protrusion and laterotrusion, immediate side shift, incisor and canine guidance, and correlations between them were evaluated. RESULTS The majority of the TMJ anatomical parameters are almost equal by mean values on the right and left sides. The main TMJ functional parameters on the right and left sides also have similar values but much higher variability, asymmetry and unpredictability. The existing anatomical asymmetry of the DS AE is compensated by articular discs, which makes HCI more symmetrical. CONCLUSION Protrusion movements have a higher probability of reproduction by mechanical articulators while laterotrusion movements have a very low probability. The existence of relationship between the inclination of DS AE and HCI, between HCI and the incisor guidance, between the inclination of DS AE and the incisor guidance is questionable. The conducted research proves the weakness or complete absence of correlation between them.
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Affiliation(s)
- A N Ryakhovsky
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
| | - F F Losev
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
| | - K D Altynbekov
- Asfendyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - M A Vykhodtseva
- Central Research Institute of Dentistry and Maxillofacial Surgery of the Ministry of Health of Russia, Moscow, Russia
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89
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Ryakhovsky AN, Vykhodtseva MA. [Validation of the technique of TMJ 3D analysis based on computer tomography]. Stomatologiia (Mosk) 2022; 101:23-32. [PMID: 35184530 DOI: 10.17116/stomat202210101123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The main aim of the study is devoted to optimization of the technique of 3D analysis of TMJ parameters, analysis of the causes of possible errors. MATERIALS AND METHODS The technique of 3D analysis of the width of the articular gap, the size of the condyle, the height and slope of the distal slope of the articular tubercle in the Avantis3D software (Russia) according to computed tomography is presented. The influence of repeated manual corrections of the condyles and articular fossa contours, shifting of the sectors measuring center, the position of starting point of the measurement sectors, and different algorithms for determining the longitudinal axis of the condyles on the accuracy of TMJ parameters detection. RESULTS The study showed that any artificial displacement of the center of measurement sectors, which coincides with the longitudinal axis of the condyle, leads to significant value changes of the parameters. In this regard, the exact determination of the longitudinal axis of the condyles, independent of the human factor, is of particular importance. The greatest inaccuracy and variability of the results of measuring the parameters of the TMJ, as shown by the study, is associated with the possible manual correction of the contours of the surfaces of the condyles and articular fossa. The study did not find a noticeable difference in measurements if the sectors starts from the top of the articular tubercle or from the line parallel to the Frankfurt horizontal. As the optimal settings of the developed method was determined, it was used to determine the average values of the TMJ parameters for patients with a conventional «norm», as well as for patients with TMJ dysfunction. A noticeable and statistically significant difference was found between the groups only for upper and posterior width of the joint space. CONCLUSION The average values of the intra-articular spaces width were justified, and can be used as the basis for the virtual assignment of the lower jaw reconstructive position for prosthetic or orthodontic treatment.
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Affiliation(s)
- A N Ryakhovsky
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Kocaaslan ND, Ünal BK, Özkan MÇ, Karadede B, Çelebiler Ö. Comparison of different treatment techniques in the mandibular condyle fracture. ULUS TRAVMA ACIL CER 2022; 28:99-106. [PMID: 34967439 PMCID: PMC10443169 DOI: 10.14744/tjtes.2020.94992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/12/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Mandibular condyle fractures can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation. Although many studies have discussed for the optimal treatment method, the issue remains controversial. In this study, we aimed to compare conservative techniques in the mandibular condyle fractures. METHODS Twenty four unilateral condyle fracture patients aged between 18 and 48 years were treated according to one of three different modalities. Bracketing, arch bar or mini screw was applied to all non-surgery patients to obtain IMF. Eight patients were treated with only IMF meanwhile eleven patients were treated with one or double-sided amplifier occlusal splint according to the status of fractured segments, in addition to IMF. Remaining five patients have undergone open reduction and fractured segments immobilized with mini plates. Pre- and post-operative images were recorded with a computerized tomography device. Clinical and radiological examinations were performed by orthodontists and surgeons at baseline and at 6 months of treatment. RESULTS The condyle lengths of the patients with unilateral fracture after recovery were compared with the unaffected side. The length between the most protruding point of the condyle and the mandible was measured and the length difference was only 5.94 mm in patients who were treated by IMF. The length difference of patients who used brackets and splints was 3.36 mm (p<0.05). The length difference of patients who were repaired by plate screws was 1.80 mm (p>0.05). However, there was no statistically significant difference (p>0.05) between the groups in the IMF, occlusal splint and IMF and mini plate groups, between the trauma side and the opposite side. None of the patients developed ankylosis, open mouth, limitation of mouth opening, facial asymmetry, laterognathia, and retrognathia. The occlusion of the patients who were not known to have pre-trauma occlusions were directed, repositioned and provided an appropriate occlusion. CONCLUSION The use of IMF with an occlusal splint is a more conservative and acceptable treatment modality than open reduction in selected cases.
