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Tekin G, Kocak ATO, Kuleli B, Ozturk T, Dereci O, Kose NS, Ugurlu M, Kosar YC, Caliskan G. The effect of mentoplate application on the condyle. BMC Oral Health 2024; 24:722. [PMID: 38915000 PMCID: PMC11194891 DOI: 10.1186/s12903-024-04506-0] [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: 03/07/2024] [Accepted: 06/20/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND The aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in the correction of skeletal class III relationship, using fractal analysis (FA). METHODS The sample consisted of 30 individuals (8-11 years) diagnosed with skeletal Class III malocclusion who underwent MP-RME treatment. Archival records provided cone-beam computed tomography (CBCT) images taken at two intervals: before MP-RME treatment (T0) and after treatment (T1). The CBCT images were obtained using standardized settings to ensure consistency in image quality and resolution. The trabecular structures in the bilateral condyles at both T0 and T1 were analyzed using FA. The FA was performed on these condylar images using the Image J software. The region of interest (ROI) was carefully selected in the condyle to avoid overlapping with cortical bone, and the box-counting method was employed to calculate the fractal dimension (FD). Statistical analysis was conducted to compare the FD values between T0 and T1 and to evaluate gender differences. The statistical significance was determined using paired t-tests for intra-group comparisons and independent t-tests for inter-group comparisons, with a significance level set at p < 0.05. RESULTS The analysis revealed no statistically significant differences in the trabecular structures of the condyles between T0 and T1 (p > 0.05). However, a significant gender difference was observed in FA values, with males exhibiting higher FA values in the left condyle compared to females at both T0 and T1 (p < 0.05). Specifically, the FA values in the left condyle increased from a mean of 1.09 ± 0.09 at T0 to 1.13 ± 0.08 at T1 in males, whereas in females, the FA values remained relatively stable with a mean of 1 ± 0.09 at T0 and 1.03 ± 0.11 at T1. CONCLUSION The findings indicate that MP-RME therapy does not induce significant alterations in the trabecular structure of the mandibular condyle. These results suggest the treatment's safety concerning the structural integrity of the condyle, although the observed gender differences in FA values warrant further investigation.
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Affiliation(s)
- Gorkem Tekin
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey.
| | | | - Batuhan Kuleli
- Faculty of Dentistry, Department of Orthodontics, Osmangazi University, Eskisehir, Turkey
| | - Taner Ozturk
- Faculty of Dentistry, Department of Orthodontics, Kayseri, Turkey
| | - Omur Dereci
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey
| | - Nesrin Saruhan Kose
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey
| | - Mehmet Ugurlu
- Faculty of Dentistry, Department of Orthodontics, Osmangazi University, Eskisehir, Turkey
| | - Yasin Caglar Kosar
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey
| | - Gizem Caliskan
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey
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Szcześniak M, Issa J, Öztürk I, Karahan E, Czajka-Jakubowska A, Orhan K, Dyszkiewicz-Konwińska M. The diagnostic accuracy of cone beam computed tomography in detecting temporomandibular joint bony disorders: a systematic review. Pol J Radiol 2024; 89:e292-e301. [PMID: 39040559 PMCID: PMC11262012 DOI: 10.5114/pjr/187943] [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: 03/22/2024] [Accepted: 04/25/2024] [Indexed: 07/24/2024] Open
Abstract
Computed tomography (CT) has been recognized as a robust and dependable technique for delineating osseous alterations and anomalies within hard tissues. The necessity for accurate diagnosis and management of patients with temporomandibular disorders in dental practices has increasingly come to the forefront. There is ongoing scholarly debate regarding the equivalence of diagnostic outcomes yielded by cone beam computed tomography (CBCT), which offers greater accessibility in dental settings than traditional CT, in identifying bony changes within the temporomandibular joint (TMJ). Our principal aim was to conduct a systematic review of studies that compare the efficacy of CT and CBCT in the detailed assessment of bone conditions affecting the TMJ. An electronic search was conducted across databases: PubMed, Medline, Web of Science, Cochrane and Scopus. Two independent reviewers screened titles and abstracts against predefined inclusion criteria. The included articles underwent rigorous critical appraisal, during which relevant data were extracted and systematically presented in a tabular format. This systematic review incorporates 5 studies published between 2006 and 2015. In 3 studies, CBCT demonstrated comparable outcomes to CT, while 2 investigations revealed significantly enhanced accuracy for CBCT compared to CT, with reported accuracies of 0.95 ± 0.04, 0.77 ± 0.17, and 89-91% for CBCT. The aggregated evidence from the included studies indicates that CBCT offers comparable or superior accuracy in detecting osseous changes within TMJ structures. Owing to its lower radiation exposure and increased accessibility, CBCT emerges as the preferred choice over conventional CT for evaluating bony structures of the TMJ.
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Affiliation(s)
- Marta Szcześniak
- Department of Diagnostics, Chair of Practical Clinical Dentistry, Poznan University of Medical Sciences, Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
| | - Julien Issa
- Department of Diagnostics, Chair of Practical Clinical Dentistry, Poznan University of Medical Sciences, Poznan, Poland
- Doctoral School, Poznan University of Medical Sciences, Poznan, Poland
| | - Irem Öztürk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Emniyet, Ankara, Turkey
| | - Emre Karahan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Emniyet, Ankara, Turkey
| | - Agata Czajka-Jakubowska
- Department of Orthodontics and Temporomandibular Disorders, Chair of Practical Clinical Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Emniyet, Ankara, Turkey
| | - Marta Dyszkiewicz-Konwińska
- Department of Diagnostics, Chair of Practical Clinical Dentistry, Poznan University of Medical Sciences, Poznan, Poland
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Panpitakkul P, Jorns TP, Kongsomboon S, Chaichit R, Sutthiprapaporn P. Three-Dimensional Changes of Condylar Position After Bimaxillary Surgery to Correct Skeletal III Malocclusion: Cone Beam Computed Tomography Voxel-Based Superimposition Analysis. J Oral Maxillofac Surg 2024:S0278-2391(24)00339-2. [PMID: 38889883 DOI: 10.1016/j.joms.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND The stability of the condylar position within the first 3 months after orthognathic surgery in patients with skeletal Class III malocclusion is crucial for subsequent orthodontic treatment. PURPOSE The purpose was to compare condylar positional changes 3 months after bimaxillary surgery to correct skeletal Class III deformities, utilizing the conventional two-dimensional combined with cone beam computed tomography voxel-based superimposition analysis. STUDY DESIGN, SETTING, SAMPLE This retrospective cohort study included skeletal Class III patients undergoing bimaxillary orthognathic surgery at Khon Kaen University, Thailand, in 2020. Exclusion criteria were patients with temporomandibular disorder symptoms, facial asymmetry prior to the surgery, or surgical complications. EXPOSURE VARIABLE The exposure variable was the timing, both preoperatively and 3 months postoperatively. This 3-month postoperative time point was chosen because complete healing of the bimaxillary surgery is expected by then, without any potential influence of condylar changes resulting from subsequent orthodontic treatment. MAIN OUTCOME VARIABLES The outcome variables are condylar position measurement, joint space (mm), and axial condylar angle (degrees). COVARIATES Demographics (age, sex) and surgical details (direction and amount of movement) were collected as covariates. ANALYSES Statistical analysis of condylar positional changes and correlations was performed using paired t-test and linear correlation (P value < .05), respectively. RESULTS The sample included 11 subjects (22 condyles), with a mean age of 24 ± 5.24 years. Both two-dimensional measurements and voxel-based three-dimensional superimposition showed significant changes in condylar position 3 months after bimaxillary surgery: inferior (0.45 ± 0.26 mm, P < .001), posterior (0.46 ± 0.39 mm, P = .003), lateral (0.38 ± 0.42 mm, P = .01) displacement, and inward rotation (5.21 ± 2.54°, P < .001). No significant correlation was found between jaw movement distance and condylar changes. CONCLUSION AND RELEVANCE To our knowledge, this is the first study to report measures of condylar changes at 3 months, when complete healing of the osteotomies would be expected, using Le Fort I osteotomy for maxillary advancement combined with bilateral sagittal split ramus osteotomy for mandibular setback. These changes are small in magnitude and may be of little relevance to patient care.
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Affiliation(s)
- Panjaree Panpitakkul
- Postgraduate Student, Division of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Teekayu Plangkoon Jorns
- Associate Professor, Division of Oral Biology, Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Supaporn Kongsomboon
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Rajda Chaichit
- Assistant Professor, Division of Dental Public Health, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pipop Sutthiprapaporn
- Associate Professor, Division of Orthodontics, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand.
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P JE, T N U. Distinctive Anatomical Patterns of the Mandibular Coronoid Process, Condyle, and Sigmoid Notch: Cone Beam Computed Tomography (CBCT) Imaging for Advanced Personal Identification. Cureus 2024; 16:e60978. [PMID: 38910783 PMCID: PMC11193888 DOI: 10.7759/cureus.60978] [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: 04/24/2024] [Accepted: 05/24/2024] [Indexed: 06/25/2024] Open
Abstract
INTRODUCTION The human mandible plays a significant role in personal identification due to its unique morphological characteristics. The coronoid process, condyle, and sigmoid notch exhibit variations that can be utilized for forensic and anthropological purposes. This study aims to analyze the morphological diversities of these mandibular features in our ethnic group using cone beam computed tomography (CBCT) imaging. MATERIALS AND METHODS A retrospective analysis was conducted using 100 CBCT images obtained from the archives of the Department of Oral Medicine and Radiology. The images were captured using Carestream 9600 machines (Carestream Dental LLC, Atlanta, GA) with standard exposure parameters. Curved slicing screenshots were utilized for tracing the morphological variations of the coronoid process, condyle, and sigmoid notch. RESULTS Out of 100 CBCT images analyzed (corresponding to 200 sides), the shape-wise distribution of the coronoid process revealed that a triangular shape was most commonly observed in 59% (118) of cases. The condyle exhibited a predominantly round shape in 38.7% (77) of cases based on shape parameter-wise distribution. Similarly, the sigmoid notch displayed a round shape in 40.5% (81) of cases based on shape-wise distribution. CONCLUSION Personal identification using radiographs has gained significance in the current scenario due to its feasibility. Cone beam computed tomography imaging has become a reliable and accurate method for revealing hidden details in forensic odontology, especially when antemortem records are available. This research sheds light on the morphological variations of the mandibular coronoid process, condyle, and sigmoid notch within our ethnic cohort, enhancing personal identification practices. Further research encompassing larger sample sizes and diverse populations would enhance the applicability of these findings in forensic and anthropological contexts.
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Affiliation(s)
- Jency Evanjelin P
- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Umamaheswari T N
- Department of Oral Medicine and Radiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Song HJ, Choi HM, Shin BM, Kim YJ, Park MS, Kim C. Age-stratified analysis of temporomandibular joint osteoarthritis using cone-beam computed tomography. Imaging Sci Dent 2024; 54:71-80. [PMID: 38571783 PMCID: PMC10985520 DOI: 10.5624/isd.20230229] [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: 10/17/2023] [Revised: 12/26/2023] [Accepted: 01/08/2024] [Indexed: 04/05/2024] Open
Abstract
Purpose This study aimed to evaluate age-stratified radiographic features in temporomandibular joint osteoarthritis using cone-beam computed tomography. Materials and Methods In total, 210 joints from 183 patients (144 females, 39 males, ranging from 12 to 88 years old with a mean age of 44.75±19.97 years) diagnosed with temporomandibular joint osteoarthritis were stratified by age. Mandibular condyle position and bony changes (flattening, erosion, osteophytes, subchondral sclerosis, and subchondral pseudocysts in both the condyle and articular eminence, thickening of the glenoid fossa, joint space narrowing, and joint loose bodies) were evaluated through cone-beam computed tomography. After adjusting for sex, the association between age groups and radiographic findings was analyzed using both a multiple regression model and a multinomial logistic regression model (α=0.05). Results The prevalence of joint space narrowing and protruded condyle position in the glenoid fossa significantly increased with age (P<0.05). The risks of bony changes, including osteophytes and subchondral pseudocysts in the condyle; flattening, erosion, osteophyte, and subchondral sclerosis in the articular eminence; joint loose bodies; and thickening of the glenoid fossa, also significantly rose with increasing age (P<0.05). The number of radiographic findings increased with age; in particular, the increase was more pronounced in the temporal bone than in the mandibular condyle (P<0.05). Conclusion Increasing age was associated with a higher frequency and greater diversity of bony changes in the temporal bone, as well as a protruded condyle position in the glenoid fossa, resulting in noticeable joint space narrowing in temporomandibular joint osteoarthritis.
