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Tesch RDS, Calcia TBB, DE Nordenflycht D. Unveiling MRI-based structural phenotypes in temporomandibular joint osteoarthritis: implications for clinical practice and research. Dental Press J Orthod 2024; 29:e24spe4. [PMID: 39230116 PMCID: PMC11368237 DOI: 10.1590/2177-6709.29.4.e24spe4] [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: 12/08/2023] [Accepted: 06/16/2024] [Indexed: 09/05/2024] Open
Abstract
INTRODUCTION Osteoarthritis (OA) is a progressive degenerative disease characterized by the gradual degradation of cartilage, remodeling of subchondral bone, synovitis, and chronic pain. This condition impacts various large and small joints, including the temporomandibular joint (TMJ). However, addressing OA, particularly in impeding or reducing disease progression, is challenging due to its clinical and imaging heterogeneity. Authors are increasingly suggesting that this heterogeneity involves different phenotypes or subpopulations, discernible by variations in the disease's pathophysiology and structural manifestations. Even within the TMJ, these phenotypes may display distinct clinical features, laboratory parameters, biochemical markers, and imaging criteria. Recent research has proposed MRI as a reference standard for TMJ OA, highlighting its substantial agreement with histopathological changes. MRI-based phenotypes offer a promising avenue for understanding disease progression and treatment response, potentially providing valuable insights for prognosis and treatment planning. OBJECTIVE This article introduces the ROAMES-TMJ (Rapid OsteoArthritis MRI Eligibility Score for TMJ) to assess the structural eligibility of individuals for inclusion in TMJ OA clinical trials.
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Affiliation(s)
- Ricardo de Souza Tesch
- Centro Universitário Arthur Sá Earp Neto/Faculdade de Medicina de Petrópolis (UNIFASE/FMP)
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Wei Y, Guo R, Zhao S. The clinical study and multi-factor analysis of temporomandibular joint disorder induced by tooth extraction. Curr Probl Surg 2024; 61:101554. [PMID: 39168539 DOI: 10.1016/j.cpsurg.2024.101554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 08/23/2024]
Affiliation(s)
- Yunpeng Wei
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Ruitong Guo
- Department of Pharmacy, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School,Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Sufeng Zhao
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
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Sang S, Ameli N, Almeida FT, Friesen R. Association between clinical symptoms and MRI image findings in symptomatic temporomandibular joint (TMJ) disease: A systematic review. J Craniomaxillofac Surg 2024; 52:835-842. [PMID: 38724287 DOI: 10.1016/j.jcms.2024.04.006] [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: 03/10/2023] [Revised: 01/16/2024] [Accepted: 04/11/2024] [Indexed: 07/23/2024] Open
Abstract
To evaluate the association between clinical signs and symptoms of temporomandibular joint (TMJ) and magnetic resonance image (MRI) findings in patients with temporomandibular disorders (TMD). Relevant articles on humans over 18 years of age were obtained from five databases (Ovid MEDLINE, PubMed, Scopus, Web of Science, and Google Scholar) up to August 2022. Risk of bias assessment was completed using the Joanna Briggs Institute critical appraisal tools. The GRADEpro (Grading of Recommendations, Assessment, Development, and Evaluation) instrument was applied to assess the level of evidence across studies in a GRADE Summary of Findings table. In total, 22 studies were included in this systematic review. Of these, 11 studies highlighted that joint pain was positively associated with particular MRI findings: joint effusion, bone marrow edema, disk displacement with/without reduction, and condylar erosion. Masticatory muscle pain was found to have a strong positive correlation with disk displacement in four studies. Five studies found no significant association between MRI findings and masticatory muscle pain. Range of motion and MRI findings were examined in six studies. Limited mouth opening was found to be correlated with disk displacement in five studies. Of the 11 studies evaluating the correlation between joint noise and MRI findings, eight reported a significant association between disk displacement and TMJ noise. The results suggested that patients with joint pain and limited range of motion may benefit from MRI. Patients exhibiting primarily muscle pain are unlikely to benefit clinically from MRI. Future studies with improved quality are warranted.
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Affiliation(s)
- Sara Sang
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Nazila Ameli
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Fabiana T Almeida
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Reid Friesen
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
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Nguyen VS, Kofod T, Nisja E, Hosseini M, Worsaae N. Interpositional arthroplasty using cartilage allografts for treating temporomandibular joint arthrosis: a 3- and 5-year retrospective clinical follow-up study. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:573-579. [PMID: 38570274 DOI: 10.1016/j.oooo.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/01/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE To evaluate the effect of arthroplasty using interpositional cartilage allografts in patients with temporomandibular joint (TMJ) arthrosis. STUDY DESIGN This retrospective study included patients treated consecutively between 2007 and 2013 using discectomy and interpositional grafting with lyophilized costal cartilage allograft (Tutoplast) sheets. TMJ pain based on the visual analogue scale (VAS), maximal interincisal opening (MIO), joint tenderness to palpation, crepitus from the affected joint, and postoperative complications were assessed. RESULTS Arthroplasty was performed on 37 joints among 34 patients (28 women; mean age: 54 years); 24 joints underwent simultaneous condyle shaving. At final follow-up (3 [n = 37] or 5 [n = 21] years), we observed reduced mean VAS (from 7.6 to 0.9; P < .001) increased mean MIO (from 32.5 to 41.1 mm; P < .001), number of joints with capsule tenderness (from 30 to 3; P < .001), and percentage of joints with crepitus (from 97% to 75%; P = .008). One joint required reoperation because of interposed cartilage fragmentation. No permanent facial nerve injury or malocclusion occurred after treatment. CONCLUSIONS Interpositional arthroplasty is a relatively simple, moderately invasive, and effective surgical treatment for TMJ arthrosis with few complications. However, long-term outcomes of this treatment, specifically beyond 3-5 years postoperatively, remain unknown.
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Affiliation(s)
- Van Son Nguyen
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
| | - Thomas Kofod
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Even Nisja
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Mandana Hosseini
- Section of Oral Rehabilitation, Department of Odontology, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Nils Worsaae
- Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Jin X, Chi W. Clinical effect of digitalized designed and 3D-printed repositioning splints in the treatment of anterior displacement of temporomandibular joint disc. BMC Musculoskelet Disord 2024; 25:348. [PMID: 38702659 PMCID: PMC11067177 DOI: 10.1186/s12891-024-07477-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 04/26/2024] [Indexed: 05/06/2024] Open
Abstract
OBJECTIVE To compare the treatment effectiveness of digitized and 3D-printed repositioning splints with that of conventional repositioning splints in the treatment of anterior displacement of the temporomandibular joint disc. METHODS This retrospective study included 96 patients with disc displacement of the anterior temporomandibular joint. They were treated with either digitally designed and 3D-printed repositioning splints or traditional splints and followed up for at least six months. Changes in signs and symptoms such as pain and mouth opening before and after treatment were recorded to evaluate treatment outcomes. RESULTS During the first month of treatment, both the digitally designed and 3D-printed repositioning splint groups (Group B) and the traditional repositioning splint group (Group A) showed significant increases in mouth opening, with increases of 4.93 ± 3.06 mm and 4.07 ± 4.69 mm, respectively, and there was no significant difference between the two groups. Both groups had a significant reduction in visual analog scale (VAS) pain scores, with Group B showing a greater reduction of 1.946 ± 1.113 compared to 1.488 ± 0.978 in Group A (P < 0.05). By the sixth month, Group B's mouth opening further improved to 38.65 ± 3.22 mm (P < 0.05), while Group A's mouth opening did not significantly improve. Regarding pain, Group A's VAS score decreased by 0.463 ± 0.778 after one month, and Group B's score decreased by 0.455 ± 0.715; both groups showed significant reductions, but there was no significant difference between the two groups. CONCLUSION Compared with traditional repositioning splints, digitally designed and 3D-printed repositioning splints are more effective at reducing patient pain and improving mouth opening. 3D-printed repositioning splints are an effective treatment method for temporomandibular joint disc displacement and have significant potential for widespread clinical application.
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Affiliation(s)
- Xiao Jin
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China
| | - Wang Chi
- Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, 325000, China.
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Xie Q, Li P, Yang C, Chen M, Li H, Bai G, Ma Z, Shen P, Liu Z. Feasibility of simultaneous TMJ arthroscopy in ADDwoR patients undergoing orthognathic surgery for jaw deformity. J Craniomaxillofac Surg 2024; 52:347-354. [PMID: 38368209 DOI: 10.1016/j.jcms.2024.01.019] [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: 11/29/2022] [Revised: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 02/19/2024] Open
Abstract
This study evaluated the feasibility of simultaneous temporomandibular joint (TMJ) arthroscopy and orthognathic surgery as a new treatment strategy for anterior disc displacement without reduction (ADDwoR) patients with severe jaw deformities. Twelve ADDwoR patients with facial deformities who underwent arthroscopy and orthognathic surgery between September 2015 and December 2019 were retrospectively evaluated. Pre- and postoperative maximum incisal opening (MIO) and joint pain were recorded. Computed tomography (CT) and three-dimensional cephalometric analysis were performed at 3 (T1) and ≥6 (T2) months postoperatively. Magnetic resonance imaging (MRI) of the TMJ was performed before, ≤7 days after and ≥6 months after surgery. The lateral profile radiological findings, the symmetry of the maxilla and mandible, and the MRI measurements were compared. Anterior disc displacement did not recur, and the maximum incisal opening (MIO) increased from 27.4 mm to 32.7 mm after surgery (p < 0.05). No significant differences were found in the lateral profile, symmetry indices or condylar height via MRI between T1 and T2. Joint morphology and the position of both the maxilla and mandible remained stable during postoperative follow-up, while joint symptoms were markedly relieved and facial appearance was noticeably improved. Combined arthroscopy and orthognathic surgery is effective and recommended for ADDwoR patients with jaw deformities.
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Affiliation(s)
- Qianyang Xie
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Peilun Li
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Chi Yang
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China.
| | - Minjie Chen
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China.
| | - Hui Li
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China.
| | - Guo Bai
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Zhigui Ma
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Pei Shen
- Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, No. 639, Zhizaoju Rd., Shanghai, 200011, China
| | - Zhiyang Liu
- Shanghai Xuhui District Dental Center, Shanghai, 200032, China
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Zhang D, Abdelrehem A, Luo Y, Shen P, Yang C. Effect of arthroscopic discopexy on condylar growth in adolescents with temporomandibular joint disc displacement without reduction: A retrospective self-controlled case series study. J Craniomaxillofac Surg 2024; 52:157-164. [PMID: 37925338 DOI: 10.1016/j.jcms.2023.06.009] [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: 06/30/2022] [Revised: 05/06/2023] [Accepted: 06/25/2023] [Indexed: 11/06/2023] Open
Abstract
This study was a retrospective self-controlled study that aimed to evaluate the effect of arthroscopic discopexy on condylar height and mandibular position in adolescents with temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDwoR). Patients between 10 and 20 years of age and diagnosed with bilateral TMJ ADDwoR by magnetic resonance image (MRI) were included in this study. All patients underwent a period of natural course before arthroscopic surgery and then a follow-up period postoperatively. Changes in condylar height and mandibular position were measured by MRI and X-ray radiographs. Data were analyzed by paired t-test, Pearson correlation analysis, and generalized estimating equations. This study comprised a total of 40 patients with a mean age of 14.80 years. Pearson correlation analysis showed correlations between condylar height and mandibular position changes. The condylar height change during the post-operative period was significantly higher than that during natural course period (3.57 mm, p < 0.001). The changes in mandibular position (including ANB angle, SNB angle, and Pog-Np) were significant different (all p < 0.05) between the two periods. This study found that arthroscopic discopexy can promote condylar growth and correct dentofacial deformity in adolescents with bilateral TMJ ADDwoR.
