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Romero-Reyes M, Arman S, Teruel A, Kumar S, Hawkins J, Akerman S. Pharmacological Management of Orofacial Pain. Drugs 2023; 83:1269-1292. [PMID: 37632671 DOI: 10.1007/s40265-023-01927-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2023] [Indexed: 08/28/2023]
Abstract
Orofacial pain is a category of complex disorders, including musculoskeletal, neuropathic and neurovascular disorders, that greatly affect the quality of life of the patient. These disorders are within the fields of dentistry and medicine and management can be challenging, requiring a referral to an orofacial pain specialist, essential for adequate evaluation, diagnosis, and care. Management is specific to the diagnosis and a treatment plan is developed with diverse pharmacological and non-pharmacological modalities. The pharmacological management of orofacial pain encompasses a vast array of medication classes and approaches. This includes anti-inflammatory drugs, muscle relaxants, anticonvulsants, antidepressants, and anesthetics. In addition, as adjunct therapy, different injections can be integrated into the management plan depending on the diagnosis and needs. These include trigger point injections, temporomandibular joint (TMJ) injections, and neurotoxin injections with botulinum toxin and nerve blocks. Multidisciplinary management is key for optimal care. New and safer therapeutic targets exclusively for the management of orofacial pain disorders are needed to offer better care for this patient population.
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Affiliation(s)
- Marcela Romero-Reyes
- Brotman Facial Pain Clinic, School of Dentistry, University of Maryland, 650 W. Baltimore St, 1st Floor, Baltimore, MD, 21201, USA.
- Department of Pain and Neural Sciences, School of Dentistry, University of Maryland, 650 W. Baltimore St, 8th Floor, Baltimore, MD, 21201, USA.
| | - Sherwin Arman
- Orofacial Pain Program, Section of Oral Medicine, Oral Pathology and Orofacial Pain, University of California, Los Angeles, School of Dentistry, Los Angeles, CA, USA
| | | | - Satish Kumar
- Department of Periodontics, Arizona School of Dentistry and Oral Health, A.T. Still University, Mesa, AZ, USA
| | - James Hawkins
- Naval Postgraduate Dental School, Naval Medical Leader and Professional Development Command, Uniformed Services University of the Health Sciences Postgraduate Dental College, Baltimore, MD, USA
| | - Simon Akerman
- Department of Pain and Neural Sciences, School of Dentistry, University of Maryland, 650 W. Baltimore St, 8th Floor, Baltimore, MD, 21201, USA
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2
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Hng J, Manchella S, Lekgabe E. Gout of the temporomandibular joint and review of the literature. BJR Case Rep 2023; 9:20220046. [PMID: 36873237 PMCID: PMC9976722 DOI: 10.1259/bjrcr.20220046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/31/2022] [Accepted: 09/21/2022] [Indexed: 01/21/2023] Open
Abstract
Gout is a disease characterised by abnormal deposition of monosodium urate crystals, typically affecting the extremities. This report describes a rare case of gout affecting the left temporomandibular joint with erosion of the skull base. A diagnosis of gout was suspected based on CT and MRI and confirmed with CT-guided biopsy. The temporomandibular joint is an uncommon location for a first presentation of gout, with very few cases documented and only three cases of skull base involvement reported in the English literature previously. Given its radiological appearance, it can easily be misdiagnosed as other erosive arthropathies or malignancy. Our paper highlights an unusual location for the first and only manifestation of gout and offers some diagnostic and treatment ideas that may help clinicians to identify and manage this disease.
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Affiliation(s)
- Joel Hng
- Department of Oral & Maxillofacial Surgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Sankar Manchella
- Department of Oral & Maxillofacial Surgery, The Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Ernest Lekgabe
- Department of Radiology, The Royal Melbourne Hospital, Parkville, VIC, Australia
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3
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McQuinn MW, Moreno SD, Perez L, Burkes JN. Management of Intraoperative Contamination of the Custom Total Temporomandibular Joint Prosthesis. J Oral Maxillofac Surg 2023; 81:17-23. [PMID: 36279938 DOI: 10.1016/j.joms.2022.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/25/2022] [Accepted: 09/15/2022] [Indexed: 01/11/2023]
Abstract
Management of intraoperative contamination of a custom total temporomandibular joint prosthesis has not been reported in the literature. As this complication is rare, it can be unsettling for the surgeon. Improper management may lead to a complicated treatment course and financial consequences. Prevention is the primary strategy for avoidance and appropriate management is dependent on many variables. The purpose of this report is to identify a unique complication associated with placement of a custom temporomandibular joint prosthesis and offer an algorithm for management.
