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Zhao J, Xia S, Yue S, Luo Y, Shen P, Yang C. Factors Influencing Mandibular Deviation: A Retrospective Clinical Study. J Craniofac Surg 2024; 35:e28-e31. [PMID: 38294302 DOI: 10.1097/scs.0000000000009710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 06/28/2023] [Indexed: 02/01/2024] Open
Abstract
This study aimed to investigate the correlation between mandibular deviation (MD) and possible clinical factors in patients with anterior disc displacement (ADD). This retrospective clinical study enrolled 296 patients with ADD, diagnosed using magnetic resonance imaging, from 2015 to 2018. The clinical symptoms and medical histories of these patients were carefully examined and recorded. Mandibular deviation was the primary outcome variable confirmed by a combination of clinical examination and facial photographs or posteroanterior cephalograms. The primary predictor variable was ADD staging. Secondary predictor variables included condylar height and distance of disc displacement. Other predictor variables were age, sex, disease course, oral parafunctions, depression, and bone mineral density. We used logistic regression to examine the correlation between the MD and all predictor variables. The χ2 test and analysis of variance were used to exclude the correlation between the predictor variables. In this study, the prevalence of MD was 77% among 278 patients with ADD. Bilateral ADD staging significantly contributed to MD on both sides. The odds ratio increased with the deterioration of disc displacement. The present study demonstrated that the ADD staging influences the condylar height and MD, and that articular disk position should be considered while treating MD.
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Affiliation(s)
- Jiong Zhao
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
| | - Simo Xia
- Transform Studio for Endodontium Stem Cell, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine
| | - Shijing Yue
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine
| | - Yi Luo
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shangai, China
| | - Pei Shen
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shangai, China
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shangai, China
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2
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Radej I, Dargiewicz E, Sawczuk-Siemieniuk M, Ferrando Cascales R, Ferrando Cascales Á, Agustín-Panadero R, Szarmach I. The Role of Maxillofacial Structure and Malocclusion on Condylar Displacement in Maximum Intercuspation and Centric Relation in Patients Seeking Orthodontic Treatment-A Scoping Review. J Clin Med 2023; 12:jcm12020689. [PMID: 36675620 PMCID: PMC9863588 DOI: 10.3390/jcm12020689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/09/2023] [Accepted: 01/13/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Available knowledge about malocclusion and cephalometric variables and their connection with an increased risk of condylar displacement (CD) is scarce. This article aims to present current information on the relationship between centric relation-maximum intercuspal position discrepancies and maxillofacial morphology and malocclusion in patients seeking orthodontic treatment as well as to identify those who require expanded diagnostic evaluation for this disorder. METHODS This review analyzed the PubMed, Cochrane Library, Web of Science, and Scopus electronic databases up to February 2022. Keywords and additional manual searches were performed. Literature selection was based the PRISMA-ScR checklist. The JBI Critical Appraisal Tool assessed the methodological quality of included studies. RESULTS The databases search provided 2321 studies. A total of 10 studies were included in this review after eligibility criteria and JBI assessment. This review was separated into five parts that evaluated CD correlations depending on the following: maxillofacial structure in different vertical and sagittal skeletal patterns, vertical, horizontal, and transverse malocclusions. CONCLUSIONS A hyperdivergent facial skeletal structure is a risk factor for increased CD, particularly in the vertical dimension. The condylar processes are usually displaced in a posteroinferior direction. Further studies are warranted to elucidate the relationship among remaining skeletal and dental malocclusions and the occurrence of CD.
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Affiliation(s)
- Ilona Radej
- Department of Orthodontics, Medical University of Białystok, ul. Waszyngtona 15A, 15-274 Białystok, Poland
- Correspondence:
| | - Ewelina Dargiewicz
- Department of Orthodontics, Medical University of Białystok, ul. Waszyngtona 15A, 15-274 Białystok, Poland
| | | | - Raúl Ferrando Cascales
- Faculty of Health Sciences, San Antonio de Murcia Catholic University (UCAM), 30107 Murcia, Spain
| | - Álvaro Ferrando Cascales
- Faculty of Health Sciences, San Antonio de Murcia Catholic University (UCAM), 30107 Murcia, Spain
| | - Rubén Agustín-Panadero
- Prosthodontic and Occlusion Unit, Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Izabela Szarmach
- Department of Orthodontics, Medical University of Białystok, ul. Waszyngtona 15A, 15-274 Białystok, Poland
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3
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Zhu R, Zheng YH, Zhang ZH, Fan PD, Wang J, Xiong X. Development of a new category system for the profile morphology of temporomandibular disorders patients based on cephalograms using cluster analysis. Front Public Health 2022; 10:1045815. [PMID: 36466455 PMCID: PMC9713943 DOI: 10.3389/fpubh.2022.1045815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
Objective This study aims to develop a new category scheme for the profile morphology of temporomandibular disorders (TMDs) based on lateral cephalometric morphology. Methods Five hundred and one adult patients (91 males and 410 females) with TMD were enrolled in this study. Cluster tendency analysis, principal component analysis and cluster analysis were performed using 36 lateral cephalometric measurements. Classification and regression tree (CART) algorithm was used to construct a binary decision tree based on the clustering results. Results Twelve principal components were discovered in the TMD patients and were responsible for 91.2% of the variability. Cluster tendency of cephalometric data from TMD patients were confirmed and three subgroups were revealed by cluster analysis: (a) cluster 1: skeletal class I malocclusion; (b) cluster 2: skeletal class I malocclusion with increased facial height; (c) cluster 3: skeletal class II malocclusion with clockwise rotation of the mandible. Besides, CART model was built and the eight key morphological indicators from the decision tree model were convenient for clinical application, with the prediction accuracy up to 85.4%. Conclusion Our study proposed a novel category system for the profile morphology of TMDs with three subgroups according to the cephalometric morphology, which may supplement the morphological understanding of TMD and benefit the management of the categorical treatment of TMD.