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Affiliation(s)
- Dahe Zhang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, No. 639, Zhi Zao Ju Road, Shanghai, 200011, Shanghai, China
| | - Ahmed Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Alexandria University, Alexandria, 21563, Egypt
| | - Yi Luo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, No. 639, Zhi Zao Ju Road, Shanghai, 200011, Shanghai, China
| | - Pei Shen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, No. 639, Zhi Zao Ju Road, Shanghai, 200011, Shanghai, China.
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, No. 639, Zhi Zao Ju Road, Shanghai, 200011, Shanghai, China.
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Lu C, Zhao J, Zhang X, Fan X, Nie X, Yu C, Yang C, He D. Comparison of disc position stability and condylar bone remodeling between two open disc repositioning surgeries: a retrospective single-center cohort study. Int J Surg 2024; 110:01279778-990000000-01003. [PMID: 38241415 PMCID: PMC11020046 DOI: 10.1097/js9.0000000000001129] [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: 10/06/2023] [Accepted: 01/09/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND AND OBJECTIVE Open suturing (OSu) and Mini-screw Anchor (MsA) are two commonly used open disc repositioning surgeries for anterior disc displacement (ADD) of the temporomandibular joint (TMJ). This study assesses the differences in disc position stability (DPS) and condylar bone remodeling (CBR) between these two surgical procedures in a single center. METHODS A retrospective cohort study using magnetic resonance imaging (MRI) scans (preoperation, 1 week and 12 mo postoperation) of all patients who had open TMJ disc repositioning surgery from January 2016 to June 2021 at one center through two surgical techniques (OSu and MsA) was performed. The predictor variable was technique (OSu and MsA). Outcome variables were DPS and CBR. During follow-up, DPS was rated as good, acceptable and poor, and CBR was graded as improved, unchanged, and degenerated. Multivariate analysis was used to compare the DPS and CBR at 12 months after adjusting 5 factors including age, sex, Wilkes stage, preoperative bone status (normal, mild/moderate abnormal) and the degree of disc repositioning (normal, overcorrected, and posteriorly repositioned). Relative risk (RR) for DPS and CBR was calculated by multivariate logistic regression. RESULTS 385 patients with 583 joints were included in the study. MRIs at 12 months showed that 514 joints (93.5%) had good DPS, and 344 joints (62.5%) had improved CBR. Multivariate analysis revealed that OSu had higher DPS (RR=2.95; 95% confidence interval [CI], 1.27 to 6.85) and better CBR (RR=1.58; 95%CI, 1.02 to 2.46) than MsA. Among the factors affecting DPS, females had better results than males (RR=2.63; 95%CI, 1.11 to 6.26) and overcorrected or posteriorly repositioned discs were more stable than normally-repositioned discs (RR=5.84; 95%CI, 2.58 to 13.20). The improvement in CBR decreased with age increasing (RR=0.91; 95%CI, 0.89 to 0.93). Preoperative mild/moderate abnormal bone status had a higher probability of improved CBR compared to normal preoperative bone status (RR=2.60; 95%CI, 1.76 to 3.83). CONCLUSION OSu had better DPS and CBR than MsA. Sex and the degree of disc repositioning impacted DPS, while age and preoperative bone status affected CBR.
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Affiliation(s)
- Chuan Lu
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Jieyun Zhao
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Xiaoyu Zhang
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Xingda Fan
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Xin Nie
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine. Shanghai, China
| | - Chuangqi Yu
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Chi Yang
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
| | - Dongmei He
- Department of Oral Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology
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de Souza-Pinto GN, Herreira-Ferreira M, Grossmann E, Brasil DDM, Hara GF, Groppo FC, Iwaki LCV. Assessment of temporomandibular joint bone changes associated with anterior disc displacement: An MRI cross-sectional study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101657. [PMID: 37866505 DOI: 10.1016/j.jormas.2023.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/17/2023] [Accepted: 10/19/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE This cross-sectional study aimed to evaluate the presence of bone changes on magnetic resonance imaging (MRI) scans of patients with temporomandibular joint (TMJ) anterior disc displacement (ADD) with reduction (ADDWR) and without reduction (ADDWoR). METHODS TMJ-MRI scans were screened for the presence of ADD. 285 scans presented ADD, being further divided into ADDWR (n = 188) and ADDWoR (n = 97). Bone changes on the mandibular condyle and articular eminence were also assessed and computed. The chi-square test compared the association of these bone changes with the presence of ADDWR and ADDWoR, with a significance level of 5 %. Also, the prevalence ratio (PR) was calculated. RESULTS In the mandibular condyle, subchondral cyst (p = 0.035, PR = 1.08) and bone edema (p = 0.044, PR = 2.40), more prevalent on ADDWR, and generalized sclerosis (p = 0.015, PR = 1.04), more prevalent on ADDWoR, presented significant association with ADD. On the articular eminence, generalized sclerosis (p = 0.015, PR = 1.04) and articular surface flattening (p = 0.003, PR = 1.19) presented significant association with ADD, both more prevalent on ADDWoR. CONCLUSION Bone changes are usual findings in TMJ with ADD diagnosis. The real influence of ADD is not fully clear, although clinicians should be aware of patients with this condition, to provide an early diagnosis and improve patient´s prognosis.
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Affiliation(s)
| | - Matheus Herreira-Ferreira
- Department of Dentistry, State University of Maringá, Avenida Mandacaru, 1550 - 87080-000, Maringá, Brazil.
| | - Eduardo Grossmann
- Dentistry Faculty, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2492- 90035-004, Porto Alegre, Brazil.
| | - Danieli de Moura Brasil
- Piracicaba Dental School, State University of Campinas, Avenida Limeira, 901 - 13414-903, Piracicaba, Brazil.
| | - Giovana Felipe Hara
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil, Avenida Mandacaru, 1550 - 87080-000, Maringá, Brazil.
| | - Francisco Carlos Groppo
- Piracicaba Dental School, State University of Campinas, Avenida Limeira, 901 - 13414-903, Piracicaba, Brazil.
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Sahoo NK, Mowar A, Pandey S, Vashisht S, Vaswani H. Histopathological Interpretation of TMJ Osteophyte: Report and Review. J Maxillofac Oral Surg 2023; 22:1078-1082. [PMID: 38105841 PMCID: PMC10719170 DOI: 10.1007/s12663-023-01938-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/13/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Osteophytes are osseocartilaginous structures which are commonly found in common degenerative joint diseases. It can be free or attached to nature. There is a paucity of information in the literature regarding the histopathological interpretation of osteophytes in Temporomandibular Joint (TMJ). Purpose To report the incidental finding of osteophytes in cases of chronic protracted TMJ dislocation. Material and Method To present case of an elderly 72-year-old female and a 35-year-old male with chronic protracted TMJ dislocation who were treated surgically for their condition with an incidental finding of an osteophyte in TMJ intraoperatively. Result The histopathological examination revealed fibrocartilaginous core tissue surrounded by bone formation due to dystrophic calcification. Conclusion The microscopic examination is mandatory in order to study and understand the pathophysiology of an osteophyte. This study presents rare histopathological evidence of an osteophyte. It reflects the process of its formation and the possibilities of fate of an osteophyte in TMJ.
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Affiliation(s)
- N. K. Sahoo
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
| | - Apoorva Mowar
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
| | - Swati Pandey
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
| | - Sahil Vashisht
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
| | - Himani Vaswani
- Department of OMFS, Subharati Dental College and Hospital, Meerut, 250005 India
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Zhou J, Ren R, Li Z, Zhu S, Jiang N. Temporomandibular joint osteoarthritis: A review of animal models induced by surgical interventions. Oral Dis 2023; 29:2521-2528. [PMID: 35615772 DOI: 10.1111/odi.14266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/14/2022] [Accepted: 05/10/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES The pathological mechanism of temporomandibular joint osteoarthritis (TMJOA) is still unclear. Animal models induced by surgical interventions are one of the most ideal tools to imitate human pathological conditions. This review aims to define the similarities and differences of different surgical animal models. METHODS Articles of TMJOA surgical animal models were collected including anterior disc displacement, disc perforation, and discectomy. We analyzed their experiments strategies based on comparing preoperative selection, intraoperative methodology, and postoperative manifestations. RESULTS No matter which surgical intervention is selected, abnormal stress forces the whole joint to remodel its structure so that it could adapt to functional requirements, resulting in TMJOA eventually. However, anterior disc displacement needs more than 16 weeks to obtain typical manifestations, where the methodology is complicated. The course of perforation and discectomy is around 12-16 weeks, but they could cause excessive damage to the TMJ structure. CONCLUSIONS All surgical interventions can cause TMJOA, but the extent of pathology varies from each other. This review will assist future experiments to better understand the pathogenesis of TMJOA and choose the most appropriate model.
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Affiliation(s)
- Jiahao Zhou
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Rong Ren
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhen Li
- AO Research Institute Davos, Davos, Switzerland
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Nan Jiang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Disease and West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Wang Q, Jia J, Zhou C, Ye W, Bi R. A Bibliometric Analysis of Research on Temporomandibular Joint Disc Displacement from 1992 to 2022. Healthcare (Basel) 2023; 11:2108. [PMID: 37510548 PMCID: PMC10379638 DOI: 10.3390/healthcare11142108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/04/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
The temporomandibular joint (TMJ) disc displacement is the most common temporomandibular disorders (TMD) condition. It causes clicking, pain, limited mandibular movements, and even masticatory difficulties in many people. The aim of this study is showcasing hotspots and frontiers in the field and providing a reference for the future research by a bibliometric analysis. Studies published from 1992 to 2022 were retrieved from Web of Science Core Collection on 23 April 2023. A total of 1882 studies (1739 articles and 143 reviews) were included in the bibliometric analysis. From 1992 to 2022, the annual number of publications and citations greatly increased. The United States of America (USA) contributed the most publications about TMJ disc displacement. Shanghai Jiao Tong University was the most productive institution; meanwhile, Yang, C. from this institution was the most prolific author. The University of Washington was the most influential institution, and Brooks, S. was the most influential author. Diagnostic criteria and management of TMJ disc displacement, as well as TMJ disc displacement-associated conditions, might be a hotspot for current global research. We provided an objective and valuable reference for future research on TMJ disc displacement.
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Affiliation(s)
- Qiuhao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jin Jia
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Changhan Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wang Ye
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Dias GM, Grossmann E, Carvalho ACP, Devito KL, Dos Santos MF, Ferreira LA. MRI changes and clinical characteristics in temporomandibular joints with displacement of the articular disk without reduction - a cross-sectional observational study. Cranio 2023:1-10. [PMID: 37097122 DOI: 10.1080/08869634.2023.2203039] [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: 04/26/2023]
Abstract
OBJECTIVES This study examined changes in magnetic resonance imaging (MRI) of temporomandibular joints (TMJ) with anterior displacement disk without reduction (DDwoR) and its correlation to clinical symptoms. METHODS 190 individuals with DDwoR were evaluated according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and MRI. Pain's chronicity/intensity and limited mouth opening (locking) were correlated with: TMJ degeneration (MRI T1), effusion (T2), disc's shape and position (proton density). RESULTS In 103 TMJ with DDwoR, hemiconvex shape (41.6%), sclerosis (45.6%) and mild effusion (47.6%) were the most prevalent findings. There was not association (p > .05) between: different DDwoR positions with pain's intensity/chronicity; effusion with locking. Disk deformation was associated with degeneration (p = .034) and pain's intensity (p = .006). Locking was associated with degeneration (p = .05). CONCLUSIONS Condylar osteodegeneration is often related to DDwoR. Locking by DDwoR is associated with severe levels of chronic pain and articular disk deformation.
