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Sang S, Ameli N, Almeida FT, Friesen R. Association between clinical symptoms and MRI image findings in symptomatic temporomandibular joint (TMJ) disease: A systematic review. J Craniomaxillofac Surg 2024; 52:835-842. [PMID: 38724287 DOI: 10.1016/j.jcms.2024.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 01/16/2024] [Accepted: 04/11/2024] [Indexed: 07/23/2024] Open
Abstract
To evaluate the association between clinical signs and symptoms of temporomandibular joint (TMJ) and magnetic resonance image (MRI) findings in patients with temporomandibular disorders (TMD). Relevant articles on humans over 18 years of age were obtained from five databases (Ovid MEDLINE, PubMed, Scopus, Web of Science, and Google Scholar) up to August 2022. Risk of bias assessment was completed using the Joanna Briggs Institute critical appraisal tools. The GRADEpro (Grading of Recommendations, Assessment, Development, and Evaluation) instrument was applied to assess the level of evidence across studies in a GRADE Summary of Findings table. In total, 22 studies were included in this systematic review. Of these, 11 studies highlighted that joint pain was positively associated with particular MRI findings: joint effusion, bone marrow edema, disk displacement with/without reduction, and condylar erosion. Masticatory muscle pain was found to have a strong positive correlation with disk displacement in four studies. Five studies found no significant association between MRI findings and masticatory muscle pain. Range of motion and MRI findings were examined in six studies. Limited mouth opening was found to be correlated with disk displacement in five studies. Of the 11 studies evaluating the correlation between joint noise and MRI findings, eight reported a significant association between disk displacement and TMJ noise. The results suggested that patients with joint pain and limited range of motion may benefit from MRI. Patients exhibiting primarily muscle pain are unlikely to benefit clinically from MRI. Future studies with improved quality are warranted.
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Affiliation(s)
- Sara Sang
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Nazila Ameli
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Fabiana T Almeida
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
| | - Reid Friesen
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.
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2
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Grossmann E, Poluha RL. Comparative study of arthrocentesis with concentric-needle cannula with classic concentric needle: A randomized single-blind controlled clinical trial. J Craniomaxillofac Surg 2024; 52:850-854. [PMID: 38724289 DOI: 10.1016/j.jcms.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/31/2024] [Accepted: 04/27/2024] [Indexed: 07/23/2024] Open
Abstract
This study aimed to assess and compare the efficacy of two distinct single-puncture techniques in temporomandibular joint (TMJ) arthrocentesis for managing disk displacement without reduction (DDwoR). Sixty patients with DDwoR were randomly and blindly assigned to two treatment groups (n = 30 each): group 1 - TMJ arthrocentesis with the classic concentric needle; and group 2 - TMJ arthrocentesis with the concentric needle-cannula system. The following variables were recorded and compared across the groups: patient's pain perception (visual analog scale - VAS, 0-10); maximal interincisal distance (MID, mm); facial edema (FE, presence or absence); and operation duration (OP, minutes). Patients in group 2 presented significantly lower values of VAS score and presence of FE (p < 0.05) when examining the data at 24 and 48 h after the arthrocentesis. They also showed an increase in MID values (p = 0.024) after 6 months. With regard to OP, no significant difference was observed between the groups. Performing a single-puncture TMJ arthrocentesis using a concentric needle-cannula system significantly reduced the patients' pain perception, and mitigated the presence of facial edema during the immediate postoperative period (at 24 and 48 h). Furthermore, it resulted in a notable increase in the MID after 6 months.
