Temporomandibular joint imaging: current clinical applications, biochemical comparison with the intervertebral disc and knee meniscus, and opportunities for advancement

Texture Analysis of Temporomandibular Joint Disc Changes Associated with Effusion Using Magnetic Resonance Images

The purpose of this study was to identify changes in the temporomandibular joint disc affected by effusion by using texture analysis of magnetic resonance images (MRIs).

METHODS

A total of 223 images of the TMJ, 42 with joint effusion and 181 without, were analyzed. Three consecutive slices were then exported to MaZda software, in which two oval ROIs (one in the anterior band and another in the intermediate zone of the joint disc) were determined in each slice and eleven texture parameters were calculated by using a gray-level co-occurrence matrix. Spearman's correlation coefficient test was used to assess the correlation between texture variables and to select variables for analysis. The Mann-Whitney test was used to compare the groups.

RESULTS

The significance level was set at 5%, with the results demonstrating that there was no high correlation between the parameter directions. It was possible to observe a trend between the average parameters, in which the group with effusion always had smaller values than the group without effusion, except for the parameter measuring the difference in entropy.

CONCLUSION

The trend towards lower overall values for the texture parameters suggested a different behavior between TMJ discs affected by effusion and those not affected, indicating that there may be intrinsic changes.

Comparison of temporomandibular joint disc, meniscus, and intervertebral disc in fundamental characteristics and tissue engineering

The temporomandibular joint (TMJ) disc, meniscus and intervertebral disc (IVD) are three fibrocartilage discs, which play critical roles in our daily life. Their degeneration contributes to diseases such as TMJ disorders, osteoarthritis and degenerative disc disease, affecting patients' quality of life and causing substantial morbidity and mortality. Interestingly, similar in some aspects of fundamental characteristics, they exhibit differences in other aspects such as biomechanical properties. Highlighting these similarities and differences can not only benefit a comprehensive understanding of them and their pathology but also assist in future research of tissue engineering. Likewise, comparing their tissue engineering in cell sources, scaffold and stimuli can guide imitation and improvement of their engineered discs. However, the anatomical structure, function, and biomechanical characteristics of the IVD, TMJ, and Meniscus have not been compared in any meaningful depth needed to advance current tissue engineering research on these joints, resulting in incomplete understanding of them and their pathology and ultimately limiting future research of tissue engineering. This review, for the first time, comprehensively compares three fibrocartilage discs in those aspects to cast light on their similarities and differences.

[Development of a program for automatic collection and archiving of clinical data of patients with dysfunction of the temporomandibular joint]

OBJECTIVE

Development of a program for the automatic collection and archiving of clinical patients with TMJ dysfunction.

MATERIAL AND METHODS

Based on the clinical examination of 50 patients aged 18 to 30 years with temporomandibular joint dysfunction and the presence of an articular disc dislocation verified by magnetic resonance imaging, 80 signs were identified and terminologically formalized and were divided into 13 groups.

RESULTS

This was the basis for the development of a detailed questionnaire for this contingent of patients, which the authors consider as the primary source of systematized data for processing in the program for automatic collection and archiving of clinical data. For graphical (animation) support for patient questioning, a library of "virtual patient" graphic files has been created, which includes static and dynamic animation explanations of the questions.

CONCLUSION

An algorithm for optimizing the patient interrogation system based on the principle of excluding irrelevant units has been developed and implemented in the program.

Relationship between Clinical Symptoms and Magnetic Resonance Imaging in Temporomandibular Disorder (TMD) Patients Utilizing the Piper MRI Diagnostic System

Clinical problems of the temporomandibular joint (TMJ) and the masticatory musculature are both included in the term temporomandibular disorder (TMD). The purpose of the present study was to examine the pathology of the joints of patients diagnosed with TMD utilizing the dedicated Piper MRI-based classification, and to link these pathologies with various symptoms while considering their severity. In total, 64 patients with clinical TMD were examined. Symptoms were recorded using a questionnaire. The clinical examination included diagnosing the occlusion in centric relation, which was followed by a standardized MRI. It was confirmed that, although they occurred in a high percentage in all classes, muscle pain and occlusal interference are not indicators of TMJ damage. The results indicate that the progressive degradation of the TMJ, represented by qualification to the higher Piper classes, is associated with an increase in TMJ pain only up to a certain stage. For the highest Piper classes, the joint pain occurs in a smaller percentage of patients, but sounds are more frequent.

Effect of botulinum toxin on quality of life of patients with chronic myofascial pain

Aim: This prospective controlled clinical study aimed to evaluate the effect of botulinum toxin Type A (BTX-A) on pain control and quality of life (QoL) in patients with chronic myofascial pain. Materials & methods: Patients with chronic myofascial pain were randomly divided into two groups (n = 20): counseling and self-care and Michigan-type occlusal splint (MOS) (CG-control group) or BTX-A injection (BTX-AG). The pain was evaluated with visual analogue scale and QoL with the oral health impact profile-14 (OHIP-14) questionnaire. Results: In both groups, the pain was reduced, and QoL improved after 30 days. The results of social disability and handicap were better for patients treated with counseling and self-care and MOS. Conclusion: Minimally invasive strategies and BTX-A application improved QoL and alleviated myofascial pain.

Sinus, disabling tension-type, and temporomandibular joint headaches

PURPOSE OF REVIEW

Clinicians frequently face questions from headache patients regarding the roles played by sinus issues, muscle tension, and temporomandibular joint (TMJ) problems. This review highlights new concepts regarding the diagnosis and management of these headache conditions and their differentiation from migraine.

RECENT FINDINGS

Recent research has clarified the roles played by pathology in the paranasal sinuses and TMJ in patients reporting headache. Additional information from physiologic studies in patients with tension-type headache (TTH) has improved the understanding of this condition.

SUMMARY

Improved understanding of sinus headache, disabling TTH, and TMJ headache and their differentiation from migraine will lead to reductions in unnecessary diagnostic procedures and unwarranted medical and surgical procedures. More expedient recognition of the origin of headache should lead to improved therapeutic outcomes.