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Al-Moraissi EA, Al-Otaibi K, Almaweri AA, Bastos RM, Haas Junior OL, Amran AG. Treatment of painful temporomandibular joint disc displacement without reduction: network meta-analysis of randomized clinical trials. Int J Oral Maxillofac Surg 2024; 53:584-595. [PMID: 38395688 DOI: 10.1016/j.ijom.2024.02.004] [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: 05/04/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
There is currently no consensus on the best treatment for painful temporomandibular disc displacement without reduction (DDwoR), and no network meta-analysis (NMA) of randomized clinical trials (RCTs) comparing all types of treatments for this condition has been conducted. The objective of this study was to compare and rank all treatments for DDwoR, including conservative treatments, occlusal splints, low-level laser therapy (LLLT), arthrocentesis (Arthro) alone, Arthro plus intra-articular injection (IAI) of platelet-rich plasma (PRP), Arthro plus IAI of hyaluronic acid (HA), Arthro with exercises, Arthro plus occlusal splints, and manipulative therapy. Outcome variables were pain intensity on a visual analogue scale (VAS) and maximum mouth opening (MMO, mm). The mean difference with 95% confidence interval was estimated using Stata software. The GRADE system was used to assess the certainty of the evidence. A total of 742 patients from 16 RCTs were included in the NMA. Both direct meta-analysis and NMA showed that Arthro with IAI of co-adjuvants provided better pain reduction in the short term (≤3 months) than Arthro alone. However, the quality of the evidence was very low. In the intermediate term, Arthro alone or combined with co-adjuvants provided better pain reduction than conservative treatment, but with low-quality evidence. Conservative treatment significantly increased MMO in the short term compared to other treatments. In conclusion, the results of this NMA suggest that arthrocentesis with intra-articular injection of adjuvant medications may be superior to conservative treatments in reducing pain intensity at long-term follow-up, while no significant differences were found for the MMO outcome. However, the quality of evidence was generally low to very low, and further RCTs are needed to confirm these findings.
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Affiliation(s)
- E A Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen.
| | - K Al-Otaibi
- Department of Maxillofacial Surgery and Diagnostics Sciences, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - A A Almaweri
- Department of Oral Medicine, Thamar University, Thamar, Yemen
| | - R M Bastos
- Department of Oral and Maxillofacial Surgery, Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - O L Haas Junior
- Department of Oral and Maxillofacial Surgery, Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - A G Amran
- Department of Periodontolgy, Thamar University, Thamar, Yemen
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Fang H, Wang R, Liu Y, Cao P, Wang P, Bi R, Zhu S. Studying positional changes of the disc-condyle-fossa complex in ADDWoR patients after TMJ disc repositioning surgery. Clin Oral Investig 2023; 27:7871-7880. [PMID: 37987822 DOI: 10.1007/s00784-023-05379-3] [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: 06/21/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
OBJETIVES To investigate the positional changes in the temporomandibular joint (TMJ) disc-condyle-fossa complex of patients with anterior disc displacement without reduction (ADDWoR) and to evaluate the effect of disc repositioning (DR) surgery. MATERIAL AND METHODS Fifteen patients with unilateral ADDWoR (30 joints) were included. MRI of the TMJ was performed at T0 (1 week before surgery), T1 (1 month after surgery), and T2 (9-12 months after surgery). The glenoid fossa, disc, and condyle were reconstructed and analyzed using Mimics software. RESULTS In the patients with unilateral ADDWoR, the disc on the ADD side showed a tendency to downward shift in the coronal direction and forward shift in the sagittal direction; the condyle of ADD side showed a tendency to backward shift in the sagittal direction and upward shift in the coronal direction. When comparing the same ADDwoR TMJ at T0, T1, and T2, the disc was found to move upward and backward after DR surgery at T1 and T2, and the condyle was found to move upward and backward after DR surgery at T1 but returned to the original position at T2. CONCLUSIONS ADDWoR leads to forward and downward displacement of the disc relative to the condyle and upward displacement of the condyle relative to the tuberosity. DR surgery improved upon the structural abnormalities of the TMJ complex, for which stability was maintained as determined in the 9 to 12 month postoperative follow-up. CLINIC RELEVANCE DR surgery effectively and constantly improves the positional abnormalities of the TMJ complex.
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Affiliation(s)
- Han Fang
- State Key Laboratory of Oral Diseases; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Road, Chengdu, 610041, China
| | - Ruiyu Wang
- State Key Laboratory of Oral Diseases; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Road, Chengdu, 610041, China
| | - Yao Liu
- State Key Laboratory of Oral Diseases; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Road, Chengdu, 610041, China
| | - Pinyin Cao
- State Key Laboratory of Oral Diseases; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Road, Chengdu, 610041, China
| | - Peng Wang
- State Key Laboratory of Oral Diseases; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Road, Chengdu, 610041, China
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Road, Chengdu, 610041, China.
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, No. 14, 3Rd Section of Ren Min Nan Road, Chengdu, 610041, China.
