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Temporomandibular joint prosthesis as treatment option for mandibular condyle fractures: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2022; 52:88-97. [PMID: 35752530 DOI: 10.1016/j.ijom.2022.05.014] [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: 11/02/2021] [Revised: 05/29/2022] [Accepted: 05/31/2022] [Indexed: 11/24/2022]
Abstract
The aim of this study was to perform a systematic review of the literature on the temporomandibular joint (TMJ) prosthesis as a treatment option after mandibular condyle fracture. Three databases were searched (PubMed, Embase, Cochrane Library) and 2670 unique papers were identified. A total of 337 studies were included (121 case reports, 89 case series, and 127 cohort/clinical studies). In total 14,396 patients and 21,560 prostheses were described. Of the 127 cohort or clinical studies, 100 (79%) reported inclusion criteria, 54 (43%) reported exclusion criteria, and 96 (76%) reported the inclusion period. The base population from which patients were recruited was reported in 57 studies (45%). The reason for TMJ prosthesis implantation was reported for 4177 patients (29.0%). A history of condylar fracture was present in 83 patients (2.0%); a history of mandibular trauma was present in 580 patients (13.9%). The meta-analysis showed a pooled prevalence of condylar fracture of 1.6% (95% confidence interval 0.9-2.4%) and a pooled prevalence of trauma or condylar fracture of 11.3% (95% confidence interval 7.1-16.0%). Heterogeneity was highly significant (P < 0.001). The TMJ prosthesis appears to be reserved for patients with persistent pain, bony or fibrous ankylosis, or osteomyelitis after primary closed or open treatment of fractures of the mandibular condyle.
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Upper Airway Changes in Diverse Orthodontic Looms: A Systematic Review and Meta-Analysis. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12020916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Upper airway assessment is particularly important in the daily work of orthodontists, because of its close connection with the development of craniofacial structures and with other pathologies such as Obstructive Sleep Apnea Syndrome (OSAS). Three-dimensional cone-beam computed tomography images provide a more reliable and comprehensive tool for airway assessment and volumetric measurements. However, the association between upper airway dimensions and skeletal malocclusion is unclear. Therefore, the current systematic review evaluates the effects of different surgical movements on the upper airway. Materials and Methods: Medline (PubMed, OVID Medline, and EBSCO), Cochrane Library (Cochrane Review and Trails), Web of Knowledge (social science, and conference abstracts), Embase (European studies, pharmacological literature, and conference abstracts), CINAHL (nursing and allied health), PsycInfo (psychology and psychiatry), SCOPUS (conference abstracts, and scientific web pages), and ERIC (education) databases were searched. Two authors independently performed the literature search, selection, quality assessment, and data extraction. Inclusion criteria encompassed computed tomography evaluations of the upper airway spaces with retrospective, prospective, and randomised clinical trial study designs. To grade the methodological quality of the included studies a GRADE risk of bias tool was used. Results and conclusion: In total, 29 studies were included. Among these, 17 studies had a low risk of bias, whereas 10 studies had a moderate risk of bias. A meta-analysis was performed with the mean differences using a fixed-effects model. Heterogeneity was assessed with the Q-test and the I2 index. The meta-analysis revealed significant (p ≤ 0.001, 95% confidence interval) increases in upper airway volume after rapid maxillary expansion and surgical advancement for the correction of Class II.
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Ma KSK, Illescas Ralda MM, Veeravalli JJ, Wang LT, Thota E, Huang JY, Kao CT, Wei JCC, Resnick CM. Patients with juvenile idiopathic arthritis are at increased risk for obstructive sleep apnoea: a population-based cohort study. Eur J Orthod 2021; 44:226-231. [PMID: 34644396 DOI: 10.1093/ejo/cjab050] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Juvenile idiopathic arthritis (JIA), an autoimmune disease, has been proposed to be comorbid with obstructive sleep apnoea (OSA). We aimed at testing the hypothesis that patients with JIA may presented with high risk of OSA in a cohort study. SUBJECTS AND METHODS This is a cohort study including patients with JIA from 1999 to 2013 identified from a longitudinal health registry. A matched non-JIA control group was also included. The primary outcome variable was presence of OSA. A Cox proportional hazard model was developed to estimate the risk of OSA in patients with JIA. A cumulative probability model was adopted to assess the time-dependent effect of JIA on OSA development, implying a causal link of the association. RESULTS A total of 2791 patients with JIA were included, and 11 164 individuals without JIA were selected as matched controls. A total of 95 included subjects had OSA: 31 in the JIA group and 64 in the control group. Patients with JIA were more likely to have OSA compared with controls (adjusted hazard ratio, aHR = 1.922, 95% confidence interval [CI] = 1.244-2.970). The incidence of developing OSA was particularly high among patients with JIA-associated deformity that presented at age 18-30 years (aHR = 1.993, 95% CI = 1.277-3.113) and males (aHR = 1.786, 95% CI = 1.097-2.906). The risk of developing OSA increased over 60 months (aHR = 2.523, 95% CI = 1.322-4.815) of follow-up after the JIA diagnosis. CONCLUSIONS Patients with JIA have a significantly increased risk of developing OSA compared with matched individuals without JIA.