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Affiliation(s)
- Nihal Durmus Kocaaslan
- Department of Plastic Reconstructive and Aesthetic Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey
| | - Beyza Karadede Ünal
- Department of Orthodontics, İzmir Katip Çelebi University Faculty of Dentistry, İzmir-Turkey
| | - Melekber Çavuş Özkan
- Department of Plastic Reconstructive and Aesthetic Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey
| | - Berşan Karadede
- Department of Orthodontics, İzmir Katip Çelebi University Faculty of Dentistry, İzmir-Turkey
| | - Özhan Çelebiler
- Department of Plastic Reconstructive and Aesthetic Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey
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Liu P, Shi J. Growth trends analysis of unilateral condylar hyperplasia followed up with planar scintigraphy: Retrospective overview of 249 cases. Medicine (Baltimore) 2021; 100:e28226. [PMID: 34941087 PMCID: PMC8702254 DOI: 10.1097/md.0000000000028226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 11/24/2021] [Indexed: 01/05/2023] Open
Abstract
The current research aimed to retrospectively investigate the trends of the growth of condylar hyperplasia with serial planar scintigraphs.Patients of unilateral condylar hyperplasia with at least one follow-up planar scintigraph were retrospectively included in the study. Patients' age, gender at the initial scan, durations of following scans, and ratios between condylar activities were recorded.The study retrospectively included 111 patients of unilateral condylar hyperplasia. Patients were divided into 3 groups (progressive, relatively stable, regressive) according to ratio variation between initial and last scans. There were 23 (21%) patients fell into the progressive group, 40 (36%) patients into the relatively stable group, and 48 (43%) patients into the regressive group. More female patients were in the progressive group than those in the other groups (P < .01). There were no significant differences among the 3 groups in terms of age or durations of follow-up (P > .05). There were no strong relations between ratio differences and ages. However, a weak relation seems to exist in the regressive group with r = -0.240, (P = .10).Our investigation showed that more than a half of patients with condylar hyperplasia remain constantly or progressively active growth in patients in the follow-up scans. Roughly less than a half of patients showed regressive trends toward normal growth. Patients' age seemly does not play a role in the growth trend pattern, although there are no optimum follow-up periods, regularly follow-up scans are needed to determine the growth status of condylar hyperplasia.
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Affiliation(s)
- Pingan Liu
- Department of Nuclear Medicine, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Shi
- Department of Oral and Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Körmendi S, Vecsei B, Ambrus S, Orhan K, Dobó-Nagy C. Evaluation of the effect of vitamin D3 on mandibular condyles in an ovariectomized mouse model: a micro-CT study. BMC Oral Health 2021; 21:627. [PMID: 34876086 PMCID: PMC8650511 DOI: 10.1186/s12903-021-01980-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 10/26/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND This study aimed to investigate the effect of ovariectomy and vitamin D3 on bone microstructure; this effect was examined in three regions of interest at one femoral and two mandibular sampling sites bone in an ovariectomized mouse model. METHODS Thirty-six week-old female mice were randomly divided into three groups: 10 subjects were given oral cholecalciferol (vitamin D3) daily for 6 weeks after undergoing bilateral ovariectomy (D3 group), while 10 ovariectomized subjects (OVX) and 10 subjects who underwent a sham operation (SHAM) received peanut oil daily during the investigation. After extermination, the left hemimandible and femur were removed and scanned by micro-CT. The bone micromorphology parameters were analyzed and the BMD was calculated. RESULTS The bone volume fraction (BV/TV) was significantly lower in the trabecular bone of the mandibular condyle in the OVX group than in the SHAM and D3 groups. Also there was a significant difference between the SHAM and D3 groups. The specific bone surface (BS/BV) was significantly higher in the OVX and D3 groups than in the SHAM group. Trabecular thickness (Tb.Th) was significantly higher in the SHAM group, and the trabecular bone pattern factor (Tb.Pf) was significantly higher in the OVX group than in the other two groups. Bone mineral density (BMD) of the femur and the mandible was significantly lower in the OVX group than in the SHAM and D3 groups. CONCLUSIONS Our results show that ovariectomy causes a significantly weaker bone microstructure in the mandibular condyle, where the protective effect of vitamin D3 resulted in a partial resorption.