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Affiliation(s)
- Eduardo Grossmann
- Dentistry Faculty, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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3
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Grossmann E, Poluha RL. The benefits of performing temporomandibular joint arthrocentesis with catheters and a vacuum pump: A randomized control trial. J Craniomaxillofac Surg 2024; 52:369-373. [PMID: 38253472 DOI: 10.1016/j.jcms.2024.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/13/2023] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
This study aims to compare the effectiveness of two different techniques of double puncture arthrocentesis with and without the addition of catheters and a vacuum pump for management of temporomandibular joint (TMJ) disc displacement without reduction (DDWOR). A total of 48 patients with DDWOR were randomly and blindly allocated into two treatment groups (N = 24): Group 1, TMJ arthrocentesis with the addition of catheters and a vacuum pump to the second needle; Group 2, TMJ arthrocentesis without any addition device. The following variables were registered and compared between groups: patient's pain perception (visual analogue scale [VAS; 0-10]); maximal interincisal distance [MID; mm]; joint effusion (JE, presence or absence); facial edema (FE; presence or absence); and the operation duration (OP; minutes). Patients in Group 1 presented with significantly lower VAS scores (p < 0.001) and presence of FE (p = 0.03) in the post-operative period, also an increase in MID values (p = 0.026), and a reduction in JE (p = 0.022) after 3 months. Besides that, in this group, the procedure was performed significantly faster (p < 0.001). Performing arthrocentesis with the addition of a vacuum pump makes the procedure faster and yields better results in terms of pain, facial swelling, mouth opening and joint effusion.
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Affiliation(s)
- Eduardo Grossmann
- Federal University of Rio Grande Do Sul, Coronel Corte Real Street, 130, 90630-080, Porto Alegre, Brazil.
| | - Rodrigo Lorenzi Poluha
- Department of Dentistry, State University of Maringá, Mandacaru Avenue, 1550, 87080-000, Maringá, Brazil.
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Kopp M, Wiesmueller M, Buchbender M, Kesting M, Nagel AM, May MS, Uder M, Roemer FW, Heiss R. MRI of Temporomandibular Joint Disorders: A Comparative Study of 0.55 T and 1.5 T MRI. Invest Radiol 2024; 59:223-229. [PMID: 37493286 DOI: 10.1097/rli.0000000000001008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
OBJECTIVES Temporomandibular disorders (TMDs) are common and may cause persistent functional limitations and pain. Magnetic resonance imaging (MRI) at 1.5 and 3 T is commonly applied for the evaluation of the temporomandibular joint (TMJ). No evidence is available regarding the feasibility of modern low-field MRI for the assessment of TMDs. The objective of this prospective study was to evaluate the image quality (IQ) of 0.55 T MRI in direct comparison with 1.5 T MRI. MATERIALS AND METHODS Seventeen patients (34 TMJs) with suspected intraarticular TMDs were enrolled, and both 0.55 and 1.5 T MRI were performed on the same day. Two senior readers independently evaluated the IQ focusing on the conspicuity of disc morphology (DM), disc position (DP), and osseous joint morphology (OJM) for each joint. We analyzed the IQ and degree of artifacts using a 4-point Likert scale (LS) at both field strengths. A fully sufficient IQ was defined as an LS score of ≥3. Nonparametric Wilcoxon test for related samples was used for statistical comparison. RESULTS The median IQ for the DM and OJM at 0.55 T was inferior to that at 1.5 T (DM: 3 [interquartile range {IQR}, 3-4] vs 4 [IQR, 4-4]; OJM: 3 [IQR, 3-4] vs 4 [IQR 4-4]; each P < 0.001). For DP, the IQ was comparable (4 [IQR 3-4] vs 4 [IQR 4-4]; P > 0.05). A sufficient diagnostic IQ was maintained for the DM, DP, and OJM in 92% of the cases at 0.55 T and 100% at 1.5 T. Minor image artifacts (LS score of ≥3) were more prevalent at 0.55 T (29%) than at 1.5 T (12%). CONCLUSIONS Magnetic resonance imaging of the TMJ at 0.55 T yields a lower IQ than does MRI at 1.5 T but maintains sufficient diagnostic confidence in the majority of patients. Further improvements are needed for reliable clinical application.
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Affiliation(s)
- Markus Kopp
- From the Department of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany (M.K., M.W., A.M.N., M.S.M., M.U., F.W.R., R.H.); Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany (M.B., M.K.); and Department of Radiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA (F.W.R.)
