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Lee YH, Chun YH, Bae H, Lee JW, Kim HJ. Comparison of ultrasonography-based masticatory muscle thickness between temporomandibular disorders bruxers and temporomandibular disorders non-bruxers. Sci Rep 2024; 14:6923. [PMID: 38519584 PMCID: PMC10960048 DOI: 10.1038/s41598-024-57696-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024] Open
Abstract
To compare masticatory muscle thickness in patients with temporomandibular disorders (TMDs) during rest and clenching, and by body position, using ultrasonography. This prospective study included 96 patients with TMD (67 females, 29 males; mean age: 40.41 ± 17.88 years): group 1, comprising 66 patients with TMD without bruxism (TMD_nonbruxer), and group 2, comprising 30 patients with concurrent TMD and bruxism (TMD_bruxer). In patients with TMD, bruxism was correlated with the presence of tinnitus, muscle stiffness, sleep problems, psychological stress, and restricted mouth opening. The masseter muscle significantly thickened during clenching (11.16 ± 3.03 mm vs 14.04 ± 3.47 mm, p < 0.001), whereas the temporalis muscle showed no significant increase in thickness from resting to clenching in an upright position (7.91 ± 1.98 vs 8.39 ± 2.08, p = 0.103). Similarly, during clenching in the supine position, the masseter muscle was significantly thicker compared with rest (11.24 ± 2.42 vs 13.49 ± 3.09, p < 0.001), but no significant difference was observed in temporal muscle thickness (8.21 ± 2.16 vs 8.43 ± 1.94, p = 0.464). In comparison between two groups, the average thickness of the masseter muscle was greater among TMD_bruxers than among TMD_nonbruxers in both the upright and supine positions (all p < 0.05). In the generalized lineal model, female sex (B = - 1.018, 95% confidence interval [CI] - 1.855 to - 0.181, p = 0.017) and bruxism (B = 0.868, 95% CI 0.567 to 1.169, p = 0.048) significantly predicted changes in masseter muscle thickness. Female sex (B = - 0.201, 95% CI - 0.299 to - 0.103, p = 0.011), increased age (B = - 0.003, 95% CI - 0.005 to 0.000, p = 0.038), and muscle stiffness (B = - 1.373, 95% CI - 2.369 to - 0.376, p = 0.007) were linked to decreased temporal muscle thickness. Comparing TMD nonbruxer and bruxer muscle thicknesses in upright and supine positions revealed significant increased thickness in the masseter muscle during clenching but not in the temporalis muscle. Masseter muscle thickness varied significantly by sex, body position, and resting/clenching, notably influenced by bruxism. These findings emphasize the relevance of these factors in clinical examinations of patients with TMD.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea.
| | - Yang-Hyun Chun
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, South Korea
| | - Hyungkyu Bae
- Division in Anatomy and Developmental Biology, Department of Oral Biology, BK21 FOUR Project, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
| | - Jung-Woo Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul, 02447, South Korea
| | - Hee-Jin Kim
- Division in Anatomy and Developmental Biology, Department of Oral Biology, BK21 FOUR Project, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, South Korea
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Lee YH, Hong SJ, Lee GJ, Shin SI, Hong JY, Chung SW, Lee YA. Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers. Sci Rep 2024; 14:4316. [PMID: 38383594 PMCID: PMC10881463 DOI: 10.1038/s41598-024-55004-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 02/19/2024] [Indexed: 02/23/2024] Open
Abstract
Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57 years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621-0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529-0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37-6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18-207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854-0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, Korea.
| | - Seung-Jae Hong
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Gi-Ja Lee
- Department of Biomedical Engineering, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Sang Wan Chung
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea
| | - Yeon-Ah Lee
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, 02447, Korea.