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Affiliation(s)
- Hee-Jeong Song
- Department of Oral Medicine and Diagnosis, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Hang-Moon Choi
- Department of Oral and Maxillofacial Radiology, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Bo-Mi Shin
- Department of Dental Hygiene, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Young-Jun Kim
- Department of Oral Medicine and Diagnosis, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Moon-Soo Park
- Department of Oral Medicine and Diagnosis, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Cheul Kim
- Department of Oral Medicine and Diagnosis, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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Deniz Y, Eren H, Sessiz R, Coşan Ata G. Comparison of CBCT radiation doses with conventional radiographs in TMJ imaging using Monte Carlo simulations. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2024; 63:39-45. [PMID: 38182962 DOI: 10.1007/s00411-023-01057-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 12/08/2023] [Indexed: 01/07/2024]
Abstract
Three-dimensional imaging methods are widely used for evaluation of bony changes of temporomandibular joint (TMJ). Besides, lateral and posterio-anterior TMJ projections in both closed- and open-jaw positions for each temporomandibular joint are used as two-dimensional diagnostic tools. The purpose of the present study was to compare effective and mean organ absorbed doses of plain radiography techniques with those of different modalities of cone beam computed tomography (CBCT) scanning of an adult's temporomandibular joint. PCXMC 2.0 software was used to calculate mean organ and effective doses. A NewTom CBCT device (Newtom 5G XL; QR systems; Verona, Italy) was simulated at 360° rotation using a 6 × 6 cm2 FOV in standard and high-resolution modes. Lateral and posterio-anterior TMJ plain projections were simulated according to recommendations of the manufacturer of the Planmeca ProMax® 2D S3 device. Doses for both projections were simulated with Monte Carlo methods and the International Commission on radiological protection adult reference computational phantoms. The highest mean organ absorbed doses occurred in bone surfaces, salivary glands, and skull for posterio-anterior TMJ and lateral TMJ, and for CBCT scanning in all examinations. The effective doses of posterio-anterior and lateral TMJ plain radiographs were found to be higher than those of the Standard Mode-Eco Scan CBCT. Therefore, the lowest effective dose was calculated in Standard Mode-Eco Scan CBCT. It is concluded that NewTom 5G XL Standard Mode-Eco Scan CBCT can be used instead of plain radiographs (lateral and posterio-anterior TMJ) in temporomandibular joint imaging as it allows visualizing the three-dimensional structure of the temporomandibular joint as an advantage.
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Affiliation(s)
- Yeşim Deniz
- Faculty of Dentistry, Dentomaxillofacial Radiology Department, Çanakkale Onsekiz Mart University, Sahil Yolu Cad. No: 5, Kepez, Çanakkale, Turkey
| | - Hakan Eren
- Faculty of Dentistry, Dentomaxillofacial Radiology Department, Çanakkale Onsekiz Mart University, Sahil Yolu Cad. No: 5, Kepez, Çanakkale, Turkey.
| | - Rüya Sessiz
- Faculty of Dentistry, Dentomaxillofacial Radiology Department, Çanakkale Onsekiz Mart University, Sahil Yolu Cad. No: 5, Kepez, Çanakkale, Turkey
| | - Gamze Coşan Ata
- Faculty of Dentistry, Dentomaxillofacial Radiology Department, Çanakkale Onsekiz Mart University, Sahil Yolu Cad. No: 5, Kepez, Çanakkale, Turkey
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Muttanahally KS, Sheppard S, Yadav S, Tadinada A. The Utility of Cone Beam Computed Tomography Scans in Diagnosing and Treating Anterior Lesions of the Maxilla and Mandible. Cureus 2024; 16:e52804. [PMID: 38389599 PMCID: PMC10883409 DOI: 10.7759/cureus.52804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The standard screening protocol for radiographic examination in dentistry as per the American Dental Association recommendations is a panoramic radiograph (PAN) and four horizontal bitewings. PAN inherently suffers from several shortcomings like the superimposition of anatomic structures, especially of the cervical spine that obscures a significant portion of the anterior maxilla and mandible. This region has a significant amount of pathology that is not adequately imaged. Three-dimensional (3D) imaging provides circumferential information on the area of interest and adds value to the diagnosis and treatment planning of pathology, especially in the anterior maxilla and mandible. However, there is not an adequate number of well-designed studies that articulate the true value addition of 3D imaging for the evaluation of this region. OBJECTIVES The objective of this study is to evaluate the value addition of 3D imaging in diagnosing pathologies in the anterior maxilla and mandible when compared to two-dimensional PAN. MATERIALS AND METHODS A total of 25 cases that had a diagnosis of anterior pathology and had both a PAN and a cone beam computed tomography (CBCT) scan were collected for this study. An institutional review board approval to retrospectively evaluate these data was obtained. The PAN and CBCT scans were randomly evaluated by a second-year dental student, an oral and maxillofacial radiology resident in training, and a board-certified oral radiologist. The scans were evaluated using a three-point modified Likert scale, where 1 represents "not visible or clear," 2 represents "visible but not clear," and 3 represents "visible and clear." The lesions were evaluated for characteristics like lesion location, size & shape, internal contents, borders of the lesion, cortical integrity, locularity, and effect on adjacent structures like root resorption. After the evaluation was completed, a comparison of the lesion diagnosis was done with histopathology to confirm the diagnosis. The evaluators were also asked to comment on the specific feature that 3D imaging provided that added value to the case. Kappa analysis was done to evaluate inter-operator reliability. RESULTS PAN demonstrated significantly lower efficacy in identifying and diagnosing lesions. Only 56% of cases were analyzed using PAN, with 44% deemed undetectable or poorly visualized. These challenging cases necessitated CBCT scans for accurate diagnosis, which successfully diagnosed all 25 cases. The p-value of 0.0002 for PAN implies a highly significant difference from histopathology, suggesting the distinctions are not due to chance. Conversely, the p-value of 0.3273 for CBCT implies that observed differences may be random, lacking sufficient evidence to reject the null hypothesis. CBCT scans consistently outperformed PAN in visualizing various lesion characteristics, underscoring their superior diagnostic capabilities. CONCLUSIONS In this study, with a small sample size, 3D imaging provided a significant value addition to the diagnosis and treatment planning by providing additional information regarding the location, extent, internal content, and effect on adjacent structures. The practical implications for clinical settings, along with comparisons to current literature, underscore the study's distinctiveness.
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Affiliation(s)
- Kavya Shankar Muttanahally
- Oral and Maxillofacial Radiology, Department of Growth and Development, University of Nebraska Medical Center, Lincoln, USA
| | - Samantha Sheppard
- Department of General Dentistry, University of Connecticut, Farmington, USA
| | - Sumit Yadav
- Department of Growth and Development, University of Nebraska Medical Center, Lincoln, USA
| | - Aditya Tadinada
- Department of Oral and Maxillofacial Radiology, University of Connecticut, Farmington, USA
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Corte-Real A, Abreu J, Figueiredo JP, Nunes T. Temporomandibular trauma and reflections on personal evaluation. Forensic Sci Med Pathol 2023:10.1007/s12024-023-00745-9. [PMID: 37987964 DOI: 10.1007/s12024-023-00745-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
Abstract
The International Consortium Network/Orofacial Pain Special Interest Group focuses on temporomandibular disease diagnosis procedure guidelines as a reference iQAn this scope. Concerning this reference, the aim of this study was to comprehensively analyze injury and sequela frames within European and American approaches to personal damage. A quasiexperimental pilot study of Portuguese orofacial trauma cases in a medico-legal evaluation database was performed with an interrupted time series design. The clinical data were recorded following five criteria of TMJ diagnosis (jaw opening, pain, anatomical deficit, functional deficit, clinical sounds, and occlusal deficit) under three degrees of severity. The injury frame evaluation was recorded in the first-degree stage in all criteria. Pain, as a sequela, was the criterion present in 45% of the sample as spontaneous (20%) or stimulated (25%). Temporomandibular trauma damage evaluation emphasizes the accurate injury diagnosis and sequela framework. Orofacial trauma analysis should focus on the inclusion or exclusion of a TMD diagnosis. This study suggests revising the reference tables on personal damage, considering the inclusion of TMD and its categorization and impact.
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Affiliation(s)
- Ana Corte-Real
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Clinic and Academic Centre of Coimbra, Coimbra, Portugal.
- Laboratory of Forensic Dentistry, Faculty of Medicine, University of Coimbra, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal.
| | - João Abreu
- Clinic and Academic Centre of Coimbra, Coimbra, Portugal
| | - José Pedro Figueiredo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Clinic and Academic Centre of Coimbra, Coimbra, Portugal
| | - Tiago Nunes
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Laboratory of Forensic Dentistry, Faculty of Medicine, University of Coimbra, Av. Bissaya Barreto, Bloco de Celas, 3000-075, Coimbra, Portugal
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Schroder ÂGD, Gonçalves FM, Germiniani JDS, Schroder LD, Porporatti AL, Zeigelboim BS, de Araujo CM, Santos RS, Stechman-Neto J. Diagnosis of TMJ degenerative diseases by panoramic radiography: is it possible? A systematic review and meta-analysis. Clin Oral Investig 2023; 27:6395-6412. [PMID: 37821655 DOI: 10.1007/s00784-023-05293-8] [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: 07/05/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE The objective of this work was to determine the diagnostic accuracy of panoramic radiography in detecting degenerative diseases of the temporomandibular joint. METHOD The protocol was registered at the PROSPERO website. To consider the eligibility of studies to be included/excluded from this review, the acronym "PIRDS" was used and appropriate word combinations and truncations were adapted in the following electronic databases: PubMed/Medline, EMBASE, Latin American and Caribbean Literature on Health Sciences, Web of Science, Scopus, and Cochrane Library. RESULTS A total of 2572 references, after the removal of duplicates, were retrieved from the eight electronic databases. After reading the titles and abstracts, a total of 26 articles were selected for full reading, of which ten were excluded, resulting in 16 articles included for qualitative synthesis. All in vivo studies were classified as having a low risk of bias. Regarding in vitro studies none of the included studies scored below 80% in the overall evaluation. CONCLUSIONS Both in vitro and in vivo studies consistently report a low accuracy in detecting degenerative diseases of the temporomandibular joint using panoramic radiography. CLINICAL RELEVANCE Cone-beam computed tomography offers a superior image quality without overlapping structures and a higher accuracy compared to panoramic radiography. However, panoramic radiography can still serve as an initial examination when combined with a clinical assessment. CBCT should be reserved for cases where there are evident clinical and/or radiographic alterations that recommend its use. This approach ensures a judicious and cost-effective use of CBCT resources.
