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Liu Z, Yin J, Cao W, Deng L, Song Z, Zhang Y, Hao J, Zhang Q. Evaluation of clinical impact of two types of Temporomandibular joint disc reduction and fixation. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101956. [PMID: 38942235 DOI: 10.1016/j.jormas.2024.101956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE To evaluate the clinical effectiveness and stability of open suture versus micro-screw anchored disc reduction and fixation in treating disc displacement without reduction in the anterior temporomandibular joint. METHODS A total of 38 patients (51 sides) with anterior disc displacement without reduction (ADDwR) of the TMJ treated in our hospital from August 2021 to January 2023 were selected, including 19 cases in group A (23 sides) treated with open temporomandibular joint disc reduction and anchorage, and 19 cases in group B (28 sides) treated with temporomandibular joint disc reduction and suture. The Magnetic Resonance Imaging (MRI) data of the two groups before and after operation were compared to evaluate the effective rate of articular disc reduction, the change of articular disc length, The Maximal Interincisal Opening (MIO) and Numeric Rating Scale (NRS) were measured before and after operation. RESULTS In group A, the MRI effective rate 6 months after disc reduction was 95.65 % (22/23), the disc length gain was 1.74 mm, MIO was 40.32±5.067 mm, and NRS was 0.47±0.697. The MRI effective rate 6 months after disc reduction in group B was 100 % (28/28). The disc length gain was 1.78 mm, MIO was 41.58±3.746 mm, and NRS was 0.00. There was no significant difference between the two groups (P > 0.05). CONCLUSIONS TMJ disc reduction and suture and open TMJ disc anchorage can effectively reduce the TMJ disc. The TMJ disc stability is high at 6 months after operation, and the pain and mouth opening can be improved, which is worthy of further promotion in clinical practice.
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Affiliation(s)
- Zhenlong Liu
- Guangdong Engineering Research Center of Oral Restoration and Reonstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Jinping Yin
- First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, Guangdong 510182, China
| | - Wei Cao
- Guangdong Engineering Research Center of Oral Restoration and Reonstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Li Deng
- Guangdong Engineering Research Center of Oral Restoration and Reonstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Zhiqiang Song
- Guangdong Engineering Research Center of Oral Restoration and Reonstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Yin Zhang
- Guangdong Engineering Research Center of Oral Restoration and Reonstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Jiansuo Hao
- Guangdong Engineering Research Center of Oral Restoration and Reonstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China
| | - Qingbin Zhang
- Guangdong Engineering Research Center of Oral Restoration and Reonstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510182, China.
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Min CK, Kim KA, Lee KE, Suh BJ, Jung W. A study on volumetric change of mandibular condyles with osteoarthritis using cone-beam computed tomography. Sci Rep 2024; 14:10232. [PMID: 38702404 PMCID: PMC11068749 DOI: 10.1038/s41598-024-60404-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] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 04/23/2024] [Indexed: 05/06/2024] Open
Abstract
This study aimed to quantitatively assess three-dimensional changes in the mandibular condyle with osteoarthritis using cone-beam computed tomography (CBCT). Pre- and post-treatment CBCT images of temporomandibular joints (TMJs) from 66 patients were used to assess longitudinal changes in condylar volume within individual patients using 3D slicer software. Total volume difference (dV), net increase (dV + , bone deposition), and net decrease (dV- , bone resorption) after treatment were analyzed based on clinical and radiological factors. Condyles with surface erosion at their first visit showed significantly decreased volume after treatment compared to condyles without erosion (p < 0.05). Amounts of bone resorption and deposition were higher in condyles with surface erosion (both p < 0.01). In patients with condylar erosion, the presence of joint pain was associated with a decrease in condylar volume and an increase in net resorption (both p < 0.01). When both joint pain and condylar erosion were present, patients with parafunctional habits showed reduced condylar volume after treatment (p < 0.05). Condylar volume change after treatment was negatively correlated with the duration of pain relief (R = - 0.501, p < 0.05). These results indicate that condylar erosion and TMJ pain could be significant variables affecting TMJ volume changes after treatment. Establishing appropriate treatment strategies is crucial for managing condylar erosion and TMJ pain.
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Affiliation(s)
- Chang-Ki Min
- Department of Oral and Maxillofacial Radiology, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Kyoung-A Kim
- Department of Oral and Maxillofacial Radiology, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Kyung-Eun Lee
- Department of Oral Medicine, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Bong-Jik Suh
- Department of Oral Medicine, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea
| | - Won Jung
- Department of Oral Medicine, Institute of Oral Bioscience, School of Dentistry, Jeonbuk National University, Jeonju, South Korea.
- Research Institute of Clinical Medicine of Jeonbuk National University - Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, South Korea.
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Yap AU, Zhang MJ, Lei J, Fu KY. Accuracy of the Fonseca Anamnestic Index for identifying pain-related and/or intra-articular Temporomandibular Disorders. Cranio 2024; 42:259-266. [PMID: 34259594 DOI: 10.1080/08869634.2021.1954375] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objectives: This study established the diagnostic accuracy of the Fonseca Anamnestic Index (FAI) in relation to the Diagnostic Criteria for TMD (DC/TMD) standard.Methods: A total of 866 TMD patients and 57 TMD-free controls were instructed to answer the FAI and DC/TMD Symptom Questionnaire (SQ). Participants were subsequently categorized into no (NT), pain-related (PT), and/or intra-articular (IT) TMDs using the DC/TMD protocolized examination/algorithms. Receiver operating characteristics (ROC) curves, best cut-off points, and accuracy measures were determined.Results:The FAI demonstrated high accuracy for detecting all TMDs, PT, and IT (AUC = 0.96-0.98). The best cut-off points were 22.50 for all TMDs/IT and 27.50 for PT. Sensitivity of the FAI was high (94.23-98.21%), but specificity was moderate (87.72%) for all diagnostic categories.Discussion:The diagnostic accuracy of the FAI for identifying pain-related and intra-articular TMDs was high. FAI scores ≥25 points should be used to screen for TMDs.
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Affiliation(s)
- Adrian Ujin Yap
- Centre for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, China; Department of Dentistry, Ng Teng Fong General Hospital; and Faculty of Dentistry, National University Health System, Singapore; National Dental Research Institute Singapore, National Dental Center Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore
| | - Min Juan Zhang
- Centre for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, China
| | - Jie Lei
- Centre for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, China
| | - Kai-Yuan Fu
- Centre for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology; Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, China
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Yap AU, Lei J, Park JW, Liu C, Kim SH, Lee BM, Fu KY. Age distribution of East Asian TMD patients and age-related differences in DC/TMD axis I findings. Cranio 2024:1-10. [PMID: 38369853 DOI: 10.1080/08869634.2024.2316081] [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: 02/20/2024]
Abstract
OBJECTIVES The pattern of age distribution in East Asian temporomandibular disorder (TMD) patients and age-related differences in DC/TMD diagnostic subtypes/categories were evaluated. SUBJECTS AND METHODS TMD patients from two University-based centers in China and South Korea were enrolled. Axis I physical diagnoses were rendered according to DC/TMD. Patients were categorized into six age groups (15-24, 25-34, 35-44, 45-54, 55-64, and 65-84 years; Groups A-F respectively). RESULTS Youths/young adults (Groups A-C) formed 74.1% of TMD patients. TMJ disc displacements (74.9%), arthralgia (49.2%), and degenerative joint disease [DJD] (36.8%) were the most common TMD subtypes. The majority had combined (54.0%) and chronic (58.5%) TMDs. Youths/young adults and middle-aged/old adults had substantially lower frequencies of merely pain-related (6.2-14.5%) and intra-articular (13.8-16.8%) TMDs correspondingly. "Being female" increased the prospects of pain-related/combined TMDs by 96%/49%, respectively. CONCLUSIONS East Asian TMD patients comprised mostly of youths/young adults who had an alarmingly high prevalence of TMJ DJD.
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Affiliation(s)
- Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- 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
| | - Jie Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Ji Woon Park
- Dental Research Institute, Seoul National University, Seoul, Korea
- Department of Dental Biomaterials Science, Seoul National University School of Dentistry, Seoul, Korea
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
| | - Chengge Liu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Seong Hae Kim
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
- Department of Oral Medicine & Oral Diagnosis, Seoul National University School of Dentistry, Seoul, Korea
| | - Byeong-Min Lee
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Kai-Yuan Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, 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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Rao C, Huang G, Mu F, Tan Z, Yuan J. Anesthetic management of patients with difficult intubation due to temporomandibular joint osteoarthritis: A case report. Medicine (Baltimore) 2024; 103:e36956. [PMID: 38215095 PMCID: PMC10783316 DOI: 10.1097/md.0000000000036956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 12/21/2023] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION Temporomandibular joint osteoarthritis (TMJOA) affects 8% to 16% of the global population, yet TMJOA remains relatively underappreciated clinically. To anesthesiologists, who is concerned about patient safety, adequate preoperative evaluation and preparation, as well as individualized anesthetic management of patients, are necessary. Therefore, the anesthesiologist should be alert for difficult airways due to TMJOA, have a full and comprehensive understanding of the disease, and possess the appropriate expertise for difficult airway intubation. CASE PRESENTATION A 52-year-old female patient was scheduled for laparoscopic operation of uterine adnexa under general anesthesia. The patient preoperative evaluation showed only 1 finger width of mouth opening, and the computed tomography scan showed bilateral temporomandibular arthritis, which was evident on the right side. Intraoperatively, the expected airway difficulties occurred, and the anesthesiologist opted to use lightwand intubation, which was ultimately successful in 1 pass without any complications. CONCLUSION Intubation using a lightwand for patients with difficult intubation due to TMJOA is a very effective intubation modality.