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5
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Mercuri LG. Temporomandibular Joint Facts and Foibles. J Clin Med 2023; 12:jcm12093246. [PMID: 37176685 PMCID: PMC10179705 DOI: 10.3390/jcm12093246] [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: 04/19/2023] [Revised: 04/25/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
The purpose of this article is to dispel some of the major foibles associated with the etiology and management of TMJ disorders, while presenting some of the facts based on the scientific literature to date. To appreciate this kind of update, the reader must be an "out of the box thinker" which requires openness to new ways of seeing the world and a willingness to accept new concepts based on evolving evidence.
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Affiliation(s)
- Louis Gerard Mercuri
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
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Moleirinho-Alves P, Cebola P, Melo X, Simões S, Godinho C. Analysis of Portuguese Physiotherapists' Self-Knowledge on Temporomandibular Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1294. [PMID: 36674049 PMCID: PMC9858732 DOI: 10.3390/ijerph20021294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/08/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Physiotherapy is one of the most referenced and effective conservative strategies for treating patients with temporomandibular disorders (TMD). This study aimed to characterize and analyze the self-knowledge of TMD of Portuguese physiotherapists. METHODS an online questionnaire was carried out, and the data collected were descriptively analyzed. RESULTS A total of 338 physiotherapists participated, of which only 142 treated patients with TMD. Seventy-six percent of the physiotherapists reported that they had not received training in the TMD area during the physiotherapy degree course. Only 11% of the physiotherapists reported that treating patients with TMD adequately identified all symptoms of TMD. CONCLUSIONS the present study showed that it is necessary to integrate TMD-related content into the basic training of physiotherapists and promote an increase in evidence-based training.
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Affiliation(s)
- Paula Moleirinho-Alves
- Escola Superior de Saúde Egas Moniz, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Egas Moniz Physiotherapy Clinic and Research Centre, Interdisciplinary Research Centre (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Cuf Tejo Hospital, 1300-352 Lisboa, Portugal
| | | | - Xavier Melo
- Escola Superior de Saúde Egas Moniz, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Egas Moniz Physiotherapy Clinic and Research Centre, Interdisciplinary Research Centre (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Centro Interdisciplinar de Estudo da Performance Humana (CIPER), Faculdade de Motricidade Humana Universidade de Lisboa, 1496-751 Oeiras, Portugal
| | - Sérgio Simões
- Escola Superior de Saúde Egas Moniz, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Egas Moniz Physiotherapy Clinic and Research Centre, Interdisciplinary Research Centre (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
| | - Catarina Godinho
- Escola Superior de Saúde Egas Moniz, Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
- Egas Moniz Physiotherapy Clinic and Research Centre, Interdisciplinary Research Centre (CiiEM), Egas Moniz School of Health and Science, 2829-511 Almada, Portugal
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Yaremchuk NI, Oshurko AP, Oliinyk IY. AGE ASSESSMENT OF THE DYNAMICS OF MORPHOLOGICAL REARRANGEMENT OF BONE TISSUE OF THE ARTICULAR PROCESSES OF THE HUMAN LOWER JAW DEPENDING ON THE LOSS OF THE MASTICATORY TEETH. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2023; 51:120-127. [PMID: 37254758 DOI: 10.36740/merkur202302103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Aim: To analyze morphometric changes in the structure of bone tissue of the mandibular articular processes and establish their densitometric dependence on the masticatory teeth loss in people of I-II periods of adulthood. PATIENTS AND METHODS Materials and methods: We analyzed 136 digital CT recordings of human temporomandibular joints. The research subjects were divided into three groups based on the degree of dentition defect acquisition: the first - a limited defect, the second - a final defect, and the third - a preserved dentition (control); by age into two periods of adulthood of postnatal human ontogenesis. Digital statistical analysis of the bone density is presented as M±σ (mean and standard deviation). We compared the experimental groups with the control group using nonparametric statistical analysis. RESULTS Results: Changes in the vertical dimension of occlusion due to limited masticatory teeth loss acquire variable morphometric features, causing an interrelated process of bone atrophy of the cellular part and the trabecular layer of the mandibular processes. The density of bone tissue of the cortical layer of the articular-fossa quadrant (A-Fh/q) of the articular head of the mandibular process increases on the right with limited defects and decreases with final defects. Indicators of bone densitometry of A-Fh/q on the left is characterized by a decrease with limited defects for individuals of the I-st period of adulthood and an increase in the final defects in the II-nd on the left and right. CONCLUSION Conclusions: Multifactorial pathomorphological compensatory processes ensure bone density, but with a change in values on the right and a decrease on the left. Morphometric values of trabecular layers, the most vulnerable areas of the neck and base of the mandibular articular processes, indicate the reconstruc¬tion of their bone tissue with limited defects; in the first period of the adulthood, they decrease with a significant predominance on the left.
