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Zieliński G, Gawda P. Analysis of the Use of Sample Size and Effect Size Calculations in a Temporomandibular Disorders Randomised Controlled Trial-Short Narrative Review. J Pers Med 2024; 14:655. [PMID: 38929876 PMCID: PMC11204826 DOI: 10.3390/jpm14060655] [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: 05/17/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND/OBJECTIVES Temporomandibular disorder (TMD) is the term used to describe a pathology (dysfunction and pain) in the masticatory muscles and temporomandibular joint (TMJ). There is an apparent upward trend in the publication of dental research and a need to continually improve the quality of research. Therefore, this study was conducted to analyse the use of sample size and effect size calculations in a TMD randomised controlled trial. METHODS The period was restricted to the full 5 years, i.e., papers published in 2019, 2020, 2021, 2022, and 2023. The filter article type-"Randomized Controlled Trial" was used. The studies were graded on a two-level scale: 0-1. In the case of 1, sample size (SS) and effect size (ES) were calculated. RESULTS In the entire study sample, SS was used in 58% of studies, while ES was used in 15% of studies. CONCLUSIONS Quality should improve as research increases. One factor that influences quality is the level of statistics. SS and ES calculations provide a basis for understanding the results obtained by the authors. Access to formulas, online calculators and software facilitates these analyses. High-quality trials provide a solid foundation for medical progress, fostering the development of personalized therapies that provide more precise and effective treatment and increase patients' chances of recovery. Improving the quality of TMD research, and medical research in general, helps to increase public confidence in medical advances and raises the standard of patient care.
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Affiliation(s)
- Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland
| | - Piotr Gawda
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland
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Ma H, Zheng T, Shao B, Liu Z. Evaluation of the effect of unilateral mastication on the morphology of temporomandibular joint from the perspective of dynamic joint space. J Oral Rehabil 2024; 51:795-804. [PMID: 38131438 DOI: 10.1111/joor.13646] [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: 12/18/2022] [Revised: 05/27/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Unbalanced alterations of temporomandibular joint morphology were associated with unilaterally masticatory habits. OBJECTIVE This study aimed to investigate the effect of unilateral mastication on the remodelling of the temporomandibular joint using dynamic joint space. METHODS Twelve volunteers with non-maxillofacial deformity and healthy temporomandibular joints were recruited. The 3D models of the mandible and the maxilla were reconstructed according to computed tomography. The subjects were asked to masticate French fries and peanuts unilaterally, which was recorded by a 3D motion capture system. The dynamic joint space during unilateral mastication was analysed. RESULTS During early closure, the joint space reduction on the non-masticatory side was significantly greater than on the masticatory side (p < .05). During later closure, the joint space reduction on the non-masticatory side was significantly lower than that on the masticatory side (p < .05). The difference in joint space reduction between both sides was greater than the French fries while masticating the peanuts. CONCLUSIONS Unilateral mastication resulted in a different major pressure area on the bilateral TMJs. Therefore, unilateral mastication might be an essential factor in the bilateral asymmetrical remodelling of the TMJ.