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Affiliation(s)
- Changle Rao
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Guihua Huang
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Fangfang Mu
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Zhengquan Tan
- Department of Anesthesiology, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jie Yuan
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Valladares-Neto J, Acioli GMR, Teodoro AB, Evangelista K, Furquim BD', Silva MAG. Conservative and minimally invasive approaches to control idiopathic condylar resorption: a scoping review. Int J Oral Maxillofac Surg 2023; 52:1188-1196. [PMID: 37271625 DOI: 10.1016/j.ijom.2023.05.003] [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: 11/04/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 06/06/2023]
Abstract
Idiopathic condylar resorption (ICR) is an uncommon disease with multiple names that challenges orthodontic and surgical treatments. The aim of this study was to investigate the existing conservative and minimally invasive approaches to controlling ICR. A scoping literature review was conducted. Inclusion criteria were young patients with degenerative joint disease based on the Research Diagnostic Criteria for Temporomandibular Disorders or Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) protocols, or ICR based on the DC/TMD expanded taxonomy protocol. Six electronic databases and the grey literature were searched, without restriction on year or language. Two reviewers independently performed the study selection and data extraction. Ten studies were selected from the 13,953 records identified. The total sample size was 424 patients; the female-to-male ratio was 7:1 and the mean age of the patients was 25.7 years. The main primary outcomes were pain, mandibular dysfunction, and condylar resorption. There is no guarantee of definitive success in the early management of ICR, despite the promising approaches studied, and there is no specific protocol to be followed. Therefore, close post-surgical follow-up is still required. This study highlights the need to standardize the nomenclature and diagnostic criteria, and assess the status of condylar activity/severity in future research.
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Affiliation(s)
- J Valladares-Neto
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | - G M R Acioli
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - A B Teodoro
- Postgraduate Program in Dentistry, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - K Evangelista
- Department of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | | | - M A G Silva
- Department of Stomatology, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
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Yap AU, Marpaung C. Correlates between temporomandibular disorder severity, emotional distress, and eudaimonic well-being among young adults. Oral Dis 2023; 29:2780-2788. [PMID: 35942541 DOI: 10.1111/odi.14343] [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: 04/28/2022] [Revised: 07/09/2022] [Accepted: 07/23/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study examined the correlates between severity of temporomandibular disorders (TMDs), emotional distress, and eudaimonic well-being. SUBJECTS AND METHODS TMD severity, negative emotions, and eudaimonia were assessed with the Fonseca Anamnestic Index (FAI), Depression, Anxiety, Stress Scales-21 (DASS-21), and Psychological Well-being Scale-18 (PWBS-18) in a cohort of community young adults. Statistical evaluations were done with non-parametric tests/correlation and multivariate regression analyses (α = 0.05). RESULTS Amongst the 873 participants (mean age 19.8 ± 1.66 years), 40.7%, 49.0%, and 10.3% had no (NT), mild (MT), and moderate-to-severe (ST) TMD, respectively. Significant differences in total-DASS, depression, anxiety, and stress were ST ≥ MT > NT. Significant variances in total-PWSB and self-acceptance were NT > MT > ST while that for environmental mastery, positive relations, and purpose in life were NT > MT, ST. An inverse relationship was discerned between total-DASS and total-PWBS (correlation coefficient = -0.54). The prospect of ST was increased by anxiety but reduced by positive relations and self-acceptance. CONCLUSIONS Young adults with mild and moderate-to-severe TMD experienced substantially higher emotional distress and lower eudaimonia than those with no TMD. As emotional distress and eudaimonic well-being are interrelated, positive psychological interventions may be beneficial for managing TMD-related psychosocial disabilities.
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Affiliation(s)
- Adrian Ujin Yap
- Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore
- National Dental Research Institute, National Dental Centre Singapore and Duke-NUS Medical School, SingHealth, Singapore
- Department of Prosthodontics, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
| | - Carolina Marpaung
- Department of Prosthodontics, Faculty of Dentistry, Trisakti University, Jakarta, Indonesia
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Yap AU, Lei J, Zhang XH, Fu KY. TMJ degenerative joint disease: relationships between CBCT findings, clinical symptoms, and signs. Acta Odontol Scand 2023; 81:562-568. [PMID: 37211630 DOI: 10.1080/00016357.2023.2215317] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES The relationships between cone-beam computed tomography (CBCT) findings, Temporomandibular disorder (TMD) symptoms, and signs were investigated in patients with TMJ degenerative joint disease (DJD). MATERIAL AND METHODS Adult patients with Diagnostic Criteria for TMDs (DC/TMD)-defined intra-articular conditions were enrolled and subjected to CBCT assessment. The participants were organized into three groups, namely no (NT), early (ET), and late (LT) TMJ DJD based on radiographic findings. TMD symptoms/signs were appraised using the DC/TMD methodology. Statistical analyses were performed using Chi-square/non-parametric tests and Kappa statistics (α = 0.05). RESULTS The mean age of the participants (n = 877) was 30.60 ± 11.50 years (86.6% women). NT, ET, and LT were observed in 39.7%, 17.0%, and 43.3% of the study sample. Significant differences in the prevalence of TMD symptoms (TMD pain, TMJ sounds, opening, and closing difficulty) and signs (TMD/TMJ pain, TMJ clicking/crepitus, and opening limitation) were discerned among the three groups (p ≤ .001). TMD/TMJ pain and opening difficulty/limitation were more prevalent in early rather than late degenerative changes. While moderate agreements between symptoms and signs were observed for TMD pain/opening limitation, the concurrence for TMJ sounds was fair. CONCLUSIONS Young adults with TMJ sounds and pain should be examined with CBCT to establish the extent/progress of osseous changes.
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Affiliation(s)
- Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, P.R. China
- Department of Dentistry, Ng Teng Fong General Hospital, and Faculty of Dentistry, National University Health System, Singapore
- National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore
| | - Jie Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, P.R. China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, P.R. China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, P.R. China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P.R. China
- Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
| | - Xiao-Han Zhang
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, P.R. China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, P.R. China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, P.R. China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P.R. China
- Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
| | - Kai-Yuan Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, P.R. China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology, Beijing, P.R. China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, P.R. China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, P.R. China
- Beijing Key Laboratory of Digital Stomatology, Beijing, P.R. China
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Effat KG, Berty A. Otological symptoms in patients with rheumatoid arthritis of the temporomandibular joint. Cranio 2023:1-8. [PMID: 37747112 DOI: 10.1080/08869634.2023.2260281] [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: 09/26/2023]
Abstract
OBJECTIVE The aim of the current study was to describe the pattern of otological symptoms in patients with rheumatoid arthritis (RA), having clinical temporomandibular joint (TMJ) involvement. This issue had not been previously addressed. METHODS A questionnaire and examination findings protocol was applied for 141 patients with RA and 141 control subjects. RESULTS Otological symptoms (otalgia, hearing loss, tinnitus, and vertigo), all had a significantly higher incidence in RA patients, compared to control subjects (P = .001). CONCLUSION The onset and maintenance of otological symptoms in patients with TMJ involvement by RA probably result from peripheral, as well as central nervous system alterations in sensory stimuli programming.