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Affiliation(s)
- Rui Zhu
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Yun-Hao Zheng
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Zi-Han Zhang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Pei-Di Fan
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Jun Wang
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xin Xiong
- The State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Sichuan, China,Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Sichuan, China,*Correspondence: Xin Xiong
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4
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Tagawa DT, de Albuquerque Franco A, Puchnick A, Wolosker AMB, Florez BM, Dominguez GC, Yamashita HK, Cevidanes LHS, de Arruda Aidar LA, Junior HC. Temporomandibular joint articular disc position and shape in skeletal Class
III. Orthod Craniofac Res 2022; 26:185-196. [PMID: 35946345 DOI: 10.1111/ocr.12599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the position and shape of the temporomandibular joint (TMJ) articular disc among the sagittal and vertical skeletal patterns in Angle Class III, Class III subdivision malocclusion and normal occlusion. The null hypothesis was that there was no difference in disc position and shape in different (1) malocclusions and (2) skeletal patterns. METHODS This cross-sectional observational study evaluated 105 patients divided into 3 groups: Class III (33, 9.39 ± 1.96 years), Class III subdivision (45, 9.51 ± 1.59 years) and a normal occlusion (27, 10.24 ± 0.87 years) was included as healthy control. Severity of the maxilla-mandibular anteroposterior discrepancy and vertical facial pattern were determined using 2D cephalometry, and the position and shape of the articular discs were evaluated in magnetic resonance images. Statistical parametric and non-parametric tests and Kappa analysis for intra-observer and inter-observer assessment were used (p ≤ .05). RESULTS Significant between-group differences were found in articular disc position. In the normal occlusion group, all the articular discs were well positioned. In Class III and Class III subdivision, the discs were displaced in 30.3% and 12.2% of the TMJs, respectively. Sagittal and vertical skeletal patterns did not affect the findings significantly. The Class III subdivision malocclusion group is probably different from the other groups, showing 97.7% of biconcave discs in both TMJs. CONCLUSION The longitudinal follow-up of this sample becomes relevant as the two groups with malocclusion in the pre-peak phase of pubertal growth showed differences in the prevalence of displacement and form of the articular disc, with no association with their vertical facial characteristics.
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Affiliation(s)
- Daniella Torres Tagawa
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
- Department of Orthodontics, Universidade Santa Cecília Santos Brazil
| | | | - Andrea Puchnick
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
| | - Angela Maria Borri Wolosker
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
| | | | | | - Helio Kiitiro Yamashita
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
| | | | | | - Henrique Carrete Junior
- Department of Diagnostic Imaging, Escola Paulista de Medicina, Universidade Federal de São Paulo São Paulo Brazil
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Craniofacial Morphology of Orthodontic Patients with and without Temporomandibular Disorders: A Cross-Sectional Study. Pain Res Manag 2022; 2022:9344028. [PMID: 35360414 PMCID: PMC8964235 DOI: 10.1155/2022/9344028] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/06/2022] [Accepted: 02/17/2022] [Indexed: 02/05/2023]
Abstract
Purpose We aimed to explore the relationship between temporomandibular disorders (TMDs) and craniofacial morphology in orthodontic patients. Methods Altogether, 262 orthodontic patients were included and divided into two groups according to their Fonseca Anamnestic Index (FAI) scores: a no-TMD group (control group, FAI < 20) and a TMD group (FAI ≥ 20). Cephalometric parameters including cranial, maxillary, mandibular, and dental parameters were traced on cephalograms. Craniofacial morphology was compared between TMD and control groups, followed by subgroup analyses based on TMD severity, gender, age, and temporomandibular joint (TMJ) symptoms. Results The prevalence of TMDs was 52.7% among included patients (138/262). The mean age of TMD patients was higher than that of the control group. No significant difference in gender distribution between the groups was observed. The most commonly reported FAI items were misaligned teeth, neck pain, and emotional tension. The Frankfort-mandibular plane angle (FMA) was larger in the TMD patients than in the control group, whereas no significant differences in other parameters were observed. Subgroup analysis based on TMD severity revealed that FMA and anterior facial height of moderate/severe TMD patients were significantly larger than those of mild or no-TMD patients. Among male patients, the anterior cranial base length was smaller, and the anterior facial height was larger in the TMD group. Among female patients, no significant differences in craniofacial morphology between the groups were observed. In juvenile patients, overjet and overbite were smaller in the TMD group. In adult patients, SNA, ANB, FMA, and gonial angle were larger in the TMD group. Within the TMD group, patients with TMJ pain or noises exhibited characteristic craniofacial features compared to patients without these symptoms. Conclusions Orthodontic patients with TMDs have specific craniofacial morphology, suggesting a relationship between TMDs and particular craniofacial features in orthodontic patients.
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6
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Skeletal Divergence and Condylar Asymmetry in Patients with Temporomandibular Disorders (TMD): A Retrospective Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:8042910. [PMID: 34608439 PMCID: PMC8487372 DOI: 10.1155/2021/8042910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/16/2021] [Accepted: 09/03/2021] [Indexed: 01/08/2023]
Abstract
Introduction This study was aimed at evaluating the association between vertical skeletal patterns, condylar height symmetry, and temporomandibular disorders in adults. Methods The study sample consisted of 200 patients (ages 18-30 years old) retrospectively recruited: 100 with temporomandibular disorders (TMD) and 100 without TMD (control), diagnosed by Diagnostic Criteria for the Temporomandibular Disorders (DC/TMD). For each subject, skeletal divergence was assessed on lateral cephalograms, and condylar height symmetry was evaluated by orthopantomography (Habets' method). Results Subjects with temporomandibular disorders showed a strong association with condylar asymmetry (p < 0.0001) and, for the skeletal pattern variables, hyperdivergence (p < 0.001). A correlation with the female sex was also found (p < 0.04), while there was no difference in terms of age in the 2 groups (p > 0.29). Conclusions Although it does not imply a direct cause-and-effect relationship, the present study suggests condylar asymmetry and hyperdivergent skeletal pattern are more likely to be associated with a higher risk of temporomandibular disorder joint diseases in adult patients.