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Affiliation(s)
- Hedi Ma
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, China
| | - Tinghui Zheng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, China
| | - Bingmei Shao
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, China
- Basic Mechanics Lab, Sichuan University, Chengdu, China
| | - Zhan Liu
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, China
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, China
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Pumklin J, Sowithayasakul T, Thaweemonkongsap C, Saptasevee P, Sangprasert P. Effects of occlusal conditions on masseter and temporalis muscle activity: An electromyographic evaluation. Saudi Dent J 2023; 35:946-952. [PMID: 38107050 PMCID: PMC10724355 DOI: 10.1016/j.sdentj.2023.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 07/06/2023] [Accepted: 07/25/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Dental occlusion contributes to the development of temporomandibular disorder. Objective This case control study examined the influence of different occlusal conditions on the surface electromyography (sEMG) of the superficial part of the masseter muscle (MM) and anterior part of the temporalis muscle (TA) during clenching in the maximum intercuspal position (MIP). Materials and methods Twelve healthy subjects had their anterior, right posterior, or left posterior teeth added by composite resin to generate the bilateral posterior, unilateral left, or unilateral right posterior tooth losses, respectively. Muscle activity in the resting stage, MM's and TA's maximum voluntary clenching (MVC; µV) in MIP, each muscle activity's symmetry (%), and ipsilateral MM and TA synergy (%) were measured by sEMG. All parameters were analyzed by SPSS version 23.0, and the significance level was set at p < 0.05. Results The MM's and TA's sEMG activity at the resting stage significantly differed from those at the other occlusal conditions (p < 0.05). Both muscles' MVC were highest at the MIP during clenching but lowest during anterior clenching. During unilateral posterior clenching, such MVC was higher at the occluding than at the non-occluding sides. The TA's symmetry during clenching at the anterior and unilateral posterior teeth was lower than that at the MIP during clenching. No significant difference was seen in the ipsilateral MM and TA synergy. Conclusion Different occlusal conditions influenced the MM's and TA's sEMG activity. Each masticatory muscle responded differently to the same occlusal conditions.
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Affiliation(s)
- Jittima Pumklin
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Thanaporn Sowithayasakul
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
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Xu M, Fang L, Xue Q, Zhang X, He Y. The Nrf2 Pathway Alleviates Overloading Force-Induced TMJ Degeneration by Downregulating Oxidative Stress Reactions. J Inflamm Res 2023; 16:5601-5612. [PMID: 38046402 PMCID: PMC10691432 DOI: 10.2147/jir.s434799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/10/2023] [Indexed: 12/05/2023] Open
Abstract
Objective Oxidative stress is involved in the mechanisms associated with temporomandibular joint (TMJ) diseases. Nuclear factor erythroid 2-related factor 2 (Nrf2) is a crucial oxidative stress marker, but the specific mechanisms of its regulation in the early stages of mandibular condylar cartilage (MCC) degeneration remain unclear. This study aimed to explore the regulatory role of Nrf2 and its related oxidative stress signaling pathway in the early stage of MCC degeneration. Materials and Methods Overloading force-induced MCC degeneration was performed in wild-type and Nrf2 knockout mice, as well as in mice after treatment with the Nrf2 activator cardamonin. Changes in MCC degeneration and the expression of oxidative stress markers in the corresponding situations were observed. Results Nrf2 and NADPH oxidase 2 (NOX2) expression were elevated during early MCC degeneration induced by an overloading force. MCC degeneration was aggravated when Nrf2 was knocked out, accompanied by increased NOX2 and superoxide dismutase 2 (SOD2) expression. The MCC degeneration process was alleviated after cardamonin treatment, with activation of the Nrf2 pathway and decreased NOX2 and SOD2 expression. Conclusion Early MCC degeneration is accompanied by mild oxidative stress progression. Activated Nrf2 and related pathways could alleviate the degeneration of MCC.
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Affiliation(s)
- Minglu Xu
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lingli Fang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qin Xue
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xuyang Zhang
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Yao He
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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Akbulut AS. The Effect of TMJ Intervention on Instant Postural Changes and Dystonic Contractions in Patients Diagnosed with Dystonia: A Pilot Study. Diagnostics (Basel) 2023; 13:3177. [PMID: 37891998 PMCID: PMC10606201 DOI: 10.3390/diagnostics13203177] [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: 09/16/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: The aim of the present study is to analyze the instant postural changes and changes in the dystonic contractions among patients with dystonia following the use of an intraoral device called a key integrative dynamic TMJ treatment appliance (KIDTA). (2) Methods: Twelve subjects, previously diagnosed with dystonia were enrolled. Their existing records were utilized to assess the changes in their posture and dystonic contractions. The posture analysis was conducted using a mobile application (APECS). The initial records (T0) and records acquired after the delivery of the KIDTA (T1) were utilized in the analysis. The Wilcoxon signed-rank test was performed to compare parameters between T0 and T1, with a significance level set at p < 0.05. (3) Results: Based on the Wilcoxon signed-rank test, statistically significant differences in T1 compared to T0 were observed in the severity of dystonic spasms, body alignment, head shift, head tilt, shoulder alignment, shoulder angle, axillae alignment, ribcage tilt, pelvic tilt, knee angle, and tibia angle (p < 0.05). (4) Conclusions: Within the limitations of the present pilot study, an intervention to the TMJ through a KIDTA appliance seems to mitigate the severity of dystonic contractions and improve the posture with respect to certain postural parameters.