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Li CX, Xie X, Li M, Gong ZC, Nie J, Liu X, Jumatai S. A pilot investigation of condylar position and asymmetry in patients with unilateral posterior scissors-bite malocclusion based on three-dimensional reconstructive imaging technique. BMC Musculoskelet Disord 2023; 24:253. [PMID: 37005598 PMCID: PMC10067181 DOI: 10.1186/s12891-023-06384-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 03/30/2023] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVE Unilateral posterior scissors-bite (uPSB) malocclusion is common clinically. This study aimed to investigate the condylar morphological alterations and condyle-fossa relationship in patients with uPSB, through cone beam computed tomography (CBCT) and three-dimensional reconstructive imaging technique. METHODS A retrospective study was designed to comparatively analyze 95 patients with uPSB between July 2016 and December 2021. They were divided into three subgroups: 12 to 20, 21 to 30, and ≥ 31 years, according the age distribution. The morphological parameters regarding condyle, fossa, and joint space after three-dimensional reconstruction were measured and analyzed by a series of digital software. SPSS 26.0 software package was performed for statistical analysis on data sets, using paired t-test, one-way analysis of variance, Wilcoxon signed-rank sun test, Kruskal-Wallis H test, and Bonferroni correction. RESULTS The condylar volume (CV) of scissors-bite side was greater than that of the non-scissors-bite side (CV A = 1740.68 ± 559.80 mm3 > CV N = 1662.25 ± 524.88 mm3, P = 0.027). So was the condylar superficial area (CSA) (CSA A = 818.71 ± 186.82 mm2 > CSA N = 792.63 ± 173.44 mm2, P = 0.030), and the superior joint space (SJS) [SJS A = 2.46 (1.61, 3.68) mm) > SJS N = 2.01 (1.55, 2.87) mm), P = 0.018], and the anterior joint space (AJS) (AJS A = 3.94 ± 1.46 mm > AJS N = 3.57 ± 1.30 mm, P = 0.017). The constituent ratios of the different parts of the bilateral condyles were 23% on the posterior slope, 21% on the top, 20% on the anterior slope, 19% on the lateral slope and 17% on the medial slope, respectively. CONCLUSION Due to long-term abnormal occlusion of uPSB, the pathological bite force in temporomandibular joint would cause changes in the shape of the condyle. Among them, CV, CSA, SJS and AJS had significant changes in the scissors-bite status, which has the greatest damage to the posterior slope of the condyloid process.
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Affiliation(s)
- Chen-Xi Li
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China.
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, 430022, P.R. China.
| | - Xin Xie
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China
| | - Mengjia Li
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China
| | - Zhong-Cheng Gong
- Department of Oral and Maxillofacial Oncology & Surgery, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, No.137 Liyushan South Road, Urumqi, 830054, P.R. China.
| | - Jing Nie
- Department of Orthodontics, Xinjiang Medical University Affiliated First Hospital, School / Hospital of Stomatology Xinjiang Medical University, Urumqi, 830054, P.R. China
| | - Xu Liu
- Department of Maxillofacial Surgery, Hospital of Stomatology, Key Laboratory of Dental-Maxillofacial Reconstruction and Biological Intelligence Manufacturing of Gansu Province, Faculty of Dentistry, Lanzhou University, Lanzhou, 730013, P.R. China
| | - Sakendeke Jumatai
- Department of Oral and Maxillofacial Radiology, Xinjiang Medical University Affiliated First Hospital, Urumqi, 830054, China
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Singer SR, Mupparapu M. Temporomandibular Joint Imaging. Dent Clin North Am 2023; 67:227-241. [PMID: 36965928 DOI: 10.1016/j.cden.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Prescriptions for imaging studies for temporomandibular disorders are based on the patient's complaint, history, and clinical findings. Appropriate selection criteria and justification for imaging examinations must be followed. Because the temporomandibular joint is composed of both hard and soft tissues, different studies are prescribed based on the clinically suspected condition. Current imaging modalities include panoramic radiographs, cone-beam computed tomography, and MRI. The entire examination must be interpreted, and the findings recorded in the patient record. No one imaging modalities is suitable for all patients. An oral and maxillofacial radiologist should be consulted when the interpretation of the study is beyond the scope of the practitioner.
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Affiliation(s)
- Steven R Singer
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, 110 Bergen Street, Room D885A, Newark, NJ 07103-2400, USA.