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7
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Protocols for orthodontic treatment of patients with temporomandibular joint disorders. Am J Orthod Dentofacial Orthop 2021; 159:373-388. [PMID: 33485717 DOI: 10.1016/j.ajodo.2020.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/23/2022]
Abstract
Orthodontists often have trouble treating patients who have temporomandibular joint disorders because occlusion changes depend on the position of unstable condyles. This characteristic means the patients do not have definite criteria with which to make an accurate orthodontic diagnosis, so clinicians are unable to establish a reliable treatment plan. This article reports on the treatment of a patient with skeletal Class II relationship and condylar resorption. A stabilization splint was used before any active orthodontic tooth movement to stabilize her condylar position. Although the patient exhibited dramatically increased open bite and a retruded mandibular position after splint therapy, her occlusion and facial esthetics were resolved by orthodontic camouflage treatment with appropriate orthodontic mechanics after extraction of 4 premolars.
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8
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Chutchalermpan T, Pumklin J, Piyapattamin T. Evaluation of Disclusion Time in Various Angle's Malocclusions by T-Scan III System. Eur J Dent 2019; 13:510-513. [PMID: 31797333 PMCID: PMC6938451 DOI: 10.1055/s-0039-1696896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective
The main purpose of this article is to evaluate the disclusion time (DT) in the lateral excursions and protrusion among subjects with Angle’s malocclusions using a T-Scan III system.
Materials and Methods
One hundred subjects with malocclusions were divided into Class I, Class II division 1, Class II division 2, and Class III (
n
= 25 per group). All groups’ DT of each excursion was evaluated by a T-Scan III system.
Statistical Analysis
One-way analysis of variance, followed by a post hoc test, was used to analyze the numerical data at
p
< 0.05.
Results
In the respective malocclusions, means ± standard deviations in second(s) of the DT were 2.08 ± 0.65, 2.13 ± 0.74, 2.12 ± 0.72, and 3.19 ± 1.34 during left excursion; 2.15 ± 0.94, 2.58 ± 1.16, 2.37 ± 1.07, and 3.28 ± 1.25 during right excursion; and 1.88 ± 0.99, 2.08 ± 1.11, 2.07 ± 0.68, and 3.01 ± 1.53 during protrusion. When compared to Class I and Class II malocclusions, Class III showed a significantly higher mean DT of each excursion (
p
< 0.05).
Conclusion
Class III had the significantly highest mean DT of each excursion and the significantly longest DT in all excursions.
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Affiliation(s)
| | - Jittima Pumklin
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Thosapol Piyapattamin
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
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Mollabashi V, Heidari A, Ebrahimi Zadeh H, Seyed Tabib M. The study of facial morphology in patients with vertical growth pattern (hyperdivergent) lacking or showing temporomandibular disorders symptoms. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2019; 121:233-237. [PMID: 31614226 DOI: 10.1016/j.jormas.2019.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/26/2019] [Accepted: 10/03/2019] [Indexed: 10/25/2022]
Abstract
AIM According to the large number of studies, there seems to be a significant relation between hyperdivergence growth pattern and temporomandibular disorders. However, it is not clearly scrutinized which morphological factors can contribute to the development of temporomandibular disorders. The aim of this study was to investigate the relation between some skeletal and facial morphologic features of hyperdivergent facial growth pattern patients and temporomandibular disorders. MATERIALS AND METHODS This case-control study was performed on a population of 50 patients including 25 patients with temporomandibular disorder and 25 non- temporomandibular disorder individuals aged between 15-30 years with hyperdivergent growth pattern (Frankfurt Mandibualr plane angle between 28 and 35 degree). Two groups of symptomatic and asymptomatic patients (case and control) were matched for age and gender. In order to evaluate the skeletal and dental variables, lateral cephalometries was taken and traced after obtaining written consent from the patients. The measured variables were A point to Nasion to B point, Frankfurt plane to Nasion to Pogonion, Nasion to A point to Pogonion, Sella to Gnathion to Frankfurt plan, Articular point to Gonion-Menton, Sella to Articular point to Gonion, Palatal plane to Mandibular plane, and Articular point to Gonion angles. The intervals of Basion to Nasion, Sella to Basion, Gonion to Menton, and amounts of Anterior facial height meas, Upper Anterior facial height ratio to Lower Anterior facial height, posterior facial height, overjet, and overbite Data were analyzed by Chi2 test, t-test, and multivariate test. RESULTS According to the descriptive statistics, the age of the control and case groups averaged 21.12±1.99 and 21.63±1.58 years respectively. Among the people referred to the dental school, the frequency of males and females in the control and case groups were 6, 7 and 19, 18 respectively. The results of t-test and multivariate tests indicated significant differences between the two variables of overbite and mandibular length. CONCLUSION The present study revealed increased overbite (dental feature) and mandibular length (skeletal feature) is more likely to be associated with a higher risk of temporomandibular disorders joint disease in patients with hyperdivergent facial growth pattern. CLINICAL SIGNIFICANCE Treatment of the deep bite condition can be helpful in improving temporomandibular disorder.
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Affiliation(s)
- Vahid Mollabashi
- Department of Orthodontics, Dental Research Center, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Ali Heidari
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Hosna Ebrahimi Zadeh
- Department of Restorative and Cosmetic Dentistry, School of Dentistry, Shahid Behesti University of Medical Sciences, Tehran, Iran.
| | - Maryam Seyed Tabib
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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10
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Piancino MG, Tepedino M, Cavarra F, Bramanti E, Laganà G, Chimenti C, Cirillo S. Condylar long axis and articular eminence in MRI in patients with temporomandibular disorders. Cranio 2018; 38:342-350. [PMID: 30332921 DOI: 10.1080/08869634.2018.1532647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To compare morphologic findings in MRI and skeletal divergence of a group of patients with temporomandibular joint disorders (TMD) subdivided into condylar symmetric and asymmetric. METHODS Fifty-nine adults (26.7 years old) with TMD were retrospectively recruited. Condylar height symmetry was evaluated by orthopantomography (Habets's method) and used to divide patients into Symmetric and Asymmetric groups; skeletal divergence was assessed on lateral cephalograms. MRI was used to evaluate the condylar long axis' angle, the glenoid fossa morphology, and the degree of disc displacement. RESULTS Asymmetric subjects showed a hyperdivergent skeletal pattern (p = 0.036), asymmetric condylar long axis (p = 0.018), and deeper (p = 0.025) and asymmetric (p = 0.001) glenoid fossa compared to symmetric subjects. CONCLUSION Patients with TMD and condylar asymmetry diagnosed with orthopantomography are more likely to show hyperdivergent skull in cephalometry, condylar asymmetry of both height and major axis, and a steeper glenoid fossa in MRI.