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Wang S, Chen Y, Guo W, She D, Liao Y, Xing Z, Huang N, Huang H, Cao D. Gender differences in lateral pterygoid muscle in patients with anterior disk displacement. Oral Dis 2023; 29:3481-3492. [PMID: 36152024 DOI: 10.1111/odi.14391] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/31/2022] [Accepted: 09/16/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To use quantitative MRI to assess gender differences in lateral pterygoid muscle (LPM) characteristics in patients with anterior disk displacement (ADD). METHODS Lateral pterygoid muscle of 51 patients diagnosed with temporomandibular joint disorders (TMD) who underwent T1-weighted Dixon and T1-mapping sequences were retrospectively analyzed. There were 34 female patients (10 with bilateral normal position disk [NP]; 24 with bilateral ADD) and 17 male patients (eight with bilateral NP; nine with bilateral ADD) among them. After controlling for age, differences in fat fraction, T1 value, volume and histogram features related to gender and disk status were tested with 2-way ANCOVA or Quade ANCOVA with Bonferroni correction. RESULTS Volume of LPM in NP was significantly smaller than that of ADD (p < 0.001). Fat fraction of LPM in females with NP was significantly higher than males with NP (p < 0.05). Females with ADD showed a significantly higher T1 value (p < 0.05), and higher intramuscular heterogeneity than males with ADD. CONCLUSIONS Lateral pterygoid muscle in female TMD patients presented more fatty infiltration in the NP stage and might present more fibrosis in the ADD stage compared with males. Together, this leads to more serious intramuscular heterogeneity during the pathogenesis of ADD in females.
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Affiliation(s)
- Shuo Wang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yu Chen
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Wei Guo
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dejun She
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yunyang Liao
- Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Zhen Xing
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Nan Huang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Hongjie Huang
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dairong Cao
- Department of Radiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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Erdil A, Demirsoy MS, Tümer MK. Evaluation of the effects of arthrocentesis combined with occlusal stabilization splint on disc displacement without reduction-induced acute and closed lock. A prospective cohort study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101438. [PMID: 36918123 DOI: 10.1016/j.jormas.2023.101438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/10/2023] [Accepted: 03/11/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE Disc displacement without reduction (DDWoR) of the temporomandibular joint is associated with limited mouth opening and arthralgia. In the natural course of the disorder, there is a tendency to progress to degenerative joint diseases. First-line treatment aims to reduce pain and restore joint function. The current study aims to examine the efficacy of an occlusal stabilization splint applied simultaneously with arthrocentesis as first-line treatment in acute and chronic closed-locks. MATERIALS AND METHODS The present prospective clinical trial included 40 patients who were diagnosed with DDWoR induced chronic (Group 1, n = 23) and acute (Group 2, n = 17) closed-locks. All participants underwent single session arthrocentesis and were applied occlusal stabilization splints. Maximum mouth opening amounts (MMO), Visual analogue scale (VAS), and McGill pain questionnaire (MPQ) scores were evaluated at baseline, on the operation day, and on seven days after the intervention. The obtained data was analyzed with the Wilcoxon signed-rank, Mann-Whitney U, Fisher's exact, Spearman's correlation tests. RESULTS According to the baseline data, a significant increase was observed in the amount of MMO in postoperative measurements (p = 0.001 and p < 0.001). A statistically significant decrease in MPQ scores was observed in the postoperative period (p < 0.001 and p < 0.001). While a significant difference was observed between the postoperative VAS scores, the scores of Group 2 were lower (p = 0.018). CONCLUSION Although combined arthrocentesis and occlusal stabilization splint provided significant changes for acute and chronic closed-locks in line with first-line treatment goals, acute closed-lock with arthralgia responded better. CLINICAL TRIAL REGISTRATION NUMBER NCT05671549.
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Affiliation(s)
- Aras Erdil
- Department of Oral and Maxillofacial Surgery, Uşak University, Faculty of Dentistry, Cumhuriyet Mh. Kolej Sk. No:3, 64200, Uşak, Turkey.
| | - Mustafa Sami Demirsoy
- Department of Oral and Maxillofacial Surgery, Sakarya University, Faculty of Dentistry, Sakarya, Turkey
| | - Mehmet Kemal Tümer
- Department of Oral and Maxillofacial Surgery, Alanya Alaaddin Keykubat University, Faculty of Dentistry, Antalya, Turkey
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Simões CASC, da Silva MAM, Magesty RA, Falci SGM, Douglas-de-Oliveira DW, Gonçalves PF, Flecha OD. Counselling treatment versus counselling associated with jaw exercises in patients with disc displacement with reduction-a single-blinded, randomized, controlled clinical trial. BMC Oral Health 2023; 23:389. [PMID: 37316791 DOI: 10.1186/s12903-023-03096-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/31/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE To compare effectiveness of counselling program versus counselling program plus jaw exercises to reduce pain and click in patients with temporomandibular joint disc displacement with reduction (DDWR). MATERIALS AND METHODS Patients were divided into two groups: instructions for temporomandibular disorders (TMD) plus jaw exercises (test, n = 34), only TMD instructions (control, n = 34). Pain was analyzed by palpation (RDC/TMD). It was investigated if the click caused discomfort. Both groups were evaluated at baseline, 24 h, 7 days, and 30 days' post treatment. RESULTS The click was present in 85.7% (n = 60). In 30-day evaluation, there was a statistically significant difference between groups in the right median temporal muscle (p = 0.041); and there was a statistically significant difference in treatment self-perception (p = 0.002) and click's discomfort (p < 0.001). CONCLUSION The exercise with recommendations showed better results, resolution of the click, and self-perception of the treatment effectiveness. CLINICAL RELEVANCE This study presents therapeutic approaches that are easy to perform and that can be monitored remotely. In view of the current stage of the global pandemic, these treatment options become even more valid and useful. CLINICAL TRIAL REGISTER This clinical trial was registered at Brazilian Clinical Trials Registry (ReBec) under protocol RBR-7t6ycp ( http://www.ensaiosclinicos.gov.br/rg/RBR-7t6ycp/ ), Date of registration: 26/06/2020.