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Affiliation(s)
- Kamal G Effat
- Consultant Otolaryngologist, El-Sahel Teaching Hospital, Cairo, Egypt
| | - Abeer Berty
- Consultant Rheumatologist, St. Mark Rheumatology Center, Cairo, Egypt
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Bi R, Li Q, Li H, Wang P, Fang H, Yang X, Wang Y, Hou Y, Ying B, Zhu S. Divergent chondro/osteogenic transduction laws of fibrocartilage stem cell drive temporomandibular joint osteoarthritis in growing mice. Int J Oral Sci 2023; 15:36. [PMID: 37626033 PMCID: PMC10457315 DOI: 10.1038/s41368-023-00240-5] [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: 04/28/2023] [Revised: 07/20/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
The anterior disc displacement (ADD) leads to temporomandibular joint osteoarthritis (TMJOA) and mandibular growth retardation in adolescents. To investigate the potential functional role of fibrocartilage stem cells (FCSCs) during the process, a surgical ADD-TMJOA mouse model was established. From 1 week after model generation, ADD mice exhibited aggravated mandibular growth retardation with osteoarthritis (OA)-like joint cartilage degeneration, manifesting with impaired chondrogenic differentiation and loss of subchondral bone homeostasis. Lineage tracing using Gli1-CreER+; Tmfl/-mice and Sox9-CreER+;Tmfl/-mice showed that ADD interfered with the chondrogenic capacity of Gli1+ FCSCs as well as osteogenic differentiation of Sox9+ lineage, mainly in the middle zone of TMJ cartilage. Then, a surgically induced disc reposition (DR) mouse model was generated. The inhibited FCSCs capacity was significantly alleviated by DR treatment in ADD mice. And both the ADD mice and adolescent ADD patients had significantly relieved OA phenotype and improved condylar growth after DR treatment. In conclusion, ADD-TMJOA leads to impaired chondrogenic progenitor capacity and osteogenesis differentiation of FCSCs lineage, resulting in cartilage degeneration and loss of subchondral bone homeostasis, finally causing TMJ growth retardation. DR at an early stage could significantly alleviate cartilage degeneration and restore TMJ cartilage growth potential.
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Affiliation(s)
- 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, Chengdu, China
| | - Qianli Li
- 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, Chengdu, China
| | - Haohan Li
- 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, Chengdu, 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, Chengdu, China
| | - 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, Chengdu, China
| | - Xianni Yang
- 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, Chengdu, China
| | - Yiru 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, Chengdu, China
| | - Yi Hou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Binbin Ying
- Department of Stomatology, Ningbo First Hospital, Ningbo, 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, Chengdu, China.
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Yap AU, Lei J, Fu KY, Kim SH, Lee BM, Park JW. DC/TMD Axis I diagnostic subtypes in TMD patients from Confucian heritage cultures: a stratified reporting framework. Clin Oral Investig 2023; 27:4459-4470. [PMID: 37243820 DOI: 10.1007/s00784-023-05067-2] [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: 09/25/2022] [Accepted: 05/07/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVES This study proposed a conceptual framework for reporting Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I conditions and investigated the prevalence of TMD subtypes/categories in patients from Confucian heritage cultures. Variances in gender, age, and TMD chronicity between Chinese (CN) and Korean (KR) patients were also explored. MATERIALS AND METHODS Subjects were recruited from consecutive patients seeking care at two University-based centers in Beijing and Seoul. Eligible patients completed a demographic survey as well as the DC/TMD Symptom Questionnaire and were clinically examined according to the DC/TMD methodology. Axis I diagnoses were subsequently rendered with the DC/TMD algorithms and documented using the stratified reporting framework. Statistical evaluations were performed with chi-square, Mann-Whitney U tests, and logistic regression analysis (α = 0.05). RESULTS Data of 2008 TMD patients (mean age 34.8 ± 16.2 years) were appraised. Substantial differences in female-to-male ratio (CN > KR), age (KR > CN), and TMD duration (KR > CN) were observed. Ranked frequencies of the most common Axis I diagnoses were: CN - disc displacements (69.7%) > arthralgia (39.9%) > degenerative joint disease (36.7%); KR - disc displacements (81.0%) > myalgia (60.2%) > arthralgia (56.1%). Concerning TMD categories, notable differences in the prevalence of intra-articular (CN 55.1% > KR 15.4%) and combined (KR 71.8% > CN 33.4%) TMDs were discerned. CONCLUSIONS Though culturally similar, the two countries require disparate TMD care planning/prioritization. While TMJ disorders in children/adolescents and young adults should be emphasized in China, the focus in Korea would be on TMD pain in young and middle-aged adults. CLINICAL RELEVANCE Besides culture, other variables including socioeconomic, environmental, and psychosocial factors can influence the clinical presentation of TMDs. Chinese and Korean TMD patients exhibited significantly more intra-articular and combined TMDs respectively.
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Affiliation(s)
- Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- 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
| | - Jie Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Kai Yan Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
- National Center for Stomatology and National Clinical Research Center for Oral Diseases, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Seong Hae Kim
- Department of Dental Biomaterials Science, Seoul National University School of Dentistry, Seoul, Korea
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Byeong-Min Lee
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea
| | - Ji Woon Park
- Dental Research Institute, Seoul National University, Seoul, Korea.
- Department of Oral Medicine, Seoul National University Dental Hospital, Seoul, Korea.
- Department of Oral Medicine & Oral Diagnosis, Seoul National University School of Dentistry, 101 Daehak-Ro, Jongno-Gu, Seoul, Korea.
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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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Chung MK, Wang S, Alshanqiti I, Hu J, Ro JY. The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models. FRONTIERS IN PAIN RESEARCH 2023; 4:1038808. [PMID: 36846071 PMCID: PMC9947567 DOI: 10.3389/fpain.2023.1038808] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Temporomandibular disorders (TMD) represent a group of musculoskeletal conditions involving the temporomandibular joints (TMJ), the masticatory muscles and associated structures. Painful TMD are highly prevalent and conditions afflict 4% of US adults annually. TMD include heterogenous musculoskeletal pain conditions, such as myalgia, arthralgia, and myofascial pain. A subpopulations of TMD patients show structural changes in TMJ, including disc displacement or degenerative joint diseases (DJD). DJD is a slowly progressing, degenerative disease of the TMJ characterized by cartilage degradation and subchondral bone remodeling. Patients with DJD often develop pain (TMJ osteoarthritis; TMJ OA), but do not always have pain (TMJ osteoarthrosis). Therefore, pain symptoms are not always associated with altered TMJ structures, which suggests that a causal relationship between TMJ degeneration and pain is unclear. Multiple animal models have been developed for determining altered joint structure and pain phenotypes in response to various TMJ injuries. Rodent models of TMJOA and pain include injections to induce inflammation or cartilage destruction, sustained opening of the oral cavity, surgical resection of the articular disc, transgenic approaches to knockout or overexpress key genes, and an integrative approach with superimposed emotional stress or comorbidities. In rodents, TMJ pain and degeneration occur during partially overlapping time periods in these models, which suggests that common biological factors may mediate TMJ pain and degeneration over different time courses. While substances such as intra-articular pro-inflammatory cytokines commonly cause pain and joint degeneration, it remains unclear whether pain or nociceptive activities are causally associated with structural degeneration of TMJ and whether structural degeneration of TMJ is necessary for producing persistent pain. A thorough understanding of the determining factors of pain-structure relationships of TMJ during the onset, progression, and chronification by adopting novel approaches and models should improve the ability to simultaneously treat TMJ pain and TMJ degeneration.
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Affiliation(s)
- Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, Program in Neuroscience, Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
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Shadamarshan R A, Sharma R, Agrawal N, Patrikar S. Suprafoveal condylar arthroplasty in unilateral disc displacement without reduction - A retrospective study. J Craniomaxillofac Surg 2023; 51:117-122. [PMID: 36759299 DOI: 10.1016/j.jcms.2023.01.010] [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: 05/16/2022] [Revised: 11/13/2022] [Accepted: 01/22/2023] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to evaluate the efficacy of suprafoveal condylar arthroplasty (SFCA) in the management of patients with unilateral temporomandibular joint (TMJ) disc displacement without reduction (DDWoR). A retrospective study comprising patients who underwent unilateral SFCA for clinically and radiologically confirmed unilateral DDWoR from 2008 to 2020 was conducted. Patients older than 18 years at the time of diagnosis with a minimum of 6 months of unsuccessful non-surgical and minimally invasive management (including diet and life style modification, physiotherapy, appliance therapy, pharmacotherapy, arthrocentesis and arthroscopic lysis and lavage) before undergoing surgery with a minimum of 1 year follow-up post-surgery were included in the study. Patients with other articular and extra-articular causes of restricted mouth opening, prior history of mandibular surgery and/or trauma, growth abnormalities, systemic, metabolic, infective, neoplastic conditions affecting TMJ, including gross occlusal disharmony, untreated existing para-functional habits and bilateral DDWoR, were excluded from the study. Patients were assessed in terms pain on a visual analog scale (VAS), interincisal mouth opening (MO) and subjective assessment of mandibular range of movements including deviation of mouth opening, protrusion and ability for contralateral laterotrusion. 23 patients (10 males and 13 female) were included in the study, with a mean age of 35.09 years and mean follow up period of 37.7 months (range = 12-58; SD = 15.3). The mean pain scores on the VAS reduced from 6.35 preoperatively to 1.13 postoperatively and were found to be statistically significant (p < 0.0001). The improvement of the mean pre-operative mouth opening of 21.83 mm to a mean post-operative mouth opening of 42.09 mm was also found to be statistically significant (p < 0.0001). The subjective improvement in protrusive (p = 0.0003), laterotrusive (p = 0.0005) and opening movements (p = 0.0001) after 1 year were also found to be statistically significant. No patient developed any significant changes in occlusion post-operatively. Four of 23 (17.3%) patients developed transient neuromotor deficit of the temporal branch of the facial nerve. Within the limitations of the study, it seems that SFCA (without addressing the disc) might be an alternative to less invasive treatment approaches, if the latter turned out not to be successful.