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Affiliation(s)
- Glaucia Marques Dias
- Programa de pós-graduação em Medicina (Radiologia) [Graduate program in Medicine (Radiology)], Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Eduardo Grossmann
- Centro de Dor e Deformidade Orofacial (CENDDOR) [Orofacial Pain and Deformity Center], Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| | - Antonio Carlos Pires Carvalho
- Programa de pós-graduação em Medicina (Radiologia) [Graduate program in Medicine (Radiology)], Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Karina Lopes Devito
- Faculdade de Odontologia [School of Dentistry], Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Marcos Fabio Dos Santos
- Instituto de Ciências Biológicas (ICB) [Institute of Biological Sciences], Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Luciano Ambrosio Ferreira
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora [School of Medical and Health Sciences of Juiz de Fora] - Suprema (FCMS), Hospital Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brasil
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14
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Ananthan S, Pertes RA, Bender SD. Biomechanics and Derangements of the Temporomandibular Joint. Dent Clin North Am 2023; 67:243-257. [PMID: 36965929 DOI: 10.1016/j.cden.2022.11.004] [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: 02/04/2023]
Abstract
The human temporomandibular joint, is a ginglymo-arthrodial joint. The articular disk serves as a fibrous, viscoelastic structure that allows force distribution and smooth movement of the joint in its normal arrangement during mandibular movements. Most studies suggest that in the normal disk position the posterior band is located at the 12'o clock position within the glenoid fossa in the closed mouth posture. When the biomechanics of the joint is altered, the disk may be displaced creating an abnormal relationship between the disk, condyle, and the eminence that is often referred to as an internal derangement. This article reviews the various presentations of internal derangements.
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Affiliation(s)
- Sowmya Ananthan
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders & Orofacial Pain, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07101, USA.
| | - Richard A Pertes
- Department of Diagnostic Sciences, Center for Temporomandibular Disorders & Orofacial Pain, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07101, USA
| | - Steven D Bender
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Texas A & M Health, 3302 Gaston Avenue, Dallas, TX 75246, USA
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15
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Fang X, Xiong X, Lin J, Wu Y, Xiang J, Wang J. Machine-learning-based detection of degenerative temporomandibular joint diseases using lateral cephalograms. Am J Orthod Dentofacial Orthop 2023; 163:260-271.e5. [PMID: 36710061 DOI: 10.1016/j.ajodo.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 10/09/2022] [Accepted: 10/17/2022] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Degenerative temporomandibular joint diseases (DJDs) are common diseases in dental practice, characterized by a series of degenerative processes in the temporomandibular joint. Early clinical detection of DJD by dental practitioners can be beneficial to prevent or alleviate the further progression of the disease. This study aimed to develop a cephalogram-based multidimensional nomogram to screen DJD. METHODS A total of 502 patients (170 normal and 332 with DJD) were randomly assigned to a training set (n = 351) or a validation set (n = 151). Thirty-six cephalometric parameters were extracted from the cephalograms to be used as input for a predictive machine-learning algorithm. Multivariable logistic regression was used to construct a combined model for visualization in the form of a nomogram. Receiver operating characteristic curve, calibration testing, and decision curve analyses were conducted to evaluate the performance of the combined model. RESULTS A Ceph score consisting of 22 cephalometric parameters were significantly associated with DJD (P <0.01). A combined model that consisted of Ceph scores and clinical features (including age, gender, limited mouth opening, crepitus, etc.) performed well in the receiver operating characteristic curve (area under the curve, 0.893), calibration test, and decision curve analyses, indicating its potential clinical value. CONCLUSIONS This study constructed and verified a multidimensional nomogram consisting of Ceph scores and clinical features, which may contribute to the clinical screening of DJD in dental practice. Future studies are needed to test the reliability of the model with similar parameters.
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Affiliation(s)
- Xinyi Fang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Orthodontics, Hospital of Stomatology, Key Laboratory of Oral Biomedical Research of Zhejiang Province, School of Stomatology, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xin Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jiu Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yange Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jie Xiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jun Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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Clinical and magnetic resonance imaging findings in patients with and without improvement after mandibular manipulation and conservative physical therapy for temporomandibular joint disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:294-302. [PMID: 36307302 DOI: 10.1016/j.oooo.2022.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/26/2022] [Accepted: 09/05/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study compared clinical and magnetic resonance imaging (MRI) findings in patients with anterior disk displacement without reduction (ADDWOR) who improved to anterior disk displacement with reduction (ADDWR) vs. patients who did not improve after mandibular manipulation (MM) and conservative self-administered physical therapy (CSAPT). STUDY DESIGN Of 15 patients diagnosed with ADDWOR by MRI, 7 improved to ADDWR (WOR-WR) and 8 did not improve (WOR-WOR). The clinical and MRI findings before and after therapy were compared in each group. RESULTS Significant differences between the groups included age, period of awareness of trismus, and maximum mouth opening (MMO). The MRI findings revealed significant differences in the degree of ADD and morphology of the disk and condyle. MMO significantly improved in the WOR-WR group between initial and follow-up visits. CONCLUSION Patients who were successfully treated with MM and CSAPT tended to be <30 years old, with a longer period of awareness of trismus, MMO <40 mm, a slight or moderate degree of ADD, no deformity of the disk, and no morphologic change in the condyle. Patients with ADDWOR who are treated with MM and CSAPT require an accurate clinical examination and MRI before treatment.
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Sun CK, Li YB, Ma HS, Li G, Sun ZP, Sun LS. Natural course of severe temporomandibular joint osteoarthrosis evaluated by a novel condylar remodelling scoring system and quantitative volumetric analysis. Int J Oral Maxillofac Surg 2023; 52:227-236. [PMID: 35970695 DOI: 10.1016/j.ijom.2022.08.001] [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: 12/22/2021] [Revised: 07/30/2022] [Accepted: 08/02/2022] [Indexed: 01/11/2023]
Abstract
Temporomandibular joint osteoarthrosis (TMJ-OA) frequently causes mild, moderate, or severe condylar morphological changes. A novel condylar remodelling scoring system (CRSS) based on three-dimensional cone beam computed tomography images is proposed, which is used to grade condylar morphological changes. In the CRSS, the condyle is divided into 10 regions by 11 reference points. For each increase in the number of regions involved in TMJ-OA, one point is subtracted from the full score of 10. The intra-class correlation coefficients for intra- and inter-observer agreement (range 0.656-0.898 and 0.841-0.906, respectively) indicated that the CRSS had good reliability. Cephalometric analysis showed that the condyles with severe morphological changes were prone to present with a retrognathic and clockwise rotating mandible, shorter ramus height, reduced mandibular length, larger mandibular angle, and maxillary retrusion. Qualitative CRSS evaluation and quantitative volumetric analysis were performed to evaluate the stability of severe TMJ-OA in its natural course (343 condyles). The continuous cortex group showed no remarkable changes with an average follow-up of 2 years. In the discontinuous cortex group, most (74.4%) converted into a continuous cortex during follow-up (mean 2 years).
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Affiliation(s)
- C-K Sun
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - Y-B Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - H-S Ma
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - G Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - Z-P Sun
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Haidian District, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China.
| | - L-S Sun
- National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Haidian District, Beijing, PR China; Key Laboratory of Oral Pathology, School and Hospital of Stomatology, Peking University, Haidian District, Beijing, PR China.
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Association between an Increased Serum CCL5 Level and Pathophysiology of Degenerative Joint Disease in the Temporomandibular Joint in Females. Int J Mol Sci 2023; 24:ijms24032775. [PMID: 36769097 PMCID: PMC9917489 DOI: 10.3390/ijms24032775] [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: 01/06/2023] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
Degenerative joint disease of the temporomandibular joints (DJD-TMJ) clinically manifests with symptoms such as orofacial pain, joint sounds and limited jaw movements. Our research group previously reported the functional necessity of a chemokine-chemokine receptor axis of CCL5-CCR5 in osteoclasts. Accumulated studies reported that this axis was involved in the pathogenesis of bone and joint destructive diseases, suggesting CCL5 as a potent biomarker. This study investigated whether or not the serum level of CCL5 can be a biomarker of DJD-TMJ and concomitantly analyzed changes in the serum and urine levels of bone markers to see whether or not changes in the rate of bone metabolism were predisposing. We enrolled 17 female subjects with diagnosed DJD-TMJ and sexually and age-matched 17 controls. The serum CCL5 level in DJD-TMJ subjects was significantly higher than that in the control subjects. Multivariate analyses indicated an association between an augmented CCL5 level and the rate of bone metabolism, especially in relatively young DJD-TMJ subjects without other systemic symptoms. A principal component analysis of serum markers and our pharmacological experiment using a postmenopausal model of ovariectomized rats suggested that an augmented serum CCL5 level specifically reflected DJD-TMJ and that covert changes in the rate of bone metabolism predisposed individuals to DJD-TMJ.
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Introducing a novice-friendly classification system for magnetic resonance imaging of the temporomandibular joint disc morphology. Oral Radiol 2023; 39:143-152. [PMID: 35524903 DOI: 10.1007/s11282-022-00615-0] [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: 02/18/2022] [Accepted: 04/12/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To introduce a new classification, aiming to correspond TMJ disc configuration with diagnosis, meanwhile reduce difficulty and subjectivity in TMJ MRI evaluation and training of TMD diagnosis for dental students. METHODS 90 patients sought for TMD treatment were enrolled in the study, whose MRIs were used to establish the new classification. A total of 180 discs were evaluated using MRI for position (normal, DDWR or DDWoR) and classified by morphology according to previous (Murakami's classification) and new classification respectively. 60 discs were selected and judged by two groups (2 TMJ specialists and 30 dental students) to assess the reliability and validity of the new classification. Questionnaires were acquired for all observers to assess the attitude toward two classification systems. Descriptive statistics, Spearman's rank correlation coefficient, and intraclass correlation coefficient were performed. P < 0.05 was considered statistically significant. RESULTS In the new classification, Class 1 disc was significantly correlated with DDWR and Class 3 disc was significantly correlated with DDWoR. Interobserver reliability/consistency for observers between TMJ specialists was 0.867 when Murakami's classification was applied and 0.948 when the new classification was applied. Interobserver ICC value for dental students was 0.656 when using Murakami's classification, and 0.831 when using the new classification. The difference in attitude toward different classification systems was statistically significant. CONCLUSION A new classification of TMJ disc configuration is presented. The correlation between disc morphology and position revealed helps diagnosis and management. The new classification improves TMJ MRI interpreting accuracy and provides a better learning and using experience.