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Santana-Penín U, Santana-Mora U, López-Solache A, Mora MJ, Collier T, Pocock SJ, Lorenzo-Franco F, Varela-Centelles P, López-Cedrún JL. Remodeling dental anatomy vs sham therapy for chronic temporomandibular disorders. A placebo-controlled randomized clinical trial. Ann Anat 2023; 250:152117. [PMID: 37302432 DOI: 10.1016/j.aanat.2023.152117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/08/2023] [Accepted: 05/20/2023] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence regarding the etiology or effective treatments for chronic orofacial pain, the majority diagnosed as temporomandibular disorder (TMD), is limited. PURPOSE To investigate whether occlusal equilibration therapy (ET) and decreasing the (higher) angle of the lateral guidance on the nonworking-side leads to a reduction in chronic TMDs intensity. METHODS It was conducted a randomized, explanatory, single blind with blinded assessment, placebo-controlled trial with strong protection against bias involving patients with chronic TMDs. Participants were randomly assigned to receive equilibration therapy or sham therapy. ET in this study consisted of minimal invasive occlusal remodeling to obtain balanced occlusion with reduction of the steeper angle of lateral mandibular movement with respect to the Frankfort plane. The primary outcome was a change in the pain intensity score (on a 0-10 point scale, with 0 indicating no pain and 10 the worst possible pain) at month 6. Secondary outcomes include maximum unassisted mouth opening and psychological distress. RESULTS A total of 77 participants underwent randomization, 39 of whom received ET and 38 sham therapy. The trial was stopped early for efficacy, according to preestablished rules when 67 participants (n = 34, n = 33, respectively) had completed the analysis. At month 6, the mean unadjusted pain intensity score was 2.1 in the ET and 3.6 in the sham therapy group (adjusted mean difference, -1.54; 95% confidence interval [CI] -0.5 to -2.6; P = 0.004; ANCOVA model). The mean increase in maximum unassisted mouth opening (main secondary outcome) was significantly higher in the real therapy group (adjusted mean difference 3.1 mm, 95% CI 0.5-5.7, p = 0.02). CONCLUSION ET significantly reduced the intensity of facial pain associated with chronic TMDs and increased maximum unassisted mouth opening, as compared with sham therapy, over the course of 6 months. There were no serious adverse events. Funded by the Instituto de Salud Carlos III from the Ministry of Science and Innovation of the Government of Spain and European Regional Development Fund, Grant nº PI11/02507; "una manera de hacer Europa".