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Affiliation(s)
- Maria Grazia Piancino
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin , Turin, Italy
| | - Michele Tepedino
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila , L'Aquila, Italy
| | | | - Ennio Bramanti
- Department of Biomedical Sciences, University of Messina , Messina, Italy
| | - Giuseppina Laganà
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata , Rome, Italy
| | - Claudio Chimenti
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila , L'Aquila, Italy
| | - Stefano Cirillo
- S.C. Diagnostic Radiology, A.O. Ordine Mauriziano Hospital "Umberto I" , Turin, Italy
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Colonna A, Manfredini D, Lombardo L, Muscatello L, Marchese-Ragona R, Arveda N, Siciliani G. Comparative analysis of jaw morphology and temporomandibular disorders: A three-dimension imaging study. Cranio 2018; 38:158-167. [DOI: 10.1080/08869634.2018.1507094] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Anna Colonna
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Daniele Manfredini
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Luca Muscatello
- Section of ENT Pathology, NOA Hospital, Massa-Carrara, Italy
| | | | - Niki Arveda
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Giuseppe Siciliani
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
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12
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Kim YK. Complications associated with orthognathic surgery. J Korean Assoc Oral Maxillofac Surg 2017; 43:3-15. [PMID: 28280704 PMCID: PMC5342970 DOI: 10.5125/jkaoms.2017.43.1.3] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 02/09/2017] [Indexed: 11/21/2022] Open
Abstract
While most patients undergo orthognathic surgery for aesthetic purposes, aesthetic improvements are most often followed by postoperative functional complications. Therefore, patients must carefully decide whether their purpose of undergoing orthognathic surgery lies on the aesthetic side or the functional side. There is a wide variety of complications associated with orthognathic surgery. There should be a clear distinction between malpractice and complications. Complications can be resolved without any serious problems if the cause is detected early and adequate treatment provided. Oral and maxillofacial surgeons must have a full understanding of the types, causes, and treatment of complications, and should deliver this information to patients who develop these complications.
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Affiliation(s)
- Young-Kyun Kim
- Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
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13
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Nicot R, Vieira AR, Raoul G, Delmotte C, Duhamel A, Ferri J, Sciote JJ. ENPP1 and ESR1 genotypes influence temporomandibular disorders development and surgical treatment response in dentofacial deformities. J Craniomaxillofac Surg 2016; 44:1226-37. [PMID: 27519661 DOI: 10.1016/j.jcms.2016.07.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 06/04/2016] [Accepted: 07/13/2016] [Indexed: 12/11/2022] Open
Abstract
UNLABELLED Dentofacial deformities are dys-morpho-functional disorders involving the temporomandibular joints (TMJ). Many authors have reported a TMJ improvement in dysfunctional subjects with malocclusion after orthodontic or combined orthodontic and surgical treatment particularly for the relief of pain. In particular, few studies have highlighted the demographic and clinical predictors of response to surgical treatment. To date, no genetic factor has yet been identified as a predictor of response to surgical treatment. The aim of this cohort study is therefore to identify single-nucleotide polymorphisms associated with postoperative temporomandibular disorders (TMD) or with TMJ symptoms after orthognathic surgery. Here, we found the AA genotype of SNP rs1643821 (ESR1 gene) as a risk factor for dysfunctional worsening after orthognathic surgery. In addition, we have identified TT genotype of SNP rs858339 (ENPP1 gene) as a protective factor against TMD in a population of patients with dentofacial deformities. Conversely, the heterozygous genotype AT was identified as a risk factor of TMD with respect to the rest of our population. All these elements are particularly important to bring new screening strategies and tailor future treatment. PERSPECTIVE This study allows us to identify sub-populations at high risk of developing postoperative temporomandibular disorders after orthognathic surgery procedures. Many other genes of interest could be potential factors influencing the dysfunctional response to orthognathic surgery, particularly genes of the Opera cohort.
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Affiliation(s)
- Romain Nicot
- Univ. Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, F-59000, Lille, France.
| | - Alexandre R Vieira
- Department of Oral Biology, University of Pittsburgh School of Dental Medicine, 3501 Terrace St, Pittsburgh, PA 15261, USA.
| | - Gwénaël Raoul
- Univ. Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, F-59000, Lille, France.
| | - Constance Delmotte
- Univ. Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, F-59000, Lille, France.
| | - Alain Duhamel
- Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, F-59000, Lille, France.
| | - Joël Ferri
- Univ. Lille, Oral and Maxillofacial Department, Roger Salengro Hospital, CHU Lille, INSERM U 1008, Controlled Drug Delivery Systems and Biomaterials, F-59000, Lille, France.
| | - James J Sciote
- Department of Orthodontics, Kornberg School of Dentistry, Temple University, Philadelphia, PA 19140, USA.
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Temporomandibular Joint Disorders in Patients With Different Facial Morphology. A Systematic Review of the Literature. J Oral Maxillofac Surg 2016; 74:29-46. [DOI: 10.1016/j.joms.2015.07.006] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2015] [Revised: 07/10/2015] [Accepted: 07/10/2015] [Indexed: 11/24/2022]
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15
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Ramírez-Caro SN, Espinosa de Santillana IA. [Association between craniofacial structures adolescents and temporomandibular disorders]. Rev Salud Publica (Bogota) 2015; 17:938-950. [PMID: 28453146 DOI: 10.15446/rsap.v17n6.34833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 08/18/2015] [Indexed: 11/09/2022] Open
Abstract
Objective To determine the association between craniofacial structures and the presence of TMD in adolescents. Material and Methods Cases-control study. 46 patients aged 10 to 16 years old were evaluated with their respective lateral cephalometric X-rays (23 cases and 23 controls matched for age and sex). The TTM was evaluated with the research diagnostic criteria for temporomandibular disorders (RDC/TMD). Results The comparison between cases and controls of the craniofacial structures did not show significant differences, however the lower facial height, facial axis and the mandibular plane were slightly higher in the group of cases. In the two-way analysis of ANOVA (diagnosis and age), facial convexity presented differences between the adolescent with and without temporomandibular disorders (p=0,002). Conclusion Craniofacial structures are not associated with the diagnosis of TMD in adolescents. However, changes occur in relation to the former location of the jaw, resulting in a skeletal pattern class II and an elongated shape of the face.