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Affiliation(s)
- Michael W McQuinn
- Staff Surgeon, Department of Oral and Maxillofacial Surgery, Naval Dental Center, Camp Lejeune, NC.
| | - Stephen D Moreno
- Fellow, Pediatric Craniofacial Surgery, Department of Oral and Maxillofacial Surgery, University of Florida-Jacksonville College of Medicine, Jacksonville, FL
| | - Leonel Perez
- Program Director and Staff Surgeon, Department of Oral and Maxillofacial Surgery, Walter Reed National Military Medical Center, Bethesda, MD
| | - Jason N Burkes
- President of the Medical Staff and Staff Surgeon, Department of Oral and Maxillofacial Surgery, Walter Reed National Military Medical Center, Bethesda, MD
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Burris BJ, Bavarian R, Shaefer JR. Nonsurgical Management of Temporomandibular Joint Arthropathy. Dent Clin North Am 2023; 67:27-47. [PMID: 36404079 DOI: 10.1016/j.cden.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Arthropathy is a broad diagnostic term for any pathologic condition afflicting one or more joints of the body. Temporomandibular joint (TMJ) arthropathy is an umbrella term that may be applied to mechanical dysfunction or disease of one or both TMJs. This article provides evidence-based recommendations for conducting a patient evaluation, initiating a diagnostic workup, formulating an assessment, and instituting various nonsurgical modalities for the treatment of TMJ arthropathies.
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Affiliation(s)
- Briana J Burris
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA; Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115, USA; Department of Oral and Maxillofacial Surgery, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Roxanne Bavarian
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA; Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115, USA.
| | - Jeffry R Shaefer
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA; Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, 188 Longwood Ave, Boston, MA 02115, USA
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5
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Lan KW, Chen JM, Jiang LL, Feng YF, Yan Y. Treatment of condylar osteophyte in temporomandibular joint osteoarthritis with muscle balance occlusal splint and long-term follow-up: A case report. World J Clin Cases 2022; 10:4264-4272. [PMID: 35665098 PMCID: PMC9131237 DOI: 10.12998/wjcc.v10.i13.4264] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/16/2021] [Accepted: 03/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Condylar osteophytes, a remodeling form of temporomandibular joint osteoarthritis (TMJ OA), mainly manifest as marginal angular outgrowths of the condyle. Previous researchers have advocated surgical removal of condylar osteophytes. Reports on the effect of occlusal splint on TMJ OA patients’ joints have mostly focused on treatment with this splint, which can reduce the absorption of the affected condyle and promote repair and regeneration. However, the effect of the splint on the dissolution of condylar osteophytes has not yet been reported.
CASE SUMMARY A 68-year-old female patient suffered from occlusal discomfort with left facial pain for 2 years. Cone beam computed tomography showed a rare osteophyte on top of her left condyle. She was finally diagnosed with TMJ OA. The patient refused surgical treatment and received conservative treatment with a muscle balance occlusal splint. The pain experienced by the patient on the left side of her face was relieved, and her chewing ability recovered after treatment. The osteophyte dissolved, and the condylar cortex remained stable during long-term follow-up observations.
CONCLUSION The muscle balance occlusal splint could be a noninvasive means of treating condylar osteophytes in TMJ OA patients.