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Affiliation(s)
- Urbano Santana-Penín
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
| | - Urbano Santana-Mora
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Alicia López-Solache
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - María Jesús Mora
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - Timothy Collier
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Stuart J Pocock
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Pablo Varela-Centelles
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Odontology, University of Santiago de Compostela, Santiago de Compostela, A Coruña, Spain
| | - José Luís López-Cedrún
- Oral and Maxillofacial Surgery Service, University Hospital of A Coruña, A Coruña, Spain
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Sritara S, Matsumoto Y, Lou Y, Qi J, Aida J, Ono T. Association between the Temporomandibular Joint Morphology and Chewing Pattern. Diagnostics (Basel) 2023; 13:2177. [PMID: 37443573 DOI: 10.3390/diagnostics13132177] [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: 05/16/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to investigate whether the morphology of the temporomandibular joint (TMJ) is associated with chewing patterns while considering skeletal morphology, sex, age, and symptoms of temporomandibular disorder (TMD). A cross-sectional observational study of 102 TMJs of 80 patients (age 16-40 years) was performed using pretreatment records of cone-beam computed tomography imaging of the TMJ, mandibular kinesiographic records of gum chewing, lateral and posteroanterior cephalometric radiographs, patient history, and pretreatment questionnaires. To select appropriate TMJ measurements, linear regression analyses were performed using TMJ measurements as dependent variables and chewing patterns as the independent variable with adjustment for other covariates, including Nasion-B plane (SNB) angle, Frankfort-mandibular plane angle (FMA), amount of lateral mandibular shift, sex, age, and symptoms of TMD. In multiple linear regression models adjusted for other covariates, the length of the horizontal short axis of the condyle and radius of the condyle at 135° from the medial pole were significantly (p < 0.05) associated with the chewing patterns in the frontal plane on the working side. "Non-bilateral grinding" displayed a more rounded shape of the mandibular condyle. Conversely, "bilateral grinding" exhibited a flatter shape in the anteroposterior aspect. These findings suggest that the mandibular condyle morphology might be related to skeletal and masticatory function, including chewing patterns.
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Affiliation(s)
- Sasin Sritara
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok 10400, Thailand
| | - Yoshiro Matsumoto
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan
| | - Yixin Lou
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan
| | - Jia Qi
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan
| | - Takashi Ono
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8510, Japan
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Zhai X, Huang D, Hu Y, Li X, Wang J, Ma J, Li H, Hu M, Liu H, Jiang H. Cone-beam computed tomographic characteristics in degenerative temporomandibular joint disease patients with chewing side preference. Clin Oral Investig 2023; 27:2267-2276. [PMID: 37017756 DOI: 10.1007/s00784-023-04961-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/17/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVES This study is aimed at assessing the Cone-beam computed tomographic (CBCT) characteristics of temporomandibular joints (TMJ) in degenerative temporomandibular joint disease (DJD) patients with chewing side preference (CSP). MATERIALS AND METHODS CBCT images of 98 patients with DJD (67 with CSP and 31 without CSP) and 22 asymptomatic participants without DJD were measured retrospectively to compare the osteoarthritic changes and the morphology of TMJ. Quantitative analysis of the TMJ radiographic images was performed to present a comparison between the three inter-group groups and between the two sides of the joints. RESULTS The frequencies of the articular flattening and surface erosion occur more often in the preferred side joints of DJD patients with CSP than the contralateral side. In addition, the horizontal angle of condyle, the depth of glenoid fossa (DGF), and the inclination of articular eminence (IAE) were larger in DJD patients with CSP than that in asymptomatic participants (p<0.05). Also, the condylar anteroposterior dimension of preferred side joints was significantly less than that of non-preferred side (p=0.026), while the width of condyles (p=0.041) and IAE (p=0.045) was greater. CONCLUSIONS DJD patients with CSP appear to have a higher prevalence of osteoarthritic changes, with the morphological changes such as flat condyle, deep glenoid fossa, and steep articular eminence, which might be considered the characteristic imaging features. CLINICAL RELEVANCE This study found that CSP is a predisposing factor for the development of DJD, and attention should be paid to the existence of CSP in DJD patients during the clinical practice.
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Affiliation(s)
- Xiaoting Zhai
- Medical School of Chinese PLA, Beijing, China
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dongzong Huang
- Medical School of Chinese PLA, Beijing, China
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yifan Hu
- Medical School of Chinese PLA, Beijing, China
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiaoxing Li
- Medical School of Chinese PLA, Beijing, China
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiazhu Wang
- Department of Radiology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Junli Ma
- Department of Stomatology, General Hospital of Southern Theater of PLA, Guangzhou, China
| | - Hongbo Li
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Min Hu
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hongchen Liu
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hua Jiang
- Department of Stomatology, First Medical Center of Chinese PLA General Hospital, Beijing, China.