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Affiliation(s)
- Szandra Körmendi
- Department of Prosthodontics, Semmelweis University, Szentkirályi u. 47, Budapest, 1088 Hungary
| | - Bálint Vecsei
- Department of Prosthodontics, Semmelweis University, Szentkirályi u. 47, Budapest, 1088 Hungary
| | - Szilvia Ambrus
- Department of Prosthodontics, Semmelweis University, Szentkirályi u. 47, Budapest, 1088 Hungary
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Emniyet Mah.İncitaş sokak.Sabancı Kız yurdu karşısı, 06500 Ankara, Turkey
| | - Csaba Dobó-Nagy
- Department of Oral Diagnostics, Semmelweis University, Szentkirályi u. 47, Budapest, 1088 Hungary
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Li Z, Liu Y, Zhang L, Liu R. The "Hand as Foot" teaching method in mandibular condyle anatomy. Asian J Surg 2021; 45:649-650. [PMID: 34863594 DOI: 10.1016/j.asjsur.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 10/23/2021] [Accepted: 11/05/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Zhengrui Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200000, China
| | - Yuan Liu
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200000, China
| | - Ling Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, 200000, China.
| | - Rui Liu
- Department of Orthopedics, Affifiliated Hospital of Inner Mongolia Medical University, Hohhot North Street, Inner Mongolia, 010050, China
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Velásquez RL, Coro JC, Bustillo JM, Sato S. Evaluation of horizontal condylar angle in malocclusions with mandibular lateral displacement using cone-beam computed tomography. Angle Orthod 2021; 91:815-821. [PMID: 34096985 PMCID: PMC8549560 DOI: 10.2319/012621-76.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 04/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the horizontal condylar angle (HCA) in mandibular lateral displacement (MLD). MATERIALS AND METHODS HCA in MLD malocclusions were examined using cone-beam computed tomography data in subjects with MLD and control subjects. RESULTS HCA in joints of control patients and contralateral side joints of MLD patients were not significantly different. The mean HCA on the shifted side was larger than on the contralateral side (P < .001) in the different HCA groups. HCA was significantly larger on the shifted side than on the contralateral side in skeletal Class I, Class II, and Class III groups (P < .001). CONCLUSIONS (1) There was no statistically significant difference between HCA in control patients and on the contralateral side in MLD patients. (2) HCA was significantly larger on the shifted side than on the contralateral side. (3) HCA on the shifted side and the contralateral side in MLD Class I, Class II, and Class III are significantly different.
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95
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周 伟, 安 金, 荣 起, 张 益. [Three-dimensional finite element analysis of traumatic mechanism of mandibular symphyseal fracture combined with bilateral intracapsular condylar fractures]. Beijing Da Xue Xue Bao Yi Xue Ban 2021; 53:983-989. [PMID: 34650306 PMCID: PMC8517683 DOI: 10.19723/j.issn.1671-167x.2021.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To analyze the biomechanical mechanism of mandibular symphyseal fracture combined with bilateral intracapsular condylar fractures using finite element analysis (FEA). METHODS Maxillofacial CT scans and temporomandibular joint (TMJ) MRI were performed on a young male with normal mandible, no wisdom teeth and no history of TMJ diseases. The three-dimensional finite element model of mandible was established by Mimics and ANSYS based on the CT and MRI data. The stress distributions of mandible with different angles of traumatic loads applied on the symphyseal region were analyzed. Besides, two models with or without disc, two working conditions in occlusal or non-occlusal status were established, respectively, and the differences of stress distribution between them were compared. RESULTS A three-dimensional finite element model of mandible including TMJ was established successfully with the geometry and mechanical properties to reproduce a normal mandibular structure. Following a blow to the mandibular symphysis with different angles, stress concentration areas were mainly located at condyle, anterior border of ramus and symphyseal region under all conditions. The maximum equivalent stress always appeared on condylar articular surface. As the angle between the external force and the horizontal plane gradually increased from 0° to 60°, the stress on the mandible gradually concentrated to symphysis and bilateral condyle. However, when the angle between the external force and the horizontal plane exceeded 60°, the stress tended to disperse to other parts of the mandible. Compared with the condition without simulating the disc, the stress distribution of articular surface and condylar neck decreased significantly when the disc was present. Compared with non-occlusal status, the stress on the mandible in occlusal status mainly distributed on the occlusal surface, and no stress concentration was found in other parts of the mandible. CONCLUSION When the direction of external force is 60° from the horizontal plane, the stress distribution mainly concentrates on symphyseal region and bilateral condylar surface, which explains the occurrence of symphyseal fracture and intracapsular condylar fracture. The stress distribution of condyle (including articular surface and condylar neck) decreases significantly in the presence of arti-cular disc and in stable occlusal status when mandibular symphysis is under traumatic force.