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Ponces MJ, Tavares JP, Lopes JD, Ferreira AP. Comparison of condylar displacement between three biotypological facial groups by using mounted models and a mandibular position indicator. Korean J Orthod 2014; 44:312-9. [PMID: 25473647 PMCID: PMC4250665 DOI: 10.4041/kjod.2014.44.6.312] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 04/13/2014] [Accepted: 04/14/2014] [Indexed: 11/19/2022] Open
Abstract
Objective Facial-type-associated variations in diagnostic features have several implications in orthodontics. For example, in hyperdivergent craniofacial types, growth imbalances are compensated by displacement of the condyle. When diagnosis and treatment planning involves centric relation (CR), detailed knowledge of the condylar position is desirable. The present study aimed to measure condylar displacement (CD) between CR and maximum intercuspation in three facial types of an asymptomatic orthodontic population. Methods The study was conducted in 108 patients classified into three groups of 36 individuals each (27 women and 9 men; mean age, 20.5 years), based on the following facial patterns: hyperdivergent, hypodivergent, and intermediate. To quantify CD along the horizontal and vertical axes, the condylar position was analyzed using mounted casts on a semi-adjustable articulator and a mandibular position indicator. The Student t-test was used to compare CD between the groups. Results Vertical displacement was found to be significantly different between the hyperdivergent and hypodivergent groups (p < 0.0002) and between the hyperdivergent and intermediate groups (p < 0.0006). The differences in horizontal displacement were not significant between the groups. In each group, vertical CD was more evident than horizontal displacement was. Conclusions All facial types, especially the hyperdivergent type, carried a significantly high risk of CD. Therefore, the possibility of CD should be carefully evaluated and considered in the assessment of all orthodontic cases in order to accurately assess jaw relationships and avoid possible misdiagnosis.
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Affiliation(s)
- Maria João Ponces
- Department of Orthodontics, Faculty of Dental Medicine of University of Porto, Porto, Portugal
| | - José Pedro Tavares
- Department of Civil Engineering, Faculty of Engineering of University of Porto, Porto, Portugal
| | - Jorge Dias Lopes
- Department of Orthodontics, Faculty of Dental Medicine of University of Porto, Porto, Portugal
| | - Afonso Pinhão Ferreira
- Department of Orthodontics, Faculty of Dental Medicine of University of Porto, Porto, Portugal
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Kwon SY, Ahn HW, Kim SH, Park YG, Chung KR, Paik CH, Nelson G. Antero-posterior lingual sliding retraction system for orthodontic correction of hyperdivergent Class II protrusion. Head Face Med 2014; 10:22. [PMID: 24897979 PMCID: PMC4053581 DOI: 10.1186/1746-160x-10-22] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 05/28/2014] [Indexed: 11/22/2022] Open
Abstract
Background This report introduces a lingual bonded retraction system (Kinematics of Lingual Bar on Non-Paralleling Technique, KILBON) for efficient sliding mechanics combined with vertical control of the anterior and posterior teeth, which is suitable for Class II hyperdivergent patients. Methods Design and biomechanics of the KILBON System were described. Two adults with hyperdivergent class II malocclusion were treated with the KILBON system and temporary skeletal anchorage devices (TSADs) on the palate. The first patient was treated with conventional KILBON system on the upper arch and detailed with lingual appliances. The second patient showed the modified design of the KILBON when applied to a low palatal vault. Results A large amount of intrusion and retraction of the anterior teeth and simultaneous intrusion of the posterior segment were achieved in short treatment time. Concomitant counterclockwise rotation of the mandible improved the esthetic profile. Periodontal support without dehiscence or bone loss was confirmed on anterior region in spite of large amount of retraction. Conclusions This report presented a lingual retraction system that provides simple and effective vertical and sagittal control of both anterior and posterior teeth. The biomechanics are dependable for correcting a dentoalveolar protrusion in a patient with Class II hyperdivergent skeletal pattern.
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Affiliation(s)
| | | | - Seong-Hun Kim
- Department of Orthodontics, School of Dentistry, Kyung Hee University, #1 Hoegi-dong, Dongdaemun-gu, Seoul 130-701, South Korea.
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Valladares-Neto J, Cevidanes LH, Rocha WC, Almeida GDA, Paiva JBD, Rino-Neto J. TMJ response to mandibular advancement surgery: an overview of risk factors. J Appl Oral Sci 2014; 22:2-14. [PMID: 24626243 PMCID: PMC3908759 DOI: 10.1590/1678-775720130056] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 08/23/2013] [Indexed: 11/22/2022] Open
Abstract
Objective In order to understand the conflicting information on temporomandibular joint
(TMJ) pathophysiologic responses after mandibular advancement surgery, an overview
of the literature was proposed with a focus on certain risk factors. Methods A literature search was carried out in the Cochrane, PubMed, Scopus and Web of
Science databases in the period from January 1980 through March 2013. Various
combinations of keywords related to TMJ changes [disc displacement, arthralgia,
condylar resorption (CR)] and aspects of surgical intervention (fixation
technique, amount of advancement) were used. A hand search of these papers was
also carried out to identify additional articles. Results A total of 148 articles were considered for this overview and, although
methodological troubles were common, this review identified relevant findings
which the practitioner can take into consideration during treatment planning: 1-
Surgery was unable to influence TMJ with preexisting displaced disc and crepitus;
2- Clicking and arthralgia were not predictable after surgery, although there was
greater likelihood of improvement rather than deterioration; 3- The amount of
mandibular advancement and counterclockwise rotation, and the rigidity of the
fixation technique seemed to influence TMJ position and health; 4- The risk of CR
increased, especially in identified high-risk cases. Conclusions Young adult females with mandibular retrognathism and increased mandibular plane
angle are susceptible to painful TMJ, and are subject to less improvement after
surgery and prone to CR. Furthermore, thorough evidenced-based studies are
required to understand the response of the TMJ after mandibular advancement
surgery.