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Muacevic A, Adler JR, El Asmar EA, Abi Chahine NH. Degenerative Disorder of the Temporomandibular Joint Treated With Autologous Bone Marrow-Derived Stem Cells Using the Regentime Technique: A Case Report. Cureus 2023; 15:e34092. [PMID: 36843829 PMCID: PMC9946899 DOI: 10.7759/cureus.34092] [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] [Accepted: 01/23/2023] [Indexed: 01/24/2023] Open
Abstract
Temporomandibular joint (TMJ) disease is a type of degenerative musculoskeletal disorder that leads to morphological and functional abnormalities. It has a poorly understood progression with numerous independent and interrelated factors, which makes it difficult for the available treatment options to meet long-term demands. We present the case of a 37-year-old woman who suffered from excruciating pain in the right temporomandibular joint, associated with limited mandibular movement. She was found to have imaging features of TMJ disorder. She underwent the Regentime procedure which uses autologous bone marrow-derived stem cells that are partially differentiated and redirected to the targeted tissue. Clinical follow-up showed total clinical recovery.
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Zhang Q, Ye Z, Wu Y, Zhu Y, Liu J, Yang W, Ye C, Lau Rui Han S, Wang J, Xiong X. Nonlinear Relationship between Temporomandibular Joint Disc Displacement Distance and Disc Length: A Magnetic Resonance Imaging Analysis. J Clin Med 2022; 11:jcm11237160. [PMID: 36498733 PMCID: PMC9741082 DOI: 10.3390/jcm11237160] [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: 11/03/2022] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/04/2022] Open
Abstract
Objective: to explore the association between the distance of disc displacement and disc morphology in patients with temporomandibular disorders (TMDs). Methods: a total of 717 joints in 473 subjects were enrolled in this cross-sectional study. The magnetic resonance imaging (MRI) of each patient was evaluated for temporomandibular joint (TMJ) disc morphology classification and position. The distance of the disc displacement and disc length were measured for smoothing spline prediction. A stratified analysis was performed based on the types of disc positions. The disc width and length-width ratio (L/W) were also measured. Descriptive statistics, one-way analysis of variance, smoothing spline analysis, threshold analysis, and two piecewise linear regression were performed to investigate the association between the displacement distance and length of discs. Results: the differences in displacement distance among morphological categories and among different disc positions were statistically significant. Nonlinear relationships were found between distance and length in all subjects. Two turning points of distance (−1.8 mm and 1.7 mm) were found, dividing the curve into three segments. Disc width and L/W were significantly different among discs in the three segments of the curve. The correlation coefficient (β) for the three segments were as follows: −0.6 [95% confidence interval (CI) = −0.9 to −0.3, p < 0.001], 0.0 (95% CI = −0.1 to 0.0, p = 0.027), and −0.7 (95% CI = −0.8 to −0.7, p < 0.001). Nonlinear relationships were also found between the distance and length in cases with anterior disc displacement (ADD), anterior disc displacement with reduction (ADDWR), and without reduction (ADDWoR). Conclusion: the turning points of the disc displacement distance may be considered as a potential reference value for high-risk disc deformation and ADD. Disc length decreases sharply with anterior disc displacement when the disc displacement distance is over 1.7 mm. Prospective and long-term studies are required to clarify the natural course of the disc at different stages of the regression curve.
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Affiliation(s)
- Qinlanhui Zhang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Ye
- Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Yange Wu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yufan Zhu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jiaqi Liu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wenke Yang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chengxinyue Ye
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Sophie Lau Rui Han
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jun Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (J.W.); (X.X.); Tel.: +86-28-85501425 (J.W.); +86-28-85503898 (X.X.)
| | - Xin Xiong
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, Department of Temporomandibular Joint, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (J.W.); (X.X.); Tel.: +86-28-85501425 (J.W.); +86-28-85503898 (X.X.)
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Feng SY, Lei J, Li YX, Shi WG, Wang RR, Yap AU, Wang YX, Fu KY. Increased joint loading induces subchondral bone loss of the temporomandibular joint via the RANTES-CCRs-Akt2 axis. JCI Insight 2022; 7:158874. [PMID: 36173680 PMCID: PMC9675482 DOI: 10.1172/jci.insight.158874] [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: 03/15/2022] [Accepted: 09/21/2022] [Indexed: 12/15/2022] Open
Abstract
Early-stage temporomandibular joint osteoarthritis (TMJOA) is characterized by excessive subchondral bone loss. Emerging evidence suggests that TMJ disc displacement is involved, but the pathogenic mechanism remains unclear. Here, we established a rat model of TMJOA that simulated disc displacement with a capacitance-based force-sensing system to directly measure articular surface pressure in vivo. Micro-CT, histological staining, immunofluorescence staining, IHC staining, and Western blot were used to assess pathological changes and underlying mechanisms of TMJOA in the rat model in vivo as well as in RAW264.7 cells in vitro. We found that disc displacement led to significantly higher pressure on the articular surface, which caused rapid subchondral bone loss via activation of the RANTES-chemokine receptors-Akt2 (RANTES-CCRs-Akt2) axis. Inhibition of RANTES or Akt2 attenuated subchondral bone loss and resulted in improved subchondral bone microstructure. Cytological studies substantiated that RANTES regulated osteoclast formation by binding to its receptor CCRs and activating the Akt2 pathway. The clinical evidence further supported that RANTES was a potential biomarker for predicting subchondral bone loss in early-stage TMJOA. Taken together, this study demonstrates important functions of the RANTES-CCRs-Akt2 axis in the regulation of subchondral bone remodeling and provides further knowledge of how disc displacement causes TMJOA.
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Affiliation(s)
- Shi-Yang Feng
- Center for Temporomandibular Disorders & Orofacial Pain, and,Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China.,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Jie Lei
- Center for Temporomandibular Disorders & Orofacial Pain, and,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Yu-Xiang Li
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China.,Center of Materials Science and Optoelectronics Engineering, University of Chinese Academy of Sciences, Beijing, China
| | - Wen-Ge Shi
- Center for Temporomandibular Disorders & Orofacial Pain, and,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Ran-Ran Wang
- State Key Laboratory of High Performance Ceramics and Superfine Microstructure, Shanghai Institute of Ceramics, Chinese Academy of Sciences, Shanghai, China.,School of Chemistry and Materials Science, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, China
| | - Adrian Ujin Yap
- Center for Temporomandibular Disorders & Orofacial Pain, and,Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore, Singapore.,National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore, Singapore
| | - Yi-Xiang Wang
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China.,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Kai-Yuan Fu
- Center for Temporomandibular Disorders & Orofacial Pain, and,National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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23
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Evaluation of the lateral pterygoid muscle area, attachment type, signal intensity and presence of arthrosis, effusion in the TMJ according to the position of the articular disc. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 123:e973-e980. [PMID: 35472484 DOI: 10.1016/j.jormas.2022.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/05/2022] [Accepted: 04/21/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of this study was to evaluate the lateral pterygoid muscle (LPM) area, attachment type, signal intensity and presence of arthrosis, effusion in the temporomandibular joint (TMJ) by magnetic resonance imaging (MRI) according to the position of the articular disc. METHODS The study included a total of 126 TMJs belonging to 69 patients over the age of 18 years who had MRI due to TMJ complaints. The position of the articular disc, the area, attachment type, and signal intensity of the LPM, the presence of arthrosis on the condyle surface, and the presence of effusion in the joint space were evaluated. RESULTS The attachment type of the LPM did not show a statistically significant difference according to the position of the articular disc. The groups were not statistically different in terms of LPM intensity. Although the distribution of the LPM area was found to be low in the anterior disc displacement with reduction (R+DD) group and high in the anterior disc displacement without reduction (R-DD) group. It was determined that the rate of arthrosis at the condyle head was significantly higher in the R-DD group compared to the normal disc position group. The incidence of effusion was found significantly higher in the R-DD and R+DD groups than joints with normal disc position. CONCLUSIONS Pathological changes in LPM and TMJ can be detected by MRI. In the group with R-DD, the rate of arthrosis at the condyle head, effusion, LPM area, and intensity of the Sup. LPM were higher.
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Takaoka R, Koishi Y, Kuyama K, Ueda Y, Ishigaki S, Uchiyama Y, Shimamoto H, Nakatani A, Yatani H. Cross-sectional and longitudinal assessment of subchondral cysts in temporomandibular joints: Clinical and MRI study with a mean follow-up of 66 months. J Prosthodont Res 2022:JPR_D_22_00089. [PMID: 36288977 DOI: 10.2186/jpr.jpr_d_22_00089] [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: 06/16/2023]
Abstract
PURPOSE This observational study aimed to elucidate the pathophysiology of subchondral cysts (SC) in the temporomandibular joint (TMJ) and examine the results of conservative therapy administered to patients with SCs in the TMJ. METHODS The study included 41 patients with SCs, extracted from 684 consecutive patients who underwent magnetic resonance imaging (MRI). The anatomical features of SCs and positional abnormalities of the articular disc were initially evaluated using MRI. A second MRI examination was performed for 28/41 patients at 40-107 months (mean, 66 months) after the first MRI. The joint space, anteroposterior width of the condylar head (WiC), articular eminence angle (AEA), and visual analog scale of jaw pain (VAS) were assessed alongside the MRI examinations. RESULTS Most SCs were present in the anterosuperior and central condyle. Disc displacement was observed in 100% of 42 TMJs with SCs. Of the 29 joints in 28 patients, SCs in 19 joints resolved with time, whereas SCs in 10 joints persisted. A significant increase in the WiC and a significant decrease in AEA and VAS scores were observed on the second MRI scan. CONCLUSIONS SCs tended to form in the anterosuperior and central parts of the condyle, where mechanical loading was likely to be applied. SCs are strongly associated with articular disc displacement. Two-thirds of SCs resolved over time, accompanied by resorption and osteophytic deformation of the condyle. SC might not be an indicator for the start of surgical treatment, and nonsurgical treatment could improve the clinical symptoms of patients with SCs.
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Affiliation(s)
- Ryota Takaoka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yukiko Koishi
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kotaro Kuyama
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - You Ueda
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Shoichi Ishigaki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Yuka Uchiyama
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Hiroaki Shimamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Atsutoshi Nakatani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka, Japan
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Advantages of deep learning with convolutional neural network in detecting disc displacement of the temporomandibular joint in magnetic resonance imaging. Sci Rep 2022; 12:11352. [PMID: 35790841 PMCID: PMC9256683 DOI: 10.1038/s41598-022-15231-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/21/2022] [Indexed: 11/24/2022] Open
Abstract
This study investigated the usefulness of deep learning-based automatic detection of anterior disc displacement (ADD) from magnetic resonance imaging (MRI) of patients with temporomandibular joint disorder (TMD). Sagittal MRI images of 2520 TMJs were collected from 861 men and 399 women (average age 37.33 ± 18.83 years). A deep learning algorithm with a convolutional neural network was developed. Data augmentation and the Adam optimizer were applied to reduce the risk of overfitting the deep-learning model. The prediction performances were compared between the models and human experts based on areas under the curve (AUCs). The fine-tuning model showed excellent prediction performance (AUC = 0.8775) and acceptable accuracy (approximately 77%). Comparing the AUC values of the from-scratch (0.8269) and freeze models (0.5858) showed lower performances of the other models compared to the fine-tuning model. In Grad-CAM visualizations, the fine-tuning scheme focused more on the TMJ disc when judging ADD, and the sparsity was higher than that of the from-scratch scheme (84.69% vs. 55.61%, p < 0.05). The three fine-tuned ensemble models using different data augmentation techniques showed a prediction accuracy of 83%. Moreover, the AUC values of ADD were higher when patients with TMD were divided by age (0.8549–0.9275) and sex (male: 0.8483, female: 0.9276). While the accuracy of the ensemble model was higher than that of human experts, the difference was not significant (p = 0.1987–0.0671). Learning from pre-trained weights allowed the fine-tuning model to outperform the from-scratch model. Another benefit of the fine-tuning model for diagnosing ADD of TMJ in Grad-CAM analysis was the deactivation of unwanted gradient values to provide clearer visualizations compared to the from-scratch model. The Grad-CAM visualizations also agreed with the model learned through important features in the joint disc area. The accuracy was further improved by an ensemble of three fine-tuning models using diversified data. The main benefits of this model were the higher specificity compared to human experts, which may be useful for preventing true negative cases, and the maintenance of its prediction accuracy across sexes and ages, suggesting a generalized prediction.