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Affiliation(s)
- Ângela Graciela Deliga Schroder
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, R. Padre Ladislau Kula, 395 - Santo Inácio-, Curitiba, PR, 82010-210, Brazil.
| | - Flávio Magno Gonçalves
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, R. Padre Ladislau Kula, 395 - Santo Inácio-, Curitiba, PR, 82010-210, Brazil
| | - Julia da Silva Germiniani
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, R. Padre Ladislau Kula, 395 - Santo Inácio-, Curitiba, PR, 82010-210, Brazil
| | | | - André Luiz Porporatti
- Laboratoire de Neurobiologie OroFaciale, Université de Paris, France and GHPS Assitance Publique Hopitaux, de Paris, France
| | - Bianca Simone Zeigelboim
- Post-graduate Program in Communication Disorders, University Tuiuti do Paraná, Curitiba, Paraná, Brazil
| | - Cristiano Miranda de Araujo
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, R. Padre Ladislau Kula, 395 - Santo Inácio-, Curitiba, PR, 82010-210, Brazil
| | - Rosane Sampaio Santos
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, R. Padre Ladislau Kula, 395 - Santo Inácio-, Curitiba, PR, 82010-210, Brazil
| | - José Stechman-Neto
- Postgraduate Program in Communication Disorders, Tuiuti University of Paraná, Center for Advanced Studies in Systematic Review and Meta-Analysis - NARSM, R. Padre Ladislau Kula, 395 - Santo Inácio-, Curitiba, PR, 82010-210, Brazil
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Potdukhe SS, Iyer JM, Nadgere JB. Evaluation of accuracy between extraoral Gothic arch tracing and various other methods assessing horizontal condylar guidance angle in completely edentulous patients: A systematic review and meta-analysis. J Indian Prosthodont Soc 2023; 23:322-334. [PMID: 37861609 DOI: 10.4103/jips.jips_216_23] [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] [Indexed: 10/21/2023] Open
Abstract
Aim The aim of this systematic review and meta-analysis was to determine the accuracy of different methods of measuring horizontal condylar guidance (HCG) angle in comparison with extraoral Gothic arch tracing for completely edentulous patients. Settings and Design This was a systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Materials and Methods Two reviewers searched the EBSCOhost, Cochrane Library, and PubMed/MEDLINE databases and the Google Scholar search engine for in vivo studies, randomized controlled trials, cross-sectional studies, and quasi-experimental studies published from January 2005 to December 2022 on various other methods of determining HCG angle in completely edentulous patients compared with extraoral Gothic arch tracing method. Statistical Analysis Used Meta-analysis was conducted from the reported quantitative data. Results A total of 513 articles were obtained from different electronic databases, of which 22 studies were included for qualitative synthesis and 20 studies were included for meta-analysis. For the right side, a statistically significant difference was observed for panoramic radiograph (P < 0.05, pooled mean difference = 5.08 [2.17, 7]) and cephalogram (P < 0.05, pooled mean difference = 10.65 [8.81, 12.49]), whereas no statistically significant difference was observed for cone-beam computed tomography (CBCT) (P = 0.41, pooled mean difference = 4.39 [-6.10, 14.87]) and protrusive interocclusal wax record (P = 0.92, pooled mean difference = -0.45 [-9.62, 8.72]) as compared with extraoral Gothic arch tracing method. For the left side, a statistically significant difference was observed for panoramic radiograph (P < 0.05, pooled mean difference = 5.07 [1.95, 8.18]) and cephalogram (P < 0.05, pooled mean difference = 10.24 [8.65, 11.83]), whereas no statistically significant difference was observed for CBCT (P = 0.31, pooled mean difference = 4.05 [-3.74, 11.84]) and protrusive interocclusal wax record (P = 0.72, pooled mean difference = -1.21 [-7.86, 5.43]) as compared with extraoral Gothic arch tracing method. Conclusion The cephalogram and panoramic radiograph obtained higher HCG angles in completely edentulous patients than extraoral Gothic arch tracing.
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Affiliation(s)
- Shruti S Potdukhe
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Janani M Iyer
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Jyoti B Nadgere
- Department of Prosthodontics and Crown and Bridge, MGM Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Petsaros S, Chatzipetros E, Donta C, Karaiskos P, Boziari A, Papadakis E, Angelopoulos C. Scattered Radiation Distribution Utilizing Three Different Cone-Beam Computed Tomography Devices for Maxillofacial Diagnostics: A Research Study. J Clin Med 2023; 12:6199. [PMID: 37834843 PMCID: PMC10573760 DOI: 10.3390/jcm12196199] [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: 07/13/2023] [Revised: 09/21/2023] [Accepted: 09/24/2023] [Indexed: 10/15/2023] Open
Abstract
This study aimed to estimate scattered radiation and its spatial distribution around three cone-beam computed tomography (CBCT) devices, in order to determine potential positions for an operator to stand if they needed to be inside the CBCT room. The following devices were tested: Morita Accuitomo (CBCT1), Newtom Giano HR (CBCT2), Newtom VGi (CBCT3). Scattered radiation measurements were performed using different kVp, mA, and Field of View (FOV) options. An anthropomorphic phantom (NATHANIA) was placed inside the X-ray gantry to simulate clinical conditions. Scattered measurements were taken with the Inovision model 451P Victoreen ionization chamber once placed at fixed distances from each irradiation isocenter, away from the primary beam. A statistically significant (p < 0.001) difference was found in the mean value of the scattered radiation estimations between the CBCT devices. Scattered radiation was reduced with a different rate for each CBCT device as distance was increased. For CBCT1 the reduction was 0.047 μGy, for CBCT2 it was 0.036 μGy, and for CBCT3 it was 0.079 μGy, for every one meter from the X-ray gantry. Therefore, at certain distances from the central X-ray, the scattered radiation was below the critical level of 1 mGy, which is defined by the radiation protection guidelines as the exposure radiation limit of the general population. Consequently, an operator could stay inside the room accompanying the patient being scanned, if necessary.
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Affiliation(s)
- Sotirios Petsaros
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
| | - Emmanouil Chatzipetros
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
| | - Catherine Donta
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
| | - Pantelis Karaiskos
- Medical Physics Laboratory, Faculty of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias Street, Goudi, 11527 Athens, Greece;
| | - Argiro Boziari
- Greek Atomic Energy Commission, Agia Paraskevi, 15310 Attiki, Greece;
| | - Evangelos Papadakis
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
| | - Christos Angelopoulos
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Street, Goudi, 11527 Athens, Greece; (S.P.); (E.C.); (C.D.); (E.P.)
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12
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Zheng J, Zhang Y, Wu Q, Xiao H, Li F. Three-dimensional spatial analysis of the temporomandibular joint in adult patients with Class II division 2 malocclusion before and after orthodontic treatment: a retrospective study. BMC Oral Health 2023; 23:477. [PMID: 37438801 DOI: 10.1186/s12903-023-03210-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/06/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND To investigate changes in the three-dimensional (3D) spatial morphology of the temporomandibular joint (TMJ) and condyle position in adult patients with Class II division 2 malocclusion using a 3D spatial measurement method and to investigate the similarities and differences in the effects of fixed appliance and clear aligner treatments on the TMJ. METHODS Cone-beam computed tomography (CBCT) data of 47 adult patients with Class II division 2 malocclusion (25, fixed appliance group; 22, clear aligner group) were collected before and after treatment. Mimics 21.0 was used to reconstruct the TMJ 3D model. Fourteen measurement items, such as the anterior, upper, and posterior joint spaces, were measured directly on the 3D model and compared. RESULTS Post-orthodontic treatment, the shape and position of the condyle changed in adult patients with Class II division 2 malocclusion. Reduction in the anterior joint space and increase in the posterior joint space after orthodontic treatment were significant in both fixed appliance and clear aligner treatments; the condyle moved forward to the center of the fossa. The superior joint space and depth of the glenoid fossa increased after clear aligner treatment, but there was no significant change after fixed appliance treatment. CONCLUSIONS The condylar shape and position in patients with Class II division 2 malocclusion changed significantly post-treatment, indicating that the condyle undergoes adaptive reconstruction during orthodontic treatment in these patients. These results provide a reference for diagnosis, design of treatment plan, and monitoring of treatment in orthodontic clinics.
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Affiliation(s)
- Jiajing Zheng
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Yueying Zhang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Qiuyue Wu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Hua Xiao
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China
| | - Feifei Li
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Orthodontics, School of Stomatology, Air Force Medical University, Xi'an, 710032, Shaanxi, People's Republic of China.
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13
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Jung W, Lee KE, Suh BJ, Seok H, Lee DW. Deep learning for osteoarthritis classification in temporomandibular joint. Oral Dis 2023; 29:1050-1059. [PMID: 34689379 DOI: 10.1111/odi.14056] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/28/2021] [Accepted: 10/21/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to develop a diagnostic support tool using pretrained models for classifying panoramic images of the temporomandibular joint (TMJ) into normal and osteoarthritis (OA) cases. SUBJECTS AND METHODS A total of 858 panoramic images of the TMJ (395 normal and 463 TMJ-OA) were obtained from 518 individuals from January 2015 to December 2018. The data were randomly divided into training, validation, and testing sets (6:2:2). We used pretrained Resnet152 and EfficientNet-B7 as transfer learning models. The accuracy, specificity, sensitivity, area under the curve, and gradient-weighted class activation mapping (grad-CAM) of both trained models were evaluated. The performances of the trained models were compared to that of dentists (both TMD specialists and general dentists). RESULTS The classification accuracies of ResNet-152 and EfficientNet-B7 were 0.87 and 0.88, respectively. The trained models exhibited the highest accuracy in OA classification. In the grad-CAM analysis, the trained models focused on specific areas in osteoarthritis images where erosion or osteophyte were observed. CONCLUSIONS The artificial intelligence model improved the diagnostic power of TMJ-OA when trained with two-dimensional panoramic condyle images and can be effectively applied by dentists as a screening diagnostic tool for TMJ-OA.
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Affiliation(s)
- Won Jung
- Department of Oral Medicine, School of Dentistry, Jeonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research and Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Kyung-Eun Lee
- Department of Oral Medicine, School of Dentistry, Jeonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research and Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Bong-Jik Suh
- Department of Oral Medicine, School of Dentistry, Jeonbuk National University, Jeonju, Korea
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research and Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Hyun Seok
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research and Institute of Jeonbuk National University Hospital, Jeonju, South Korea
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Jeonbuk National University, Jeonju, Korea
| | - Dae-Woo Lee
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research and Institute of Jeonbuk National University Hospital, Jeonju, South Korea
- Department of Pediatric Dentistry, School of Dentistry, Jeonbuk National University, Jeonju, Korea
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14
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Feng JL, Ma RH, Du H, Zhao YP, Meng JH, Li G. Diagnostic accuracy of fused CBCT images in the evaluation of temporomandibular joint condylar bone resorption. Clin Oral Investig 2023; 27:1277-1288. [PMID: 36303076 DOI: 10.1007/s00784-022-04761-x] [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: 06/28/2022] [Accepted: 10/18/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the diagnostic accuracy of fused CBCT images for patients with condylar bone resorption of temporomandibular joint (TMJ) osteoarthrosis. MATERIALS AND METHODS Forty-two TMJs from twenty-one patients were included. Bone resorption of condyles evaluated by three experts was used as the reference standard. Three oral and maxillofacial radiology residents evaluated the resorption of condyles with a five-point scale for the four sets of images (two consecutive CBCT images without fusion, fused 2D cross-sectional images, fused 3D images, and combining fused 2D cross-sectional images and fused 3D images) randomly and independently. Each set of images was evaluated at least 1 week apart, and a second evaluation was performed 4 weeks later. Intraclass correlation coefficients were calculated to assess the intra- and inter-observer agreement. The areas under the ROC curves (AUCs) were compared among the four image sets using the Z test. RESULTS Twenty-four TMJs were determined as condylar bone resorption, and eighteen were determined as no obvious change. The average AUC values from the three observers for the three fused image sets (0.94, 0.93, 0.93) were significantly higher than the image set without fusion (p < 0.01). The intra- and inter-observer agreement on the three fused image sets (0.70-0.89, 0.91-0.92) was higher than the image set without fusion (0.37-0.63, 0.75). CONCLUSIONS Fused CBCT images of TMJ osteoarthrosis patients can intuitively display the condylar bone resorption and significantly improve the diagnostic accuracy. CLINICAL RELEVANCE Fused CBCT images can help clinicians intuitively observe bone changes of the condyle in TMJ osteoarthrosis patients.