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Affiliation(s)
| | | | - Rafael Alvim Magesty
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Centro, Diamantina, Minas Gerais, 39100-000, Brazil
| | - Saulo Gabriel Moreira Falci
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Centro, Diamantina, Minas Gerais, 39100-000, Brazil
| | | | - Patricia Furtado Gonçalves
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Centro, Diamantina, Minas Gerais, 39100-000, Brazil
| | - Olga Dumont Flecha
- Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187, Centro, Diamantina, Minas Gerais, 39100-000, Brazil
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Shao B, Li CX, Liu X, Pataer P, Gong ZC. Investigation of Morphologic Changes in Temporomandibular Joint With Anterior Disk Displacement Based on 3-Dimensional Reconstructive Imaging. J Craniofac Surg 2023; 34:1271-1277. [PMID: 36730117 DOI: 10.1097/scs.0000000000009139] [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: 04/18/2022] [Accepted: 09/18/2022] [Indexed: 02/03/2023] Open
Abstract
The objective of this study was to measure the association between the disk position and condylar alteration in patients diagnosed with anterior disk displacement (ADD) of temporomandibular joint (TMJ). A retrospective cross-sectional study was designed, dividing into 4 groups: normal articular disk position (NADP) of unilateral ADD patients (n=10), ADD with reduction (ADDwR, n=16), ADD without reduction (ADDwoR, n=24), and healthy volunteers (HV, n=30) based on magnetic resonance imaging and cone-beam computed tomography. After morphologic parameters were calculated from 3-dimensional reconstructive images, differences in parameters with respect to ADD status were tested with analysis of variance and Fisher least significant difference multiple comparisons were performed. Condylar volume of ADDwR, ADDwoR, NADP, and HVs were 1768.29±404.19, 1467.13±438.20, 1814.48±753.60, and 1914.66±476.48 mm, respectively, showing a significant downward trend from healthy disk to a displaced one ( P <0.05). Same trend also found in condylar superficial area, with the condylar superficial area of the ADDwR, ADDwoR, NADP, and HVs were 842.56±138.78 mm, 748.52±157.42 mm, 842.87±263.00 mm, and 892.73±164.19 mm, respectively. From NADP to ADDwR to ADDwoR, superior joint space (SJS) was declined, [SJS (NADP) (2.10±0.91 mm) > SJS (ADDwR) (1.85±0.61 mm) > SJS (ADDwoR) (1.50±0.50 mm), P =0.034]; medial joint space was significantly associated with the different disk displacement types ( P(HV-ADDwR) =0.001; P(HV-ADDwoR) =0.021; P(NADP-ADDwR) =0.022; P(ADDwR-ADDwoR) =0.001). Our findings suggest that condylar volume and superficial area, and superior and medial joint space, albeit with a small sample size, are significantly associated with different disk displacement types, detection of which might therefore be worth exploring for assessing ADD.
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Affiliation(s)
- Bo Shao
- Oncological Department of Oral and Maxillofacial Surgery, Xinjiang Medical University Affiliated First Hospital, School of Stomatology, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Xinjiang Medical University, Urumqi, China
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Effects of osseous structure based on three-dimensional reconstructive imaging evaluation in the assessment of temporomandibular joint disc position. Clin Oral Investig 2023; 27:1449-1463. [PMID: 36877406 DOI: 10.1007/s00784-023-04936-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVES This pilot morphological study aimed to investigate the association between anterior disc displacement (ADD) and the status of the mandibular condyle and articular fossa. MATERIALS AND METHODS Thirty-four patients were divided into a normal articular disc position group and an ADD with and without reduction group. Images reconstructed were used to determine multiple group comparisons of these three different types of disc position, and the diagnostic efficacy for the morphological parameters with significant group difference was analyzed to assess. RESULTS The condylar volume (CV), condylar superficial area (CSA), superior joint space (SJS), and medial joint space (MJS) all exhibited obvious changes (P < 0.05). Additionally, they all had a reliable diagnostic accuracy in differentiating between normal disc position and ADD with an AUC value from 0.723 to 0.858. Among them, the CV, SJS, and MJS (P < 0.05) had a significantly positive impact on the groups by analysis of multivariate logistic ordinal regression model. CONCLUSIONS The CV, CSA, SJS, and MJS are significantly associated with different disc displacement types. The condyle in ADD exhibited altered dimensions. These could be promising biometric markers for assessing ADD. CLINICAL RELEVANCE The morphological changes of mandibular condyle and glenoid fossa were significantly influenced by the status of disc displacement, and condyles with disc displacement had three-dimensionally altered condylar dimensions, irrespective of age and sex.