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Affiliation(s)
| | - Rohit Sharma
- Dept of Oral and Maxillofacial Surgery, Command Military Dental Centre (Western Command), Chandimandir, India.
| | - Nitesh Agrawal
- Dept of Anesthesiology, Military Hospital, Jalandhar Cantt, Punjab, India
| | - Seema Patrikar
- Department of Preventive & Social Medicine, Armed Forces Medical College, Pune, Maharashtra, India
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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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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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Mélou C, Pellen-Mussi P, Jeanne S, Novella A, Tricot-Doleux S, Chauvel-Lebret D. Osteoarthritis of the Temporomandibular Joint: A Narrative Overview. MEDICINA (KAUNAS, LITHUANIA) 2022; 59:medicina59010008. [PMID: 36676632 PMCID: PMC9866170 DOI: 10.3390/medicina59010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
Background and Objectives: This study reviewed the literature to summarize the current and recent knowledge of temporomandibular joint osteoarthritis (TMJOA). Methods: Through a literature review, this work summarizes many concepts related to TMJOA. Results: Although many signaling pathways have been investigated, the etiopathogenesis of TMJOA remains unclear. Some clinical signs are suggestive of TMJOA; however, diagnosis is mainly based on radiological findings. Treatment options include noninvasive, minimally invasive, and surgical techniques. Several study models have been used in TMJOA studies because there is no gold standard model. Conclusion: More research is needed to develop curative treatments for TMJOA, which could be tested with reliable in vitro models, and to explore tissue engineering to regenerate damaged temporomandibular joints.
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Affiliation(s)
- Caroline Mélou
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
- CHU Rennes, Pôle d’Odontologie, 35033 Rennes, France
- UFR Odontologie, 35043 Rennes, France
| | - Pascal Pellen-Mussi
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
| | - Sylvie Jeanne
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
- CHU Rennes, Pôle d’Odontologie, 35033 Rennes, France
- UFR Odontologie, 35043 Rennes, France
| | - Agnès Novella
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
| | - Sylvie Tricot-Doleux
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
| | - Dominique Chauvel-Lebret
- CNRS, ISCR (Institut des Sciences Chimiques de Rennes), University Rennes, UMR 6226, 35000 Rennes, France
- CHU Rennes, Pôle d’Odontologie, 35033 Rennes, France
- UFR Odontologie, 35043 Rennes, France
- Correspondence: ; Tel.: +33-2-23-23-43-64; Fax: +33-2-23-23-43-93
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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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21
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Memiş S. Evaluation of the effects of temporomandibular joint arthrocentesis with hyaluronic acid injection on mandibular condyles using fractal dimension analysis: A retrospective study. J Craniomaxillofac Surg 2022; 50:643-650. [DOI: 10.1016/j.jcms.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/15/2022] [Accepted: 07/02/2022] [Indexed: 12/01/2022] Open
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22
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Yap AU, Zhang XH, Cao Y, Fu KY. Degenerative temporomandibular joint diseases and their relation with sleep and emotional disturbance. Cranio 2022:1-8. [PMID: 35285424 DOI: 10.1080/08869634.2022.2050976] [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: 10/18/2022]
Abstract
OBJECTIVE The relation of degenerative temporomandibular joint (TMJ) diseases (DJDs) with sleep and emotional disturbance were investigated. METHODS CBCT examination of patients (n = 358) with DC/TMD-defined intra-articular temporomandibular disorders was performed and stratified into NN: no DJD and no arthralgia; NA: no DJD with arthralgia; TO: osteoarthrosis; and TR: osteoarthritis. Sleep and emotional disturbance were assessed with the Pittsburgh Sleep Quality Index (PSQI) and Depression Anxiety Stress Scale-21 (DASS-21). Data were evaluated using non-parametric and multivariate logistic regression analyses (α = 0.05). RESULTS Distributions of NN, NA, TO, and TR groups were 23.2%, 27.1%,19.0%, and 30.7%, respectively. No significant differences in total-PSQI/DASS scores were detected among the four groups. The presence of pain and stress predicted poor quality sleep with odds ratios of 10.75 and 1.07, accordingly. CONCLUSION Sleep quality was affected more by arthralgia and stress than the presence of TMJ DJDs.
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Affiliation(s)
- Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, BJ, China
- Department of Dentistry, Ng Teng Fong General Hospital, Jurong East, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore
- National Dental Research Institute Singapore, National Dental Center Singapore and Duke-NUS Medical School, Singapore Health Services, Singapore
| | - Xian-Han Zhang
- Center for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, BJ, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, BJ, China
| | - Ye Cao
- Center for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, BJ, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, BJ, China
| | - Kai-Yuan Fu
- Center for TMD & Orofacial Pain, Peking University, Hospital & School of Stomatology, Beijing, BJ, China
- Department of Oral & Maxillofacial Radiology, Peking University School & Hospital of Stomatology: National Clinical Research Center for Oral Diseases, Beijing, BJ, China
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Yuan S, Liu Y, Deng K, Li X, Bakker AD, Klein-Nulend J, Pathak JL, Zhang Q, Wang Z. Correlation of clinical manifestations and condylar morphology of patients with temporomandibular degenerative joint diseases. Cranio 2022:1-8. [PMID: 34986737 DOI: 10.1080/08869634.2021.2018199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To study the correlation between condylar morphology and clinical manifestations in patients with degenerative joint disease (DJD) of the temporomandibular joint (TMJ). METHODS A total of 175 joints of 131 patients with DJD were included. Data on patients' basic information and symptoms were collected and analyzed. Condylar morphology was evaluated using cone beam computed tomography (CBCT). The correlation between the condylar morphology and clinical manifestations was analyzed. RESULTS The prevalence of joint noises, clicks, and crepitus was 93/175 (53%), 73/175 (42%), and 20/175 (11%), respectively. Condylar anteroposterior diameter and condylar height were correlated with pain. There was a correlation between the shape of the condyle in the sagittal plane and joint noise. CONCLUSION Condylar morphology and clinical features of DJD were correlated to some extent.
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Affiliation(s)
- ShanShan Yuan
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Reasearch of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - YaRui Liu
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Reasearch of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - KaiTong Deng
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Reasearch of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - XingYang Li
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Reasearch of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Astrid D Bakker
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Jenneke Klein-Nulend
- Department of Oral Cell Biology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Janak L Pathak
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Reasearch of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - QingBin Zhang
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Reasearch of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - ZhaoJian Wang
- Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Reasearch of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
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24
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Yap AU, Zhang XH, Cao Y, Fu KY. Functional, physical and psychosocial impact of degenerative temporomandibular joint disease. J Oral Rehabil 2021; 49:301-308. [PMID: 34862971 DOI: 10.1111/joor.13288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/28/2021] [Accepted: 11/26/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVES This study evaluated the functional, physical and psychosocial impacts of TMJ degenerative joint disease (DJD). The bearing of TMJ osteoarthrosis/osteoarthritis and early/late TMJ DJD on oral health-related quality of life (OHRQoL) were also compared. METHODS Participants were enrolled from a TMD/oro-facial pain centre. Those diagnosed with intra-articular conditions based on the Diagnostic Criteria for Temporomandibular disorders (DC/TMD) were subjected to CBCT assessment and categorised into four discrete groups: NN-no TMJ DJD and no arthralgia; NA-no TMJ DJD with arthralgia; TO-TMJ osteoarthrosis; and TR-TMJ osteoarthritis. The TO/TR groups were subdivided into early/late TMJ osteoarthrosis (EO/LO) and osteoarthritis (ER/LR). OHRQoL was examined using the OHIP-TMD, and data were appraised with the Kruskal-Wallis/Mann-Whitney U tests (α = 0.05). RESULTS The study participant (n = 358) had a mean age of 31.85 ± 12.39 years (85.6% women). Frequencies of the TMD groups were as follows: NN-23.2%; NA-27.1%; TO-19.0%; and TR-30.7%. Participants with TR/NA had significantly worse OHRQoL than those with TO/NN. Additionally, participants with ER/LR reported significantly poorer OHRQoL than their counterparts with EO/LO. For all TMD groups and TMJ DJD subgroups, the psychological discomfort domain was generally the most impaired. Differences in global OHIP scores were significant between participants with and without arthralgia (i.e., NA-NN, ER-EO and LR-LO). CONCLUSIONS The presence of TMJ pain appeared to impair OHRQoL more than the severity of TMJ DJD. As psychological domains were most impacted, psychosocial care should be incorporated when managing patients with painful TMJ DJD.
