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Tang L, Bai X, Wang Y, Chen Y, Chen ME, Xia C, Li Z. Effect of TMJ disc position on condylar bone remodeling after arthroscopic disc repositioning surgery. Eur J Radiol 2023; 169:111189. [PMID: 37939605 DOI: 10.1016/j.ejrad.2023.111189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/17/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE The objective of this study was to analyze the effect of TMJ disc position on condylar bone remodeling after arthroscopic disc repositioning surgery. METHODS Nine patients with anterior disc displacement without reduction (ADDWoR, 15 sides) who underwent arthroscopic disc repositioning surgery were included. Three-dimensional (3D) reconstruction of the articular disc and the condyle in the closed-mouth position was performed using cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) data. Then, the CBCT and MRI images were fused and displayed together by multimodal image registration techniques. Morphological changes in the articular disc and condyle, as well as changes in their spatial relationship, were studied by comparing preoperative and 3-month postoperative CBCT-MRI fused images. RESULTS The volume and superficial area of the articular disc, as well as the area of the articular disc surface in the subarticular cavity, were significantly increased compared to that before the surgical treatment(P < 0.01). There was also a significant increase in the volume of the condyle (P < 0.001). All condyles showed bone remodeling after surgery that could be categorized as one of two types depending on the position of the articular disc, suggesting that the location of the articular disc was related to the new bone formation. CONCLUSIONS The morphology of the articular disc and condyle were significantly changed after arthroscopic disc repositioning surgery. The 3D changes in the position of the articular disc after surgery tended to have an effect on condylar bone remodeling and the location of new bone formation.
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Affiliation(s)
- Liangchen Tang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xiaofeng Bai
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yujie Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yifan Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Min-Er Chen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Chenlong Xia
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Zhiyong Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China.
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Demir MG. Comparison of symptoms, signs, gender, and magnetic resonance images of temporomandibular joint disorder patients. Cranio 2022:1-5. [PMID: 36170015 DOI: 10.1080/08869634.2022.2128591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To compare patients' complaints, clinician's examination findings, and magnetic resonance imaging (MRI) findings by considering gender. METHODS Temporomandibular joint (TMJ) pain, difficulty in mouth opening, masseter tenderness, deviation, clicking sound, bruxism, restriction, normal occlusion and normal mouth opening symptoms, and findings of temporomandibular disorder (TMD) patients who came to the author's outpatient clinic were recorded. These recordings were compared with MRI. RESULTS In the study, symptoms, signs, and MRIs of 276 TMD patients were analyzed, including gender. No difference was observed in terms of symptoms, signs, or MRI results for either gender. MRI findings were correlated with restriction and normal mouth opening in both groups (p < 0.05). Normal MRI findings were observed in 52.5% of the MRI results. CONCLUSION Except for normal mouth opening and limitation, MRI findings did not provide a significant result. Therefore, careful detection of symptoms and signs rather than MRI helps in diagnosis.
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Affiliation(s)
- Mehmet Gökhan Demir
- Istanbul Medical School, Department Oral and Maxillofacial Surgery, Istanbul University, Istanbul, Turkey
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Clinical Manifestations, Imaging Features, and Pathogenic/Prognostic Risk Factors for Temporomandibular Disorders (TMD): A Case-Control Study Based on Psychogenic Factors of Patients. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8279357. [PMID: 35924116 PMCID: PMC9343186 DOI: 10.1155/2022/8279357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/06/2022] [Accepted: 06/23/2022] [Indexed: 11/17/2022]
Abstract
Objective. To survey the clinical manifestations and imaging features of temporomandibular disorders (TMD) and analyze the risk factors for pathogenesis/prognosis through a case-control study based on psychogenic factors of patients. Methods. According to the inclusion criteria, 200 adult patients were randomly enrolled from the maxillofacial department of our hospital from January 2020 to May 2021, including 100 patients with TMD as the study group and 100 healthy patients as the control group. The study group can be assigned into four subgroups according to their clinical manifestations: (1) articular area or/and masticatory muscle pain group, (2) mandibular movement abnormality group, (3) joint murmur group, and (4) two or more symptom groups. Based on the study of psychogenic factors of patients, the clinical manifestations and imaging features of TMD were determined, and the risk factors for pathogenesis/prognosis were analyzed. Results. The distribution of psychological status in the TMD group was higher than that in the control group (
). The distribution of anxiety, depression, and somatic symptoms in the TMD group was significantly different from that in the control group (
). Anxiety, depression, and somatic symptoms were the risk factors for TMD. Compared with the control group, the incidence of abnormal MRI images in patients with temporomandibular disorders was significantly different (
). There were significant differences in psychological status (anxiety, depression, and somatic symptoms) among the three groups (
). Anxiety, depression, and somatic symptoms were the risk factors for abnormal mandibular movement and joint tremor and murmur (
). Somatic symptoms were the risk factors for various clinical symptoms of TMD (
). Depression was the risk factor for pain (
). Conclusion. In patients with TMD, MRI can early identify disc abnormalities and other related imaging features, which is helpful for more comprehensive clinical evaluation and treatment of TMD patients. There exhibits no significant difference in psychological status (anxiety, depression, and somatic symptoms) of patients with different clinical symptoms, and abnormal psychological status may be one of the risk factors leading to different clinical symptoms and development of different types of TMD patients.
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Pitak-Arnnop P, Mutirangura W, Neff A. TMDs for ENTs - Some more details from non-ENTs. Am J Otolaryngol 2022; 43:103414. [PMID: 35279285 DOI: 10.1016/j.amjoto.2022.103414] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/08/2021] [Indexed: 12/21/2022]
Affiliation(s)
- Poramate Pitak-Arnnop
- Attending, Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany.
| | - Wantanee Mutirangura
- Associate Professor, Department of Occlusion and Accredited Training Center for Dental Occlusion and Orofacial Pain, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Andreas Neff
- Head Professor and Chairman, Department of Oral and Maxillofacial Surgery, University Hospital of Giessen and Marburg, UKGM GmbH, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Marburg, Germany; Specialist for Functional Diagnostics and Therapy of the TMJ (DGFDT), Head of the TMJ Section of the Strasbourg Osteosynthesis Research Group (S.O.R.G), Guideline Coordinator of TMJ Surgery of the German Association for Oral-Maxillofacial Surgeons (DGMKG), Immediate Past President of the European Society of TMJ Surgeons (ESTMJS)
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Garcia E, Flores RE, Doherty JK. Temporomandibular Joint Syndrome from an Ear Versus Dental-Related Standpoint. Otolaryngol Clin North Am 2022; 55:649-658. [PMID: 35490046 DOI: 10.1016/j.otc.2022.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Temporomandibular disorders (TMDs) are a prominent reason for visits to medical providers. The presentation of headaches within this population remains a challenging diagnosis, given the prevalence and overlap of symptomatology of both conditions. The literature demonstrates an undeniable association between headaches and TMD. Regardless of causality and etiology, the literature supports that prompt diagnosis and treatment results in improvement or resolution of symptoms, including headaches. Treatment of TMD headaches should begin with conservative measures, including medical management with NSAIDs, heat therapy, and muscle-stretching exercises.
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Affiliation(s)
- Erick Garcia
- Rick and Tina Caruso Department of Otolaryngology - Head & Neck Surgery, Keck Medicine of University of Southern California, Los Angeles, CA, USA.
| | - Ryan E Flores
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Joni K Doherty
- Rick and Tina Caruso Department of Otolaryngology - Head & Neck Surgery, Keck Medicine of University of Southern California, Los Angeles, CA, USA
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