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Chang MS, Choi JH, Yang IH, An JS, Heo MS, Ahn SJ. Association between Condylar Bone Density and Disk Displacement in the Temporomandibular Joint. J Clin Densitom 2022; 25:215-222. [PMID: 34391639 DOI: 10.1016/j.jocd.2021.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/22/2022]
Abstract
Measuring bone density (BD) is a common method of determining bone quality; however, the relationship between condylar BD and the occurrence of temporomandibular joint (TMJ) disorders has not been investigated. To address this knowledge gap, we aimed to investigate condylar BD in terms of TMJ disk displacement (TMJ DD) using computed tomography (CT) and magnetic resonance imaging (MRI). We classified TMJ MRI results according to the position of the disk: normal disk position (Normal), anterior disk displacement with reduction (ADDR), and anterior disk displacement without reduction (ADDNR). After retrospectively evaluating 86 female condyles, we determined the total, cortical, and trabecular BD in the upper-joint portion of the condyle and the whole condyle using CT data. To standardize condylar BD, we calculated the BD ratios by dividing the condylar BD by the cervical axis BD. The Kruskal-Wallis test analyzed the differences in BD measurements in the TMJ DD patient groups and showed significant between-group differences in condylar BD. The total and trabecular BD was significantly higher in ADDNR condyles than in Normal or ADDR condyles (Normal = ADDR < ADDNR). However, there was no significant difference in the cortical BD among the three TMJ DD groups. The BD ratios showed a similar tendency with condylar BD. These results suggest that increased condylar BD - specifically total and trabecular BD - may be significantly associated with ADDNR condyles. Our findings will help clinicians determine the course of treatment for patients with disk-related TMJ disorders.
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Affiliation(s)
- Min-Seok Chang
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jeong-Ho Choi
- Department of Orthodontics, Seoul National University Dental Hospital, Seoul, Korea
| | - Il-Hyung Yang
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jung-Sub An
- Department of Orthodontics, Seoul National University Dental Hospital, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sug-Joon Ahn
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
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Ferreira NDR, Sanz CK, Raybolt A, Pereira CM, DosSantos MF. Action of Hyaluronic Acid as a Damage-Associated Molecular Pattern Molecule and Its Function on the Treatment of Temporomandibular Disorders. FRONTIERS IN PAIN RESEARCH 2022; 3:852249. [PMID: 35369538 PMCID: PMC8971669 DOI: 10.3389/fpain.2022.852249] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
The temporomandibular joint is responsible for fundamental functions. However, mechanical overload or microtraumas can cause temporomandibular disorders (TMD). In addition to external factors, it is known that these conditions are involved in complex biological mechanisms, such as activation of the immune system, activation of the inflammatory process, and degradation of extracellular matrix (ECM) components. The ECM is a non-cellular three-dimensional macromolecular network; its most studied components is hyaluronic acid (HA). HA is naturally found in many tissues, and most of it has a high molecular weight. HA has attributed an essential role in the viscoelastic properties of the synovial fluid and other tissues. Additionally, it has been shown that HA molecules can contribute to other mechanisms in the processes of injury and healing. It has been speculated that the degradation product of high molecular weight HA in healthy tissues during injury, a low molecular weight HA, may act as damage-associated molecular patterns (DAMPs). DAMPs are multifunctional and structurally diverse molecules that play critical intracellular roles in the absence of injury or infection. However, after cellular damage or stress, these molecules promote the activation of the immune response. Fragments from the degradation of HA can also act as immune response activators. Low molecular weight HA would have the ability to act as a pro-inflammatory marker, promoting the activation and maturation of dendritic cells, the release of pro-inflammatory cytokines such as interleukin 1 beta (IL-1β), and tumor necrosis factor α (TNF-α). It also increases the expression of chemokines and cell proliferation. Many of the pro-inflammatory effects of low molecular weight HA are attributed to its interactions with the activation of toll-like receptors (TLRs 2 and 4). In contrast, the high molecular weight HA found in healthy tissues would act as an anti-inflammatory, inhibiting cell growth and differentiation, decreasing the production of inflammatory cytokines, and reducing phagocytosis by macrophages. These anti-inflammatory effects are mainly attributed to the interaction of high-weight HA with the CD44 receptor. In this study, we review the action of the HA as a DAMP and its functions on pain control, more specifically in orofacial origin (e.g., TMD).
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Affiliation(s)
- Natália dos Reis Ferreira
- Faculty of Medicine, Institute of Occlusion and Orofacial Pain, University of Coimbra, Coimbra, Portugal
| | - Carolina Kaminski Sanz
- Laboratório de Propriedades Mecânicas e Biologia Celular (PropBio), Departamento de Prótese e Materiais Dentários, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Programa de Engenharia Metalúrgica e de Materiais, COPPE, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Aline Raybolt
- Laboratório de Propriedades Mecânicas e Biologia Celular (PropBio), Departamento de Prótese e Materiais Dentários, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Cláudia Maria Pereira
- Laboratório de Propriedades Mecânicas e Biologia Celular (PropBio), Departamento de Prótese e Materiais Dentários, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcos Fabio DosSantos
- Laboratório de Propriedades Mecânicas e Biologia Celular (PropBio), Departamento de Prótese e Materiais Dentários, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Neurociência Translacional, Instituto Nacional de Neurociência Translacional (INNT-UFRJ), Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Odontologia (PPGO), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- *Correspondence: Marcos Fabio DosSantos ;
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Lin B, Cheng M, Wang S, Li F, Zhou Q. Automatic detection of anteriorly displaced temporomandibular joint discs on magnetic resonance images using a deep learning algorithm. Dentomaxillofac Radiol 2022; 51:20210341. [PMID: 34788124 PMCID: PMC8925876 DOI: 10.1259/dmfr.20210341] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES This study aimed to develop models that can automatically detect anterior disc displacement (ADD) of the temporomandibular joint (TMJ) on MRIs before orthodontic treatment to reduce the risk of developing serious complications after treatment. METHODS We used 9009 sagittal MRI of the TMJ as input and constructed three sets of deep learning models to detect ADD automatically. Deep learning models were developed using a convolutional neural network (CNN) based on the ResNet architecture and the "Imagenet" database. Five-fold cross-validation, oversampling, and data augmentation techniques were applied to reduce the risk of overfitting the model. The accuracy and area under the curve (AUC) of the three models were compared. RESULTS The performance of the maximum open mouth position model was excellent with accuracy and AUC of 0.970 (±0.007) and 0.990 (±0.005), respectively. For closed mouth position models, the accuracy and AUC of diagnostic Criteria 1 were 0.863 (±0.008) and 0.922 (±0.009), respectively significantly higher than that of diagnostic Criteria 2 with 0.839 (±0.013) (p = 0.009) and AUC of 0.885 (±0.018) (p = 0.003). The classification activation heat map also improved our understanding of the models and visually displayed the areas that play a key role in the model recognition process. CONCLUSION Our CNN model resulted in high accuracy and AUC in detecting ADD and can therefore potentially be used by clinicians to assess ADD before orthodontic treatment, and hence improve treatment outcomes.
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Affiliation(s)
- Bolun Lin
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, PR China
| | - Mosha Cheng
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, PR China
| | - Shuze Wang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, PR China
| | - Fulong Li
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, PR China
| | - Qing Zhou
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, PR China
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Lu C, Zhao J, Zhang C, Yu C, He D. Stability of the contralateral temporomandibular joint disk position after disk repositioning on one side. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:323-326. [PMID: 35428597 DOI: 10.1016/j.oooo.2022.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/15/2022] [Accepted: 02/24/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the stability of the contralateral temporomandibular joint disk position after disk repositioning on 1 side. STUDY DESIGN Patients with unilateral anterior disk displacement (ADD) treated by disk repositioning from 2015 to 2019 were included in the study. The contralateral disk status was classified as follows: normal, ADD with reduction (ADDwR), and medial/lateral displacement. At 1-year follow-up, changes in the contralateral disk position were evaluated by MRI. RESULTS Two hundred thirty-four patients were included in the study. There were 84 disks with normal position, 51 with ADDwR, and 99 with medial/lateral displacement (M/LD) in the contralateral joint. At 1-year follow-up, all the repositioned disks were stable without relapse. In the contralateral joints, 75% of the disks with normal position were unchanged compared with 43.1% of the ADDwR and 54.5% of the M/LD. ADDwR had the highest rate of changing to ADDwoR compared with the disks in normal position (4.8%) and M/LD (7.1%, χ2 = 16.13, P < .001). There were 28.3% of M/LD disks and 3.9% of ADDwR that changed to normal position. CONCLUSIONS After unilateral disk repositioning, most of the contralateral disks with normal position were stable. M/LD disks tended to move to normal position, whereas ADDwR was largely changed to ADDwoR.
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Affiliation(s)
- Chuan Lu
- Attending, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology. No. 639 Zhi Zao Ju Road, Huang Pu District, Shanghai, 200011, China
| | - Jieyun Zhao
- Resident and co-first author, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology. No. 639 Zhi Zao Ju Road, Huang Pu District, Shanghai, 200011, China
| | - Changbin Zhang
- Attending, Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital of Kunming Medical University, Kunming 650000, China
| | - Chuangqi Yu
- Professor, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology. No. 639 Zhi Zao Ju Road, Huang Pu District, Shanghai, 200011, China
| | - Dongmei He
- Professor, Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology; National Clinical Research Center of Stomatology. No. 639 Zhi Zao Ju Road, Huang Pu District, Shanghai, 200011, China.
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Involvement of an FTO gene polymorphism in the temporomandibular joint osteoarthritis. Clin Oral Investig 2021; 26:2965-2973. [PMID: 34812958 PMCID: PMC8898224 DOI: 10.1007/s00784-021-04278-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/01/2021] [Indexed: 11/05/2022]
Abstract
Objectives The FTO gene has been reported as an obesity-associated gene and is also considered a risk gene for osteoarthritis (OA). However, its exact function is unclear, and there is conflicting evidence on the involvement of FTO polymorphisms in OA via obesity. The purpose of this study was to determine the effects of FTO polymorphism rs8044769 alleles on OA in the temporomandibular joint (TMJ), which is minimally affected by body weight. Materials and methods A total of 324 TMJs (113 with OA and 211 without OA, serving as controls) from 162 Japanese patients with temporomandibular disorders and undergoing MRI examination were analyzed. Genotyping was conducted, and multivariate analysis was performed after adjusting for the effects of age, sex, body mass index, and TMJ disc abnormalities. Results Mean age, BMI, and sex did not differ between the TMJs with OA and the TMJs without OA, but a significant difference was found for positional and dynamic disc abnormalities (P < 0.05). The allele frequency of FTO polymorphisms also differed significantly between the TMJs with OA and the TMJs without OA (P = 0.011). Moreover, logistic regression analysis showed no significant association between BMI (P = 0.581) and the occurrence of TMJOA but also indicated that the CC allele of rs8044769 is a risk factor for TMJOA (P = 0.040). Conclusions Our results show that rs8044769 in the FTO gene might be involved in TMJOA. Clinical relevance The present study provides a basis for a deeper understanding of the mechanism underlying degenerative skeletal diseases and the more effective selection and development of treatment strategies based on the patients’ genetic characteristics. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04278-9.