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Affiliation(s)
- Adrian Ujin Yap
- Centre for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China.,Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore City, Singapore.,National Dental Centre Singapore and Duke-NUS Medical School, National Dental Research Institute Singapore, Singapore Health Services, Singapore City, Singapore
| | - Xiao-Han Zhang
- Centre 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 Center of Stomatology & National Clincial 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
| | - Ye Cao
- Centre 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 Center of Stomatology & National Clincial 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
| | - Kai-Yuan Fu
- Centre 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 Center of Stomatology & National Clincial 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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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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Is the Temporomandibular Joints' Reciprocal Clicking Related to the Morphology and Position of the Mandible, as Well as to the Sagittal Position of Lower Incisors?-A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094994. [PMID: 34066772 PMCID: PMC8125905 DOI: 10.3390/ijerph18094994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/28/2021] [Accepted: 05/07/2021] [Indexed: 01/25/2023]
Abstract
The number of patients diagnosed with temporomandibular joint (TMJ) internal derangements, who are seeking orthodontic treatment, is increasing. The aim of the study was to assess the relationship between the presence of TMJ reciprocal clicking and the morphology and position of the mandible, and position of lower incisors, examined on the lateral cephalograms. Fifty patients diagnosed with reciprocal clicking in at least one of the TMJs and 55 patients with no symptoms of TMJ dysfunction were included in the study. Cephalometric analysis was used for the assessment of: skeletal class, sagittal and vertical position of the mandible, angle of the mandible, inclination of the mandibular ramus and the mandibular corpus, as well as for the assessment of the position of the mandibular incisors. The statistical significance level was set at p = 0.05. There were no statistically significant differences between the examined groups regarding the sagittal and vertical position of the mandible, as well as regarding the sagittal position of the mandibular incisors. Presence of TMJ reciprocal clicking is not associated with the position and the morphology of the mandible, as well as with the sagittal position of the mandibular incisors. Patients with early stages of TMJ internal derangements do not present any significant changes in Cephalometrics. Patients diagnosed with TMJ internal derangements before orthodontic treatment require an interdisciplinary approach to the treatment, including physiotherapy.
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Lei J, Yap AU, Zhang M, Fu KY. Temporomandibular disorder subtypes, emotional distress, impaired sleep, and oral health-related quality of life in Asian patients. Community Dent Oral Epidemiol 2021; 49:543-549. [PMID: 33829540 DOI: 10.1111/cdoe.12643] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study determined the differences in emotional states, sleep and oral health-related quality of life (OHRQoL) between patients with pain-related and intra-articular Temporomandibular disorders (TMDs), and associated emotional symptoms with sleep and OHRQoL. METHODS Participants were recruited from a tertiary TMDs referral centre. The Depression, Anxiety, Stress Scales-21 (DASS-21), Pittsburgh Sleep Quality Index (PSQI) and Oral Health Impact Profile-TMDs (OHIP-TMDs) were used to assess emotional states, sleep and Oral health-related quality of life (OHRQoL), respectively. TMD-related and sociodemographic data were also gathered. Patients were divided into pain-related (PT), intra-articular (IT) and combined TMDs (CT) groups based on the Diagnostic Criteria for TMDs. Data were analysed using one-way ANOVA, Chi-square test, Pearson's correlation and logistic regression analysis with the significance level set at P < .05. RESULTS Data from 1079 participants with a mean age of 29.6 ± 14.2 years were appraised (93.3% response rate). The severity/prevalence of emotional distress, impaired sleep and OHRQoL of the PT/CT groups were higher than the IT group. Moderate-to-strong inter-relationships between emotional, sleep and OHRQoL variables were more explicit for participants with painful TMDs. Logistic regression analysis demonstrated that painful TMDs were associated with higher stress and poorer OHRQoL with odds ratios (ORs) of 1.482 (95% CI 1.039-2.114) and 6.502 (95% CI 3.201-13.210), respectively. CONCLUSIONS Painful TMDs are associated with higher levels of emotional distress, sleep and OHRQoL impairments. Routine evaluation of the biopsychosocial distress, especially stress and life quality, is necessary for patients with painful TMDs.
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Affiliation(s)
- Jie 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
| | - Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China.,Department of Dentistry, Faculty of Dentistry, Ng Teng Fong General Hospital, 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
| | - Minjuan Zhang
- 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
| | - Kai-Yuan 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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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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Yap AU, Zhang MJ, Lei J, Fu KY. Diagnostic accuracy of the short-form Fonseca Anamnestic Index in relation to the Diagnostic Criteria for Temporomandibular Disorders. J Prosthet Dent 2021; 128:977-983. [PMID: 33795162 DOI: 10.1016/j.prosdent.2021.02.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 01/31/2023]
Abstract
STATEMENT OF PROBLEM Screening for temporomandibular disorders (TMDs) is important in research and clinical practice. The short-form Fonseca Anamnestic Index (SFAI) was recently introduced but had only been validated for muscle disorders. PURPOSE The purpose of this clinical study was to determine the diagnostic accuracy of the SFAI and its discrete and pooled items in relation to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) benchmark. MATERIAL AND METHODS A total of 866 consecutive participants with TMDs and 57 TMD-free controls (aged ≥18 years) were recruited. The participants (n=923; mean age 32.8 ±13.3 years; women 79.2%) answered the FAI, and TMD diagnoses were derived based on the DC/TMD protocol and algorithms. The 5-item SFAI, which comprised 2 pain-related and 3 function-related TMD questions, was subsequently acquired and assessed with reference to the DC/TMD diagnoses. The receiver operating characteristics (ROC) was used to verify accuracy (area under the curve [AUC]) and the best cutoff points. Sensitivity, specificity, predictive values, and likelihood ratios were also examined. RESULTS Pain-related (PT) and intra-articular (IT) TMDs were present in 48.3% (446/923) and 82.7% (763/923) of the participants, respectively. The SFAI demonstrated high accuracy for identifying all TMDs, PT, and IT (AUC of 0.97, 0.99, and 0.97, respectively). The best cutoff points were 12.5 for all TMDs/IT and 17.5 for PT. Sensitivity of the SFAI ranged from 90.7% to 97.5% while specificity varied from 93.0% to 96.5%, with the highest values for PT. As positive predictive values (99.4% to 99.5%) were greater than negative ones (41.7% to 83.3%), the SFAI was better at detecting the presence than the absence of TMDs. With reference to PT, the sensitivity, and specificity of the 2 discrete and pooled pain-related questions (questions 3 and 4), extended from 82.3% to 99.3% and 77.2% to 96.5% respectively. With regard to IT diagnoses, sensitivity and specificity ranged from 56.0% to 98.3% and 86.0% to 98.3% for the 3 discrete and pooled function-related items (questions 1, 2, and 5). CONCLUSIONS The SFAI presented high degrees of diagnostic accuracy in relation to the DC/TMD and can be used for screening TMDs. SFAI scores between 15 and 50 points should be used to identify the presence of TMDs, with scores ≥20 points specifying possible pain-related TMDs.
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Affiliation(s)
- Adrian Ujin Yap
- Guest Academic, Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, PR China; Clinical Associate Professor, Department of Dentistry, Ng Teng Fong General Hospital and Faculty of Dentistry, National University Health System, Singapore; Adjunct Associate Professor, National Dental Research Institute Singapore, National Dental Centre Singapore and Duke-NUS Medical School, SingHealth, Singapore
| | - Min-Juan Zhang
- Research Associate, Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, PR China; National Clinical Research Center for Oral Diseases, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China; Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Jie Lei
- Associate Professor, Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, PR China; National Clinical Research Center for Oral Diseases, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China; Beijing Key Laboratory of Digital Stomatology, Beijing, PR China
| | - Kai-Yuan Fu
- Professor, Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, PR China; National Clinical Research Center for Oral Diseases, Beijing, PR China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, PR China; Beijing Key Laboratory of Digital Stomatology, Beijing, PR China.