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Affiliation(s)
- Kai-Wen Lan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Jia-Min Chen
- Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou 510182, Guangdong Province, China
| | - Liu-Lin Jiang
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Yi-Fan Feng
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
| | - Ying Yan
- Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Guangzhou 510080, Guangdong Province, China
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6
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Treatment of the Temporomandibular Joint Ankylosis with a Customized Prosthesis in a Single Stage: The Use of 3D Cutting Guides and Virtual Surgical Planning. J Maxillofac Oral Surg 2021; 20:702-705. [PMID: 34776707 DOI: 10.1007/s12663-021-01562-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/03/2021] [Indexed: 10/21/2022] Open
Abstract
Background Ankylosis of the temporomandibular joint (TMJ) is a debilitating condition and disabling as a result of craniomandibular fusion, which can result in trismus, pain and a poor quality of life. Current management includes interposition arthroplasty, gap arthroplasty, and reconstruction. Traditionally, the joints are reconstructed with pre-made prostheses (in stock), or the procedure is performed in two steps; with a computerized tomography scan, its design is observed between the respective and reconstructive procedures. Study Design A technical note about the customization management of ankylosis of the temporomandibular joint. Objective and Methods Describe a modification of technique using 3D surgical cutting and positioning guides digitally created to help determine the position and dimensions of the osteotomies as an auxiliary tool in the management of TMJ ankylosis, enabling the installation of personalized prostheses in a single stage. Conclusion This technique has the advantage of allowing the installation of customized TMJ prostheses in a single stage, allowing greater predictability, less surgical time and less morbidity, in addition to being relatively simple and can be easily picked up by young surgeons.
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Bavarian R, Schatman ME, Keith DA. Persistent Pain Following Proplast-Teflon Implants of the Temporomandibular Joint: A Case Report and 35-Year Management Perspective. J Pain Res 2021; 14:3033-3046. [PMID: 34611434 PMCID: PMC8486010 DOI: 10.2147/jpr.s329123] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 09/16/2021] [Indexed: 01/03/2023] Open
Abstract
Over three decades ago, hundreds of predominantly young women with temporomandibular joint pain and other symptoms were implanted with a prosthetic device composed of Proplast-Teflon that subsequently caused considerable harm, with patients developing chronic pain, dysfunction, and disability. This perspective review presents such a patient who suffered for decades with severe pain despite extensive pharmacotherapy, injection therapy, multiple surgeries, and behavioral health interventions. The details of the origin and subsequent events regarding the use of Proplast-Teflon interpositional implants in the temporomandibular joint are described with resources from several different perspectives. The lessons learned demonstrate failures at the federal, professional, and individual level.
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Affiliation(s)
- Roxanne Bavarian
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.,Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, Ma, USA
| | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care, & Pain Medicine, NYU School of Medicine, New York, NY, USA.,School of Social Work, North Carolina State University, Raleigh, NC, USA
| | - David A Keith
- Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA, USA.,Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, Ma, USA
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8
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Ermolin VI, Chkadua TZ, Romanovsky MA. [Temporomandibular joint replacement: old ideas and new concepts]. STOMATOLOGII︠A︡ 2021; 100:127-131. [PMID: 34357741 DOI: 10.17116/stomat2021100041127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This systematic literature review presents the history of the development of temporomandibular joint reconstruction, discusses the problems and difficulties faced by engineers and surgeons. Better understanding of the history of temporomandibular joint prostheses explains the origin of negative public opinion about the prosthesis. TMJ prostheses design evolution and used biomaterials are discussed to justify the lack of variability of commercially available TMJ-reconstruction systems.
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Affiliation(s)
- V I Ermolin
- Central Research Institute of Dentisty and Maxillofacial Surgery, Moscow, Russia
| | - T Z Chkadua
- Central Research Institute of Dentisty and Maxillofacial Surgery, Moscow, Russia
| | - M A Romanovsky
- Central Research Institute of Dentisty and Maxillofacial Surgery, Moscow, Russia
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9
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Bielajew BJ, Donahue RP, Espinosa MG, Arzi B, Wang D, Hatcher DC, Paschos NK, Wong MEK, Hu JC, Athanasiou KA. Knee orthopedics as a template for the temporomandibular joint. Cell Rep Med 2021; 2:100241. [PMID: 34095872 PMCID: PMC8149366 DOI: 10.1016/j.xcrm.2021.100241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although the knee joint and temporomandibular joint (TMJ) experience similar incidence of cartilage ailments, the knee orthopedics field has greater funding and more effective end-stage treatment options. Translational research has resulted in the development of tissue-engineered products for knee cartilage repair, but the same is not true for TMJ cartilages. Here, we examine the anatomy and pathology of the joints, compare current treatments and products for cartilage afflictions, and explore ways to accelerate the TMJ field. We examine disparities, such as a 6-fold higher article count and 2,000-fold higher total joint replacement frequency in the knee compared to the TMJ, despite similarities in osteoarthritis incidence. Using knee orthopedics as a template, basic and translational research will drive the development and implementation of clinical products for the TMJ. With more funding opportunities, training programs, and federal guidance, millions of people afflicted with TMJ disorders could benefit from novel, life-changing therapeutics.