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Affiliation(s)
- José Valladares-Neto
- Federal University of Goiás, School of Dentistry, Department of Orthodontics, GoiâniaGO, Brazil, Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, GO, Brazil
| | - Lucia Helena Cevidanes
- University of Michigan, School of Dentistry, Department of Orthodontics, Ann Arbor, USA, Department of Orthodontics, School of Dentistry, University of Michigan, Ann Arbor, USA
| | - Wesley Cabral Rocha
- General Hospital of Goiânia, Department of Oral and Maxillofacial Surgery, GoiâniaGO, Brazil, Department of Oral and Maxillofacial Surgery, General Hospital of Goiânia, Goiânia, GO, Brazil
| | - Guilherme de Araújo Almeida
- Federal University of Uberlândia, School of Dentistry, Department of Orthodontics, UberlândiaMG, Brazil, Department of Orthodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - João Batista de Paiva
- University of São Paulo, School of Dentistry, Department of Orthodontics, São PauloSP, Brazil, Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - José Rino-Neto
- University of São Paulo, School of Dentistry, Department of Orthodontics, São PauloSP, Brazil, Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
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Dubrovsky B, Raphael KG, Lavigne GJ, Janal MN, Sirois DA, Wigren PE, Nemelivsky LV, Klausner JJ, Krieger AC. Polysomnographic investigation of sleep and respiratory parameters in women with temporomandibular pain disorders. J Clin Sleep Med 2014; 10:195-201. [PMID: 24533003 DOI: 10.5664/jcsm.3452] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Temporomandibular pain disorders (TMD) and myofascial pain were linked to increased prevalence of insomnia and obstructive sleep apnea (OSA) on clinical grounds. However, the literature lacks an accurate polysomnographic (PSG) characterization of sleep abnormalities associated with TMD, given that prior studies included small or uncontrolled samples of TMD patients. The present investigation aims to objectively evaluate measures of sleep and respiratory disturbance in a large representative sample of TMD cases in comparison with matched controls. METHODS Sleep, respiration, and limb movements were measured using a 2-night attended PSG protocol in 170 women-124 TMD cases with myofascial pain and 46 demographically matched controls. The second night data were compared between the groups using ANCOVAs. In TMD cases, the relationship between pain ratings and sleep parameters was analyzed using multiple regressions. RESULTS In comparison to healthy controls, TMD cased evidenced a significant increase in stage N1 sleep (12.2% ± 7.6% vs. 9.2% ± 5.0%, p = 0.03), which was only mild relative to normative values. TMD cases also demonstrated mild but significant elevations in arousals associated with all types of respiratory events (6.0/h ± 6.1 vs. 3.5/h ± 3.3 p = 0.02) and in respiratory effort related arousals (RERAs, 4.3/h ± 4.3 vs. 2.6/h ± 2.7, p = 0.02). Myofascial pain predicted a lower sleep efficiency (p = 0.01), more frequent awakenings (p = 0.04), and higher RERA index (p = 0.04) among TMD cases. CONCLUSIONS Myofascial pain in TMD is associated with mild elevation in sleep fragmentation and increased frequency of RERA events. Further research is required to evaluate the clinical significance of these findings.
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Affiliation(s)
- Boris Dubrovsky
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY ; Center for Sleep Disorders Medicine and Research, Division of Pulmonary and Critical Care Medicine New York Methodist Hospital, Brooklyn, NY
| | - Karen G Raphael
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY
| | - Gilles J Lavigne
- Faculté de Médecine Dentaire, Université de Montréal, Montréal, Canada
| | - Malvin N Janal
- Department of Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY
| | - David A Sirois
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY
| | - Pia E Wigren
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY ; Private practice, Stockholm, Sweden
| | - Lena V Nemelivsky
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY ; Cancer Trials Office, Mount Sinai Medical Center, New York, NY
| | - Jack J Klausner
- Department of Oral and Maxillofacial Pathology, Radiology and Medicine, NYU College of Dentistry, New York, NY
| | - Ana C Krieger
- Departments of Medicine, Neurology and Genetic Medicine, Weill Cornell Medical College, Cornell University, New York, NY
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Al-Ahmad HT, Al-Bitar ZB. The effect of temporomandibular disorders on condition-specific quality of life in patients with dentofacial deformities. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 117:293-301. [PMID: 24528790 DOI: 10.1016/j.oooo.2013.11.493] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 10/23/2013] [Accepted: 11/03/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE This study investigated the effect of temporomandibular disorders on quality of life (QOL) of patients with dentofacial deformities. STUDY DESIGN A case-control study was performed involving 3 age- and gender-matched groups: 38 preoperative participants, 38 postoperative participants, and 39 control participants. Temporomandibular joints were assessed using the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD axis I), and QOL was assessed using the Orthognathic Quality of Life Questionnaire (OQLQ) and the Short-Form Health Survey (SF-36). RESULTS Significantly lower OQLQ scores were found in postoperative patients with one or more RDC/TMD findings; the domains in which these occurred were mental health, dentofacial esthetics, and awareness of dentofacial esthetics for patients with myofascial pain; social aspects and awareness of dentofacial esthetics for patients with disk displacement with reduction; and all domains for patients with arthritis (all P < .05). CONCLUSIONS Despite the variable effect of orthognathic treatment on TMDs, the presence of TMDs in patients after treatment can have a negative effect on their QOL.