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Zhou H, Xue Y, Liu P. Application of auriculotemporal nerve block and dextrose prolotherapy in exercise therapy of TMJ closed lock in adolescents and young adults. Head Face Med 2021; 17:11. [PMID: 33773589 PMCID: PMC8004452 DOI: 10.1186/s13005-021-00261-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 03/11/2021] [Indexed: 12/19/2022] Open
Abstract
Background Temporomandibular joint (TMJ) ‘closed lock’ is a clinical condition causing TMJ pain and limited mouth opening (painful locking). Recent studies suggest an increasing prevalence of degenerative joint disease associated with the onset of TMJ closed lock in adolescents and young adults. Early interventions are recommended, but the curative effect of standard therapies remains controversial. In this retrospective study, an alternative method of non-surgical treatment of TMJ closed lock is presented, and its long-term efficacy has been observed. Methods Forty adolescents and young adults, aged 16 to 30 years old, with distinct combination of symptoms of TMJ closed lock, were enrolled. Patients received anesthetic blockages of the auriculotemporal nerve, then performed mandibular condylar movement exercise for 10 min, and subsequently received hypertonic dextrose prolotherapy in retro-discal area of TMJ. Clinical assessments at baseline and at follow-up (2 weeks, 2 months, 6 months, and 5 years) included intensity and frequency of TMJ pain, mandibular range of motion, TMJ sounds, and impairment of chewing. Results Cone beam CT images of the TMJs revealed joint space changes in all patients and degenerative bone changes in 20% (8/40) of the patients. The patients were diagnosed as having disc displacement without reduction with limited opening. Successful reduction of displaced disc had been achieved in the treatment. And pain at rest and pain on mastication had substantially decreased in all patients and mandibular function and mouth opening had significantly improved since 2 weeks’ follow-up. The overall success rate kept at a high level of 97.5% (39/40) at 6 months and 5 years’ follow-up. Conclusions The technique combining mandibular condylar movement exercise with auriculotemporal nerve block and dextrose prolotherapy is straightforward to perform, inexpensive and satisfactory to young patients with TMJ closed lock.
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Affiliation(s)
- Hongzhi Zhou
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, 145# Western Changle Road, Xi'an, 710032, P.R. China. .,Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University (FMMU), Xi'an, 710032, China.
| | - Yang Xue
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, 145# Western Changle Road, Xi'an, 710032, P.R. China.,Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University (FMMU), Xi'an, 710032, China
| | - Ping Liu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, 145# Western Changle Road, Xi'an, 710032, P.R. China.,Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University (FMMU), Xi'an, 710032, China
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The Effect of Condylar Regeneration After Different Disc Repositioning Surgeries in Adolescents with Skeletal Class II Malocclusion. J Oral Maxillofac Surg 2021; 79:1851-1861. [PMID: 33901450 DOI: 10.1016/j.joms.2021.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE To evaluate the effect of different temporomandibular joint (TMJ) disc repositioning surgeries for the treatment of anterior disc displacement (ADD) in juvenile patients with skeletal Class II malocclusion. PATIENTS AND METHODS Patients (< 20 years, cervical vertebral maturation stage, IV-V) who had bilateral TMJ ADD with skeletal Class II malocclusion were treated by disc repositioning surgery (mini-screw anchor, [MsA]; or opening suturing, [OSu]). Magnetic resonance imaging (MRI) and lateral cephalometric films before and more than 12 months after surgery were collected from all patients. Changes of SNA, SNB, ANB, incisor overjet, pogonion position (pg'-G'), and condylar height were measured before and after surgery in different disc reposition surgeries and compared by statistical analysis. RESULTS Eighty-four patients with an average age of 16.44 years and follow-up time of 14.60 months (12 to 33 months) were included in the study. Among them, 16 patients had a mean follow-up of 14.8 months without treatment before disc repositioning. Their condylar height was significantly decreased (P = .004) by MRI measurement. Six patients who had cephalometric films showed significantly decreased SNB (P = .042) and increased overjet (P = .037). After disc repositioning by either OSu (54 cases) or MsA (30 cases), condylar height, SNB were significantly increased and overjet, Pg'-G', ANB were decreased in both groups (P < 0.001). There was more new bone height in OSu than MsA (P = .004), but no significant differences in SNB, ANB, overjet and Pg'-G' between the 2 groups (P > .05). The new bone height was significantly correlated with the surgical method (P = .029), age (P = .015), SNB (P = .008), overjet (P = .048) and pg'-G' (P = .001). CONCLUSIONS Both types of disc repositioning method can effectively promote condylar regeneration and improve skeletal Class II malocclusion in adolescents with ADD. Disc repositioning by OSu obtained more new bone height than MsA.
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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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Yap AU, Cao Y, Zhang MJ, Lei J, Fu KY. Temporomandibular disorder severity and diagnostic groups: Their associations with sleep quality and impairments. Sleep Med 2021; 80:218-225. [PMID: 33607558 DOI: 10.1016/j.sleep.2021.01.063] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 01/28/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVES This study evaluated the impact of TMD severity on sleep quality and established the associations between TMD diagnostic groups/pain subtypes and sleep impairments. METHODS A total of 1151 patients from a tertiary Dental Hospital were screened for eligibility. Consenting subjects who met the inclusion criteria were directed to complete a general/health questionnaire, the Fonseca Anamnestic Index (FAI), Diagnostic Criteria for Temporomandibular disorders (DC/TMD) Symptom Questionnaire, and Pittsburgh Sleep Quality Index (PSQI) at their intake visit. Patients who screened positive for TMDs with the FAI were subjected to a protocolized physical examination and TMD diagnostic groups/subtypes were subsequently derived based on the DC/TMD "diagnostic tree" and algorithms. Statistical analyses were conducted using non-parametric methods and logistic regression (α = 0.05). RESULTS The final sample consisted of 845 subjects with TMDs and 116 TMD-free controls. The mean age of the TMD and TMD-free subjects were 33.17 ± 13.55 and 31.66 ± 9.50 years. Subjects with severe and moderate TMDs had significantly greater global PSQI scores than those with mild and no TMDs (p < 0.001). Those with pain-related, intra-articular, and combined TMDs reported significantly poorer sleep quality than those with no TMDs (p < 0.001). Moreover, subjects with myalgia and myalgia plus arthralgia presented significantly greater sleep impairments than their counterparts with intra-articular disorders (p < 0.001). Multivariate logistic regression indicated that pain-related (OR = 3.23; CI = 1.69-6.14) and intra-articular TMDs (OR = 1.91; CI = 1.15-3.16) were most related to poor sleep. CONCLUSIONS Sleep quality worsened with increasing TMD severity and the presence of painful and intra-articular TMDs increased the likelihood of poor sleep.
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Affiliation(s)
- Adrian Ujin 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, Singapore; National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
| | - Ye Cao
- 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
| | - Min-Juan Zhang
- 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
| | - Jie 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
| | - Kai-Yuan 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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Yap AU, Cao Y, Zhang MJ, Lei J, Fu KY. Comparison of emotional disturbance, sleep, and life quality in adult patients with painful temporomandibular disorders of different origins. Clin Oral Investig 2021; 25:4097-4105. [PMID: 33404766 DOI: 10.1007/s00784-020-03740-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 12/10/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES This study compared the differences in emotional disturbance, sleep, and life quality among adult patients with temporomandibular (TMD) muscle and/or joint pain. MATERIALS AND METHODS The study involved an analytical cross-sectional design. A total of 420 consecutive patients diagnosed with pain-related TMDs based on the Diagnostic Criteria for TMDs (DC/TMD) were recruited from a TMD referral centre and stratified into three groups, namely muscle pain (MP; n = 50), joint pain (JP; n = 329), and combined muscle-joint pain (CP; n = 41). Emotional disturbance, sleep quality, and oral health-related quality of life (OHRQoL) were assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21), Pittsburgh Sleep Quality Index (PSQI), and Oral Health Impact Profile-TMDs (OHIP-TMDs) respectively. Statistical analyses were performed using the chi-square test, one-way ANOVA, and Pearson's correlation (p < 0.05). RESULTS Mean age for the three pain groups (females = 349; males = 71) ranged from 37.15 ± 14.91 to 38.60 ± 14.37 years (p = 0.973). Ranking of depression, anxiety, and stress scores was as follows: CP > MP > JP. Significant differences in emotional disturbances were observed (p < 0.001). CP patients had significantly poorer sleep quality than those with JP (p = 0.004). Moreover, OHRQoL was also significantly more impaired as compared to both MP (p = 0.006) and JP (p < 0.001) patients. Correlations between global PSQI and OHIP-TMDs scores were weak to moderate (rs = 0.30-0.47). CONCLUSIONS Patients with combined muscle-joint pain presented higher levels of emotional disturbance than those with only MP or JP. They also had significantly poorer sleep quality and lower OHRQoL. CLINICAL RELEVANCE Emotional and sleep health must be considered in the management of painful TMDs.