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8
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Poluha RL, De la Torre Canales G, Bonjardim LR, Conti PCR. Who is the individual that will complain about temporomandibular joint clicking? J Oral Rehabil 2022; 49:593-598. [DOI: 10.1111/joor.13318] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 01/17/2022] [Accepted: 03/06/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rodrigo Lorenzi Poluha
- State University of Maringá Department of Dentistry Bauru Orofacial Pain Group Av. Mandacaru 1550 ‐ 87080‐000 Maringá Brazil
| | - Giancarlo De la Torre Canales
- Bauru Orofacial Pain Group Department of Prosthodontics Bauru School of Dentistry University of São Paulo Al. Octávio Pinheiro Brisola, 9‐75 ‐ 17012‐901 Bauru Brazil
| | - Leonardo Rigoldi Bonjardim
- Bauru Orofacial Pain Group Section of Head and Face Physiology. Department of Biological Sciences Bauru School of Dentistry University of São Paulo Al. Octávio Pinheiro Brisola, 9‐75 ‐ 17012‐901 Bauru Brazil
| | - Paulo César Rodrigues Conti
- Bauru Orofacial Pain Group Department of Prosthodontics Bauru School of Dentistry University of São Paulo Al. Octávio Pinheiro Brisola, 9‐75 ‐ 17012‐901 Bauru Brazil
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9
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Ma J, Wang J, Huang D, Wang Z, Hu M, Liu H, Jiang H. Cone-beam computed tomographic assessment of the inclination of the articular eminence in patients with temporomandibular disorders and chewing side preference. BMC Oral Health 2021; 21:396. [PMID: 34389008 PMCID: PMC8364061 DOI: 10.1186/s12903-021-01760-4] [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: 05/07/2021] [Accepted: 08/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background Chewing side preference (CSP) has been proposed as one etiology of temporomandibular disorders (TMDs) as it can induce the structural changes of the temporomandibular joint. But its association with the inclination of the articular eminence (IAE) is unknown. This study aimed to compare IAE between patients with CSP and without CSP. Methods Cone-beam computed tomography images of 90 patients with TMD (mean age of 45.6 years, 69 with CSP, 21 without CSP) and 20 participants without TMD and CSP (mean age of 41.3 years) were measured to compare IAE and depth of the glenoid fossa (DGF) Results IAE and DGF showed a positive correlation among all the participants. Compared with the participants without TMD and CSP, the TMD patients without CSP presented a similar IAE but with a significantly higher value of DGF (p < 0.05); in contrast, the TMD patients with CSP presented a significantly greater IAE and DGF (p < 0.05). No bilateral differences in IAE and DGF were observed in all the participants. Except the male patients with CSP had a deeper fossa than did the female, no differences in IAE and DGF according to gender were observed. Conclusions TMD patients with CSP seem to have a deep glenoid fossa with steep eminence which might be considered one characteristic imaging feature.