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Affiliation(s)
- Hazem T Al-Ahmad
- Associate Professor, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, University of Jordan, Amman, Jordan.
| | - Zaid B Al-Bitar
- Associate Professor, Orthodontics Department, Faculty of Dentistry, University of Jordan, Amman, Jordan
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Abrahamsson C, Henrikson T, Nilner M, Sunzel B, Bondemark L, Ekberg EC. TMD before and after correction of dentofacial deformities by orthodontic and orthognathic treatment. Int J Oral Maxillofac Surg 2013; 42:752-8. [DOI: 10.1016/j.ijom.2012.10.016] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 08/28/2012] [Accepted: 10/11/2012] [Indexed: 10/27/2022]
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Jung WS, Kim H, Jeon DM, Mah SJ, Ahn SJ. Magnetic resonance imaging-verified temporomandibular joint disk displacement in relation to sagittal and vertical jaw deformities. Int J Oral Maxillofac Surg 2013; 42:1108-15. [PMID: 23618835 DOI: 10.1016/j.ijom.2013.03.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 02/06/2013] [Accepted: 03/18/2013] [Indexed: 10/26/2022]
Abstract
This retrospective study was designed to analyze the relationships between temporomandibular joint (TMJ) disk displacement and skeletal deformities in orthodontic patients. Subjects consisted of 460 adult patients. Before treatment, lateral cephalograms and TMJ magnetic resonance imaging (MRI) were recorded. Subjects were divided into six groups based on TMJ MRI according to increasing severity of TMJ disk displacement, in the following order: bilateral normal TMJs, unilateral disk displacement with reduction (DDR) and contralateral normal, bilateral DDR, unilateral disk displacement without reduction (DDNR) and contralateral normal, unilateral DDR and contralateral DDNR, and bilateral DDNR. Subjects were subdivided sagittally into skeletal Class I, II, and III deformities based on the ANB (point A, nasion, point B) angle and subdivided vertically into hypodivergent, normodivergent, and hyperdivergent deformities based on the facial height ratio. Linear trends between severity of TMJ disk displacement and sagittal or vertical deformities were analyzed by Cochran-Mantel-Haenszel test. The severity of TMJ disk displacement increased as the sagittal skeletal classification changed from skeletal Class III to skeletal Class II and the vertical skeletal classification changed from hypodivergent to hyperdivergent. There were no significant differences in the linear trend of TMJ disk displacement severity between the sexes according to the skeletal deformities. This study suggests that subjects with skeletal Class II and/or hyperdivergent deformities have a high possibility of severe TMJ disk displacement, regardless of sex.
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Affiliation(s)
- W-S Jung
- Dental Research Institute and Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Almăşan OC, Băciuţ M, Almăşan HA, Bran S, Lascu L, Iancu M, Băciuţ G. Skeletal pattern in subjects with temporomandibular joint disorders. Arch Med Sci 2013; 9:118-26. [PMID: 23515361 PMCID: PMC3598125 DOI: 10.5114/aoms.2013.33072] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 04/15/2011] [Accepted: 05/11/2011] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION To establish the skeletal pattern in subjects with malocclusions and temporomandibular disorders (TMD); to assess the relationship between craniofacial skeletal structures and TMD in subjects with malocclusions. MATERIAL AND METHODS Sixty-four subjects with malocclusions, over 18 years of age, were included in the study. Temporomandibular disorders were clinically assessed according to the Helkimo Anamnestic Index. Subjects underwent a lateral cephalogram. Subjects were grouped according to the sagittal skeletal pattern (ANB angle) into class I, II and III. Parametric Student tests with equal or unequal variations were used (variations were previously tested with Levene test). RESULTS Twenty-four patients with TMD (experimental sample); 40 patients without TMD (control group); interincisal angle was higher in class I and II (p < 0.05) experimental subjects; overjet was larger in experimental subjects; midline shift and Wits appraisal were broader in the experimental group in all three classes. In class III subjects, the SNB angle was higher in the experimental group (p = 0.01). Joint noises followed by reduced mandible mobility, muscular pain and temporomandibular joint (TMJ) pain were the most frequent symptoms in subjects with TMD and malocclusions. CONCLUSIONS Temporomandibular joint status is an important factor to consider when planning orthodontic treatment in patients with severe malocclusions; midline shift, large overjet and deep overbite have been associated with signs and symptoms of TMD.
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Affiliation(s)
- Oana Cristina Almăşan
- Department of Prosthetic Dentistry, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Mihaela Băciuţ
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Horea Artimoniu Almăşan
- Department of Cranio-Maxillofacial Surgery, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Simion Bran
- Department of Maxillofacial Surgery and Implantology, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Liana Lascu
- Department of Prosthetic Dentistry, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Mihaela Iancu
- Department of Medical Informatics and Biostatistics, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Grigore Băciuţ
- Department of Cranio-Maxillofacial Surgery, Faculty of Dentistry, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
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Barrera-Mora JM, Espinar Escalona E, Abalos Labruzzi C, Llamas Carrera JM, Ballesteros EJC, Solano Reina E, Rocabado M. The relationship between malocclusion, benign joint hypermobility syndrome, condylar position and TMD symptoms. Cranio 2012; 30:121-30. [PMID: 22606856 DOI: 10.1179/crn.2012.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The current study investigated the association between temporomandibular disorders, malocclusion patterns, benign joint hypermobility syndrome and the initial condylar position. One hundred sixty-two subjects were analyzed using the Rocabado Temporomandibular Pain Analysis; Helkimo Index parameters; the Carter-Wilkinson modified test; and a mounting cast with condylar position indicator registration (MPI). The study revealed a significant association between: 1. Delta H, skeletal pattern (p = 0.034); 2. Delta Y, transversal malocclusion (p = 0.04); 3. right and left, Delta Z, right and left posteroinferior synovial pain (p < 0.05); 4. hypermobility scale, gender (p < 0.001), malocclusion pattern (p = 0.021); 5. TMJ function impairment, gender (p = 0.043); 6. sagittal malocclusion pattern, right temporomandibular pain analysis joint (TPAJ) (p = 0.0034); 7. TMJ function impairment, left and right TPAJ (p = 0.007); and 8. mandibular motion, left and right TPAJ (p = 0.035, p = 0.015). The conclusion was that anterior crossbite and condylar displacements in the vertical plane are risk factors in developing TMJ symptoms.