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Affiliation(s)
- Ji-Ling Feng
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Ruo-Han Ma
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China
| | - Han Du
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.,Shanghai Stomatological Hospital & School of Stomatology, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Yan-Ping Zhao
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.,Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing, China
| | - Juan-Hong Meng
- Center for Temporomandibular Disorders and Orofacial Pain, Peking University School and Hospital of Stomatology, Beijing, China
| | - Gang Li
- Department of Oral and Maxillofacial Radiology, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, No.22 Zhongguancun South Avenue, Haidian District, Beijing, 100081, People's Republic of China.
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15
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Evaluation of congruency of condyle convexity and fossa concavity and interrelationship bony components in temporomandibular joint anterior dislocation. Oral Radiol 2023:10.1007/s11282-023-00676-9. [PMID: 36826738 DOI: 10.1007/s11282-023-00676-9] [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: 01/10/2023] [Accepted: 02/09/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVES This study aimed to compare the congruency of surface geometry of the articulating bones and morphologic differences in temporomandibular joint (TMJ) structure, between patients with TMJ anterior dislocation and healthy controls. METHODS The study included 15 patients with TMJ anterior dislocation and 15 controls who underwent cone-beam computed tomography. The surface angle of the articular fossa (fossa-concavity) and condyle (condyle-convexity) and joint spaces were measured from both sagittal and coronal views. The articular eminence morphology and horizontal condyle position were also evaluated. RESULTS Coronal fossa angles were significantly lower in controls than in patients (p < 0.05). There was a positive correlation between coronal condyle and fossa angle values in controls and in patients' joints (p < 0.05), however, the fossa-condylar congruence was higher in controls than in patients. Superior joint space was significantly higher in controls than in patients (p < 0.05). There were no significant differences in articular eminence measurements, mean condyle angle variables and condyle position between the patients and controls (p > 0.05). CONCLUSIONS The findings of this study which include lower joint congruency, higher fossa concavity and superior joint space distance in patients with anterior dislocation may be related to the inferior positioning of the condyle away from the fossa and potentially the elongation of the capsular ligament.
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Rosa VLM, Zwir LMF, Dutra MEP, Russo GCS, Rodrigues WDR, Terreri MT. Does the use of panoramic radiography add information in the temporomandibular joint evaluation in Juvenile Idiopathic Arthritis patients? A case control study. Adv Rheumatol 2023; 63:6. [PMID: 36782277 DOI: 10.1186/s42358-023-00285-4] [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: 06/10/2022] [Accepted: 01/19/2023] [Indexed: 02/15/2023] Open
Abstract
OBJECTIVE To determine the frequency of radiographic changes in the temporomandibular joint, in a representative population of patients with Juvenile Idiopathic Arthritis (JIA) and to compare with findings in healthy controls matched by sex and age. PATIENTS AND METHODS One hundred and thirty-seven panoramic radiographies (PR) from JIA patients of a pediatric rheumatology outpatient clinic were prospectively evaluated and compared to 137 PR from healthy individuals. RESULTS 102 (74.5%) JIA patients and 47 (34.3%) controls showed at least one radiological alteration (p < 0.001). The following radiographic alterations were more frequently observed in JIA patients than in controls: erosion (p < 0.001), altered condylar morphology (p < 0.001), disproportion between condylar process and the coronoid process (p < 0.001) and accentuated curve in the antegonial notch (p = 0.002). Twenty patients (14.6%) presented the four radiographic alterations simultaneously compared to only two controls (1.5%) (p < 0.001). CONCLUSION Due to the difference in the frequency of findings in the PR of patients and controls, we concluded that PR has value as a screening tool. In the presence of major changes in the mandible head in the PR of patients with a confirmed diagnosis of JIA, MRI should be considered to detect an active inflammatory process in this joint.
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Affiliation(s)
- Vera Lucia Mestre Rosa
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil.
| | - Liete M Figueiredo Zwir
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil
| | - Marcelo Eduardo Pereira Dutra
- Department of Oral Diagnosis/Radiology/Stomatology, Dental School in Integrated Clínic of Nove de Julho University, São Paulo, Brazil
| | - Gleice Clemente Souza Russo
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil
| | - Wellington Douglas R Rodrigues
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil
| | - Maria Teresa Terreri
- Department of Pediatrics, Universidade Federal de São Paulo/Escola Paulista de Medicina (UNIFESP/EPM), Borges Lagoa Street, 802, Vila Clementino, São Paulo, SP, 04038-001, Brazil
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Yildizer E, Odabaşı O. Differences in clinical and radiographic features between bilateral and unilateral adult degenerative temporomandibular joint disease: A retrospective cross-sectional study. Int Orthod 2023; 21:100731. [PMID: 36780795 DOI: 10.1016/j.ortho.2023.100731] [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: 11/08/2022] [Revised: 01/09/2023] [Accepted: 01/22/2023] [Indexed: 02/13/2023]
Abstract
OBJECTIVE To study the correlations of clinical findings and the severity of osseous alterations between bilateral and unilateral degenerative joint disease (DJD) of the temporomandibular joint (TMJ). MATERIALS AND METHODS Forty-eight joints from 35 adult patients with DJD were retrospectively examined. The joints were divided into two groups: bilateral DJD (BDJD) (26 joints) and unilateral DJD (UDJD) (22 joints). We collected data on patient characteristics and symptoms, including pain on palpation, limited mouth opening, pain during mandibular movement, and joint noises. Cone beam Computed Tomography (CBCT) was used to assess bony changes, including maximum condylar bone change, severity of erosion, severity of osteophytes, glenoid fossa changes, and superior joint space measurements. Data were correlated between subgroups. RESULTS There was no significant difference between the two groups in terms of age or gender. However, pain on palpation was significantly more common in UDJD joints (81.8%) compared to BDJD joints (53.9%). Limitation of mouth opening was also significantly more common in BDJD cases (61.5%) compared to UDJD cases (22.7%). The number of joints with painless degeneration was more common in BDJD TMJs (38.4%) than in UDJD TMJs (9%). There was no significant difference between the two subgroups with regard to pain during mandibular movements or joint sounds and severity of bony changes. CONCLUSIONS This study provided important results outlining clinical the clinical profiles of DJD patients. While painful degeneration was more frequent in UDJD joints, painless degeneration was higher in BDJD joints. Limitation of mouth opening was more common in BDJD patients.
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Affiliation(s)
- Elif Yildizer
- Department of Oral Diagnosis and Dentomaxillofacial Radiology, Ankara Yildirim Beyazit University Faculty of Dentistry, Ankara, Turkey.
| | - Onur Odabaşı
- Department of Oral and Dentomaxillofacial Surgery, Ankara Yildirim Beyazit University Faculty of Dentistry, Ankara, Turkey
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18
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Panoramic imaging may detect morphologically abnormal temporomandibular joints in children with juvenile idiopathic arthritis. PEDIATRIC DENTAL JOURNAL 2023. [DOI: 10.1016/j.pdj.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Augdal TA, Angenete OW, Shi XQ, Säll M, Fischer JM, Nordal E, Rosendahl K. Cone beam computed tomography in the assessment of TMJ deformity in children with JIA: repeatability of a novel scoring system. BMC Oral Health 2023; 23:12. [PMID: 36627622 PMCID: PMC9830735 DOI: 10.1186/s12903-022-02701-5] [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: 08/15/2022] [Accepted: 12/28/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The temporomandibular joint (TMJ) is frequently involved in juvenile idiopathic arthritis (JIA). Diagnostic imaging is necessary to correctly diagnose and evaluate TMJ involvement, however, hitherto little has been published on the accuracy of the applied scoring systems and measurements. The present study aims to investigate the precision of 20 imaging features and five measurements based on cone beam computed tomography (CBCT). METHODS Imaging and clinical data from 84 participants in the Norwegian study on juvenile idiopathic arthritis, the NorJIA study, were collected. Altogether 20 imaging features and five measurements were evaluated independently by three experienced radiologists for intra- and interobserver agreement. Agreement of categorical variables was assessed by Fleiss', Cohen's simple or weighted Kappa as appropriate. Agreement of continuous variables was assessed with 95% limits of agreement as advised by Bland and Altman. RESULTS "Overall impression of TMJ deformity" showed almost perfect intraobserver agreement with a kappa coefficient of 0.81 (95% CI 0.69-0.92), and substantial interobserver agreement (Fleiss' kappa 0.70 (0.61-0.78)). Moreover, both "flattening" and "irregularities" of the eminence/fossa and condyle performed well, with intra- and interobserver agreements of 0.66-0.82 and 0.55-0.76, respectively. "Reduced condylar volume" and "continuity" of the fossa/eminence had moderate intra- and interobserver Kappa values, whereas continuity of the condyle had Kappa values above 0.55. Measurements of distances and angles had limits of agreement of more than 15% of the sample mean. CONCLUSIONS We propose a CBCT-based scoring system of nine precise imaging features suggestive of TMJ deformity in JIA. Their clinical validity must be tested.
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Affiliation(s)
- Thomas A. Augdal
- grid.412244.50000 0004 4689 5540Section of Paediatric Radiology, University Hospital of North Norway, Postboks 100, 9038 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Oskar W. Angenete
- grid.52522.320000 0004 0627 3560Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Faculty of Medicine and Health Sciences, Institute for Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Xie-Qi Shi
- grid.7914.b0000 0004 1936 7443Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway ,grid.32995.340000 0000 9961 9487Department of Oral and Maxillofacial Radiology, Faculty of Odontology, University of Malmö, Malmö, Sweden
| | - Mats Säll
- grid.52522.320000 0004 0627 3560Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Johannes M. Fischer
- grid.7914.b0000 0004 1936 7443Department of Clinical Dentistry, The Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Ellen Nordal
- grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway ,grid.412244.50000 0004 4689 5540Department of Paediatrics, University Hospital of North Norway, Tromsø, Norway
| | - Karen Rosendahl
- grid.412244.50000 0004 4689 5540Section of Paediatric Radiology, University Hospital of North Norway, Postboks 100, 9038 Tromsø, Norway ,grid.10919.300000000122595234Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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Yamashita FC, Yamashita AL, Romanichen IMM, Tolentino EDS, Chicarelli M, Iwaki LCV. Three-dimensional evaluation of mandibular condyle and coronoid process according to sex, age, and skeletal deformities. Cranio 2023; 41:26-31. [PMID: 32741267 DOI: 10.1080/08869634.2020.1800323] [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] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To correlate the volume of the mandibular condyle (MC) and the coronoid process (CP) with sex, age, and skeletal deformities. METHODS The structures were visualized through semi-automatic segmentation of the 3D model and complemented with manual segmentation, using the ITK-SNAP 3.0 software. Mann-Whitney, Kruskal-Wallis, and the Dunn test were performed (p < 0.05). RESULTS The MC volume showed statistical differences between sex and skeletal deformities. Men and Class III patients showed higher values. CP volume was not influenced by age or skeletal deformities. However, statistical differences were found between sex, with higher values for men. CONCLUSION MC volume was influenced by sex and skeletal deformities, while CP was influenced only by sex. Women have smaller volumes for these structures. Age is not correlated with the volume of MC and CP. The highest and lowest values of condylar volume were found for Class III and II individuals, respectively.