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Li CX, Liu X, Gong ZC, Jumatai S, Ling B. Morphologic Analysis of Condyle among Different Disc Status in the Temporomandibular Joints by Three-dimensional Reconstructive Imaging: A Preliminary Study. BMC Oral Health 2022; 22:395. [PMID: 36096796 PMCID: PMC9465965 DOI: 10.1186/s12903-022-02438-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Morphological study is a common approach in the field of anterior disc displacement (ADD) pathology; however, analysis based on three-dimensional reconstructive imaging has not been investigated. This study investigated the association between ADD and the status of the mandibular condyle and articular fossa. METHODS Thirty-four patients were divided into three groups: normal articular disc position (NADP), anterior disc displacement with reduction (ADDwR), and anterior disc displacement without reduction (ADDwoR). Multiple grouped comparisons of three different disc statuses were performed by Kruskal-Wallis H test and variance analysis respectively. Receiver-operating characteristic curve was plotted to assess the diagnostic efficacy of the morphological parameters. Multivariate logistic regression analysis was used to investigate the interfering factors of ADD. RESULTS The condylar volume (CV) and condylar superficial area (CSA) in the NADP, ADDwR, and ADDwoR groups exhibited obvious changes (P < 0.05). Both CV and superior joint space (SJS) presented a good diagnostic accuracy for NADP-ADDwoR [area under the curve (AUC)CV = 0.813; AUCSJS = 0.855)], and ADDwR-ADDwoR (AUCCV = 0.858; AUCSJS = 0.801). CSA presented a good diagnostic accuracy for ADDwR-ADDwoR (AUC = 0.813). A multivariate logistic ordinal regression model showed that the CV [odds ratio (OR) = 1.011; regression coefficient (RC) = 0.011, P = 0.018], SJS (OR, 8.817; RC = 2.177; P < 0.001), and medial joint space (MJS) (OR, 1.492; RC = 0.400; P = 0.047) had a significantly impact on the groups. CONCLUSION CV, CSA, SJS, and MJS were significantly associated with the different disc status, and the condyle in ADD exhibited 3-dimensionally altered dimensions. They could be considered as promising biometric markers to assess the ADD.
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Affiliation(s)
- Chen-Xi Li
- Oncological Department of Oral and Maxillofacial Surgery, Xinjiang Medical University Affiliated First Hospital, No.137 Liyushan South Road, Urumqi, 830054, People's Republic of China. .,School of Stomatology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China. .,Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, 830054, People's Republic of China.
| | - Xu Liu
- Oncological Department of Oral and Maxillofacial Surgery, Xinjiang Medical University Affiliated First Hospital, No.137 Liyushan South Road, Urumqi, 830054, People's Republic of China.,School of Stomatology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China.,Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, 830054, People's Republic of China
| | - Zhong-Cheng Gong
- Oncological Department of Oral and Maxillofacial Surgery, Xinjiang Medical University Affiliated First Hospital, No.137 Liyushan South Road, Urumqi, 830054, People's Republic of China. .,School of Stomatology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China. .,Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, 830054, People's Republic of China.
| | - Sakendeke Jumatai
- Department of Oral and Maxillofacial Radiology, Xinjiang Medical University Affiliated First Hospital, Urumqi, 830054, People's Republic of China.,School of Stomatology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China.,Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, 830054, People's Republic of China
| | - Bin Ling
- Oncological Department of Oral and Maxillofacial Surgery, Xinjiang Medical University Affiliated First Hospital, No.137 Liyushan South Road, Urumqi, 830054, People's Republic of China.,School of Stomatology, Xinjiang Medical University, Urumqi, 830011, People's Republic of China.,Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Urumqi, 830054, People's Republic of China
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Haggag MA, Al-Belasy FA, Said Ahmed WM. Dextrose prolotherapy for pain and dysfunction of the TMJ reducible disc displacement: A randomized, double-blind clinical study. J Craniomaxillofac Surg 2022; 50:426-431. [DOI: 10.1016/j.jcms.2022.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 01/08/2022] [Accepted: 02/27/2022] [Indexed: 11/29/2022] Open
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Huo J, Liu Y, Yang X, Wang Q. Inclination of the osseous components of the temporomandibular joint related with disc displacement: Magnetic resonance and cone beam computed tomography imaging-based study. Cranio 2022:1-10. [PMID: 35157556 DOI: 10.1080/08869634.2022.2036438] [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: 02/08/2023]
Abstract
OBJECTIVE To assess the association between three-dimensional inclination of the osseous structures of temporomandibular joints (TMJ) and the risk of disc displacement (DD). METHODS The 120 TMJs of 60 patients were evaluated. According to magnetic resonance images, disc position was classified as normal, anterior DD with reduction (ADDWR) and without reduction (ADDWoR) and as normal, medial DD (MDD), and lateral DD (LDD) on the sagittal and coronal views, respectively. Condyle and eminence inclinations were measured using cone beam computed tomography. RESULTS Smaller horizontal condylar inclination was associated with ADDWoR (p < 0.05). Larger coronal condylar inclination was associated with ADDWR (p < 0.05) and LDD (p < 0.05). There was no association between sagittal eminence inclination and DD (p < 0.05). CONCLUSION Medial condylar rotation in the axial view may be associated with ADDWoR. The condyle head horizontally inclined in the coronal view may be associated with ADDWR and LDD.