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Sakar O, Calisir F, Oztas E, Marsan G. Evaluation of the effects of temporomandibular joint disk displacement and its progression on dentocraniofacial morphology in symptomatic patients using lateral cephalometric analysis. Cranio 2012; 29:211-8. [PMID: 22586830 DOI: 10.1179/crn.2011.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The aim of this study was to evaluate the effects of disk displacement (DD) and its progression on dentocraniofacial morphology in symptomatic patients and compare the results with asymptomatic volunteers. Skeletal and dental Class I female patients with DD, diagnosed using magnetic resonance imaging (MRI) and lateral cephalometric analysis were included in the study. Subjects were grouped as follows: control group with bilateral normal disk position (group 1, n=12), unilateral DD with reduction (group 2, n=16), bilateral DD with reduction (group 3, n=26), unilateral DD without reduction (group 4, n=12), and bilateral DD without reduction (group 5, n=8). Thirty-two (32) cephalometric variables were measured, and statistically significant differences were found in 11. Dental and soft tissue measurements did not reveal any differences, but variables related to the mandible showed statistically significant differences. Progression of DD was associated with an increase in all angular measurements related to vertical skeletal relationships and articular angle and a decrease in the ratio of posterior face height to anterior face height indicating clockwise rotation of the mandible. Similarly, the height of ramus was decreased with the progression of DD. The results of this study demonstrated that the presence of DD in skeletal Class I female patients effects facial morphology, and its progression makes the differences more significant and remarkable. These results emphasize the importance of early diagnosis and treatment in the management of DD.
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Affiliation(s)
- Olcay Sakar
- Department of Prosthodontics, Faculty of Dentistry of Istanbul University, Istanbul, Turkey.
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Tallents RH, Stein S, Macher D, Katzberg R, Murphy W. Predisposing and Precipitating Factors in Temporomandibular Disorders. Semin Orthod 2012. [DOI: 10.1053/j.sodo.2011.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Moon BS, Yang IH, Ahn SJ. Dentofacial characteristics of women with oversized mandible and temporomandibular joint internal derangement. Angle Orthod 2011; 81:469-77. [PMID: 21299385 DOI: 10.2319/082910-503.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION To analyze dentofacial characteristics of temporomandibular joint internal derangement (TMJ ID) in orthodontic patients with oversized mandible (skeletal Class III pattern). MATERIALS AND METHODS The sample consisted of 66 women whose mandibular body length to anterior cranial base ratio is greater than 1.12. They were divided into three groups based on magnetic resonance images of bilateral TMJs: bilateral normal disk position (BN), bilateral disk displacement with reduction (DDR), and bilateral disk displacement without reduction (DDNR). Thirty-five cephalometric variables regarding their lateral cephalograms were analyzed by Kruskal-Wallis test to evaluate differences in dentofacial morphology among the three groups. RESULTS Subjects with TMJ ID had a clockwise rotation of the ramus, with backward position of mandible, labial tipping of mandibular incisors, and protrusion of upper and lower lips. However, TMJ ID did not significantly influence vertical skeletal relationships. Most of the significant dentofacial changes were found between BN and DDR, and dentofacial changes between DDR and DDNR were minimal. CONCLUSIONS This study suggests that dentofacial changes associated with TMJ ID begin to appear when TMJ ID develops to DDR from BN in patients with oversized mandible.
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Affiliation(s)
- Beom-Seok Moon
- Dental Research Institute and Department of Orthodontics, School of Dentistry, Seoul National University, Chongro-Ku, Seoul, Korea, South Korea
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Pneumatized articular eminence in a cohort of orthodontic patients with different sagittal skeletal anomalies: a retrospective cone beam computed tomography study. Oral Radiol 2010. [DOI: 10.1007/s11282-010-0045-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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30
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Abrahamsson C, Ekberg EC, Henrikson T, Nilner M, Sunzel B, Bondemark L. TMD in Consecutive Patients Referred for Orthognathic Surgery. Angle Orthod 2009; 79:621-7. [DOI: 10.2319/060408-293.1] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Accepted: 09/01/2008] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective: To answer the question whether temporomandibular disorders (TMD) were more common in a group of individuals referred for orthognathic surgery than in a control group. The null hypothesis was that neither the frequency of signs and symptoms of TMD or diagnosed TMD would differ between the patient group and a control group.
Materials and Methods: A sample of 121 consecutive patients referred for orthognathic surgery at the Department of Oral Maxillofacial Surgery, Malmö University Hospital, Sweden, was interviewed and examined regarding signs and symptoms of TMD and headaches. A control group was formed by 56 age- and gender-matched individuals attending the Department of Oral Diagnosis, Faculty of Odontology, Malmö University, Sweden, and Public Dental Health Clinic in Oxie, County of Skane, Sweden. TMD diagnoses were used according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).
Results: The patient group showed more myofascial pain without limited opening, disc displacement with reduction, and arthralgia according to RDC/TMD than the control group. The patient group also had more symptoms and signs of TMD in general.
Conclusions: The null hypothesis was rejected because patients who were to be treated with orthognathic surgery had more signs and symptoms of TMD and higher frequency of diagnosed TMD compared with the matched control group.
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Affiliation(s)
- Cecilia Abrahamsson
- a Research Fellow, Department of Orthodontics, Faculty of Odontology, Malmö University, Malmo, Sweden
| | - Ewa Carin Ekberg
- b Associate Professor, Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmo, Sweden
| | - Thor Henrikson
- c Odont Dr, Department of Orthodontics, Faculty of Odontology, Malmö University, Sweden
| | - Maria Nilner
- d Chair and Professor, Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmo, Sweden
| | - Bo Sunzel
- e Odont Dr, Department of Oral and Maxillofacial Surgery, Malmö University Hospital, Malmo, Sweden
| | - Lars Bondemark
- f Chair and Professor, Department of Orthodontics, Faculty of Odontology, Malmö University, Malmo, Sweden
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