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Dhabale GS, Bhowate RR. Cone-Beam Computed Tomography for Temporomandibular Joint Imaging. Cureus 2022; 14:e31515. [DOI: 10.7759/cureus.31515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
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Mallya SM, Ahmad M, Cohen JR, Kaspo G, Ramesh A. Recommendations for imaging of the temporomandibular joint. Position statement from the American Academy of Oral and Maxillofacial Radiology (AAOMR) and the American Academy of Orofacial Pain (AAOP). Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:639-648. [DOI: 10.1016/j.oooo.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/15/2022] [Accepted: 06/19/2022] [Indexed: 10/17/2022]
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The Effect of Mandibular Angulation on Preoperative Assessment of Dental Implant Insertion at Premolar Region: CBCT Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7879239. [PMID: 35669722 PMCID: PMC9167095 DOI: 10.1155/2022/7879239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/24/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]
Abstract
Backgrounds This study investigated the effect of mandibular angulation on the perioperative evaluation of the implant placement at the premolar region on panoramic reconstructed images using cone beam computed tomography (CBCT). Methods A total of six dried anonymous human mandibles was included. Two implants were inserted in the left and right first premolar region. CBCT scans were obtained from each mandible at the standard position, +20° extension, and -20° flexion. The distance of the implant from the anterior loop of the inferior alveolar nerve and mental foramen was measured. Mean absolute error (MAE) of the distance of the implant from both anatomical landmarks was measured. The Wilcoxon matched-pair signed-rank test was used for the comparison of the measurements. All data were analyzed with the Stata program (version 15.1). Results No statistically significant differences were found between the distance of the implant from the mental foramen and the anterior loop of the inferior alveolar nerve up to 20° extension and flexion at both sides of the mandible. (All p > 0.1) However, a variable range of MAE (SD) in the distance of the implant from different anatomical landmarks was found (0.9 ± 0.7 to 3.3 ± 2.1). Conclusions We found no statistical difference in measurements of the distance of the implant from two anatomical landmarks at different head positions up to 20° extension and flexion. However, clinically, variable range in the distance of the implant from anatomical landmarks should be considered. Our findings could alert dentists of the possibility of error up to 20° extension and flexion on the perioperative evaluation of dental implant placement.
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Amin J, Anjum MA, Sharif M, Kadry S, Nadeem A, Ahmad SF. Liver Tumor Localization Based on YOLOv3 and 3D-Semantic Segmentation Using Deep Neural Networks. Diagnostics (Basel) 2022; 12:diagnostics12040823. [PMID: 35453870 PMCID: PMC9025116 DOI: 10.3390/diagnostics12040823] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 12/17/2022] Open
Abstract
Worldwide, more than 1.5 million deaths are occur due to liver cancer every year. The use of computed tomography (CT) for early detection of liver cancer could save millions of lives per year. There is also an urgent need for a computerized method to interpret, detect and analyze CT scans reliably, easily, and correctly. However, precise segmentation of minute tumors is a difficult task because of variation in the shape, intensity, size, low contrast of the tumor, and the adjacent tissues of the liver. To address these concerns, a model comprised of three parts: synthetic image generation, localization, and segmentation, is proposed. An optimized generative adversarial network (GAN) is utilized for generation of synthetic images. The generated images are localized by using the improved localization model, in which deep features are extracted from pre-trained Resnet-50 models and fed into a YOLOv3 detector as an input. The proposed modified model localizes and classifies the minute liver tumor with 0.99 mean average precision (mAp). The third part is segmentation, in which pre-trained Inceptionresnetv2 employed as a base-Network of Deeplabv3 and subsequently is trained on fine-tuned parameters with annotated ground masks. The experiments reflect that the proposed approach has achieved greater than 95% accuracy in the testing phase and it is proven that, in comparison to the recently published work in this domain, this research has localized and segmented the liver and minute liver tumor with more accuracy.
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Affiliation(s)
- Javaria Amin
- Department of Computer Science, University of Wah, Wah Cantt 47040, Pakistan;
| | | | - Muhammad Sharif
- Department of Computer Science, Comsats University Islamabad, Wah Campus, Wah Cantt 47040, Pakistan;
| | - Seifedine Kadry
- Department of Applied Data Science, Noroff University College, 4609 Kristiansand, Norway
- Correspondence:
| | - Ahmed Nadeem
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (A.N.); (S.F.A.)
| | - Sheikh F. Ahmad
- Department of Pharmacology & Toxicology, College of Pharmacy, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia; (A.N.); (S.F.A.)
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Diniz de Lima E, Souza Paulino JA, Lira de Farias Freitas AP, Viana Ferreira JE, Barbosa JDS, Bezerra Silva DF, Bento PM, Araújo Maia Amorim AM, Melo DP. Artificial intelligence and infrared thermography as auxiliary tools in the diagnosis of temporomandibular disorder. Dentomaxillofac Radiol 2022; 51:20210318. [PMID: 34613829 PMCID: PMC8802706 DOI: 10.1259/dmfr.20210318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To assess three machine learning (ML) attribute extraction methods: radiomic, semantic and radiomic-semantic association on temporomandibular disorder (TMD) detection using infrared thermography (IT); and to determine which ML classifier, KNN, SVM and MLP, is the most efficient for this purpose. METHODS AND MATERIALS 78 patients were selected by applying the Fonseca questionnaire and RDC/TMD to categorize control patients (37) and TMD patients (41). IT lateral projections of each patient were acquired. The masseter and temporal muscles were selected as regions of interest (ROI) for attribute extraction. Three methods of extracting attributes were assessed: radiomic, semantic and radiomic-semantic association. For radiomic attribute extraction, 20 texture attributes were assessed using co-occurrence matrix in a standardized angulation of 0°. The semantic features were the ROI mean temperature and pain intensity data. For radiomic-semantic association, a single dataset composed of 28 features was assessed. The classification algorithms assessed were KNN, SVM and MLP. Hopkins's statistic, Shapiro-Wilk, ANOVA and Tukey tests were used to assess data. The significance level was set at 5% (p < 0.05). RESULTS Training and testing accuracy values differed statistically for the radiomic-semantic association (p = 0.003). MLP differed from the other classifiers for the radiomic-semantic association (p = 0.004). Accuracy, precision and sensitivity values of semantic and radiomic-semantic association differed statistically from radiomic features (p = 0.008, p = 0.016 and p = 0.013). CONCLUSION Semantic and radiomic-semantic-associated ML feature extraction methods and MLP classifier should be chosen for TMD detection using IT images and pain scale data. IT associated with ML presents promising results for TMD detection.
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Affiliation(s)
- Elisa Diniz de Lima
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | | | | | | | | | | | - Patrícia Meira Bento
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | | | - Daniela Pita Melo
- Department of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
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Phi L, Albertson B, Hatcher D, Rathi S, Park J, Oh H. Condylar degeneration in anterior open bite patients: A cone beam computed tomography study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:221-228. [PMID: 34503937 DOI: 10.1016/j.oooo.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/16/2021] [Accepted: 07/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the prevalence of condylar degeneration in patients with anterior open bites (AOB). STUDY DESIGN Cone beam computed tomography (CBCT) scans of 194 patients with AOB (108 with skeletal open bites and 86 with dental open bites) and 100 patients serving as controls were included in this retrospective study. Two oral and maxillofacial radiologists categorized each of the 588 condyles as normal, degenerative-active, or degenerative-repair. The χ2 analysis with Bonferroni adjustment was used to evaluate the relationship of condylar status (normal vs degenerative) to anterior open bites. RESULTS Of the 103 degenerative condyles, there were 59 in the group with skeletal open bites, 14 in the group with dental open bites, and 30 in the control group. Condylar degeneration occurred twice as frequently in patients with skeletal open bites as it did in the control group (P < .0001). Conversely, a greater frequency of normal condyles was found in the group of patients with dental open bites (P = .0002). The group with skeletal open bites also showed a significantly higher frequency of bilateral degenerative condyles (P = .0001). The frequency of condylar degeneration did not differ significantly between female and male individuals. CONCLUSIONS Degenerative condylar change was significantly more likely in patients with skeletal open bites and less likely in patients with dental open bites.
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Affiliation(s)
- Linda Phi
- Adjunct Assistant Professor, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Brad Albertson
- Private practice, Austin, Texas, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - David Hatcher
- Adjunct Associate Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Shikha Rathi
- Adjunct Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Joorok Park
- Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Heesoo Oh
- Professor and Chair, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
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Emshoff R, Bertram A, Hupp L, Rudisch A. A logistic analysis prediction model of TMJ condylar erosion in patients with TMJ arthralgia. BMC Oral Health 2021; 21:374. [PMID: 34303363 PMCID: PMC8305951 DOI: 10.1186/s12903-021-01687-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 06/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In terms of diagnostic and therapeutic management, clinicians should adequately address the frequent aspects of temporomandibular joint (TMJ) osteoarthritis (OA) associated with disk displacement. Condylar erosion (CE) is considered an inflammatory subset of OA and is regarded as a sign of progressive OA changes potentially contributing to changes in dentofacial morphology or limited mandibular growth. The purpose of this study was to establish a risk prediction model of CE by a multivariate logistic regression analysis to predict the individual risk of CE in TMJ arthralgia. It was hypothesized that there was a closer association between CE and magnetic resonance imaging (MRI) indicators. METHODS This retrospective paired-design study enrolled 124 consecutive TMJ pain patients and analyzed the clinical and TMJ-related MRI data in predicting CE. TMJ pain patients were categorized according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD) Axis I protocol. Each patient underwent MRI examination of both TMJs, 1-7 days following clinical examination. RESULTS In the univariate analysis analyses, 9 influencing factors were related to CE, of which the following 4 as predictors determined the binary multivariate logistic regression model: missing posterior teeth (odds ratio [OR] = 1.42; P = 0.018), RDC/TMD of arthralgia coexistant with disk displacement without reduction with limited opening (DDwoR/wLO) (OR = 3.30, P = 0.007), MRI finding of disk displacement without reduction (OR = 10.96, P < 0.001), and MRI finding of bone marrow edema (OR = 11.97, P < 0.001). The model had statistical significance (chi-square = 148.239, Nagelkerke R square = 0.612, P < 0.001). Out of the TMJs, 83.9% were correctly predicted to be CE cases or Non-CE cases with a sensitivity of 81.4% and a specificity of 85.2%. The area under the receiver operating characteristic curve was 0.916. CONCLUSION The established prediction model using the risk factors of TMJ arthralgia may be useful for predicting the risk of CE. The data suggest MRI indicators as dominant factors in the definition of CE. Further research is needed to improve the model, and confirm the validity and reliability of the model.
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Affiliation(s)
- Rüdiger Emshoff
- Orofacial Pain and TMD Unit, University Clinic of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Annika Bertram
- Otto Von Guericke University of Magdeburg, Magdeburg, Germany
| | - Linus Hupp
- University Clinic of Oral and Maxillofacial Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Ansgar Rudisch
- University Clinic of Radiology, Medical University of Innsbruck, Innsbruck, Austria
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Kim YH, Shin JY, Lee A, Park S, Han SS, Hwang HJ. Automated cortical thickness measurement of the mandibular condyle head on CBCT images using a deep learning method. Sci Rep 2021; 11:14852. [PMID: 34290333 PMCID: PMC8295413 DOI: 10.1038/s41598-021-94362-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/05/2021] [Indexed: 11/09/2022] Open
Abstract
This study proposes a deep learning model for cortical bone segmentation in the mandibular condyle head using cone-beam computed tomography (CBCT) and an automated method for measuring cortical thickness with a color display based on the segmentation results. In total, 12,800 CBCT images from 25 normal subjects, manually labeled by an oral radiologist, served as the gold-standard. The segmentation model combined a modified U-Net and a convolutional neural network for target region classification. Model performance was evaluated using intersection over union (IoU) and the Hausdorff distance in comparison with the gold standard. The second automated model measured the cortical thickness based on a three-dimensional (3D) model rendered from the segmentation results and presented a color visualization of the measurements. The IoU and Hausdorff distance showed high accuracy (0.870 and 0.928 for marrow bone and 0.734 and 1.247 for cortical bone, respectively). A visual comparison of the 3D color maps showed a similar trend to the gold standard. This algorithm for automatic segmentation of the mandibular condyle head and visualization of the measured cortical thickness as a 3D-rendered model with a color map may contribute to the automated quantification of bone thickness changes of the temporomandibular joint complex on CBCT.
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Affiliation(s)
- Young Hyun Kim
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Jin Young Shin
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea
| | - Ari Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Seungtae Park
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
| | - Hyung Ju Hwang
- Department of Mathematics, Pohang University of Science and Technology, 150 Jigok-ro Nam-gu, Pohang-si, Gyeongsangbuk-do, 37666, South Korea.