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Affiliation(s)
- 伟 周
- 北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - 金刚 安
- 北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
| | - 起国 荣
- 北京大学工学院力学与工程科学系,北京 100871Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing 100871, China
| | - 益 张
- 北京大学口腔医学院·口腔医院,口腔颌面外科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
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96
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Kim YH, Shin JY, Lee A, Park S, Han SS, Hwang HJ. Automated cortical thickness measurement of the mandibular condyle head on CBCT images using a deep learning method. Sci Rep 2021; 11:14852. [PMID: 34290333 PMCID: PMC8295413 DOI: 10.1038/s41598-021-94362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/05/2021] [Indexed: 11/09/2022] Open
Abstract
This study proposes a deep learning model for cortical bone segmentation in the mandibular condyle head using cone-beam computed tomography (CBCT) and an automated method for measuring cortical thickness with a color display based on the segmentation results. In total, 12,800 CBCT images from 25 normal subjects, manually labeled by an oral radiologist, served as the gold-standard. The segmentation model combined a modified U-Net and a convolutional neural network for target region classification. Model performance was evaluated using intersection over union (IoU) and the Hausdorff distance in comparison with the gold standard. The second automated model measured the cortical thickness based on a three-dimensional (3D) model rendered from the segmentation results and presented a color visualization of the measurements. The IoU and Hausdorff distance showed high accuracy (0.870 and 0.928 for marrow bone and 0.734 and 1.247 for cortical bone, respectively). A visual comparison of the 3D color maps showed a similar trend to the gold standard. This algorithm for automatic segmentation of the mandibular condyle head and visualization of the measured cortical thickness as a 3D-rendered model with a color map may contribute to the automated quantification of bone thickness changes of the temporomandibular joint complex on CBCT.
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Affiliation(s)
- Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Jin Young Shin
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea
| | - Ari Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Seungtae Park
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
| | - Hyung Ju Hwang
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea.
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Pedersen TK, Stoustrup P. How to diagnose idiopathic condylar resorptions in the absence of consensus-based criteria? J Oral Maxillofac Surg 2021; 79:1810-1811. [PMID: 34097867 DOI: 10.1016/j.joms.2021.04.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/20/2022]
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98
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Diego SM, Juan DVL. Reliability of the Intraoral Records for programming the Condylar Inclination of the Semiadjustable Articulator. J Contemp Dent Pract 2021; 22:624-629. [PMID: 34393118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
AIM AND OBJECTIVE The purpose of the investigation was to determine the reliability of intraoral records for the programming of the condylar inclination of the semiadjustable articulator (SAA), performed by dentistry students at the Central University of Ecuador (UCE). MATERIALS AND METHODS The concordance study was of an observational type and was carried out in sixth- and seventh-semester students of the Faculty of Dentistry of the UCE in the period 2019 to 2020. It was applied to a sample made up of 60 students: divided into G1 (n = 30), sixth-semester students and G2 (n = 30), seventh-semester students. The students were given articulated plaster models in an SAA in order to program the condylar inclination based on intraoral records, comparing it with the condylar inclination obtained from a computed tomography (CT) scan by an expert, determining inter-rater reliability. A Fleiss' Kappa test was performed for this study, with a 95% confidence level. RESULTS The average condylar inclination of the left side measured by the groups of students was 28.68° ± 10.16° and for the right side it was 27.85° ± 10.59°, while in CT, it was 45° on the left side and 35° on the right side. The range of discrepancy of the groups with the CT values is 4.30° to 19.11°, with a significant difference between the programmed condylar inclination of the SAA between the study groups (p <0.05), with greater amount of success in G1 (40% of students programmed the condylar inclination perfectly) compared to G2 (31.67% of students did it perfectly). CONCLUSION When performing the Fleiss' Kappa test, the concordance of the condylar inclination in an SAA programmed by the students gave a result with a negative sign, which suggests that there is no concordance of the articulator data compared to the CT, verifying that the students are not trained in this practice. CLINICAL SIGNIFICANCE The clinical significance of this study lies in the fact that students must learn to better program the condylar inclination so that the treatments they carry out in the future are jointly and preserving all the normal anatomical factors related to the mouth and the TMJ, in order to do so. achieve more personalized treatments for each patient.