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Affiliation(s)
- Jingyi Huo
- Department of Stomatology, Peking Union Medical College Hospital, Beijing, China
| | - Yuebo Liu
- Department of Stomatology, Peking Union Medical College Hospital, Beijing, China
| | - Xianrui Yang
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qi Wang
- Department of Stomatology, Peking Union Medical College Hospital, Beijing, China
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Ramakrishnan D, Kandamani J, Nathan KPS. Comparison of intraarticular injection of platelet-rich plasma following arthrocentesis, with sodium hyaluronate and conventional arthrocentesis for management of internal derangement of temporomandibular joint. Natl J Maxillofac Surg 2022; 13:254-261. [PMID: 36051804 PMCID: PMC9426706 DOI: 10.4103/njms.njms_94_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 09/02/2020] [Accepted: 05/18/2021] [Indexed: 11/07/2022] Open
Abstract
Aim: The aim of the study is to compare the efficacy of platelet-rich plasma (PRP) for the management of internal derangement of temporomandibular joint (TMJ). Settings and Design: Thirty-three patients were selected from the pool of patients visiting the department of oral and maxillofacial surgery. Simple randomization was done. Subjects and Methods: Patients with anterior disc displacement without reduction (DDWOR) were indicated for arthrocentesis. Group A patients are treated with PRP, Group B patients with sodium hyaluronate following arthrocentesis, and Group C patients were treated with arthrocentesis alone. Postoperative pain and maximal incisal opening are the primary outcomes evaluated. Statistical Analysis Used: The collected data were analyzed with IBM. SPSS statistics software 23.0 version and the one-way ANOVA with Tukey's post hoc test were used. Results: The mean age is 33 years, with female predominance. The statistical significant differences (P < 0.05) in pain and MIO between the 3 groups at the end of 3rdweek, 4thweek, and 3rd month postoperatively are seen in PRP group comparative to other groups. Conclusions: Our study has concluded that the intraarticular injection of PRP is an effective management for anterior DDWOR of TMJ than intraarticular injection of sodium hyaluronate and arthrocentesis in, reducing the pain and improving the interincisal distance in patients with DDWOR, thus providing a rapid recovery and improved quality of life.
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He J, Ran J, Zheng B, Algahefi A, Liu Y. Finite element analysis of various thickness occlusal stabilization splint therapy on unilateral temporomandibular joint anterior disc displacement without reduction. Am J Orthod Dentofacial Orthop 2021; 161:e277-e286. [PMID: 34776321 DOI: 10.1016/j.ajodo.2021.09.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Occlusal stabilization splint is the most common treatment modality for temporomandibular joint disorders, but the optimal thickness is still uncertain. This study investigated the effect of the occlusal splint with different thicknesses on the stress distribution of the temporomandibular joint. METHODS Cone-beam computed tomography and magnetic resonance images were used to reconstruct the maxillofacial and disc, and the unilateral anterior disc displacement without reduction was established manually as the basic model. Occlusal splint with 5 different thickness levels (2, 3, 4, 5, and 6 mm) was added to the basic model as the study models. The displacement and stress distribution of the disc were evaluated. RESULTS The maximum von Mises stress of the condylar cartilage was the largest on the affected side, whereas the maximum von Mises stress of the disc was the largest on the unaffected side. The disc stress on the affected side was mainly distributed on the posterior zone and the intermediate zone for the unaffected side. The maximum von Mises stress of the bilaminar region on the affected side was greater than the unaffected side. The stress of the disc and bilaminar region was the lowest on the affected side in the 2 mm model. The disc displacement on the affected side gradually increased, whereas, on the unaffected side, it fluctuated. CONCLUSIONS These results showed that occlusal stabilization splint could decrease the stress of disc and bilaminar region, and 2 mm was considered the optimal thickness for the treatment of unilateral temporomandibular joint anterior disc displacement without reduction.
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Affiliation(s)
- Jia He
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Junyi Ran
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Bowen Zheng
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Ahmed Algahefi
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China
| | - Yi Liu
- Department of Orthodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, Liaoning, China.
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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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Zhao X, Xiong X, Sun W, Shu C, Gu J, Liu Y. Symptoms, disc position, occluding pairs, and facial skeletal characteristics of older patients with temporomandibular disorders. J Int Med Res 2021; 49:300060521990530. [PMID: 33583228 PMCID: PMC7890733 DOI: 10.1177/0300060521990530] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective To describe the proportions of different osseous diagnoses in older patients with temporomandibular disorders (TMD) and to analyze the symptoms, disc position, occluding pairs, and facial skeletal characteristics of patients with bilateral osteoarthrosis (BOA) and bilateral normal joints (BNJ). Methods This retrospective cross-sectional study constituted 88 older patients (age ≥60 years). The osseous diagnosis, symptoms, disc position, occluding pairs, and facial skeletal characteristics were evaluated. Variables in BOA patients and BNJ patients were compared using the t-test and chi-square test. Results Forty-eight patients had BOA, 7 had unilateral osteoarthrosis, 11 had intermediate osteoarthrosis, and 22 had BNJ. The prevalence of disc displacement without reduction (DDw/oR) in BOA patients was significantly higher than in BNJ patients. BOA patients exhibited greater ANB angle, PP-MP, U1-NPo, L1-NPo, and facial convexity angle; shorter posterior cranial base; and decreased ramus height. Conclusion BOA patients with associated DDw/oR had more complaints of orofacial pain and exhibited a shorter posterior cranial base, and greater mandibular retrusion, anterior tooth protrusion, and protruded profile than BNJ patients.