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Bielajew BJ, Donahue RP, Espinosa MG, Arzi B, Wang D, Hatcher DC, Paschos NK, Wong MEK, Hu JC, Athanasiou KA. Knee orthopedics as a template for the temporomandibular joint. Cell Rep Med 2021; 2:100241. [PMID: 34095872 PMCID: PMC8149366 DOI: 10.1016/j.xcrm.2021.100241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although the knee joint and temporomandibular joint (TMJ) experience similar incidence of cartilage ailments, the knee orthopedics field has greater funding and more effective end-stage treatment options. Translational research has resulted in the development of tissue-engineered products for knee cartilage repair, but the same is not true for TMJ cartilages. Here, we examine the anatomy and pathology of the joints, compare current treatments and products for cartilage afflictions, and explore ways to accelerate the TMJ field. We examine disparities, such as a 6-fold higher article count and 2,000-fold higher total joint replacement frequency in the knee compared to the TMJ, despite similarities in osteoarthritis incidence. Using knee orthopedics as a template, basic and translational research will drive the development and implementation of clinical products for the TMJ. With more funding opportunities, training programs, and federal guidance, millions of people afflicted with TMJ disorders could benefit from novel, life-changing therapeutics.
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Affiliation(s)
- Benjamin J Bielajew
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Ryan P Donahue
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - M Gabriela Espinosa
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Dean Wang
- Department of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, USA
| | | | - Nikolaos K Paschos
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark E K Wong
- Department of Oral and Maxillofacial Surgery, University of Texas School of Dentistry, Houston, TX, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
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Choi E, Kim D, Lee JY, Park HK. Artificial intelligence in detecting temporomandibular joint osteoarthritis on orthopantomogram. Sci Rep 2021; 11:10246. [PMID: 33986459 PMCID: PMC8119725 DOI: 10.1038/s41598-021-89742-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/27/2021] [Indexed: 11/23/2022] Open
Abstract
Orthopantomogram (OPG) is important for primary diagnosis of temporomandibular joint osteoarthritis (TMJOA), because of cost and the radiation associated with computed tomograms (CT). The aims of this study were to develop an artificial intelligence (AI) model and compare its TMJOA diagnostic performance from OPGs with that of an oromaxillofacial radiology (OMFR) expert. An AI model was developed using Karas' ResNet model and trained to classify images into three categories: normal, indeterminate OA, and OA. This study included 1189 OPG images confirmed by cone-beam CT and evaluated the results by model (accuracy, precision, recall, and F1 score) and diagnostic performance (accuracy, sensitivity, and specificity). The model performance was unsatisfying when AI was developed with 3 categories. After the indeterminate OA images were reclassified as normal, OA, or omission, the AI diagnosed TMJOA in a similar manner to an expert and was in most accord with CBCT when the indeterminate OA category was omitted (accuracy: 0.78, sensitivity: 0.73, and specificity: 0.82). Our deep learning model showed a sensitivity equivalent to that of an expert, with a better balance between sensitivity and specificity, which implies that AI can play an important role in primary diagnosis of TMJOA from OPGs in most general practice clinics where OMFR experts or CT are not available.
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Affiliation(s)
- Eunhye Choi
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, #101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - Donghyun Kim
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, 03722, Korea
| | - Jeong-Yun Lee
- Seoul Cheongchoon Dental Clinic, Seoul, 03086, Korea
| | - Hee-Kyung Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, #101, Daehak-ro, Jongro-gu, Seoul, 03080, Korea.
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Cone-Beam Computed Tomography: A User-Friendly, Practical Roadmap to the Planning and Execution of Every Rhinoplasty-A 5-Year Review. Plast Reconstr Surg 2021; 147:749e-762e. [PMID: 33835107 DOI: 10.1097/prs.0000000000007900] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cone-beam computed tomography has recently rapidly developed worldwide as a versatile and convenient alternative to traditional computed tomography for imaging of the maxillofacial region. However, most surgeons performing rhinoplasty are surprisingly unfamiliar with it, in both the plastic surgery and ear, nose, and throat communities. METHODS The broad clinical experience of a single center over the past 5 years is reviewed. The many applications of cone-beam computed tomography to primary and secondary rhinoplasty are analyzed regarding septum, turbinates, nasal bones, skin thickness, and other issues. The importance of a paradigm shift from a two-dimensional to a three-dimensional approach in image reconstruction is demonstrated, together with the value of surface contour enhancement. RESULTS Cone-beam computed tomography has a multitude of practical applications highly relevant to rhinoplasty. The surface image will strengthen aesthetic analysis, and the detailed preview of bony and functional anatomy will facilitate surgical planning. Cone-beam computed tomography serves as a roadmap to plan and execute rhinoplasties more predictably and efficiently. The availability of spatial views and accurate detail, together with the possibility of easy, accurate measuring, offers a plenitude of potential applications. CONCLUSIONS Cone-beam computed tomography is a user-friendly, quick technique with abundant advantages in planning any rhinoplasty. It causes the patient no inconvenience and has very few, if any, drawbacks, with these being limited to radiation exposure and limited cost.
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Evaluation of various low-dose cone-beam computed tomography protocols in the diagnosis of specific condylar defects. Am J Orthod Dentofacial Orthop 2021; 159:491-501.e2. [PMID: 33541784 DOI: 10.1016/j.ajodo.2020.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 12/01/2019] [Accepted: 01/01/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION This study aimed to determine the identifiability and measurement accuracy of defined bony defects of the temporomandibular joint (TMJ) in cone-beam computed tomographies, depending on different milliampere-second (mAs)-reduced protocols. METHODS Defined artificial defects were prepared on 30 condyles from 15 intact pig heads, with a maximum of surrounding soft tissue preserved. Three-dimensional imaging was performed using ProMax 3D Mid (Planmeca, Helsinki, Finland). The scan protocol with maximum resolution and without mAs-reduction was defined as control. Twenty-six mAs-reduced imaging protocols were analyzed by 1 examiner regarding the protocol-specific measurement accuracy. Defect depth (DD) was divided into 3 categories: I, <2 mm; II, 2-3 mm; and III, >3 mm. The protocol-specific sensitivity and specificity were evaluated in relation to localization and defect size as determined from the results of 3 examiners. RESULTS There was a significant difference from the control protocol in DD measurement in 8 mAs-reduced protocols, P <0.001-0.027. In most protocols, there was no significant difference in measurement accuracy concerning defect size and localization. The mean sensitivity reached values between 93.3% and 98.6% and differed significantly among protocols (P = 0.002). The mean specificity amounted to 97.0%-98.1% and did not differ among protocols (P = 0.462). The specificity of DD III (99.1%) was higher than DD I (97.7%) and DD II (97.1%). There was a significant difference in specificity and sensitivity concerning defect localization (P <0.001). CONCLUSIONS This study showed that mAs-reduced cone-beam computed tomographies protocols are suitable for the analysis of defined osseous TMJ defects. When 3-dimensional TMJ imaging is indicated because of potential erosive defects, validated mAs-reduced scan protocols should be applied instead of high-definition protocols.
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Is There an Association between Temporomandibular Disorders and Articular Eminence Inclination? A Systematic Review. Diagnostics (Basel) 2020; 11:diagnostics11010029. [PMID: 33375312 PMCID: PMC7824549 DOI: 10.3390/diagnostics11010029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022] Open
Abstract
(1) Background: In order to determine the correlation between the inclination of articular eminence (AEI) and the development of temporomandibular disorders (TMDs), a systematic review was performed. (2) Methods: A systematic literature research was conducted between 1946 and January 2020, based on the following electronic databases: PubMed, Cochrane Library, Embase, Medline, Scope, SciELO, and Lilacs. Observational studies, analytical case-control studies, and cohort studies written in English were identified. The articles were selected and analyzed by two authors independently. The PICO format was used to analyze the studies and the Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. (3) Results: Sixteen articles were included in this review, ten case-control studies and six cohort studies. Eight articles (50%) established a positive relation between AEI and TMDs and eight (50%) did not. The scientific quality was medium-low, mainly influenced by the exposure to the risk of bias and the lack of clinical methods with adequate consistency and sensitivity on the diagnosis of TMDs. (4) Conclusions: It is controversial to establish a causal relationship between the TMDs and the AEI in the field of stomatology, due to limited and inconclusive evidence. However, it is suggested that the AEI defined by some specific methods may be associated with some special pathological stages of TMDs. High-quality prospective studies are required to draw any definitive conclusions.
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Arayapisit T, Ngamsom S, Duangthip P, Wongdit S, Wattanachaisiri S, Joonthongvirat Y, Mitrirattanakul S. Understanding the mandibular condyle morphology on panoramic images: A conebeam computed tomography comparison study. Cranio 2020:1-8. [PMID: 33297888 DOI: 10.1080/08869634.2020.1857627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective: To compare variations in condylar morphology (CM) in panoramic images with those demonstrated in cone beam computed tomography (CBCT) and to investigate factors related to the variations.Methods: Three thousand panoramic images were analyzed for CM classification and relationship between CM and patient factors. Then, CM of 178 cases of panoramic and CBCT images were compared.Results: CM was classified into five types: round (70.63%), pointed (15.12%), angled (8.43%), flat (4.53%), and irregular (1.28%). CM was significantly related to all patient factors (p < 0.001). Round CM in panoramic images presented as round in CBCT images. Pointed and flat CM were observed mainly in the lateral aspect of the condyle, and no angle-shaped CM was found, according to CBCT images.Conclusion: Round, flat, and pointed CM seen on panoramic images possibly reflected the actual shape of the condyle, as confirmed by CBCT, whereas angled CM appeared not to exist.
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Affiliation(s)
- Tawepong Arayapisit
- Department of Anatomy, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Supak Ngamsom
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Sarut Wongdit
- Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | | | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Xia K, Sun W, Yu L, Huang X, Zhao Z, Liu J. Treatment of the mandibular shift in an adult woman and the diagnostic value of joint space index: a case report. Eur J Med Res 2020; 25:50. [PMID: 33092645 PMCID: PMC7579934 DOI: 10.1186/s40001-020-00451-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/08/2020] [Indexed: 02/08/2023] Open
Abstract
Background Mandibular deviations are common clinical complaints. The orthodontic or orthognathic treatment of mandibular deviations is tricky because a comprehensive diagnosis, especially a functional one, is difficult to make. A inaccurate diagnosis may lead to a compromised and unstable treatment outcome. Case presentation This article describes the diagnosis and treatment of a woman with a mandibular deviation and facial skeletal asymmetry. By eliminating the disharmony of the arch form with elastics and bite turbos, her esthetic and functional outcomes improved. Cone-beam CT (CBCT) and Joint Space Index (JSI) analyses served as the diagnostic approaches and outcome evaluation methods before and after treatment. Conclusions A condyle position displacement could be an indication of functional deviation. JSI analysis is a quantitative and convenient choice to compare condyle relative positions.
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Affiliation(s)
- Kai Xia
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Wentian Sun
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Liyuan Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Xinqi Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Zhihe Zhao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China
| | - Jun Liu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China. .,Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, South Renmin Road, Chengdu, 610041, Sichuan, China.
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Malik S, Singh S, George RT, Kakkar M, Vaid NR. Optimal Use of a Panoramic Radiograph as a Screening Tool for Condylar Resorption in Patients Undergoing Active Orthodontic Treatment: A Case Series. J Clin Imaging Sci 2020; 10:65. [PMID: 33194307 PMCID: PMC7656026 DOI: 10.25259/jcis_143_2020] [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: 08/12/2020] [Accepted: 08/27/2020] [Indexed: 11/04/2022] Open
Abstract
Condylar resorption of temporomandibular joint findings in the panoramic radiographs is an indication of bone resorption suggesting possible degenerative joint disease that warrants early screen and subsequent referral to a dedicated specialist. This case series reports three patients that underwent the active orthodontic treatment for the duration of approximately 24-36 months. The patients were asymptomatic at the initial examination. The clinical examination was negative for clicking; the range of motion on opening, lateral excursion, and protrusion was normal. Neither of these patients had a history of rheumatic disease or bruxism. During the later stages of orthodontic treatment, two of the three patients reported mild pain and clicking during mastication, which was also confirmed chairside on clinical evaluation. Patients were referred to the orofacial pain specialist, were they were prescribed specific medication for the symptoms, along with cognitive behavioral therapy, and were further evaluated for splint therapy. Panoramic radiographs taken before the start of the treatment, during the treatment and at the completion of the orthodontic treatments indicate the progression in the resorption of mandibular condyle in all three patients suggesting possible degeneration that warrants further investigation and therapy.