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Darawsheh HM, Safronova AA, Vasil'ev YL, Makarova NI, Diachkova EY, Saleeva GT, Saleev NR, Saleev RA. Choosing the optimal mandible position for inferior alveolar nerve block (IANB) using finite element analysis. Ann Anat 2023; 247:152055. [PMID: 36696926 DOI: 10.1016/j.aanat.2023.152055] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/05/2022] [Accepted: 12/21/2022] [Indexed: 01/23/2023]
Abstract
BACKGROUND One of the most popular methods of local anesthesia in dentistry, inferior alveolar nerve block (IANB) involves the blockade of the inferior alveolar nerve (IAN) and lingual nerve (LN) in the pterygomandibular space. Despite the large number of works describing the contents of this space, the spatial displacements of the anatomical structures of this area at different positions of the mandible have not been sufficiently studied. The aim of our study was to study the spatial movements of the IAN and inferior alveolar artery (IAA) at various positions of the mandible using computer simulation and finite element analysis to find the safest way to conduct IANB. MATERIALS AND METHODS Reverse engineering was used to create a model of the cranial base and the mandible based on computed tomography (CT) data obtained from patient N (male, 24 years old), the arteries of the head and neck were designed from the data of multiphase angiography of patient M (female, 61 years old). Masticatory muscles, sphenomandibular ligament, temporomandibular joint and mandibular nerve were modeled in the SolidWorks software package based on an open database of anatomical structures. The finite element grid was generated in the Solidworks software. In the first series of experiments, the displacement of the mandible was modeled along the vertical axis down by 48 mm (maximum opening of the mouth), in the second series, the jaw was displaced vertically by 48 mm with a simultaneous transversal movement of 10 mm, in the third series, the jaw was displaced along the vertical axis down by 34 mm and transversally by 22 mm. RESULTS The largest distance between IAN and IAA was noted in the third series of experiments. The distance between the nerve and the vessel was minimal in the first series, with an open mouth without lateral displacements. CONCLUSION The generated computer model opens new possibilities for studying the dynamic anatomy of the pterygomandibular space. The results of this study can be used for further experimental and clinical trials to find the safest approach to the implementation of IANB, as well as applied in the practice of the educational process.
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Affiliation(s)
- H M Darawsheh
- Sechenov University, Moscow, Russia; Penza State University, Penza, Russia.
| | - A A Safronova
- Saint Petersburg State University of Aerospace Instrumentation, St. Petersburg, Russia
| | | | | | | | - G T Saleeva
- Kazan State Medical University, Kazan, Russia
| | - N R Saleev
- Kazan State Medical University, Kazan, Russia
| | - R A Saleev
- Kazan State Medical University, Kazan, Russia
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Ma H, Teng H, Li A, Zhang Z, Zheng T, Chong DYR, Shao B, Liu Z. The pressure in the temporomandibular joint in the patients with maxillofacial deformities. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101285. [PMID: 36087916 DOI: 10.1016/j.jormas.2022.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/05/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Temporomandibular disorder (TMD) symptoms were found to be common in the patients with maxillofacial deformities. The mandibular structure was in relation with the stress within temporomandibular joint (TMJ). However, the current studies on the TMJ stresses in the patients with different maxillofacial deformities are not comprehensive enough. PURPOSE The aim of this study was to investigate the compression and morphology of the TMJ in the patients with different maxillofacial deformities under central occlusion. METHODS 24 patients and 10 asymptomatic individuals were included in this study and divided into patient groups and control group. The 3D models were reconstructed. Muscle forces and boundary conditions corresponding to the central occlusion were applied. Nine morphological parameters of mandible were evaluated. RESULTS The minimum principal stresses in the articular disc and condyle were significantly greater than those of the control group (P<0.05). For the articular disc, the compression on the non-deviation side was greater than those on the deviation side in patients with asymmetrical mandibles. There was difference between both sides in the mandibular prognathism and retrusion groups. The joint space of patients was significantly lower than that of the control group (P<0.05). CONCLUSIONS Maxillofacial deformities might change the condylar position within the articular fossa, which decreased the joint space and increased the compression within TMJ. The patients with asymmetry mandible suffered greater pressure within TMJ on the non-deviation side. The bilaterally over-developed and under-developed mandible in patients might also increase the compression within TMJ.