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Affiliation(s)
- Xiaokai Zhao
- Department of Dental Research, The Affiliated Stomatological Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xin Xiong
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Sun
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Chang Shu
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinning Gu
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yang Liu
- Department of Temporomandibular Joint, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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15
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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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Ramachandran A, Jose R, Tunkiwala A, Varma R B, M Shanmugham A, Nair PK, Kumar KS, Sam LM. Effect of deprogramming splint and occlusal equilibration on condylar position of TMD patients - A CBCT assessment. Cranio 2019; 39:294-302. [PMID: 31451061 DOI: 10.1080/08869634.2019.1650216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Assessment of clinical symptoms and condylar position of TMD patients using CBCT imaging with deprogramming splint therapy and occlusal equilibration. The hypothesis tested was the alleviation of symptoms of TMD with possible changes in condylar position occurs with this treatment.Methods: The condylar position of 12 TMD patients was observed from CBCT images, and clinically, symptom severity score, mouth opening, and range of motion were compared pre- and post-treatment.Results: All patients reported a statistically significant decrease in the symptom severity score and increase in mouth opening and range of motion (p < .05). A significant decrease was only achieved in the left anterior joint space (p < .05).Conclusion: Deprogramming splint therapy and occlusal equilibration benefitted patients with a reduction in clinical symptoms, and minor changes in condylar position were observed.
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Affiliation(s)
- Anu Ramachandran
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Renju Jose
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Ali Tunkiwala
- Consultant Prosthodontist, Private Practice, Mumbai, India
| | - Beena Varma R
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Aravind M Shanmugham
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Priya K Nair
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Krishna S Kumar
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
| | - Lisa Maria Sam
- Department of Oral Medicine and Radiology, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
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Poluha RL, Canales GDLT, Costa YM, Grossmann E, Bonjardim LR, Conti PCR. Temporomandibular joint disc displacement with reduction: a review of mechanisms and clinical presentation. J Appl Oral Sci 2019; 27:e20180433. [PMID: 30810641 PMCID: PMC6382319 DOI: 10.1590/1678-7757-2018-0433] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/02/2018] [Indexed: 11/25/2022] Open
Abstract
Disc displacement with reduction (DDWR) is one of the most common intra-articular disorders of the temporomandibular joint (TMJ). Factors related to the etiology, progression and treatment of such condition is still a subject of discussion. This literature review aimed to address etiology, development, related factors, diagnosis, natural course, and treatment of DDWR. A non-systematic search was conducted within PubMed, Scopus, SciELO, Medline, LILACS and Science Direct using the Medical Subjective Headings (MeSH) terms “temporomandibular disorders”, “temporomandibular joint”, “disc displacement” and “disc displacement with reduction”. No time restriction was applied. Literature reviews, systematic reviews, meta-analysis and clinical trials were included. DDWR is usually asymptomatic and requires no treatment, since the TMJ structures adapt very well and painlessly to different disc positions. Yet, long-term studies have shown the favorable progression of this condition, with no pain and/or jaw locking occurring in most of the patients.
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Affiliation(s)
- Rodrigo Lorenzi Poluha
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese, Grupo de Dor Orofacial de Bauru, Bauru, São Paulo, Brasil
| | - Giancarlo De la Torre Canales
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese, Grupo de Dor Orofacial de Bauru, Bauru, São Paulo, Brasil
| | - Yuri Martins Costa
- Universidade de Campinas, Faculdade de Odontologia de Piracicaba, Departamento de Ciências Fisiológicas, Piracicaba, São Paulo, Brasil
| | - Eduardo Grossmann
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Departamento de Ciências Morfológicas, Porto Alegre, Rio Grande do Sul, Brasil
| | - Leonardo Rigoldi Bonjardim
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ciências Biológicas, Seção de Fisiologia da Cabeça e da Face, Bauru, São Paulo, Brasil
| | - Paulo César Rodrigues Conti
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Prótese, Grupo de Dor Orofacial de Bauru, Bauru, São Paulo, Brasil
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Grossmann E, Poluha RL, Iwaki LCV, Santana RG, Iwaki Filho L. The use of arthrocentesis in patients with temporomandibular joint disc displacement without reduction. PLoS One 2019; 14:e0212307. [PMID: 30759144 PMCID: PMC6374052 DOI: 10.1371/journal.pone.0212307] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 01/31/2019] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to evaluate the efficacy of the use of the arthrocentesis in patients with disc displacement without reduction (DDWOR). Two hundred and thirty-four (234) patients with DDWOR were evaluated and the following data collected: gender; affected side; age (years); duration of the pain (months); patient's perception of pain (measured by Visual Analogue Scale [VAS 0-10]); maximal interincisal distance (MID) (mm); and joint disc position, determined by magnetic resonance imaging. Data were obtained in two different moments: before the arthrocentesis (M1) and three or four months later (M2). Paired t-Student Test, Scores Test and Wilcoxon Test showed a statistical significant difference (p<0.0001) between the M1 and M2 for the variables VAS and MID. There was an alteration in the joint disc position in 93.88% of the cases after arthrocentesis. There was no association between the general characteristics of the patients on the M1 and the results of the arthrocentesis (p>0.05). It can be concluded that the arthrocentesis is efficient in reducing the pain, in increasing interincisal distance, and altering the joint disc position in patients with DDWOR regardless gender, age side and pain duration.