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Freire DBDL, Celeste RK, Arús NA, Vizzotto MB, Silveira HLDD. [Dental imaging procedures in the Unified Health System and the expansion of secondary care: series between 2000-2016]. CIENCIA & SAUDE COLETIVA 2021; 26:4727-4736. [PMID: 34730658 DOI: 10.1590/1413-812320212610.15172020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 08/13/2020] [Indexed: 11/22/2022] Open
Abstract
The scope of this paper was to analyze the time series of dental procedures performed between 2000 and 2016 in the Brazilian Unified Health System (SUS). The data were obtained from the Outpatient Information System of the SUS (SIA-SUS). The influence of the 2004 National Oral Health Policy of Ordinance No. 600/2006 (which instituted the financing of Dental Specialty Centers - CEOs), and Ordinance No. 1,234/2013 (Financial incentive for the Program for Enhancement of Quality and Access - PMAQ-CEO) were analyzed. Descriptive analyses of the initial and final years of the time series were presented, assessing trends and seasonality in seven types of imaging procedures. The time series of rates of periapical/bitewing radiographic exams revealed a trend of moderate increase and was the only area in which the impact of the financial implementation policy of the CEOs was observed, though not of the PMAQ-CEO. Extraoral imaging exams, such as panoramic radiography, facial CT/TMJ and TMJ MRI revealed a strong upward trend, despite the very low rates. The conclusion reached is that between 2000 and 2016, the policy of expansion of secondary care increased the use of periapical/bitewing imaging exams.
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Affiliation(s)
- Danielle Bianca de Lima Freire
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santa Cecília. 90035-004 Porto Alegre RS Brasil.
| | - Roger Keller Celeste
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santa Cecília. 90035-004 Porto Alegre RS Brasil.
| | - Nádia Assein Arús
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santa Cecília. 90035-004 Porto Alegre RS Brasil.
| | - Mariana Boessio Vizzotto
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santa Cecília. 90035-004 Porto Alegre RS Brasil.
| | - Heraldo Luis Dias da Silveira
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santa Cecília. 90035-004 Porto Alegre RS Brasil.
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Condylar erosion is predictive of painful closed lock of the temporomandibular joint: a magnetic resonance imaging study. Head Face Med 2021; 17:40. [PMID: 34507596 PMCID: PMC8431861 DOI: 10.1186/s13005-021-00291-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 08/24/2021] [Indexed: 12/19/2022] Open
Abstract
Background To assess whether magnetic resonance imaging (MRI) findings of condylar erosion (CE) are predictive of a specific clinical diagnosis of painful closed lock of the temporomandibular joint (TMJ), and to determine the strength of association between CE and types of internal derangement (ID). Methods Based upon sample size estimation, this retrospective paired-design study involved 62 patients, aged between 18 and 67 years. Inclusion criteria were the presence of a unilateral clinical diagnosis of arthralgia coexisting with disk displacement without reduction (‘AR and DDwoR/wLO’), assigned according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I, and the absence of signs and symptoms of TMJ pain and dysfunction on the contralateral TMJ side. Bilateral sagittal and coronal MR images were obtained to establish the prevalence of CE and TMJ ID types of disk displacement with (DDR) and without reduction (DDNR). Logistic regression analysis was used to compute odds ratios for CE and ID types. Confounding variables adjusted for were age, sex, time since pain onset, pain intensity, and type of ID. Results In the regression analysis, the MRI items of DDR (p = 0.533) and DDNR (p = 0.204) dropped out as nonsignificant in the diagnostic clinical ‘AR and DDwoR/wLO’ group. Significant increases in the risk of ‘AR and DDwoR’ occurred with CE (3.1:1 odds ratio; p = 0.026). The presence of CE was significantly related to DDNR (adjusted OR = 43.9; p < 0.001). Conclusions The data suggest CE as a dominant factor in the definition of painful closed lock of the TMJ, support the view that joint locking needs to be considered as a frequent symptom of osteoarthritis, and emphasize a strong association between the MRI items of CE and DDNR.
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Seo BY, Huh KH, An JS, Chang MS, Ahn SJ. Relationship of computed tomography-verified degenerative condylar morphology with temporomandibular joint disk displacement and sex. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:93-103. [PMID: 34006488 DOI: 10.1016/j.oooo.2021.03.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study investigated the association of computed tomography (CT)-verified degenerative condylar changes with disk displacement (DD) and sex. STUDY DESIGN Multidetector CT and cone beam CT scans of 165 condyles were evaluated for erosion, osteophyte formation, flattening, subcortical sclerosis, generalized sclerosis, subcortical defects, and loose joint bodies. Disk position was determined using magnetic resonance imaging. The association of degenerative alterations with disk position and sex was analyzed. RESULTS The risks of erosion, osteophyte formation, and flattening were significantly increased by 3.72, 9.00, and 6.35 times, respectively, in the joints with DD without reduction (DDNR); however, the risks of these changes did not increase significantly in joints with DD with reduction. The risks of extensive erosion and slight and moderate osteophyte formation significantly increased only in the joints with DDNR. The degenerative changes were more likely to exist together in the joints with DDNR than in those with a normal disk position. The association of DD and most degenerative morphologies was not significantly influenced by sex. CONCLUSIONS Erosion, osteophyte formation, and flattening were significantly associated with DDNR, regardless of sex.
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Affiliation(s)
- Bo-Yeon Seo
- Graduate Student, Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kyung-Hoe Huh
- Professor, Dental Research Institute and Department of Oral and Maxillofacial Radiology, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jung-Sub An
- Clinical Professor, Department of Orthodontics, Seoul National University Dental Hospital, Seoul, Korea
| | - Min-Seok Chang
- Graduate Student, Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sug-Joon Ahn
- Professor, Dental Research Institute and Department of Orthodontics, School of Dentistry, Seoul National University, Seoul, Korea.
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Takaoka R, Yatani H, Senzaki Y, Koishi Y, Moriguchi D, Ishigaki S. Relative risk of positional and dynamic temporomandibular disc abnormality for osteoarthritis-magnetic resonance imaging study. J Oral Rehabil 2021; 48:375-383. [PMID: 33372318 DOI: 10.1111/joor.13138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 12/21/2020] [Indexed: 11/28/2022]
Abstract
Dynamic articular disc abnormality (wR, with reduction; woR, without reduction) is well known as the risk factor for temporomandibular joint osteoarthritis (TMJOA). However, there are few speculations on the potential risk of positional disc abnormalities for TMJOA. The purpose of this study was to investigate the relative risk of positional abnormality and dynamic abnormality of the temporomandibular disc for OA after the three-dimensional interpretation of all the sagittal and coronal planes of magnetic resonance (MR) data in a large dataset of consecutive subjects. Experimental samples consisted of images of 1356 TMJs of patients. A diagnosis of disc state was established in each TMJ utilising a 1.5T MR imaging scanner. A binary logistic regression analysis was performed to identify the significant associations between the outcome (dependent variable: the presence of OA) and the predictors (covariates: age, sex, dynamic disc state [the presence of woR], and 5 categories of the positional disc state [NA, no abnormality; SW, sideways; pADD, partial anterior; cADD, complete anterior; PDD, posterior]). Based on the result of the binary logistic regression analysis, the presence of woR showed an odds ratio of 14.1 (P < .05). In addition, compared with the joints NA, those with SW and cADD showed odds ratios of 5.62 and 10.88, respectively (P < .05). Despite the limitations of the study, in the positional disc abnormalities, sideways disc displacement and complete anterior disc displacement could be associated with the occurrence of TMJOA. All the coronal and sagittal MR images should be evaluated to assess intra-articular joint disorders accurately.
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Affiliation(s)
- Ryota Takaoka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Yuki Senzaki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Yukiko Koishi
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Daisuke Moriguchi
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
| | - Shoichi Ishigaki
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Suita, Japan
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Comparing Clinical and Radiological Manifestations of Adolescent Idiopathic Condylar Resorption and Juvenile Idiopathic Arthritis in the Temporomandibular Joint. J Oral Maxillofac Surg 2020; 79:774-785. [PMID: 33217307 DOI: 10.1016/j.joms.2020.10.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE This cross-sectional study compared orofacial manifestations at the time of diagnosis in 2 temporomandibular joint (TMJ) conditions: adolescent idiopathic condylar resorption (ICR) and TMJ involvement from juvenile idiopathic arthritis (JIA). MATERIALS AND METHODS This retrospective study included 19 JIAs, 19 ICRs, and 19 control patients, all treated at the Section of Orthodontics, Aarhus University Craniofacial Clinic, Denmark. From patient files, we retrieved radiological data from cone-beam computed tomographies along with information on symptoms and orofacial function at the time of diagnosis. Validated methodologies were used to evaluate TMJ and dentofacial morphology. RESULTS We found no statistically significant intergroup differences in severity of deformation of TMJ structures (TMJ deformity) between JIA and ICR patients. However, the ICR group showed significantly greater signs of dentofacial deformity on 4 outcome variables: mandibular inclination, posterior/anterior lower face height ratio, mandibular sagittal position, and mandibular occlusal plane inclination. Significant intergroup differences in clinical presentation were seen in 5 of 20 variables. Thus, the JIA group reported significantly more symptoms of TMJ pain, TMJ morning stiffness, and TMJ pain on palpation during the clinical examination, whereas the ICR group reported significantly more TMJ clicking during function and had a higher proportion of patients with anterior open bite. CONCLUSIONS Cone-beam computed tomography examination showed a similar degree of TMJ deformity in ICR and JIA patients at the time of diagnosis. ICR patients presented with a significantly higher degree of dentofacial deformity than JIA patients and healthy controls, which relates to the timing of the diagnosis. Arthralgia, TMJ morning stiffness, and TMJ palpitation pain were more common in JIA patients, whereas TMJ clicking during function and anterior open bites were more common in ICR patients.
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MRI characteristics of the asymptomatic temporomandibular joint in patients with unilateral temporomandibular joint disorder. Oral Radiol 2020; 37:469-475. [PMID: 32946019 DOI: 10.1007/s11282-020-00483-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the association between unilateral temporomandibular joint disorder (TMD) and the presence of imaging abnormalities in the contralateral, asymptomatic joint. METHODS MRI studies of 219 subjects with symptoms of unilateral TMD were examined for signs of disc displacement, osteoarthritis, disc deformation, and effusion in both temporomandibular joints (TMJ). The Chi-Square test and stepwise logistic regression analysis were performed. RESULTS Disc displacement, osteoarthritis, disc deformation, and effusion were more common on the symptomatic side. However, in the category of disc displacement with a reduction in open mouth position (DDWR), the difference was not significant between the symptomatic and the asymptomatic TMJs. Stepwise logistic regression showed that the presence of any imaging abnormality other than DDWR was related to osteoarthritis and disc deformity on the symptomatic side. On the other hand, the presence of any MRI abnormality (including DDWR) on the asymptomatic side was related only to the presence of osteoarthritis on the symptomatic side. CONCLUSIONS Unilateral symptomatic TMD is related to the presence of imaging abnormalities on the contralateral, asymptomatic side, suggesting that the development and progression of joint changes in symptomatic and contralateral asymptomatic TMJs are interrelated.