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Affiliation(s)
- Adrian Ujin Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, China.,Department of Dentistry, Ng Teng Fong General Hospital, National University Health System, Singapore, Singapore.,Faculty of Dentistry, National University of Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore and National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore
| | - Ye Cao
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, 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
| | - Min-Juan Zhang
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, 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
| | - Jie Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, 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
| | - Kai-Yuan Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, No. 22 Zhong Guan Cun South Ave, Beijing, 100081, 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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Shu C, Xiong X, Huang L, Liu Y. The relation of cephalometric features to internal derangements of the temporomandibular joint: A systematic review and meta-analysis of observational studies. Orthod Craniofac Res 2020; 24:305-313. [PMID: 33290631 DOI: 10.1111/ocr.12454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/29/2020] [Accepted: 12/02/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE To review and summarize the data on the relationship between craniofacial morphology features and internal derangement (ID) of the temporomandibular joint (TMJ). METHOD A systematic review was designed and registered at PROSPERO, CRD42019132731. The PubMed, Embase and Scopus databases were searched for cephalometric studies comparing craniofacial morphology between female patients with TMJ ID and controls. The Newcastle-Ottawa Scale (NOS) was used for quality assessment. Weighted mean differences for cephalometric measurements were pooled for subsequent meta-analysis. RESULT From the establishment date to August 2020, 14 of 1038 collected records were selected, which consisted of 772 patients with TMJ ID and 423 controls. These records were eventually pooled for the designed statistical analysis after the NOS quality assessment. Compared with the controls, TMJ ID patients had obviously smaller, retruded and clockwise-rotated mandible, showing significantly decreased S-Na, S-Go, Go-Me, Ar-Pog, Ar-Go, SNB, Na perp Pog, and increased FH-MP, SN-MP, PP-MP, SN to Ar-Go, S-Ar-Go and ANB. CONCLUSION Certain craniofacial morphology features were found strongly associated with the presence of TMJ ID, especially the size and position of the mandible.
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Affiliation(s)
- Chang Shu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China
| | - Xin Xiong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China
| | - Liwei Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China
| | - Yang Liu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chengdu, China
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Zhu H, Yang Z, He D, Hu N, Cheng Z. The effect of TMJ disk repositioning by suturing through open incision on adolescent mandibular asymmetry with and without a functional orthodontic appliance. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 131:405-414. [PMID: 33612440 DOI: 10.1016/j.oooo.2020.11.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 10/21/2020] [Accepted: 11/25/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the effect of combined temporomandibular joint (TMJ) disk repositioning by suturing through open incision and orthodontic functional appliance (OFA) treatment for adolescents with mandibular asymmetry. STUDY DESIGN Adolescent patients (12-20 years old) with mandibular asymmetry combined with unilateral TMJ disk displacement without reduction were treated with disk repositioning by suturing through open incision with and without postoperative OFA. Magnetic resonance imaging and posteroanterior cephalometric radiographs (PA) were used to measure and compare the changes in condylar height, joint space, and menton deviation pre- and postoperatively. RESULTS Twenty-six patients were included in the study. Joint space was significantly increased postoperatively and new bone mostly formed at the superior or posterior superior part of the condyle after 6 to 18 months in all surgically treated joints. Fourteen patients with OFA had a significant increase in condylar height and menton deviation compared to 12 patients without OFA (2.29 ± 0.91 mm vs 1.22 ± 0.69 mm, P = .003; 4.56 ± 1.48 mm vs 2.01 ± 0.74 mm, P = .000). CONCLUSIONS Combined treatment with TMJ disk repositioning by suturing through open incision and OFA can promote condylar growth and correct mandibular deviation in adolescent patients. Postoperative OFA can maintain the increased joint space created by disk repositioning and promote new bone formation at the superior and posterior parts of the condyle.
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Affiliation(s)
- Huimin Zhu
- Resident, 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, Huang Pu District, Shanghai, China
| | - Zhi Yang
- Associate Professor, Department of Oral and Cranio-maxillofacial 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, Huang Pu District, Shanghai, 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, Huang Pu District, Shanghai, China.
| | - Nan Hu
- Resident, Department of Oral and Cranio-maxillofacial 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, Huang Pu District, Shanghai, China
| | - Zheying Cheng
- Resident, Department of Oral and Cranio-maxillofacial 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, Huang Pu District, Shanghai, China
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Ujin Yap A, Cao Y, Zhang MJ, Lei J, Fu KY. Age-related differences in diagnostic categories, psychological states and oral health-related quality of life of adult temporomandibular disorder patients. J Oral Rehabil 2020; 48:361-368. [PMID: 33113158 DOI: 10.1111/joor.13121] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/21/2020] [Accepted: 10/21/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The peak prevalence of temporomandibular disorders (TMDs) may occur in middle age. This study determined the proportion of matured adults seeking TMD treatment and compared their diagnostic, psychological and oral health-related quality-of-life (OHRQoL) profiles to younger patients. METHODS Adult subjects were recruited from a tertiary TMD centre and assigned to three age groups, namely 18-44 years (young adults [YA]), 45-64 (middle-aged adults [MA]) and ≥65 (old adults [OA]). TMD diagnoses were established with the Diagnostic Criteria for TMDs and categorised as pain-related (PT), intra-articular (IT) and combined (CT) TMDs. Psychological states and OHRQoL were assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Oral Health Impact Profile-TMDs (OHIP-TMDs). Demographic, DASS-21, and OHIP-TMDs data were analysed using chi-square test, one-way ANOVA and Pearson's correlation (P < .05). RESULTS Middle-aged (19.7%; 136/692) and old (4.0%; 28/692) adults comprised about a quarter of the TMD patients. Although gender distribution was comparable, significant differences in TMD categories were observed (P < .001). Pain-related TMDs were more prevalent in the MA/OA groups while intra-articular TMDs were more frequent in the YA group. No significant difference in DASS-21 and total OHIP scores was noted among three groups. However, the MA and OA groups had significantly lower OHRQoL in the physical pain domain. Correlations between DASS-21 and OHIP-TMDs scores varied with age and ranged from rs = 0.47-0.92. CONCLUSIONS Matured patients constituted a quarter of TMD cohort and presented higher frequencies of painful TMDs. They have similar psychological profiles to younger patients but experienced lower OHRQoL in physical pain domain.
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Affiliation(s)
- Adrian Ujin 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, Singapore.,National Dental Research Institute Singapore, National Dental Centre, Singapore
| | - Ye Cao
- 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
| | - Min-Juan Zhang
- 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
| | - Jie 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
| | - Kai-Yuan 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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Xiong X, Yin X, Liu F, Qin D, Liu Y. Magnetic resonance imaging-guided disc-condyle relationship adjustment via articulation: a technical note and case series. J Int Med Res 2020; 48:300060520951052. [PMID: 32847435 PMCID: PMC7457669 DOI: 10.1177/0300060520951052] [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] [Indexed: 02/05/2023] Open
Abstract
A normal disc-condyle relationship is crucial to the health and function of the temporomandibular joint. We herein introduce a novel technique that can precisely and rapidly restore the disc-condyle relationship. An initial bite rim was made, and the patient was instructed to wear this bite rim during magnetic resonance imaging (MRI) scanning. A quick MRI scan was performed, and the disc-condyle relationship and direction and vector of the displacement was measured. Adjustments to the mandible position were made on an articulator based on the measurements, after which a second bite rim was made. A second quick preview MRI scan was immediately performed, and the images were evaluated and measured again. Additional adjustments were made as needed, and the preview scan was repeated until an ideal disc-condyle relationship was achieved. Once a good disc-condyle relationship was acquired, the mandible position was recorded as the treatment mandible position, and a splint was fabricated. MRI visualization enabled precise and very fine adjustment of the disc-condyle relationship by articulating. This technique might help to simplify the clinical process and improve treatment effectiveness.
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Affiliation(s)
- 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
| | - Xiaoli Yin
- 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
| | - Fang Liu
- Department of Prosthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Danqing Qin
- Department of Prosthodontics, 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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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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41
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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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42
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Abrahamsson AK, Arvidsson LZ, Småstuen MC, Larheim TA. Improvement of bone-erosive temporomandibular joint (TMJ) abnormalities in adolescents undergoing non-surgical treatment: a longitudinal study. Dentomaxillofac Radiol 2020; 49:20190338. [PMID: 32101476 DOI: 10.1259/dmfr.20190338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To investigate the longitudinal changes of the imaging temporomandibular joint (TMJ) characteristics in young patients with TMJ-related symptoms and treated with non-surgical methods. The severity of self-reported symptoms at follow-up was also investigated. METHODS A cone beam CT (CBCT)/CT follow-up examination [median follow-up 4.1 (1.3-6.4) years] was performed in 22 patients with erosive TMJ abnormalities [baseline median age 16 (12-18) years]. Imaging characteristics were analyzed and the changes between the examinations were categorized as (A) improvement, (B) no change, or (C) worsening. Severity of follow-up symptoms was evaluated using Jaw Functional Limitation Scale (JFLS-8) and Graded Chronic Pain Scale (Grade 0-IV). Analyses were performed separately for left and right TMJ. Findings at baseline and follow-up were compared using McNemar test to account for dependencies. Changes in proportions of hard tissue findings between examinations were assessed using Wilcoxon signed ranks test. RESULTS A significant reduction in the proportion of patients with erosive abnormalities was found [59.1%, 95% CI (36.4-79.3) %]. Baseline erosions improved in 9/12 (75%) right and 14/15 (93%) left TMJs. About half repaired; developed an intact cortical outline. Number of joints with osteophytes increased (right: p < 0.04, left: p < 0.003). New osteophytes were mostly found in joints with erosive findings. Low or no limitation of jaw function (Jaw Functional Limitation Scale) was found in 12/22 (55%) and no or low intensity of pain (Graded Chronic Pain Scale Grade 0 or I) in 19/22 (86%) at follow-up. CONCLUSION We found a high potential for repair of erosive TMJ abnormalities. However, the patient series was small. The majority of patients assessed their symptom severity at follow-up as low.