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Affiliation(s)
- Junli Ma
- Department of Stomatology, General Hospital of Southern Theater of PLA, Guangzhou, People's Republic of China
| | - Jiazhu Wang
- Department of Stomatology, Chinese PLA General Hospital, No. 28 FuXing Road, Beijing, 100853, People's Republic of China
| | - Dongzong Huang
- Department of Stomatology, Chinese PLA General Hospital, No. 28 FuXing Road, Beijing, 100853, People's Republic of China
| | - Zhaowu Wang
- Department of Stomatology, Chinese PLA General Hospital, No. 28 FuXing Road, Beijing, 100853, People's Republic of China
| | - Min Hu
- Department of Stomatology, Chinese PLA General Hospital, No. 28 FuXing Road, Beijing, 100853, People's Republic of China
| | - Hongchen Liu
- Department of Stomatology, Chinese PLA General Hospital, No. 28 FuXing Road, Beijing, 100853, People's Republic of China
| | - Hua Jiang
- Department of Stomatology, Chinese PLA General Hospital, No. 28 FuXing Road, Beijing, 100853, People's Republic of China.
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10
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Belikova K, Rogov OY, Rybakov A, Maslov MV, Dylov DV. Deep negative volume segmentation. Sci Rep 2021; 11:16292. [PMID: 34381093 PMCID: PMC8357924 DOI: 10.1038/s41598-021-95526-1] [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: 01/22/2021] [Accepted: 07/27/2021] [Indexed: 11/14/2022] Open
Abstract
Clinical examination of three-dimensional image data of compound anatomical objects, such as complex joints, remains a tedious process, demanding the time and the expertise of physicians. For instance, automation of the segmentation task of the TMJ (temporomandibular joint) has been hindered by its compound three-dimensional shape, multiple overlaid textures, an abundance of surrounding irregularities in the skull, and a virtually omnidirectional range of the jaw's motion-all of which extend the manual annotation process to more than an hour per patient. To address the challenge, we invent a new workflow for the 3D segmentation task: namely, we propose to segment empty spaces between all the tissues surrounding the object-the so-called negative volume segmentation. Our approach is an end-to-end pipeline that comprises a V-Net for bone segmentation, a 3D volume construction by inflation of the reconstructed bone head in all directions along the normal vector to its mesh faces. Eventually confined within the skull bones, the inflated surface occupies the entire "negative" space in the joint, effectively providing a geometrical/topological metric of the joint's health. We validate the idea on the CT scans in a 50-patient dataset, annotated by experts in maxillofacial medicine, quantitatively compare the asymmetry given the left and the right negative volumes, and automate the entire framework for clinical adoption.
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Affiliation(s)
- Kristina Belikova
- Skolkovo Institute of Science and Technology, Bolshoy Blvd., 30/1, Moscow, Russia, 121205
| | - Oleg Y Rogov
- Skolkovo Institute of Science and Technology, Bolshoy Blvd., 30/1, Moscow, Russia, 121205
| | - Aleksandr Rybakov
- First Pavlov State Medical University of St. Petersburg, L'va Tolstogo Str., 6-8, St. Petersburg, Russia, 197022
| | - Maxim V Maslov
- First Pavlov State Medical University of St. Petersburg, L'va Tolstogo Str., 6-8, St. Petersburg, Russia, 197022
| | - Dmitry V Dylov
- Skolkovo Institute of Science and Technology, Bolshoy Blvd., 30/1, Moscow, Russia, 121205.