| | - Mel Mupparapu
- University of Pennsylvania School of Dental Medicine, Philadelphia, PA, USA
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Jo JH, Bae S, Gil J, Oh D, Park S, Cheon GJ, Park JW. Limited implication of initial bone scintigraphy on long-term condylar bone change in temporomandibular disorders-Comparison with cone beam computed tomography at 1 year. J Oral Rehabil 2021; 48:880-890. [PMID: 34032306 DOI: 10.1111/joor.13209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/23/2021] [Accepted: 05/18/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The current diagnostic criteria for temporomandibular disorders (TMD) do not require imaging for the diagnosis of degenerative joint disease (DJD) of the temporomandibular joint (TMJ) condyle, and there is a lack of data investigating the effectiveness of imaging modalities in predicting long-term TMJ DJD prognosis. OBJECTIVES To verify the association between initial bone scintigraphy results and long-term DJD bone changes occurring in the TMJ condyle on cone beam computed tomography (CBCT). METHODS Initial bone scintigraphy, panoramic radiography and CBCT results were analysed in relation to long-term (12 months) TMJ DJD bone change on CBCTs in 55 TMD patients (110 joints). Clinical and radiographic indices were statistically analysed among three groups (improved, no change, and worsened) based on long-term TMJ DJD prognosis calculated by destructive change index (DCI). RESULTS Neither the uptake ratio nor visual assessment results from initial bone scintigraphy showed a significant difference according to long-term condylar bone change groups. The cut-off value of bone scintigraphy uptake ratio was 2.53 for long-term worsening of TMJ DJD. Worsening of TMJ DJD was significantly associated with the diagnosis based on panoramic radiography (p = .011) and CBCT (p < .001). Initial DCI (β = -.291, p = .046) had a significant association with long-term worsening of TMJ DJD. CONCLUSION Initial bone scintigraphy results did not show sufficiently close associations with long-term TMJ DJD prognosis. This should be considered in the selection process of imaging modalities for TMJ DJD patients. Future studies are needed to develop prognostic indices that comprise both clinical and imaging contents for improved predictive ability.
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Affiliation(s)
- Jung Hwan Jo
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
| | - Sungwoo Bae
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Joonhyung Gil
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
| | - Dongkyu Oh
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea
| | - Seoeun Park
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea.,Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Ji Woon Park
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea.,Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, Seoul, Korea.,Dental Research Institute, Seoul National University, Seoul, Korea
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Li DTS, Leung YY. Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics (Basel) 2021; 11:diagnostics11030459. [PMID: 33800948 PMCID: PMC8000442 DOI: 10.3390/diagnostics11030459] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/17/2022] Open
Abstract
Temporomandibular disorders (TMD) are a group of orofacial pain conditions which are the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.
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Lee JW, Jung KJ, Lee SM, Chang SH. Clinical Use of Quantitative Analysis of Bone Scintigraphy to Assess the Involvement of Arthritis Diseases in Patients with Joint Symptoms. Diagnostics (Basel) 2020; 10:diagnostics10121000. [PMID: 33255422 PMCID: PMC7761348 DOI: 10.3390/diagnostics10121000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/12/2020] [Accepted: 11/23/2020] [Indexed: 11/16/2022] Open
Abstract
We aimed to compare the diagnostic ability of quantitative analysis of bone scintigraphy with that of visual analysis for identifying arthritis disease involvement in patients with joint symptoms. We retrospectively included 93 patients with joint symptoms who underwent Tc-99m methylene diphosphonate bone scintigraphy for evaluating arthritis disease involvement. Bone scintigraphy images were visually and quantitatively analyzed using an in-house software by two reviewers. On quantitative analysis, joint uptake ratio was measured for 64 joints in 14 joints areas. The inter-rater agreement of visual and quantitative analyses was assessed, and diagnostic abilities were compared based on the area under the receiver operating characteristic (ROC) curve (AUC) values. Regarding visual analysis, there was a moderate degree of inter-rater agreement (kappa coefficient of 0.597), while there was a substantial inter-rater agreement (concordance correlation coefficient of 0.987) in the measurement of the joint uptake ratio. The comparisons of ROC curves for the total 5941 joints revealed that the joint uptake ratio had a significantly higher AUC value (0.789) to detect the affected joint than that of the visual analysis (p < 0.001). Quantitative analysis using joint uptake ratio showed substantial reproducibility and higher diagnostic ability to detect joints involving arthritis diseases than visual analysis on bone scintigraphy.
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Affiliation(s)
- Jeong Won Lee
- Department of Nuclear Medicine, Catholic Kwandong University College of Medicine, International St. Mary’s Hospital, 25, Simgok-ro 100-gil, Seo-gu 22711, Incheon, Korea;
| | - Ki Jin Jung
- Department of Orthopedic Surgery, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Chungcheongnam-do, Korea;
| | - Sang Mi Lee
- Department of Nuclear Medicine. Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Chungcheongnam-do, Korea
- Correspondence: (S.M.L.); (S.H.C.); Tel.: +82-415-703-540 (S.M.L.); +82-41-530-2971 (S.H.C.)
| | - Sung Hae Chang
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan 31151, Chungcheongnam-do, Korea
- Correspondence: (S.M.L.); (S.H.C.); Tel.: +82-415-703-540 (S.M.L.); +82-41-530-2971 (S.H.C.)
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