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Silva MAG, Pantoja LLQ, Dutra-Horstmann KL, Valladares-Neto J, Wolff FL, Porporatti AL, Guerra ENS, De Luca Canto G. Prevalence of degenerative disease in temporomandibular disorder patients with disc displacement: A systematic review and meta-analysis. J Craniomaxillofac Surg 2020; 48:942-955. [PMID: 32896478 DOI: 10.1016/j.jcms.2020.08.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/01/2020] [Accepted: 08/16/2020] [Indexed: 12/15/2022] Open
Abstract
To assess the available literature on the prevalence of degenerative joint disease (DJD) in patients with anterior disc displacement (ADD) of the temporomandibular joint (TMJ), using a systematic review with meta-analysis. Search strategies were performed in the following databases: PubMed/MEDLINE, EMBASE, LILACS, Web of Science, Scopus, and LIVIVO. A search was also carried out in the gray literature. Two independent reviewers selected the included articles using a two-phase process based on the eligibility criteria. Three reviewers independently collected the required information from the included articles. The methodological quality of the selected studies was assessed individually. In accordance with the inclusion and exclusion criteria, 1349 studies were found and 18 articles were included. The total sample size was 3158 TMJs. The sex distribution was predominant for females (1161 females and 345 males). The average age was 46 (range 10-82) years. Among the 1762 TMJs quantitatively assessed, the prevalence of DJD involving disc displacement with reduction (DDWR) was 35%, while for disc displacement without reduction (DDWoR) the prevalence was 66%. The prevalences of different features of DJD were as follows: sclerosis 24.3%, erosion 23.5%, osteophyte 17.9%, and subcortical cyst 7.6%. The prevalence of DJD in temporomandibular disorder patients with disc displacement is around 50% and is higher in DDWoR (66%) than in DDWR (35%). Sclerosis and erosion would be the most expected radiological signs in a developing DJD. Clinicians should adequately address the frequent DJD features associated with disc displacement in terms of diagnostics and therapeutic management.
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Affiliation(s)
- Maria Alves Garcia Silva
- Department of Stomatological Sciences, Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | | | | | - José Valladares-Neto
- Department of Orthodontics, Faculty of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - André Luís Porporatti
- Brazilian Centre for Evidence-Based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Eliete Neves Silva Guerra
- Laboratory of Oral Histopathology, Health Sciences Faculty, University of Brasília, Brasília, Brazil
| | - Graziela De Luca Canto
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Feng SY, Lei J, Chen HM, Wang YX, Yap AUJ, Fu KY. Increased chemokine RANTES in synovial fluid and its role in early-stage degenerative temporomandibular joint disease. J Oral Rehabil 2020; 47:1150-1160. [PMID: 32609901 DOI: 10.1111/joor.13041] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/12/2020] [Accepted: 06/23/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Degenerative joint disease (DJD) of the temporomandibular joints (TMJs) in adolescents and young adults is closely associated with disc displacement without reduction (DDw/oR). OBJECTIVE This study aimed to determine the pathogenesis of early-stage TMJ DJD induced by DDw/oR. METHODS 31 female subjects aged 12-30 years were enrolled, comprising 12 patients with DDw/oR without DJD, 13 with DDw/oR and early-stage DJD, and 6 healthy volunteers. The synovial fluid samples of the subjects were screened for 27 inflammatory-related cytokines using multiple cytokine array. Significantly increased cytokines and a key regulator of osteoclastogenesis "receptor activator of nuclear factor-κB ligand" (RANKL) were further determined by sandwich immunoassay. These factors were also assessed for the possible pathophysiologic actions on RAW264.7 cell proliferation, migration, osteoclastogenesis and bone-resorbing activity using Cell Counting Kit-8, Transwell system, tartrate-resistant acid phosphatase staining and osteo assay plates. RESULTS Macrophage-derived inflammatory protein-1 beta (MIP-1β) and regulated upon activation normal T cell expressed and secreted (RANTES) were found to vary significantly in relation to the controls. In contrast to an unchanged concentration of RANKL, a strong increase in the level of RANTES was detected in subjects with DDw/oR and early-stage DJD. MIP-1β concentrations were only elevated in subjects with DDw/oR without DJD. Functionally, both MIP-1β and RANTES could enhance macrophage migration in a concentration-dependent manner, while only RANTES exhibited a promoting effect on osteoclast formation and bone-resorbing activity. CONCLUSIONS Chemokine RANTES was significantly upregulated and might be a key regulator of osteoclastogenesis contributing to DDw/oR-induced early-stage TMJ DJD.
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Affiliation(s)
- Shi-Yang Feng
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China
| | - Jie Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China
| | - Hui-Min Chen
- National Clinical Research Center for Oral Diseases, Beijing, China.,Department of General Dentistry II, Peking University School & Hospital of Stomatology, Beijing, China
| | - Yi-Xiang Wang
- National Clinical Research Center for Oral Diseases, Beijing, China.,Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Adrian U-Jin Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China.,Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore.,Faculty of Dentistry, National University of Singapore, Singapore.,Duke-NUS Medical School and National Dental Research Institute Singapore, National Dental Centre, SingHealth, Singapore
| | - Kai-Yuan Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China.,National Clinical Research Center for Oral Diseases, Beijing, China
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Fernandes BV, Brancher JA, Michels AC, Nagashima S, Johann ACBR, Bóia Ferreira M, da Costa DJ, Rebellato NLB, Klüppel LE, Scariot R, Zielak JC. Immunohistochemical panel of degenerated articular discs from patients with temporomandibular joint osteoarthritis. J Oral Rehabil 2020; 47:1084-1094. [PMID: 32524653 DOI: 10.1111/joor.13034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 05/04/2020] [Accepted: 06/01/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Temporomandibular joint osteoarthritis (TMJOA) is a progressive degenerative disease caused by imbalance between anabolic and catabolic stimuli. OBJECTIVE The aim of this study was to evaluate histopathological changes, collagen degeneration and the expression of eleven TMJOA biomarkers in articular discs. METHODS Specimens were obtained from eight female patients submitted to discectomy. Discs were divided into anterior band (AB), intermediate zone (IZ) and posterior band (PB) for computerised histomorphometric analyses. Each was assigned a histopathological degeneration score (HDS). Collagen degeneration was assessed with Picrosirius-polarisation method. Biomarkers were evaluated through immunohistochemistry, including IGF-1, OPG, VEGF, TNF-α, FGF-23, IHH, MMP-3, MMP-9, TGF-β1 , BMP-2 and WNT-3. Image processing software was used to calculate average immature collagen ratios and immunostained areas. Spearman rank tests were applied to verify correlations, with significance level of 0.05. RESULTS The HDS showed negative correlation with expression of VEGF in IZ and PB (P < .05) and positive with TNF-α in AB (P < .01). Collagen degeneration correlated with TGF-β1 (P < .05), BMP-2 (P < .01) and IHH (P < .05) immunostained areas in the IZ; TGF-β1, BMP-2 and IHH expression correlated among each other in AB and IZ (P < .05). CONCLUSION Angiogenesis and tissue fragmentation may result from aberrant physiologic responses mediated by VEGF and TNF-α, compromising TMJ discs during OA progression. The expression of TGF-β1, BMP-2 and IHH could be related to collagen degeneration in displaced discs and may participate in TMJOA pathogenesis.
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Affiliation(s)
| | - João A Brancher
- School of Health Sciences, Universidade Positivo, Curitiba, Brazil.,School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Arieli C Michels
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Seigo Nagashima
- School of Life Sciences, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | | | - Marianna Bóia Ferreira
- School of Health Sciences, Universidade Positivo, Curitiba, Brazil.,School of Biological Sciences, Department of Cell Biology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Delson J da Costa
- School of Health Sciences, Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | - Nelson Luis B Rebellato
- School of Health Sciences, Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | - Leandro E Klüppel
- School of Health Sciences, Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | - Rafaela Scariot
- School of Health Sciences, Universidade Positivo, Curitiba, Brazil.,School of Health Sciences, Department of Oral and Maxillofacial Surgery, Universidade Federal do Paraná, Curitiba, Brazil
| | - João C Zielak
- School of Health Sciences, Universidade Positivo, Curitiba, Brazil
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Leissner O, Maulén-Yáñez M, Meeder-Bella W, León-Morales C, Vergara-Bruna E, González-Arriagada WA. Assessment of mandibular kinematics values and its relevance for the diagnosis of temporomandibular joint disorders. J Dent Sci 2020; 16:241-248. [PMID: 33384804 PMCID: PMC7770294 DOI: 10.1016/j.jds.2020.05.015] [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: 04/12/2020] [Revised: 05/16/2020] [Indexed: 11/18/2022] Open
Abstract
Background/purpose Temporomandibular disorders (TMD) are common conditions that involve the temporomandibular joints (TMJs), jaw muscles, or both, and can cause alteration in the mandibular kinematics. The aim of this study was to assess the relationship between mandibular kinematics and temporomandibular joint disorders (TMJD) as a clinical tool for evaluation and diagnosis of these patients. Materials and methods A retrospective study based on the analysis of the clinical findings from patients’ charts was carried out, with a sample size of 476 patients. Statistical analysis was made with chi-square test for qualitative variables and student t-test for quantitative variables. Then, odds ratio with its confidence interval were calculated. A p value < 0.05 was considered statistically significant. Results Most patients were female (80.7%) and between 16 and 25 years old. Disc displacement with reduction (DDwR) and subluxation were associated with increased kinematic parameters, while disc displacement without reduction (DDwoR) and retrodiscitis were associated with decreased kinematic values. A soft end feel was related to osteoarthritis (OA). Structural incompatibility was most prevalent in older patients. Conclusion Mandibular kinematic values are associated with specific temporomandibular joint disorders and could be considered as a useful clinical tool to perform the right diagnosis of TMJD.
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Affiliation(s)
- Oliver Leissner
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
| | - Miguel Maulén-Yáñez
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
- Clinic of Temporomandibular Disorders and Orofacial Pain, Department of Dentistry, Gustavo Fricke Hospital, Viña del Mar, Chile
| | - Walther Meeder-Bella
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
| | - Camilo León-Morales
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
| | - Eduardo Vergara-Bruna
- Department of Oral Physiology, Temporomandibular Disorders and Orofacial Pain, Universidad de Valparaíso, Valparaíso, Chile
| | - Wilfredo Alejandro González-Arriagada
- Department of Oral Pathology and Diagnosis, Universidad de Valparaíso, Valparaíso, Chile
- Centro de Investigación en Ciencias Odontológicas y Médicas (CICOM), Universidad de Valparaíso, Valparaíso, Chile
- Corresponding author. Department of Oral Pathology and Diagnosis & Centro de Investigación en Ciencias Odontológicas y Médicas (CICOM), Universidad de Valparaíso, Valparaíso, Chile.