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Affiliation(s)
- Hedi Ma
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Haidong Teng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Annan Li
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Zhifei Zhang
- Department of Statistics, School of Mathematics, Southwest Jiaotong University,611756, China
| | - Tinghui Zheng
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China
| | - Desmond Y R Chong
- Engineering Cluster, Singapore Institute of Technology, Singapore, Singapore
| | - Bingmei Shao
- Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China; Basic Mechanics Lab, Sichuan University, Chengdu, 610065, China
| | - Zhan Liu
- Key Laboratory of Biomechanical Engineering of Sichuan Province, Sichuan University, Chengdu, 610065, China; Yibin Institute of Industrial Technology/Sichuan University Yibin Park, Yibin Lingang Economic and Technological Development Zone, Yibin, 644600, China.
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Upgrading removable denture design by using strategic implants: A case report. Ann Anat 2022; 245:152002. [PMID: 36183934 DOI: 10.1016/j.aanat.2022.152002] [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: 03/16/2022] [Revised: 08/17/2022] [Accepted: 09/13/2022] [Indexed: 11/22/2022]
Abstract
Inserting a dental implant in a strategic position under a removable partial denture (RPD) can upgrade the RPD design by changing a mainly tissue-supported RPD to an implant-tissue-supported RPD or an implant-tooth-tissue-supported RPD with better retention, support, and stability. CASE PRESENTATION: The patient (female, 77-year-old) was unsatisfied with her maxillary and mandibular clasp-retained removable dentures (RDs). Medical, social, and systemic health evaluations revealed that the patient was healthy. Dental history, intraoral and extraoral examinations, functional screening, and esthetic analyses revealed that the patient had a reduced vertical dimension, resulting in pseudo-class III malocclusion and angular cheilitis. Strategic implants were used to improve the retention, support, and stability of the new RDs. The maxillary canine 23 (World Dental Federation notation) and maxillary premolar 24 were used to retain the maxillary conical crown attachments. Three strategic mini-implants were inserted in the positions of teeth 12, 13, and 14 to support and retain the maxillary RPD. Two locators above the standard implants (33 and 43) were used to support and retain the mandibular overdenture. An improvement in the oral health-related quality of life and patient satisfaction with respect to the maxillary and mandibular RDs was observed immediately after using the new RDs. This improvement did not diminish after a year. CONCLUSION: Herein, using strategic implants to support the maxillary RPD and two standard implants under the mandibular overdenture improved the oral health-related quality of life and patient satisfaction with respect to the maxillary and mandibular prostheses in terms of the retention, stability, support, eating ability, speaking ability, appearance, and cleanability.
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The effect of mandibular movement on temporomandibular joint morphology while eating French fries. Ann Anat 2022; 244:151992. [PMID: 36041696 DOI: 10.1016/j.aanat.2022.151992] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The preferred masticatory side was reported to be almost always the same as the affected side of the temporomandibular disorder. Unbalanced alterations of temporomandibular joint morphology were found to be associated with unilaterally masticatory habits. The aim of this study was to investigate the effect of the mandibular movement on the remodeling of temporomandibular joint during eating French fries using a 3D motion capture system. METHODS Twelve volunteers with non-maxillofacial deformity and a healthy temporomandibular joint were recruited. The 3D models of the mandible and the maxilla were reconstructed according to computed tomography. The subjects were asked to eat French fries by unilaterally mastication, which was recorded by a 3D motion capture system. The trajectories of the incisors and the condyles and the condylar acceleration during unilateral mastication were analyzed. RESULTS During incisal biting, there was no significant difference in the condylar trajectories between the left and right sides (P > 0.05). During unilateral mastication, the average displacement and acceleration of the masticatory condyles were significantly lower than those of the non-masticatory condyles (P < 0.05). The trajectory angles of the masticatory condyles were significantly steeper than those of the non-masticatory condyle (P < 0.05). During swallowing, there was no obvious movement of the mandible. CONCLUSIONS Between both temporomandibular joints, unilateral mastication resulted in significant differences in the regions of the condylar movement within the articular fossa, and then caused different compressive regions of the temporomandibular joints. Thus, unilateral mastication might result in a significantly different pattern of temporomandibular joint remodeling between the two sides.