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Affiliation(s)
- Eduardo Grossmann
- Department of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- * E-mail: ,
| | | | | | | | - Liogi Iwaki Filho
- Department of Dentistry, State University of Maringá, Maringá, Paraná, Brazil
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Folle FS, Poluha RL, Setogutti ET, Grossmann E. Double puncture versus single puncture arthrocentesis for the management of unilateral temporomandibular joint disc displacement without reduction: A randomized controlled trial. J Craniomaxillofac Surg 2018; 46:2003-2007. [DOI: 10.1016/j.jcms.2018.10.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 08/16/2018] [Accepted: 10/18/2018] [Indexed: 11/26/2022] Open
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Pasqual PGV, Poluha RL, Setogutti ÊT, Grossmann E. Evaluation of effusion and articular disc positioning after two different arthrocentesis techniques in patients with temporomandibular joint disc displacement without reduction. Cranio 2018; 38:256-263. [PMID: 30165804 DOI: 10.1080/08869634.2018.1511266] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To evaluate joint effusion and positioning of the articular disc through magnetic resonance imaging (MRI) before and after two different arthrocentesis techniques. METHODS Twenty-six patients with dislocation of the articular disc without reduction (ADDwoR) were included and randomly divided into two groups: single needle arthrocentesis with distention of the upper compartment of the TMJ (A1) and conventional arthrocentesis with 2 needles (A2). RESULTS A statistically significant difference was observed between the different effusion categories (p = 0.009). No differences were found comparing both treatment modalities concerning the position of the mandibular condyle and the articular disc. CONCLUSION Conventional arthrocentesis was able to change the effusion variable, whereas the single needle arthrocentesis was not. Both techniques were responsible for altering the position of the mandibular head or the disc-head complex, projecting them to a more anterior position related to the increase in the final maximum interincisal distance.
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Affiliation(s)
| | | | | | - Eduardo Grossmann
- Department of Dentistry, Craniofacial Pain Applied to Dentistry, Dentistry Faculty, Federal University of Rio Grande do Sul , Porto Alegre, RS, Brazil
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Grossmann E, Poluha RL, Iwaki LCV, Iwaki Filho L. Arthrocentesis with different irrigation volumes in patients with disc displacement without reduction: One-year follow-up. Cranio 2018; 38:122-127. [PMID: 30048223 DOI: 10.1080/08869634.2018.1491930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: This study evaluated the clinical efficacy of arthrocentesis when varying the irrigation volume in patients with disc displacement without reduction (DDWOR). Methods: Thirty DDWOR patients were equally divided into two groups: G1 (50 mL) and G2 (200 mL). Information was compared for pain, the maximum interincisal distance (MID), protrusion, and right and left laterality. Results: Arthrocentesis was able to reduce the pain and increase the MID, protrusion, and both laterality values significantly one year after the procedure (p < 0.001) in both groups. However, comparisons between the groups revealed no significant difference (p > 0.05). Furthermore, changes in volume did not affect the arthrocentesis results (p = 0.626, odds ratio = 1.625; 95% confidence interval = 0.230-11.461). Conclusion: Arthrocentesis techniques using 50- and 200-mL irrigation volumes were both effective, with no significant differences between techniques observed after one year of follow-up.
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Affiliation(s)
- Eduardo Grossmann
- Department of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | - Liogi Iwaki Filho
- Department of Dentistry, State University of Maringá, Maringá, Brazil
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Poluha RL, Grossmann E, Iwaki LCV, Uchimura TT, Santana RG, Iwaki Filho L. Myofascial trigger points in patients with temporomandibular joint disc displacement with reduction: a cross-sectional study. J Appl Oral Sci 2018; 26:e20170578. [PMID: 29898186 PMCID: PMC6010330 DOI: 10.1590/1678-7757-2017-0578] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Accepted: 03/14/2018] [Indexed: 11/21/2022] Open
Abstract
Objective The objective of this retrospective study was to evaluate the impact of myofascial trigger points (MTrPs) in patients with articular disc displacement with reduction (DDWR) and to identify which clinical variables are associated with the concomitant presence of DDWR and MTrPs. Material and Methods 130 patients were selected that sought treatment due to joint pain, with ages ≥18 years, of both genders, with DDWR confirmed by magnetic resonance imaging. The sample was divided into two groups: Group 1, patients with DDWR and MTrPs (N=101); and Group 2, patients with DDWR and no MTrPs (N=29). Information on gender, age, pain duration, pain scores, and maximal interincisal distance (MID) were collected. The logistic regression model was used and the odds ratios (OR) was calculated (p<0.05). Results Group 1 presented statistically significant higher mean pain scores (p=0.007), and smaller MID (p=0.0268) than Group 2. OR were significant for the pain scores (1.429), MID (0.937) and gender (women) (2.810). Conclusions Patients with DDWR and MTrPs had increased pain scores and a MID decrease compared to patients with DDWR and no MTrPs. The variables pain scores, MID, and gender (women) showed a significant association with the concomitant presence of DDWR and MTrPs.