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Affiliation(s)
- Suasti Mendoza Diego
- Faculty of Dentistry, Central University of Ecuador, Quito, Ecuador, Phone: +593987139485, e-mail:
| | - Del Valle Lovato Juan
- Department of Restorative Dentistry, School of Dentistry, Central University of Ecuador and Ortodoncia and Implantes Private Practice, Quito, Ecuador
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de Oliveira Reis L, Fontenele RC, Devito KL, Cunha KS, Domingos ADC. Evaluation of the dimensions, morphology, and position of the mandibular condyles in individuals with neurofibromatosis 1: a case-control study. Clin Oral Investig 2021; 26:159-169. [PMID: 34050829 DOI: 10.1007/s00784-021-03985-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/10/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the mandibular condyles of neurofibromatosis 1 (NF1) individuals without facial plexiform neurofibroma using cone beam computed tomography images. MATERIALS AND METHODS Eighty cone beam computed tomography scans (160 mandibular condyles) were analyzed: 40 from NF1 individuals (study group) and 40 from individuals without NF1 (control group). The anteroposterior and mediolateral dimensions, height, and volume of the mandibular condyles were measured. The mandibular condyles were classified according to their morphology: healthy (absence of morphological changes), with flattening (loss of rounded contour of at least one of the surfaces), with erosion (loss of continuity of the cortical bone), with osteophyte (exophytic formation of the condyle surface), and with sclerosis (any increase in the cortical thickness in the load-bearing areas). Furthermore, the position of the mandibular condyles in relation to the joint fossa in an anteroposterior view was classified as anterior, concentric, or posterior. RESULTS The study group had a higher anteroposterior dimension of the mandibular condyles compared with the control group (p < 0.05). There were no differences in condylar morphology and position between both groups (p > 0.05). The morphological alterations were not associated with sex or age in any group evaluated (p > 0.05). For both groups, the concentric position was the most common. For the study group, there was a significant difference in the condylar position between the sides (p < 0.05). CONCLUSIONS NF1 individuals without facial plexiform neurofibroma present a high prevalence of condyles with a large anteroposterior dimension and asymmetric position in the joint fossa. However, no morphological and volumetric changes were observed in the mandibular condyles of them. CLINICAL RELEVANCE The knowledge of the TMJ alterations in individuals with NF1 is important to establish an evaluation protocol, which would allow early intervention if indicated.
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Affiliation(s)
- Larissa de Oliveira Reis
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil.
| | - Rocharles Cavalcante Fontenele
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, São Paulo, Brazil
| | - Karina Lopes Devito
- Department of Dental Clinic, School of Dentistry, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Karin Soares Cunha
- Department of Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, Rio de Janeiro, Brazil
| | - Andréa de Castro Domingos
- Department of Oral Pathology and Diagnosis, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
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100
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Wang H, Xue C, Luo E, Dai W, Shu R. Three-dimensional surgical guide approach to correcting skeletal Class II malocclusion with idiopathic condylar resorption. Angle Orthod 2021; 91:399-415. [PMID: 33373430 DOI: 10.2319/050320-383.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022] Open
Abstract
Treatment of skeletal Class II patients with dual bite and idiopathic condylar resorption (ICR) is challenging for orthodontists because of the unstable position of the mandible as well as skeletal relapse attributed to improper seating of the mandibular condyles. This case report describes the successful treatment of an 18-year-old Mongolian man diagnosed with centric relation-maximum intercuspation discrepancy and ICR. After making a definitive diagnosis from verified centric relation using bilateral manipulation, orthodontic treatment was initiated followed by three-dimensional computer-aided design/computer-aided manufacturing prebent titanium plate-guided sagittal split ramus osteotomy and genioplasty. Postoperative 3D superimposition demonstrated that this surgical guide approach provided accurate repositioning of the condyles, which were well positioned in the fossae. Complete orthodontic and surgical treatment time was 24 months. The patient's facial appearance and occlusion improved significantly, and a stable result was obtained with a 1-year follow-up.
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