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Disc Displacement of the Temporomandibular Joint and Facial Asymmetry in Children and Adolescents: A Systematic Review and Meta-Analysis. CHILDREN 2022; 9:children9091297. [PMID: 36138607 PMCID: PMC9497886 DOI: 10.3390/children9091297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/14/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022]
Abstract
Subjects with facial skeletal asymmetries have a higher incidence of anterior temporomandibular joint disc displacement. The objective of the study was to consolidate existing evidence on the connection between temporomandibular joint disc displacement and mandibular asymmetry in youngsters and adolescents. A thorough examination was undertaken in the following databases: PubMed, Scopus, EMBASE, Web of Science, and Cochrane. To judge the publications’ methodological quality Newcastle Ottawa Scale was used. From the 1011 identified records, eight were selected for the qualitative synthesis and five for the quantitative synthesis, amounting to 692 subjects. Fifteen cephalometric variables were meta-analyzed. The distance from menton (Me) to midline (lateral mandibular asymmetry) was significantly shorter [−1.75 (95% CI −2.43–−1.07), p ≤ 0.001] in subjects with disc displacement compared to those without disc displacement. The distance from articulare (Ar) to gonion (Go) was significantly longer [3.74 (95% CI 1.04–6.44), p = 0.007] in subjects with disc displacement compared to those without disc displacement. The relationship between distance from articulare (Ar) to gonion (Go) or sella (S) to gonion (Go) and disc displacement was shown to be close to statistical significance level, but not for other cephalometric data. Disc displacement was associated with several cephalometric measurement variations in children and adolescents.
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Saczuk K, Lapinska B, Wawrzynkiewicz A, Witkowska A, Arbildo-Vega HI, Domarecka M, Lukomska-Szymanska M. Temporomandibular Disorders, Bruxism, Perceived Stress, and Coping Strategies among Medical University Students in Times of Social Isolation during Outbreak of COVID-19 Pandemic. Healthcare (Basel) 2022; 10:740. [PMID: 35455915 PMCID: PMC9028346 DOI: 10.3390/healthcare10040740] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023] Open
Abstract
The COVID-19 pandemic caught universities along with their students off-guard, enforcing online education. Fear of the unknown, disinformation, and isolation resulted in an increased stress level in the entire population. Medical university students are particularly endangered with high stress levels and developing TMD. Temporomandibular disorders (TMD) are of multifactorial etiology, and manifest with jaw dysfunction, masticatory muscle tension or pain, as well as headache. Though bruxism can act as an exacerbating factor for TMD, stress can also play crucial role in the onset. The study aimed to measure occurrence of TMD and bruxism symptoms in the medical student population, asses the stress level, and evaluate adopted stress-coping strategies during the COVID-19 pandemic outbreak. A survey study was performed among 1018 students at Medical University of Lodz during April 2020. A self-designed questionnaire for screening TMD and bruxism symptoms, Perceived Stress Scale (PSS-10), and Brief-COPE questionnaires were applied. TMD and bruxism symptoms were observed in the majority of subjects during social isolation. The perceived stress levels were significantly higher in those experiencing TMD and bruxism symptoms. Mostly maladaptive, emotion-focused coping strategies were chosen by study subjects experiencing high levels of stress. Choosing Self-Blaming as a coping strategy is the strongest predictor of perceived stress.
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Affiliation(s)
- Klara Saczuk
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (K.S.); (B.L.); (M.D.)