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Affiliation(s)
- Shaima Malik
- Department of Orthodontics and Dentofacial Orthopedics, University of Rochester, New York, United States
| | - Shilpa Singh
- Department of Orofacial Pain/TMD and Community Dentistry, University of Rochester, New York, United States
| | - Robby T. George
- Department of Orofacial Pain/TMD and Community Dentistry, University of Rochester, New York, United States
| | - Mayank Kakkar
- Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York, United States
| | - Nikhilesh R. Vaid
- Department of Department of Orthodontics, European University College, Dubai, United Arab Emirates
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Singh B, Kumar NR, Balan A, Nishan M, Haris PS, Jinisha M, Denny CD. Evaluation of Normal Morphology of Mandibular Condyle: A Radiographic Survey. J Clin Imaging Sci 2020; 10:51. [PMID: 32874756 PMCID: PMC7451156 DOI: 10.25259/jcis_84_2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/10/2020] [Indexed: 11/04/2022] Open
Abstract
Objectives The temporomandibular joint (TMJ) is a complex, highly specialized joint. Along with the teeth, these joints are considered to be a "tri-joint complex." Mandibular condyle morphology is characterized by a rounded bone projection with an upper biconvex and oval surface in axial plane. Anatomical knowledge of the TMJ is one of the basic foundations of clinical practice, allowing the understanding of TMJ pathologies and fabrication of condylar prostheses. The cross-sectional descriptive study was undertaken to evaluate normal variation in the condylar morphology on radiographs in persons without TMJ symptomatology and its relation to age, gender, dentition status, chewing habits, parafunctional habits, history of orthodontic treatment, and denture wearing was assessed. Material and Methods A total of 350 subjects without TMJ symptomatology included in the study were further grouped by age, gender, dentition status, chewing habits, parafunctional habits, history of orthodontic treatment, and denture wearing history. Panoramic radiograph was taken for the assessment of condylar morphology. Results A significant association between dentition status and bilaterally similar condylar morphology was noticed. Bilaterally similar condyles were seen in 81.4% of subjects. Round-shaped condyles were seen in 176 (62%) persons. Loss of bilateral occlusion tends to alter the condylar morphology. Association between normal chewing habits and bilaterally similar condyle shapes was significant. Conclusion The study describes the normal morphology of mandibular condyles in a population attending the tertiary dental care center, Kozhikode. The dentition status and chewing habits of individuals had a significant role in determining condylar morphology.
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Affiliation(s)
- Bhupender Singh
- Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (Calicut), Kerala, India.,Department of Oral Medicine and Radiology, Government Dental College, Kottayam, Kerala, India
| | - Nileena R Kumar
- Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (Calicut), Kerala, India
| | - Anita Balan
- Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (Calicut), Kerala, India.,Principal, Government Dental College, Thiruvananthapuram, Kerala, India
| | - Mohammed Nishan
- Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (Calicut), Kerala, India
| | - P S Haris
- Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (Calicut), Kerala, India.,Department of Oral Medicine and Radiology, Government Dental College, Thrissur, Kerala, India
| | - M Jinisha
- Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (Calicut), Kerala, India
| | - C Dimla Denny
- Department of Oral Medicine and Radiology, Government Dental College, Kozhikode (Calicut), Kerala, India.,Department of Oral Medicine and Radiology, Government Dental College, Thrissur, Kerala, India
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Iskanderani D, Alstergren P, Ekberg EC, Shi XQ, Hellén-Halme K. Web-based educational programme for temporomandibular joint assessment with cone-beam computed tomography. J Oral Rehabil 2020; 47:1330-1336. [PMID: 32757414 DOI: 10.1111/joor.13065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To develop and evaluate an educational web-based programme for temporomandibular joint (TMJ) assessment using cone-beam computed tomography (CBCT). METHODS A web-based educational programme was designed for TMJ assessment using CBCT images. Fifteen CBCT cases of the TMJ (three-dimensional reconstructed volumes) and an assessment module based on image analysis criteria in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were added to the programme. Thirty-six undergraduate dental students were invited to test the programme by assessing all cases twice: before and after 2 months of training. Participants submitted written subjective evaluations of the programme. RESULTS The web-based programme can be accessed on Malmö University webpage (www.cbct-tmj.mau.se). Despite limited CBCT learning in their undergraduate training and not using the programme in the 2-month interval, the students were able to correctly diagnose 80% of the cases at the second assessment. Their diagnoses, however, did not differ significantly from the first assessment. Overall, the students were satisfied with the programme and considered it user-friendly. CONCLUSION The web-based educational programme that was developed in the present study and tested by dental students could be a useful educational tool for TMJ assessment using CBCT.
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Affiliation(s)
- Durer Iskanderani
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ewa Carin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Xie-Qi Shi
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Division of Oral Maxillofacial Radiology, Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Kristina Hellén-Halme
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Abu-Taleb NS, ElBeshlawy DM. Low-dose cone-beam computed tomography in simulated condylar erosion detection: a diagnostic accuracy study. Oral Radiol 2020; 37:427-435. [PMID: 32803679 DOI: 10.1007/s11282-020-00474-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 08/05/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of the present study was to assess the diagnostic accuracy of low-dose cone-beam computed tomography (CBCT) in the detection of simulated mandibular condyle erosions. METHODS 102 simulated erosions were performed on the condyles of eight dry human mandibles. Each mandible was subjected to four CBCT scan protocols: high-definition (HD), normal definition (NORM), ultra-low-dose high-definition (ULD-HD), and ultra-low-dose normal definition (ULD-NORM). All scans were analyzed by two observers. The inter-observer and intra-observer agreement as well as the agreement with the gold standard were assessed. The sensitivity, specificity, positive-predictive value, negative-predictive value and accuracy of erosion detection were calculated. RESULTS A substantial to almost perfect agreement with the gold standard was found regarding the HD protocol and substantial agreement in NORM and ULD-HD protocols; however, moderate agreement was found regarding the ULD-NORM protocol. The sensitivity, specificity and accuracy values were highest for the HD protocol followed by the NORM and ULD-HD which showed comparable results; while, the ULD-NORM protocol showed the least values. CONCLUSIONS The studied ULD-HD CBCT protocol can be recommended for the detection of mandibular condylar erosions due to the reduced radiation dose; however, ULD-NORM is not advocated for similar clinical use.
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Affiliation(s)
- Noha Saleh Abu-Taleb
- Oral and Maxillofacial Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, 11, El Saraya St., Almanyal, Cairo, 11553, Egypt.
| | - Dina Mohamed ElBeshlawy
- Oral and Maxillofacial Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, 11, El Saraya St., Almanyal, Cairo, 11553, Egypt
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Mehdizadeh M, Rezaei Z, Moghadam FG. Incidental Findings in Temporomandibular Joint Region Detected by Cone-beam Computed Tomography: A Retrospective Study. Open Dent J 2020. [DOI: 10.2174/1874210602014010337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Purpose:
The purpose of this study was to investigate the prevalence of Incidental Findings (IFs) in the temporomandibular joint (TMJ) region detected in Cone-Beam Computed Tomography (CBCT) scans of maxilla and mandible.
Materials and Methods:
In this study, 384 CBCT scans were reviewed for IFs of the TMJ region. Demographic data including age and sex were recorded. The scans were evaluated in multiplanar views: corrected sagittal, corrected coronal and axial sections. IFs in TMJ region were categorized into eight groups: osteoarthritis, flattening and erosion of condyle and articular eminence, osteophytes, subchondral pseudocyst, condyle hyperplasia, condyle hypoplasia, bifid condyle, and soft tissue calcification. Statistical analyses were performed using the SPSS statistic v.22.
Results:
From the CBCT scans, a total of 81 (21.1%) IFs were identified. 184 of the subjects (47.9%) were male and 200 (52.1%) were females. Their age ranged from 10 to 75 years old with a mean of 36.8 and a standard deviation of 13.9 years. The most frequent IFs were flattening and erosion of condyle and articular eminence (40.74%), followed by soft tissue calcification (30.86%). Osteoarthritis was not observed in any of the subjects. There was no significant difference between females and males in IFs of TMJ joint and its related structures. Flattening and erosion of condyle and articular eminence, soft tissue calcification, osteophytes and, subchondral pseudo cyst showed significant differences between individuals of different age ranges.
Conclusion:
While examining CBCT images, it is critical to check for evidence of IFs in the TMJ region. The findings of this study emphasize the value of a thorough examination of all areas visualized on CBCT scans even those beyond the region of interest.
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Tsai CM, Wu FY, Chai JW, Chen MH, Kao CT. The advantage of cone-beam computerized tomography over panoramic radiography and temporomandibular joint quadruple radiography in assessing temporomandibular joint osseous degenerative changes. J Dent Sci 2020; 15:153-162. [PMID: 32595895 PMCID: PMC7305453 DOI: 10.1016/j.jds.2020.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/04/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND/PURPOSE The clinical diagnosis of temporomandibular joint (TMJ) degenerative joint disease (DJD) is based primarily on radiographic features of the condyle and articular eminence. The purpose of this study was to compare the reliability, sensitivity, and specificity of using plain radiography to that of cone-beam computerized tomography (CBCT) in identifying different types of osseous degenerative features in the TMJ condyle. MATERIALS AND METHODS The panoramic radiography (PANO), TMJ quadruple radiography (TMJQR) and CBCT images of 29 patients' TMJs were retrieved from a computer database and independently evaluated by a young oral surgeon and a senior TMD specialist. The examiners diagnosed osseous degenerative features on the radiographic images. The radiologist-assisted CBCT diagnoses were used as a reference standard and the reliability, sensitivity, and specificity of using the three radiographic modalities were statistically analyzed. RESULTS There were cases of indeterminate diagnoses using the PANO and TMJQR due to superimposition from surrounding structures, but none using CBCT. Reliability was generally poor when using PANO and TMJQR for detecting osseous degenerative features of the TMJ condyle but good to excellent when using CBCT. The sensitivity and specificity in the use of PANO and TMJQR were typically below acceptable, but the levels were generally satisfactory when using CBCT. CONCLUSION CBCT is superior to plain radiographic modalities for diagnosing osseous degenerative features of TMJs with regard to indeterminate cases, reliability, sensitivity, and specificity. It is recommended that CBCT can be used as an effective tool in identifying TMJ osteoarthritis.
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Affiliation(s)
- Chih-Mong Tsai
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Fang-Yu Wu
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Jyh-Wen Chai
- Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Mu-Hsiung Chen
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Ting Kao
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
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2D vs. 3D Radiological Methods for Dental Age Determination around 18 Years: A Systematic Review. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10093094] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The age of a living human being can be determined by applying a number of different methods; the most diffused are skeletal and dental methods, both principally based on X-rays examinations. This systematic review assesses the current evidence regarding the accuracy and reliability of Cone Beam Computed Tomography (CBCT) vs. Orthopantomography (OPG) in age determination. A computerized systematic literature search of studies published up to January 2020 was conducted without language restrictions in order to identify articles comparing CBCT vs. OPG in dental anatomy evaluation, articles evaluating the accuracy of dental methods for age estimation, both with CT and OPG exams, and articles comparing CBCT vs. OPG in terms of radiation dose. CBCT was found to be more accurate compared to OPG in dental anatomy evaluation. When analyzing young adults, an estimation error of two years is considered forensically acceptable. The radiation dose of a CBCT exam is higher compared to an OPG exam. However, the difference is not as marked with small Fields Of View (FOV) and low-resolution protocols. Final conclusion was that a small FOV CBCT centered on the mandibular angle of a young patient is an accurate and safe method for dental age estimation around the age of 18.