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Affiliation(s)
| | - Eduardo Grossmann
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Porto Alegre, Rio Grande do Sul, Brasil
| | | | | | | | - Liogi Iwaki Filho
- Universidade Estadual de Maringá, Departamento de Odontologia, Maringá, Paraná, Brasil
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Tonin RH, Iwaki Filho L, Grossmann E, Lazarin RO, Pinto GNDS, Previdelli ITS, Iwaki LCV. Correlation between age, gender, and the number of diagnoses of temporomandibular disorders through magnetic resonance imaging: A retrospective observational study. Cranio 2018; 38:34-42. [PMID: 29806568 DOI: 10.1080/08869634.2018.1476078] [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] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the correlation among age, gender and the number of temporomandibular disorder (TMD) findings. METHODS The records from 228 patients with TMD were analyzed for the presence of these findings: morphological changes, disc displacement with reduction (DDWR) and without reduction (DDWOR), bone edema, effusion, and avascular necrosis. Statistical analyses were conducted using multinomial regression with a 5% significance level. RESULTS DDWR was the most frequent finding. Group 1 was composed of 94 patients (41.22%), Group 2, of 67 patients (29.38%), and Group 3, of 67 patients (29.38%). Men were significantly less likely to belong to Group 3 than women (p = 0.5517). Older patients were slightly more likely to fall in Groups 2 and 3 than in Group 1. DISCUSSION Women were shown to be more susceptible to developing a higher number of concomitant conditions than men, and the number of findings tended to increase with age.
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Affiliation(s)
- Renata Hernandes Tonin
- Integrated Dentistry, Department of Dentistry, State University of Maringá , Maringá, Brazil
| | - Liogi Iwaki Filho
- Oral and Maxillofacial Surgery, Department of Dentistry, State University of Maringá , Maringá, Brazil
| | - Eduardo Grossmann
- Craniofacial Pain Applied to Dentistry, Dentistry Faculty, Federal University of Rio Grande do Sul , Porto Alegre, Brazil
| | - Rafael Oliveira Lazarin
- Integrated Dentistry, Department of Dentistry, State University of Maringá , Maringá, Brazil
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Giozet AF, Iwaki LCV, Grossmann E, Previdelli ITS, Pinto GNDS, Iwaki Filho L. Correlation between clinical variables and magnetic resonance imaging findings in symptomatic patients with chronic temporomandibular articular disc displacement with reduction: A retrospective analytical study. Cranio 2018; 37:374-382. [PMID: 29570042 DOI: 10.1080/08869634.2018.1449360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Objective: To correlate the clinical aspects of symptomatic patients with chronic articular disc displacement with reduction with alterations in the articular disc (AD) morphology and sagittal position. Methods: Records from 109 patients were selected that included data on AD morphology and sagittal position as determined by MRI. According to the MRI results, the sagittal position and AD morphology with opened and closed mouth were correlated with many clinical variables. Results: More than half of the patients studied were female, and the biconcave and hemiconvex morphologies were most common. Thirty-four patients (31.3%) presented with restricted maximum interincisal distance (MID). The biplanar morphology was associated with eccentric bruxism and MID (p < 0.05). Visual analog scale (VAS) scores between 2 and 7 were shown to be risk factors (p < 0.05). Conclusion: The mouth position can influence AD morphology and eccentric bruxism. VAS scores and unknown etiology were risk factors.
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Affiliation(s)
| | | | - Eduardo Grossmann
- Craniofacial Pain Applied to Dentistry, Dentistry Faculty, Federal University of Rio Grande do Sul , Porto Alegre , Brazil
| | | | | | - Liogi Iwaki Filho
- Dental Radiology and Stomatology, Department of Dentistry, State University of Maringá , Maringá , Brazil
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Grossmann E, Poluha RL, Iwaki LCV, Santana RG, Filho LI. Predictors of arthrocentesis outcome on joint effusion in patients with disk displacement without reduction. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:382-388. [PMID: 29422400 DOI: 10.1016/j.oooo.2017.12.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/28/2017] [Accepted: 12/13/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the preoperative variables in patients with articular disk displacement without reduction that may influence the results of arthrocentesis on joint effusion (JE). STUDY DESIGN The records of 203 patients with clinical signs and symptoms of unilateral painful disk displacement without reduction and JE, confirmed by magnetic resonance imaging (MRI), and treated with arthrocentesis were selected. The following preoperative data were recorded: sex; age; joint side; pain duration; pain intensity, measurement with the visual analogue scale; and maximum interincisal distance (MID). All patients underwent a second MRI examination 3 to 4 months postoperatively to assess JE. The sample was then divided into 2 groups: group 1 (n = 160) comprised patients with no signs of JE; and group 2 (n = 43) comprised patients still showing signs of JE. Univariate and multivariate analyses were used to compare the groups. RESULTS Among the studied variables, pain duration (P = .0175), pain intensity (P < .0001), and MID (P = .0085) were shown to affect arthrocentesis outcomes. The longer the pain duration (odds ratio [OR] = 0.930), the more intense was the pain (OR = 0.346), and the smaller the MID (OR = 0.562), the less were the chances of arthrocentesis completely eliminating JE. CONCLUSIONS Pain duration, pain intensity, and MID can be used as predictors for the effect of arthrocentesis on JE outcomes and considered during treatment planning.
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Affiliation(s)
- Eduardo Grossmann
- Craniofacial Pain Applied to Dentistry, Department of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
| | | | | | | | - Liogi Iwaki Filho
- Oral and Maxillofacial Surgery, Department of Dentistry, State University of Maringá, Maringá, Brazil
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