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Toshima H, Ogura I. Characteristics of patients with temporomandibular joint osteoarthrosis on magnetic resonance imaging. J Med Imaging Radiat Oncol 2020; 64:615-619. [PMID: 32478461 DOI: 10.1111/1754-9485.13054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/20/2020] [Accepted: 05/06/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Temporomandibular joint (TMJ) dysfunction is a common condition that is best evaluated with magnetic resonance (MR) imaging. The aim of this study was to investigate the characteristics of the patients with TMJ osteoarthrosis on MR imaging. METHODS The MR images of 206 TMJs of 103 patients with temporomandibular disorders (TMD) were evaluated retrospectively in this study. The relationship between osteoarthrosis and age, gender, TMJ pain and MR imaging findings, such as disc displacement with or without reduction and TMJ effusion, was analysed. RESULTS The patients with TMJ osteoarthrosis (mean: 51.6 years) were significantly older than those without osteoarthrosis (mean: 44.8 years, P = 0.027). The incidence of the patients with TMJ osteoarthrosis was significantly different between with (10.0 %) and without reduction (57.0 %, P < 0.001). Logistic multivariate regression analysis demonstrated that disc displacement without reduction was significant in patients with TMJ osteoarthrosis (odds ratio = 12.285, P < 0.001). CONCLUSIONS This study suggests that characteristics of the patients with TMJ osteoarthrosis on MR imaging include older and disc displacement without reduction.
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Affiliation(s)
- Hiroo Toshima
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
| | - Ichiro Ogura
- Quantitative Diagnostic Imaging, Field of Oral and Maxillofacial Imaging and Histopathological Diagnostics, Course of Applied Science, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan.,Department of Oral and Maxillofacial Radiology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
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Temporomandibular Joints' Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking-A Case Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103428. [PMID: 32423066 PMCID: PMC7277452 DOI: 10.3390/ijerph17103428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 12/24/2022]
Abstract
Background: Patients referred for orthodontic treatment often present symptoms of temporomandibular joints’ disorders (TMD), predominantly clicking. The objective was to analyze the morphology of the temporomandibular joints in cone-beam computed tomography (CBCT) images based on the presence of reciprocal clicking before orthodontic treatment. Methods: 105 participants took part in the study. 210 temporomandibular joints (TMJs) were allocated into one of two groups regarding the presence of reciprocal clicking. Morphology of condyle’s head, glenoid fossa, and articular eminence as well as condylar head position in the glenoid fossa and osteoarthritic changes in the area of the condylar head were examined for each TMJ in the CBCT images. Statistical analysis was performed with STATISTICA version 12.0. The following tests were performed: U-Mann Whitney, Kruskal-Wallis, t-Student, and chi-square. The statistical significance level was p = 0.05 for all the measurements included. Results: Significantly smaller condylar A-P dimension (p = 0.040) characterized temporomandibular joints with reciprocal clicking. Condyles were substantially more often positioned posteriorly (p = 0.043) and were significantly more often accompanied by subcortical cysts and pathologic osteoarthritic bone changes (p < 0.001). Conclusions: The early stages of internal derangements stay with alterations in morphology and position of TMJs as well as with the presence of osteoarthritic changes.
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Seo BY, An JS, Chang MS, Huh KH, Ahn SJ. Changes in condylar dimensions in temporomandibular joints with disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:72-79. [DOI: 10.1016/j.oooo.2019.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 03/13/2019] [Accepted: 04/12/2019] [Indexed: 12/13/2022]
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Jung H, Chae H. The Safety and Efficacy of Methocarbamol as a Muscle Relaxant with Analgesic Action: Analysis of Current Data. INNOVATIVE BIOSYSTEMS AND BIOENGINEERING 2019. [DOI: 10.20535/ibb.2019.3.4.183336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Liu YS, Yap AUJ, Lei J, Liu MQ, Fu KY. Association between hypoplastic condyles and temporomandibular joint disc displacements: a cone beam computed tomography and magnetic resonance imaging metrical analysis. Int J Oral Maxillofac Surg 2019; 49:932-939. [PMID: 31564480 DOI: 10.1016/j.ijom.2019.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 07/16/2019] [Accepted: 09/10/2019] [Indexed: 10/25/2022]
Abstract
This study investigated the association between hypoplastic condyles and disc displacements without reduction (DDw/oR). Consecutive patients with non-syndromic unilateral condylar hypoplasia were recruited and clinical, cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) data were acquired. Linear measurements including condylar head width, depth, height and condyle length were determined with CBCT while MRI was used to assess disc position, morphology and displacement. A total of 43 patients were enrolled of which 93.02% had a history of temporomandibular disorders (TMDs) and 83.72% presented with TMD signs and symptoms. Depth and height of the condylar head along with condyle length of hypoplastic joints (6.68±1.67mm, 4.97±1.25mm and 14.49±3.02mm, respectively) were significantly lesser than normal joints (7.77±1.26mm, 6.35±1.45mm and 18.20±3.18mm) (P<0.001). The prevalence of DDw/oR was significantly higher in hypoplastic joints (79.07% versus 13.95%) (P<0.001). Joints with hypoplastic condyles had shorter disc lengths (6.99 ± 2.16 mm vs, 8.45 ± 2.26 mm) (P=0.007). Furthermore, disc displacements were significantly more advanced (8.52 ± 2.84 mm) and severe (76.74% with severe translations) when compared to the contralateral side (4.77 ± 2.97 mm and 32.56%) (P<0.05). A significant association was observed between condylar hypoplasia and temporomandibular joint DDw/oR with hypoplastic joints exhibiting more severely displaced and deformed discs. DDw/oR coupled with repaired degenerative joint disease may mimic condylar hypoplasia radiographically.
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Affiliation(s)
- Y-S Liu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - A U-J Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore; Faculty of Dentistry, National University of Singapore, Singapore; National Dental Centre Singapore, Singapore
| | - J Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - M-Q Liu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - K-Y Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Beijing Key Laboratory of Digital Stomatology, Beijing, China.
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Ferreira NR, DosSantos MF. Evaluation of temporomandibular disorders by magnetic resonance imaging. Radiol Bras 2019; 52:VII-VIII. [PMID: 31210706 PMCID: PMC6561373 DOI: 10.1590/0100-3984.2019.52.3e2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Natália R Ferreira
- Laboratory of Cell Morphogenesis/Institute of Biomedical Sciences, and Graduate Program in Medicine (Radiology)/School of Medicine - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Marcos F DosSantos
- Laboratory of Cell Morphogenesis/Institute of Biomedical Sciences, and Graduate Program in Medicine (Radiology)/School of Medicine - Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
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Bedran LM, Dos Santos AASMD. Changes in temporomandibular joint anatomy, changes in condylar translation, and their relationship with disc displacement: magnetic resonance imaging study. Radiol Bras 2019; 52:85-91. [PMID: 31019336 PMCID: PMC6472865 DOI: 10.1590/0100-3984.2018.0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Objective To assess changes in the articular surfaces of the temporomandibular joint (TMJ) and in condylar translation, as detected by magnetic resonance imaging (MRI), determining whether such changes correlate with disc displacement. Materials and Methods We retrospectively analyzed the MRI scans of 2076 TMJs of 1038 patients with symptoms of temporomandibular disorder. We attempted to determine whether articular disc deformity and changes in condylar translation, as well as changes in the articular surfaces of the condyle, glenoid fossa, and articular eminence, correlated with disc displacement. Results Disc displacement with reduction was associated with changes in the shape of the articular eminence. Disc displacement without reduction was most strongly associated with disc deformity, condylar degeneration, glenoid fossa degeneration, and effusion. Neither decreases nor increases in condylar translation were associated with disc deformity, degenerative bone changes, or disc displacement. Conclusion Changes in the shape of the articular eminence seem to predispose to progression of internal derangement of the TMJ.
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Ren R, Dai J, Si J, Cai B, Shi J. Changes of disc status in adult patients with condylar head fracture who did or did not undergo disc anchoring operation. J Craniomaxillofac Surg 2018; 46:2248-2255. [PMID: 30389311 DOI: 10.1016/j.jcms.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 09/22/2018] [Accepted: 10/01/2018] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Views on treatment procedures for condylar head fractures (CHFs) are far from reaching a consensus. The aim of this study was to evaluate the changes in disc status for anteromedial disc displacement with anchorage (AMDDwA) and without anchorage (AMDDwoA - just suturing to the adjacent TMJ soft tissue) in adult CHFs, to get a better understanding of this very complex process and to show that rigid disc anchorage is an essential technique for the treatment of CHF during the open reduction and internal fixation (ORIF). PATIENTS AND METHODS 144 temporomandibular joints (TMJ) in 95 patients were included in this retrospective study, and were divided into an AMDDwA group (50 TMJs in 38 patients) and an AMDDwoA group (94 TMJs in 57 patients) based on the different surgical procedures. The joints were quantitatively and qualitatively assessed for disc length and disc morphology preoperatively and at follow-up visits. Other variables, such as disc position, joint effusion, retrodiscal tear and lateral capsular tear, were also evaluated. Paired t-tests, Wilcoxon signed rank tests, independent t-tests and χ2 tests were used to assess intragroup and intergroup differences. RESULTS The results showed that discs became shorter, moved further forward and distorted more seriously in the AMDDwoA group. In contrast, discs became longer, maintained a normal disc-condyle relationship in the AMDDwA group. Joint effusion, retrodiscal tear, and lateral capsular tear healed well in both groups. CONCLUSION Taking these findings together suggests that the rigid disc anchorage is an alternative technique for the treatment of CHF.
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Affiliation(s)
- Rong Ren
- Department of Oral & Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China; Department of Oral & Maxillofacial Surgery, Second Hospital of Lanzhou University, Lanzhou, People's Republic of China
| | - Jiewen Dai
- Department of Oral & Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China
| | - Jiawen Si
- Department of Oral & Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China
| | - Bolei Cai
- Department of Oral & Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China
| | - Jun Shi
- Department of Oral & Craniomaxillofacial Science, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, People's Republic of China.
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Almashraqi AA, Ahmed EA, Mohamed NS, Halboub ES. An MRI evaluation of the effects of qat chewing habit on the temporomandibular joint. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:272-282.e2. [DOI: 10.1016/j.oooo.2018.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/29/2018] [Accepted: 05/11/2018] [Indexed: 02/07/2023]
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Emes Y, Bilici IŞ, Aybar B, Sancaklı E, Issever H, Yalcin S. Evaluation of occlusion types, pain severity, and onset of complaints in 127 patients with temporomandibular disorders: A retrospective study. Cranio 2018; 38:168-173. [PMID: 30153092 DOI: 10.1080/08869634.2018.1509824] [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: 10/28/2022]
Abstract
Objective: The aims of this study are to evaluate if occlusal types affect the type of temporomandibular disorders and if the onset of complaints are related to the type of internal derangements. Methods: One hundred thirty-four patients were evaluated. Occlusion types were grouped as Angle Class I, II, and III. The temporomandibular disorders were classified as masticatory muscle disorders, anterior disc dislocation with reduction, and anterior disc dislocation without reduction. Results: No significant relationships were found between the occlusion types, pain severity, the onset of the complaints, and the temporomandibular disorders. Premature contacts were found to be significantly higher in Class II and Class III patients, but no significant relations were found between premature contacts and temporomandibular disorders. Discussion: Occlusal features are not discriminant factors in the occurrence of temporomandibular disorders. Also, it cannot be concluded that the longer the patients have temporomandibular disorders, the higher their pain scores will be.
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Affiliation(s)
- Yusuf Emes
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkey
| | - Itır Şebnem Bilici
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkey
| | - Buket Aybar
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkey
| | - Erkan Sancaklı
- Faculty of Dentistry, Department of Prosthodontics, Istanbul University, İstanbul, Turkey
| | - Halim Issever
- Faculty of Medicine, Department of Public Health, Istanbul University, İstanbul, Turkey
| | - Serhat Yalcin
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkey
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