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Affiliation(s)
- Benjamin J Bielajew
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Ryan P Donahue
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - M Gabriela Espinosa
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Dean Wang
- Department of Orthopaedic Surgery, University of California, Irvine Medical Center, Orange, CA, USA
| | | | - Nikolaos K Paschos
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark E K Wong
- Department of Oral and Maxillofacial Surgery, University of Texas School of Dentistry, Houston, TX, USA
| | - Jerry C Hu
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
| | - Kyriacos A Athanasiou
- Department of Biomedical Engineering, University of California, Irvine, Irvine, CA, USA
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10
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Primary aneurysmal bone cyst of the temporomandibular joint: Multidisciplinary management with a CAD/CAM total joint replacement in a unique patient population. ORAL AND MAXILLOFACIAL SURGERY CASES 2020. [DOI: 10.1016/j.omsc.2020.100193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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11
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Quality of life, chronic pain, insomnia, and jaw malfunction in patients after alloplastic temporomandibular joint replacement: a questionnaire-based pilot study. Int J Oral Maxillofac Surg 2020; 50:948-955. [PMID: 33162296 DOI: 10.1016/j.ijom.2020.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 08/03/2020] [Accepted: 09/25/2020] [Indexed: 11/24/2022]
Abstract
Studies of patients undergoing alloplastic total temporomandibular joint replacement seldom report on quality of life (QoL) and sleep. The aim of this pilot study was to assess these factors in such a patient cohort using validated psychometric questionnaires. Data were collected via online surveys comprising the following six questionnaires: Short Form-12 Health Survey (SF-12), Patient Health Questionnaire-15, European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30, Insomnia Severity Index, Graded Chronic Pain Scale, and Jaw Disability List. Pain intensity, limitation in nutrition, and treatment satisfaction were assessed using numerical rating scales. Mouth opening was measured at follow-up. The SF-12 Physical Composite Score was markedly lower than that of the age-matched general population, whereas the Mental Composite Score did not differ significantly. Participants indicated a low somatization level and low level of disability due to pain, but reduced QoL. Clinically relevant insomnia was reported by 36% of participants. In conclusion, the results of this pilot study indicate that QoL and sleep in patients with a total temporomandibular joint replacement differ from those in the general population, indicating the need for a comprehensive outcome assessment utilizing validated psychometric tools in accordance with the current biopsychosocial model of chronic disorders.
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12
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Yoda T, Ogi N, Yoshitake H, Kawakami T, Takagi R, Murakami K, Yuasa H, Kondoh T, Tei K, Kurita K. Clinical guidelines for total temporomandibular joint replacement. JAPANESE DENTAL SCIENCE REVIEW 2020; 56:77-83. [PMID: 32612715 PMCID: PMC7310689 DOI: 10.1016/j.jdsr.2020.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
Total joint replacement (TJR) of the temporomandibular joint (TMJ) is a promising surgical procedure and device for treating end-stage diseases of the TMJ. For the functional and aesthetic reconstruction of the oral and maxillofacial head and neck region, TMJ TJR significantly helps maintain the patient's quality of life in terms of a better diet, mastication, speech and social interaction. TMJ TJR was approved by regulatory authorities in 2019 in Japan, thus enabling the clinical application of the TJR system. However, the surgery demands particularly difficult and high-risk procedures, necessitating the prudent selection of indicated patients. The joint committee of the Japanese Society of Oral and Maxillofacial Surgeons and Japanese Society for Temporomandibular Joint is working together to develop an appropriate clinical guideline for TMJ TJR.