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Affiliation(s)
- Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Life Science, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei, Taiwan
| | - Monica Maria Illescas Ralda
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan
| | | | - Li-Tzu Wang
- Department of Obstetrics and Gynaecology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Obstetrics and Gynaecology, School of Medicine, National Taiwan University, Taipei, Taiwan
| | - Eshwar Thota
- Department of Life Science, National Taiwan University, Taipei, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, TaichungTaiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chia-Tze Kao
- Department of Dentistry, Chung Shan Medical University and Chung Shan Medical University Hospital, Taichung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Cory M Resnick
- Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine and Harvard Medical School, Boston, MA, USA
- Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, USA
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Wolford LM, Kesterke MJ. Does Combined Temporomandibular Joint Reconstruction With Patient-Fitted Total Joint Prosthesis and Orthognathic Surgery Provide Stable Skeletal and Occlusal Outcomes in Juvenile Idiopathic Arthritis Patients? J Oral Maxillofac Surg 2021; 80:138-150. [PMID: 34648757 DOI: 10.1016/j.joms.2021.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/10/2021] [Accepted: 09/11/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To determine skeletal and occlusal surgical changes and long-term stability outcomes for patients diagnosed with juvenile idiopathic arthritis (JIA) after TMJ reconstruction with TMJ Concepts patient-fitted total joint prostheses (TJP) and concomitant maxillary orthognathic surgery. MATERIAL/METHODS A retrospective cohort study was conducted of all patients diagnosed with JIA, receiving TJP, and concomitant maxillary orthognathic surgery between 1991 and 2019, at Baylor University Medical Center treated by 1 surgeon. Patient evaluations presurgery (T1), immediate postsurgery (T2), and at longest follow-up (LFU) (T3) were analyzed using 20 cephalometric landmarks to compute 29 linear and angular measurements to determine surgical changes, long-term skeletal and occlusal stability, as well as oropharyngeal airway changes. Comparative data were tested for significance (α = 0.05) using paired and unpaired t tests. RESULTS Forty-two patients met the JIA inclusion criteria, with a median age of 17.5 years and median postsurgical follow-up of 26 months. There were significant surgical changes (T1-T2) (P ≤ .05) for all parameters associated with mandibular linear and angular surgical changes, except for the horizontal position of posterior nasal spine and the vertical/horizontal position of gonion, indicating highly stable surgical outcomes. There were significant improvements in the oropharyngeal airway dimensions. CONCLUSIONS This study suggests that TMJ Concepts patient-fitted TJP for TMJ reconstruction in conjunction with maxillary orthognathic surgery for counterclockwise rotation of the maxillo-mandibular complex for the JIA patients provides long-term skeletal and occlusal stability as well as dimensional improvement in the oropharyngeal airway.
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Affiliation(s)
- Larry M Wolford
- Clinical Professor, Departments or Oral and Maxillofacial Surgery and Orthodontics, Texas A&M University College of Dentistry, Baylor University Medical Center, Dallas, TX.
| | - Matthew J Kesterke
- Assistant Professor, Department of Biomedical Sciences, Texas A&M College of Dentistry, Dallas, TX
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Gupta RJ, Silva R, Connelly ST. Bilateral Temporomandibular Joint Reconstruction and Maxillomandibular Advancement for Concomitant Temporomandibular Joint Degeneration and Obstructive Sleep Apnea. Atlas Oral Maxillofac Surg Clin North Am 2019; 27:43-52. [PMID: 30717923 DOI: 10.1016/j.cxom.2018.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Rishi Jay Gupta
- Oral and Maxillofacial Surgery Section, Department of Dental Service, San Francisco VA Health Care System, 4150 Clement Street (160), San Francisco, CA 94121, USA; Department of Oral and Maxillofacial Surgery, University of California, San Francisco, 707 Parnassus Ave, San Francisco, CA 94143, USA; Department of Otolaryngology Head and Neck Surgery, University of California, Davis, 2521 Stockton Blvd, Sacramento, CA 95817, USA.
| | - Rebeka Silva
- Oral and Maxillofacial Surgery Section, Department of Dental Service, San Francisco VA Health Care System, 4150 Clement Street (160), San Francisco, CA 94121, USA; Department of Oral and Maxillofacial Surgery, University of California, San Francisco, 707 Parnassus Ave, San Francisco, CA 94143, USA
| | - Stephen T Connelly
- Oral and Maxillofacial Surgery Section, Department of Dental Service, San Francisco VA Health Care System, 4150 Clement Street (160), San Francisco, CA 94121, USA; Department of Oral and Maxillofacial Surgery, University of California, San Francisco, 707 Parnassus Ave, San Francisco, CA 94143, USA
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Xu J, Sun R, Wang L, Hu X. Cone-beam evaluation of pharyngeal airway space in adult skeletal Class II patients with different condylar positions. Angle Orthod 2018; 89:312-316. [PMID: 30457352 DOI: 10.2319/040518-253.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To test the null hypothesis that there is no significant difference in pharyngeal airway space among adult skeletal Class II patients with different condylar positions using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT records of 60 patients with skeletal Class II malocclusion (ANB angle ≥ 4°, Wits ≥ 0) were selected from the CBCT database. According to the condyle position, the patients were divided in three groups: anterior group (CD ≤ -12%), centric group (-12% ≤ CD ≤ +12%), and posterior group (CD ≥ +12%). Three-dimensional (3D) pharyngeal airway models were reconstructed using InvivoDental software 5.1.3. The volume and area of the pharyngeal airway space were measured in the 3D airway model. RESULTS The volume and area of the pharyngeal airway space in the centric group were significantly smaller than those in the posterior group ( P < .01). The volume and area of the pharyngeal airway space were smallest in the anterior group and significantly increased in the centric and posterior groups ( P < .001). CONCLUSIONS The null hypothesis was rejected. Significant differences were noted in pharyngeal airway space among adult skeletal Class II patients with different condylar positions.
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