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Poluha RL, Canales GDLT, Bonjardim LR, Conti PCR. Oral behaviors, bruxism, malocclusion and painful temporomandibular joint clicking: is there an association? Braz Oral Res 2021; 35:e090. [PMID: 34378672 DOI: 10.1590/1807-3107bor-2021.vol35.0090] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 12/15/2020] [Indexed: 11/22/2022] Open
Abstract
The present cross-sectional case-control study aimed to determine if there is an association between specific oral behaviors, sleep bruxism (SB), awake bruxism (AB), and painful temporomandibular joint (TMJ) clicking. Ninety individuals were dived into three groups; Group 1 (n = 30): painful TMJ clicking; Group 2 (n = 30): painless TMJ clicking; and Group 3 (n = 30): control group. The following clinical data were studied: oral behaviors (unilateral chewing, gum chewing, nail biting, foreign objects biting, leaning with jaw against the hand, and sleeping in a position that pressures the jaw), SB, AB (including the frequency in 10 days, evaluated by ecological momentary assessment), and malocclusions investigated based on clinical inspections (anterior open bite, posterior cross-bite, abnormal overbite/overjet, occlusal guidance, mediotrusive and/or laterotrusive interferences, retruded contact position to maximum intercuspation slide, missing posterior teeth). All statistical tests (Kolmogorov-Smirnov, chi-square, and one-way ANOVA) were performed with a 5% significance level. Group 1 had the highest frequency of and a significant association with leaning with jaw in the hand, sleeping position that pressures the jaw, gum chewing, nail biting, and AB (p<0.05). Gum chewing, nail biting, and AB were associated with Group 2 only when compared to Group 3 (p<0.05). No significant difference among groups was found for other behaviors (unilateral chewing and foreign objects biting), SB, and all malocclusions (p>0.05). It can be concluded that patients with painful TMJ clicking had a higher frequency of and a significant association with some specific harmful behaviors and AB.
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Affiliation(s)
- Rodrigo Lorenzi Poluha
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Prosthodontics, Bauru, SP, Brazil
| | | | - Leonardo Rigoldi Bonjardim
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
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12
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Fan XC, Ma LS, Chen L, Singh D, Rausch-Fan X, Huang XF. Temporomandibular Joint Osseous Morphology of Class I and Class II Malocclusions in the Normal Skeletal Pattern: A Cone-Beam Computed Tomography Study. Diagnostics (Basel) 2021; 11:diagnostics11030541. [PMID: 33803644 PMCID: PMC8002863 DOI: 10.3390/diagnostics11030541] [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: 02/07/2021] [Revised: 03/07/2021] [Accepted: 03/16/2021] [Indexed: 11/22/2022] Open
Abstract
(1) Background—The aim of the present study was to evaluate the correlation between the temporomandibular joint (TMJ) osseous morphology of normal skeletal pattern individuals with different dental malocclusions by using cone-beam computed tomography (CBCT). (2) Methods—The CBCT images of bilateral TMJs in 67 subjects with skeletal class I and average mandibular angle (26 males and 41 females, age range 20–49 years) were evaluated in this study. The subjects were divided into class I, class II division 1, and class II division 2 according to the molar relationship and retroclination of the maxillary incisors. Angular and linear measurements of TMJ were evaluated and the differences between the groups were statistically analyzed. (3) Results—Intragroup comparisons showed statistical differences for articular eminence inclination, the width of the glenoid fossa, the ratio of the width of the glenoid fossa to the depth of the glenoid fossa, the condylar angle, and the intercondylar angle between the malocclusion groups. The measurements of the glenoid fossa shape showed no significant difference between the left and right sides. Females showed more differences in the morphological parameters of TMJ between the three malocclusion groups than the males. (4) Conclusion—The present study revealed differences in the TMJ osseous morphology between dental class I and class II malocclusions in the normal skeletal pattern.
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Affiliation(s)
- Xiao-Chuan Fan
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; (X.-C.F.); (L.-S.M.)
| | - Lin-Sha Ma
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; (X.-C.F.); (L.-S.M.)
| | - Li Chen
- Department of Orthodontics, Beijing Stomatological Hospital & School of Stomatology, Capital Medical University, Beijing 100050, China;
| | - Diwakar Singh
- Clinical Research Center, Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, 1090 Vienna, Austria;
| | - Xiaohui Rausch-Fan
- Clinical Research Center, Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, 1090 Vienna, Austria;
- Correspondence: (X.R.-F.); (X.-F.H.)
| | - Xiao-Feng Huang
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; (X.-C.F.); (L.-S.M.)
- Correspondence: (X.R.-F.); (X.-F.H.)