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Affiliation(s)
- Tetsuya Yoda
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Nobumi Ogi
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Japan
| | - Hiroyuki Yoshitake
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan
| | - Tetsuji Kawakami
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Oral and Maxillofacial Surgery, Nara Medical University, Japan
| | - Ritsuo Takagi
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Division of Oral and Maxillofacial Surgery, Niigata University, Graduate School of Medical and Dental Sciences, Japan
| | - Kenichiro Murakami
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Oral and Maxillofacial Surgery, Ako City Hospital, Japan
| | - Hidemichi Yuasa
- Joint Committee of Japanese Society of Oral and Maxillofacial Surgeons and the Japanese Society for the Temporomandibular Joint for Clinical Guidelines for Total Temporomandibular Joint Replacement, Japan.,Department of Oral and Maxillofacial Surgery, National Hospital Organization Toyohashi Medical Center, Japan
| | - Toshirou Kondoh
- Department of Maxillofacial Surgery, Nihon University School of Dentistry at Matsudo, Japan
| | - Kanchu Tei
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine and Graduate, School of Dental Medicine, Hokkaido University, Japan
| | - Kenichi Kurita
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Aichi Gakuin University, Japan
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13
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Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2018; 120:816-878. [DOI: 10.1016/j.prosdent.2018.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 09/24/2018] [Indexed: 02/08/2023]
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14
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Surgical Versus Nonsurgical Management of Degenerative Joint Disease. Oral Maxillofac Surg Clin North Am 2018; 30:291-297. [DOI: 10.1016/j.coms.2018.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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15
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Efeoglu C, Calis AS, Koca H, Yuksel E. A stepped approach for the management of symptomatic internal derangement of the temporomandibular joint. J Otolaryngol Head Neck Surg 2018; 47:33. [PMID: 29764480 PMCID: PMC5952503 DOI: 10.1186/s40463-018-0282-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 05/07/2018] [Indexed: 11/12/2022] Open
Abstract
Background Internal derangement is the clinical and pathological condition of disc displacement of the temporomandibular joint. Management of these cases involve conservative and surgical treatment options. Minimally invasive surgical procedures namely arthrocentesis and arthroscopy are promising techniques in the management of internal derangement. However patient selection algorithms, indications for minimally invasive procedures and details of the techniques should be further studied for safe and cost effective management of these cases. This manuscript aims to retrospectively analyze the significance of a stepped surgical treatment approach (arthrocentesis under local anaesthesia as the first line of treatment, followed by arthroscopic lysis and lavage under general anaesthesia in unresolving cases) of internal derangement with or without osteoarthritis. Methods This is a retrospective cohort study. Case notes of 1414 patients that were managed with a standard protocol were reviewed. Appropriate inclusion and exclusion criteria were set. Thirty-three patients were eligible for inclusion. Parameters recorded were pain-free inter-incisal opening, spontaneous pain, pain on function, difficulty on chewing, and perceived disability on jaw movements. Pre-operative and post-operative (at the end of the follow up period) pain free maximum interincisal opening values were compared with paired t test and the subjective parameters were evaluated with Chisquare analysis. Treatment outcome and success rate according to American Association of Oral and Maxillofacial Surgeons were descriptively shown. Results Interincisal opening values increased, and the number of patients with severe or medium rated subjective parameters were reduced at discharge. These improvements were found to be statistically significant. Clinical (Wilkes) staging of internal derangement pre-operatively and at discharge remained either unchanged or was lower. Treatment outcome and success according to American Association of Oral and Maxillofacial Surgeons criteria was 94%. Conclusion The stepped approach for the management of symptomatic internal derangement with or without osteoarthritis is a successful treatment strategy with favourable therapeutic outcomes.
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Affiliation(s)
- Candan Efeoglu
- Oral Surgery Department, Ege University School of Dentistry, 35100, Izmir, Turkey.
| | - Aylin Sipahi Calis
- Oral Surgery Department, Ege University School of Dentistry, 35100, Izmir, Turkey
| | - Huseyin Koca
- Oral Surgery Department, Ege University School of Dentistry, 35100, Izmir, Turkey
| | - Esra Yuksel
- Anesthesiology Department, Ege University School of Medicine, 35100, Izmir, Turkey
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