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (K.S.); (B.L.); (M.D.)
| | - Adam Wawrzynkiewicz
- Department of Clinical Chemistry and Biochemistry, Medical University of Lodz, 90-419 Lodz, Poland;
| | | | - Heber Isac Arbildo-Vega
- Department of General Dentistry, Dentistry School, Universidad San Martín de Porres, Chiclayo 14012, Peru;
- Department of Human Medicine, Human Medicine School, Universidad San Martín de Porres, Chiclayo 14012, Peru
- Department of General Dentistry, Dentistry School, Universidad Particular de Chiclayo, Chiclayo 14012, Peru
- Department of Stomatology, School of Stomatology, Universidad Alas Peruanas, Lima 15072, Peru
| | - Monika Domarecka
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (K.S.); (B.L.); (M.D.)
| | - Monika Lukomska-Szymanska
- Department of General Dentistry, Medical University of Lodz, 92-213 Lodz, Poland; (K.S.); (B.L.); (M.D.)
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Xu M, Zhang X, He Y. An updated view on Temporomandibular Joint degeneration: insights from the cell subsets of mandibular condylar cartilage. Stem Cells Dev 2022; 31:445-459. [PMID: 35044232 DOI: 10.1089/scd.2021.0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The high prevalence of temporomandibular joint osteoarthritis (TMJOA), which causes joint dysfunction, indicates the need for more effective methods for treatment and repair. Mandibular condylar cartilage (MCC), a typical fibrocartilage that experiences degenerative changes during the development of TMJOA, has become a research focus and therapeutic target in recent years. MCC is composed of four zones of cells at various stages of differentiation. The cell subsets in MCC exhibit different physiological and pathological characteristics during development and in TMJOA. Most studies of TMJOA are mainly concerned with gene regulation of pathological changes. The corresponding treatment targets with specific cell subsets in MCC may provide more accurate and reliable results for cartilage repair and TMJOA treatment. In this review, we summarized the current research progress on the cell subsets of MCC from the perspective of MCC development and degeneration. We hope to provide a reference for further exploration of the pathological process of TMJOA and improvement of TMJOA treatment.
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Affiliation(s)
- Minglu Xu
- Chongqing Medical University, 12550, Chongqing, Chongqing, China;
| | - Xuyang Zhang
- Chongqing Medical University, 12550, Chongqing, Chongqing, China;
| | - Yao He
- Chongqing Medical University, 12550, Chongqing, China, 400016;
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Temporomandibular joint innervation: Anatomical study and clinical implications. Ann Anat 2021; 240:151882. [PMID: 34906668 DOI: 10.1016/j.aanat.2021.151882] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 11/17/2021] [Accepted: 12/07/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Temporomandibular disorders and related pain are commonly seen in clinical practice. Due to its recurrent nature, they adversely affect a patient's social life. Current knowledge on the temporomandibular joint (TMJ) innervation is debatable and insufficient to ensure optimal treatment for the underlying pathology. This study aimed to elucidate the pathophysiology of temporomandibular pain by revealing the TMJ innervation topography, its variations, and its relationships with the surrounding anatomical structures. This will aid in creating a guide for temporomandibular, infratemporal, and preauricular interventions. METHODS A total of 20 cadaver half heads, 10 fresh frozen and 10 embalmed, were used. The TMJ nerves were dissected together with the surrounding anatomical structures. RESULTS We showed that the TMJ is mainly innervated by the auriculotemporal nerve posteriorly, the masseteric nerve anteriorly, the posterior deep temporal nerve anteromedially, and the TMJ branch originating directly from the mandibular nerve medially, and that there are variations in these innervation pathways. Additionally, we emphasized how these nerves might be affected in certain clinical conditions based on their anatomical relationships and pathophysiological mechanisms. To our knowledge, this is the first study showing the existence of a branch of the mandibular nerve directly innervating the TMJ. CONCLUSION In light of our findings, elucidating TMJ pain based on the anatomical characteristics of the region will allow precise treatment algorithms and better clinical outcomes in these patients. Based on this study, new clinical studies and interventions can be designed to reduce healthcare costs and alleviate the burden of temporomandibular disorders.
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