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Long-term Changes of Temporomandibular Joint Osteoarthritis on Computed Tomography. Sci Rep 2020; 10:6731. [PMID: 32317672 PMCID: PMC7174364 DOI: 10.1038/s41598-020-63493-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 03/30/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to understand long-term changes of the osteoarthritic temporomandibular joint (TMJ) condyle using computed tomography (CT) and to verify its correlation with clinical characteristics of temporomandibular disorders. Eighty-nine patients (152 joints; 76 female, 13 male) who had taken follow-up CTs (mean follow-up period: 644.58 ± 325.71 days) at least once in addition to their initial evaluation were selected. Cross-sectional demographic and clinical data and longitudinal CT images were collected. Data were analyzed by analysis of variance and logistic regression. Overall destructive change index (number of TMJ condyle sections in which destructive change was observed) decreased from 1.56 to 0.66. Improvement was seen in 93 joints (61.2%) and 27 joints (17.8%) worsened. In the pain positive group, both initial and final destructive change index were significantly higher compared to the pain negative group (p = 0.04). Occlusal stabilization splint therapy and nonsteroidal anti-inflammatory drug administration showed a significant effect on improving the prognosis of TMJ osteoarthritis (p = 0.015 and 0.011). In conclusion, TMJ osteoarthritis showed long-term improvement in the majority of cases. TMJ osteoarthritis accompanied by pain showed unfavorable prognosis with additional bone destruction. Occlusal stabilization splint and nonsteroidal anti-inflammatory drug administration were beneficial on the prognosis of TMJ osteoarthritis.
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Are Signs of Degenerative Joint Disease Associated With Chin Deviation? J Oral Maxillofac Surg 2020; 78:1403-1414. [PMID: 32304661 DOI: 10.1016/j.joms.2020.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Degenerative joint changes commonly affect the temporomandibular joint (TMJ) and can result in chin deviation. However, the extent of degenerative TMJ changes and chin deviation has not been well-characterized. The present study sought to correlate degenerative TMJ changes with condylar volume, grayscale measures, and chin deviation. MATERIALS AND METHODS The present cross-sectional study had enrolled women with skeletal Class III malocclusion. Cone-beam computed tomography scans were acquired preoperatively. For each condyle, degenerative TMJ signs were analyzed and the condylar volume and grayscale were measured. The predictor variable was the presence of degenerative TMJ signs, classified as categorical data: 0, if none; 1, only present in 1 joint; and 2, present in both joints. The primary outcome variable was a chin deviation of 3 mm or more. Other associated variables were grouped by age, cephalometric data, and 3-dimensional condylar measurements. Descriptive bivariate statistics were computed, and univariate and multiple logistic regression analyses were conducted to identify any associations between degenerative TMJ disease and chin deviation. RESULTS We included 85 patients, who were classified into 2 groups: less than 3 mm of chin deviation (n = 43) and 3 mm or more of chin deviation (n = 42). The presence of more than 10 degenerative TMJ signs was significantly associated with the presence of 3 mm or more of chin deviation (P < .001). In multiple regression models, the presence of subcortical sclerosis in 1 joint and in both joints (adjusted odds ratio [OR], 3.698; 95% confidence interval [CI], 1.051 to 13.012; adjusted OR, 5.001; 95% CI, 1.461-17.119, respectively) correlated significantly with the presence of 3 mm or more of chin deviation (P < .05). The volume difference between the 2 condyles was significantly greater in the group with more than 10 degenerative TMJ signs and 3 mm or more of chin deviation than in the group with 10 or fewer degenerative TMJ signs and less than 3 mm of chin deviation (P = .016 and P < .001, respectively). CONCLUSIONS In women with skeletal Class III malocclusion, the presence of more than 10 degenerative TMJ signs increased the prevalence of 3 mm or more of chin deviation. The presence of subcortical sclerosis in either 1 or both joints and volume differences between the 2 condyles were associated with greater chin deviation.
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Yalcin ED, Bozan C. Relationship between mandibular condyle and articular eminence cortication with mandibular cortical index on cone-beam CT. Surg Radiol Anat 2019; 42:515-522. [PMID: 31768698 DOI: 10.1007/s00276-019-02385-7] [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: 08/19/2019] [Accepted: 11/19/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Mandibular condyle development can be evaluated with radiographic evaluation of subchondral cortical bone. The aim of this study is to investigate mandibular condyle cortication (MCC), articular eminence cortication (AEC) and mandibular cortical index (MCI) according to age and gender on CBCT, and relationship between each other. METHODS CBCT scans of 520 patients (312 male and 208 female, age range 7-84) were retrospectively investigated to evaluate MCC, AEC and MCI. MCC and AEC were examined in sagittal section and MCI in panoramic reformatted image. MCC and AEC were classified as Type I, Type II and Type III according to density difference between the cortical bone enclosing condyle and articular eminence. Categorical variables were tested by Chi square. RESULTS When MCC, AEC and MCI were compared, a significant relationship was detected (p < 0.05). According to age, there was a significant difference between MCC, MCI and AEC types with each other (p < 0.05). No significant discrepancy was found between gender and MCC, AEC and MCI (p > 0.05). CONCLUSIONS This study evaluated the distribution of MCC, AEC, MCI according to age and gender and detected that these cortications were correlated. This result may be caused by anatomical proximity bone components and functional stimuli. Knowledge of these cortications can be important for accurate diagnosis of TMJ disorders and may also be helpful for prediction of osteoporotic changes.
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Affiliation(s)
- Eda Didem Yalcin
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Sehitkamil, 27410, Gaziantep, Turkey.
| | - Cigdem Bozan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gaziantep University, Sehitkamil, 27410, Gaziantep, Turkey
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Ramachandran A, Jose R, Tunkiwala A, Varma R B, M Shanmugham A, Nair PK, Kumar KS, Sam LM. Effect of deprogramming splint and occlusal equilibration on condylar position of TMD patients - A CBCT assessment. Cranio 2019; 39:294-302. [PMID: 31451061 DOI: 10.1080/08869634.2019.1650216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Assessment of clinical symptoms and condylar position of TMD patients using CBCT imaging with deprogramming splint therapy and occlusal equilibration. The hypothesis tested was the alleviation of symptoms of TMD with possible changes in condylar position occurs with this treatment.Methods: The condylar position of 12 TMD patients was observed from CBCT images, and clinically, symptom severity score, mouth opening, and range of motion were compared pre- and post-treatment.Results: All patients reported a statistically significant decrease in the symptom severity score and increase in mouth opening and range of motion (p < .05). A significant decrease was only achieved in the left anterior joint space (p < .05).Conclusion: Deprogramming splint therapy and occlusal equilibration benefitted patients with a reduction in clinical symptoms, and minor changes in condylar position were observed.
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Affiliation(s)
- Anu Ramachandran
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Renju Jose
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Ali Tunkiwala
- Consultant Prosthodontist, Private Practice, Mumbai, India
| | - Beena Varma R
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Aravind M Shanmugham
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Priya K Nair
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Krishna S Kumar
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Lisa Maria Sam
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
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Relationship between condyle cortication, sphenooccipital synchondrosis, and chronological age. Oral Radiol 2019; 36:190-196. [PMID: 31332652 DOI: 10.1007/s11282-019-00398-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To assess the relationship between chronologic age, mandibular condyle cortication, and sphenooccipital synchondrosis (SOS) fusion. METHODS Cone Beam Computed Tomography data of 253 patients were retrospectively evaluated. Mandibular condyle cortication was divided into three classes as Types I, II, and III. SOS fusion grade was categorized using a four-stage system (0-3). These variables were evaluated in relation to age and sex. RESULTS There were significant positive relationships between age and condyle cortication, and between age and SOS fusion stage and between cortication type and SOS fusion stage. CONCLUSION Due to the positive correlation between the degree of SOS fusion stage, the condyle cortication type, and the chronological age, these indicators can be used for age estimation.
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Gorucu-Coskuner H, Atik E, El H. Reliability of cone-beam computed tomography for temporomandibular joint analysis. Korean J Orthod 2019; 49:81-88. [PMID: 30941294 PMCID: PMC6433603 DOI: 10.4041/kjod.2019.49.2.81] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/14/2018] [Accepted: 06/22/2018] [Indexed: 11/17/2022] Open
Abstract
Objective The aim was to assess the intraobserver and interobserver reliabilities of temporomandibular joint linear measurements and condylar shape classifications performed with cone-beam computed tomography (CBCT). Methods CBCT images of 30 patients were measured at two different time points by two orthodontists using the Dolphin 3D program (n = 60). Anterior, posterior, and superior joint space measurements and sagittal joint morphology classification in the sagittal view and medial and lateral joint space and mediolateral width measurements and coronal joint morphology classification in the coronal view were recorded. Intraclass-interclass correlation coefficients (ICC) and kappa statistics were used to assess intraobserver and interobserver reliability for the measurements and morphology classifications, respectively. Results The ICC values were good for measurements of the posterior joint space by observer I and for measurements of the posterior, medial, and lateral joint spaces by observer II, while the other intraobserver measurements were excellent. Only the mediolateral width measurements showed excellent interobserver ICC values, while the other measurements showed good interobserver ICC values. Intraobserver agreement for the sagittal morphology classifications was moderate (κ = 0.479) and almost perfect (κ = 0.858) for observers I and II, respectively, while the corresponding agreement for the coronal morphology classifications was substantial for both observers. The interobserver agreement values for sagittal and coronal morphology classifications were slight (κ = 0.181) and fair (κ = 0.265), respectively. Conclusions Linear temporomandibular joint measurements were reproducible and reliable in both intraobserver and interobserver evaluations. However, interobserver agreement for assessments of condylar shape was low.
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Affiliation(s)
- Hande Gorucu-Coskuner
- Department of Orthodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Ezgi Atik
- Department of Orthodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
| | - Hakan El
- Department of Orthodontics, School of Dentistry, Hacettepe University, Ankara, Turkey
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50
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Walewski LÂ, Tolentino EDS, Yamashita FC, Iwaki LCV, da Silva MC. Cone beam computed tomography study of osteoarthritic alterations in the osseous components of temporomandibular joints in asymptomatic patients according to skeletal pattern, gender, and age. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:70-77. [PMID: 30876841 DOI: 10.1016/j.oooo.2019.01.072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/01/2019] [Accepted: 01/18/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the prevalence of osteoarthritic alterations in the osseous components of the temporomandibular joint (TMJ) in asymptomatic patients with different skeletal patterns, gender, and age groups with cone beam computed tomography (CBCT) images. STUDY DESIGN CBCT images of 213 asymptomatic patients were assessed for the presence of any degenerative changes in the condyle and fossa/eminence complex. Each TMJ was evaluated separately and was classified as normal, indeterminate for osteoarthritis, or affected by osteoarthritis. Differences were tested by using the χ2 and Fisher's exact tests (P < .05). RESULTS In total, 52.3% of the joints presented some visible alteration in the osseous components. Abnormalities were detected in 32.6% of the condyles and 31.5% of the articular fossae/eminences, and flattening was the most prevalent alteration in all classes. There was no statistically significant difference in the prevalence of alterations in either the condyle or the articular fossa/eminence among the skeletal groups for the entire sample or for the gender and age subsets. CONCLUSIONS There are no differences in degenerative TMJ changes in patients with or without skeletal jaw discrepancies. No differences were found when gender and age were considered.
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Affiliation(s)
- Letícia Ângelo Walewski
- Postgraduate Program in Integrated Dentistry, Department of Dentistry, State University of Maringá, Paraná, Brazil.
| | - Elen de Souza Tolentino
- Professor of Dental Radiology and Stomatology, Department of Dentistry, State University of Maringá, Paraná, Brazil
| | - Fernanda Chiguti Yamashita
- Postgraduate Program in Integrated Dentistry, Department of Dentistry, State University of Maringá, Paraná, Brazil
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