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Affiliation(s)
- Anna-Karin Abrahamsson
- Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Linda Z Arvidsson
- Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | | | - Tore A Larheim
- Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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43
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Clinical protocol for managing acute disc displacement without reduction: a magnetic resonance imaging evaluation. Int J Oral Maxillofac Surg 2020; 49:361-368. [DOI: 10.1016/j.ijom.2019.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/01/2019] [Accepted: 07/10/2019] [Indexed: 11/22/2022]
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44
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Jaggad RK, Patel IB, Choksi RH, Gosai KB. A multidisciplinary approach for the management of temporomandibular joint disc displacement without reduction. J Indian Prosthodont Soc 2019; 19:379-383. [PMID: 31649449 PMCID: PMC6803798 DOI: 10.4103/jips.jips_284_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/01/2019] [Accepted: 09/18/2019] [Indexed: 11/15/2022] Open
Abstract
The temporomandibular joint (TMJ) is one of the primary components of the complex masticatory system. Any disturbance in the joint due to congenital or acquired causes such as trauma, pathology, or functional disturbance affects the masticatory system. This case report highlights the management of condylar hypoplasia due to trauma by forceps delivery which led to TMJ dysfunction and chronic disc displacement without reduction. A combination of stabilization appliance and arthrocentesis using platelet-rich plasma along with patient education has been proved effective for the conservative management of patients with chronic disc displacement and TMJ dysfunction.
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Affiliation(s)
- Rashmi Kishor Jaggad
- Department of Prosthodontics, Ahmedabad Municipal Corporation Dental College, Ahmedabad, Gujarat, India
| | - Ina Bhupesh Patel
- Department of Prosthodontics, Ahmedabad Municipal Corporation Dental College, Ahmedabad, Gujarat, India
| | - Ronak Hemant Choksi
- Department of Prosthodontics, Ahmedabad Municipal Corporation Dental College, Ahmedabad, Gujarat, India
| | - Khyati Bhavik Gosai
- Department of Prosthodontics, Ahmedabad Municipal Corporation Dental College, Ahmedabad, Gujarat, India
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45
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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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46
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Effat KG, Berty A. A comparative clinical study of temporomandibular disorder patients in the otolaryngology clinic versus a rheumatology clinic. Cranio 2019; 37:329-334. [DOI: 10.1080/08869634.2017.1422846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kamal G. Effat
- Department of Otolaryngology, El-Sahel Teaching Hospital, Cairo, Egypt
| | - Abeer Berty
- Department of Rheumatology, St. Mark Center, Cairo, Egypt
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47
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Assessment of Occlusal Appliance for the Reposition of Temporomandibular Joint Anterior Disc Displacement With Reduction. J Craniofac Surg 2019; 30:1140-1143. [PMID: 31166259 DOI: 10.1097/scs.0000000000005210] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aim of our study was to evaluate the success rates and prognoses of patients treated with occlusal appliances used to reposition the temporomandibular joint anterior disc displacement with reduction (ADDWR). A sample of 144 consecutive patients (210 joints) diagnosed with ADDWR based on MRI were included in our study. Disc recapture was confirmed in a mandible-anterior position to eliminate joint clicking based on magnetic resonance imaging (MRI). Anterior repositioning appliance (ARS) was applied to keep the mandible in this position. The occlusal surface of the ARS was ground down by 1 mm approximately every 4 weeks for bite reconstruction. MRI was carried out before treatment, 6 months after the start of treatment, at the end of the treatment, and at their last follow-up visit. A Cox regression model was used to estimate the risk of failure of the treatment. The mean treatment duration was 9.5±2.6 months. A total of 177 joints (84.3%) were successfully repositioned at the end of splint treatment according to MRI. Regular follow-up indicated that almost 53% of the patients had normal disc-condyle relationships after 2 years. Sex, age, treatment duration, and orthodontics used were included in the final Cox regression model, with hazard ratios of 1.375, 1.141, 0.396, and 0.364, respectively. ARS is inferior for recapturing ADDWR in the long-term. It is thus better to explore other more effective methods to reposition the displaced disc in patients with ADDWR.
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48
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Reconstruction of the temporomandibular joint: a comparison between prefabricated and customized alloplastic prosthetic total joint systems. Int J Oral Maxillofac Surg 2019; 48:1066-1071. [DOI: 10.1016/j.ijom.2019.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/20/2018] [Accepted: 02/04/2019] [Indexed: 11/23/2022]
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49
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Lei J, Yap AUJ, Liu MQ, Fu KY. Condylar repair and regeneration in adolescents/young adults with early-stage degenerative temporomandibular joint disease: A randomised controlled study. J Oral Rehabil 2019; 46:704-714. [PMID: 31009097 DOI: 10.1111/joor.12805] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/08/2019] [Accepted: 04/10/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Anterior repositioning splint (ARS) can facilitate regenerative condylar remodelling. OBJECTIVE To determine the effect of ARS on osseous condylar changes in adolescents/young adults with early-stage degenerative joint disease (DJD). METHODS Sixty-nine patients with early-stage temporomandibular joint (TMJ) DJD based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and cone beam computed tomography (CBCT) imaging were recruited and randomly allocated to two treatment groups: (a) conservative therapy with ARS and (b) conservative therapy without ARS. Subjects with acute TMJ closed-lock had their displaced discs physically reduced by mandibular manipulation prior to ARS therapy. Clinical and CBCT data of 59 patients (86.4% females, mean age 17.95 ± 4.53 years, 67 joints) were attained pre- and at 6 or 12 months post-treatment. Osseous changes after treatment were categorised into (a) progressed, (b) unchanged, (c) repaired (remodelled without new bone formation) and (d) regenerated (remodelled with new bone formation). Statistical analysis including chi-square test, independent samples t test or Mann-Whitney U test was conducted. RESULTS About 85.5% of patients (59/69) completed the study, with 28 subjects (32 joints) in the splint group and 31 (35 joints) in the control group. The occurrence of condylar repair and regeneration was significantly higher with ARS (78.1%/[25/32] of joints) when compared to control group (48.6%/[17/35]) (P < 0.05). Moreover, condylar regeneration was exclusively observed in 50%/(16/32) of joints with ARS. For the 14 joints in splint group that received physical TMJ closed-lock reduction, 85.7%/(12/14) exhibited condylar regeneration. The splint group (3.1%/[1/32]) also had significantly lower incidence of progressive TMJ degeneration than the control (37.1%/[13/35]) (P < 0.001). CONCLUSION Condylar repair and regeneration in early-stage TMJ DJD are possible, and ideal spatial disc-condyle relationship appears important. The possibility of restoring TMJ form/structure by ARS therapy presents an attractive area of new basic science and clinical research (Bone defect repair in early osteoarthrosis of temporomandibular joint by joint distraction therapy: A randomized controlled trial/ChiCTR-TRC-14005172).
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Affiliation(s)
- Jie 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
| | - Adrian 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 City, Singapore.,Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - Mu-Qing 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
| | - Kai-Yuan 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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50
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Liu YS, Yap AUJ, Lei J, Fu KY. Is Temporomandibular Joint Disc Displacement without Reduction a Plausible Cause of Condylar Hypoplasia? A Case Report. ACTA ACUST UNITED AC 2019. [DOI: 10.2174/2542579x01666180919121059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The causes of mandibular condylar hypoplasia can be congenital or acquired
in nature. Cited local causes of acquired hypoplasia include trauma, infection and irradiation.
We report a case of hypoplastic condyle that was attributed to temporomandibular joint (TMJ) disc
displacement without reduction (DDwoR).
Clinical Presentation:
A 16-year-old male presented with restricted mouth opening and right TMJ
pain for 6 months. He was subsequently diagnosed with DDwoR. Conservative treatment comprising
self-care and moist-heat therapy was administered and he was followed for 27 months without
any further interventions. During this period, transitions from “normal” morphology to condylar
flattening / erosion, and eventually a re-modeled smaller “normal” right TMJ were observed.
Conclusion:
The present case provided initial support that DDwoR could be a plausible cause of
condylar hypoplasia in adolescents / young adults.
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Affiliation(s)
- Yi-Shu Liu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
| | - Adrian U-Jin Yap
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
| | - Jie Lei
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
| | - Kai-Yuan Fu
- Center for TMD & Orofacial Pain, Peking University School & Hospital of Stomatology, Beijing, China
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