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13
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Grossmann E, Poluha RL. Comparison between TMJ arthrocentesis techniques with different needle positions: A randomized single-blind controlled clinical trial. J Craniomaxillofac Surg 2021; 49:368-372. [PMID: 33642116 DOI: 10.1016/j.jcms.2021.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 12/01/2020] [Accepted: 02/14/2021] [Indexed: 01/31/2023] Open
Affiliation(s)
- Eduardo Grossmann
- Dentistry Faculty, Federal University of Rio Grande Do Sul, Coronel Corte Real Street, 513, 90630-080, Porto Alegre, Brazil.
| | - Rodrigo Lorenzi Poluha
- Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, 17012-901, Bauru, Brazil.
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Is There an Association between Temporomandibular Disorders and Articular Eminence Inclination? A Systematic Review. Diagnostics (Basel) 2020; 11:diagnostics11010029. [PMID: 33375312 PMCID: PMC7824549 DOI: 10.3390/diagnostics11010029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/18/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022] Open
Abstract
(1) Background: In order to determine the correlation between the inclination of articular eminence (AEI) and the development of temporomandibular disorders (TMDs), a systematic review was performed. (2) Methods: A systematic literature research was conducted between 1946 and January 2020, based on the following electronic databases: PubMed, Cochrane Library, Embase, Medline, Scope, SciELO, and Lilacs. Observational studies, analytical case-control studies, and cohort studies written in English were identified. The articles were selected and analyzed by two authors independently. The PICO format was used to analyze the studies and the Newcastle-Ottawa Scale (NOS) was used to verify the quality of the evidence. (3) Results: Sixteen articles were included in this review, ten case-control studies and six cohort studies. Eight articles (50%) established a positive relation between AEI and TMDs and eight (50%) did not. The scientific quality was medium-low, mainly influenced by the exposure to the risk of bias and the lack of clinical methods with adequate consistency and sensitivity on the diagnosis of TMDs. (4) Conclusions: It is controversial to establish a causal relationship between the TMDs and the AEI in the field of stomatology, due to limited and inconclusive evidence. However, it is suggested that the AEI defined by some specific methods may be associated with some special pathological stages of TMDs. High-quality prospective studies are required to draw any definitive conclusions.
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Poluha RL, De la Torre Canales G, Bonjardim LR, Conti PCR. Clinical variables associated with the presence of articular pain in patients with temporomandibular joint clicking. Clin Oral Investig 2020; 25:3633-3640. [PMID: 33184719 DOI: 10.1007/s00784-020-03685-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 11/06/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study and estimate the impact of clinical, somatosensory, and psychosocial variables associated with the concomitant presence of temporomandibular joint (TMJ) pain in patients with TMJ clicking. MATERIALS AND METHODS Ninety-three individuals composed the sample: patients with painful TMJ clicking (n = 47) and patients with painless TMJ clicking (n = 46). Four categories of data were evaluated: clinical features (gender, maximal interincisal distance (MID), side of complaint, age); bruxism (sleep bruxism (SB), awake bruxism (AB)); somatosensory (mechanical pain threshold (MPT), wind-up ratio (WUR), pressure pain threshold (PPT), conditioned pain modulation (CPM)); and psychosocial (Pittsburgh Sleep Quality Index (PSQI), pain vigilance and awareness questionnaire (PVAQ), Pain Catastrophizing Scale (PCS), Tampa Scale for Kinesiophobia for Temporomandibular Disorders (TSK/TMD), Oral Behaviors (OBs)). RESULTS Female gender, AB, WUR, CPM, PSQI, PCS, and OBs significantly (p < 0.05) increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. On the other hand, MID, MPT, and PPT significantly (p < 0.05) decreased this chance. The other variables had no association. CONCLUSION It can be concluded that being a woman, having AB, hyperalgesia in WUR, less efficient CPM, poor sleep quality, pain catastrophizing, and harmful OBs significantly increased the chance of the concomitant presence of TMJ pain in patients with TMJ clicking. In the opposite, high figures of MID, MPT, and PPT decreased the chance. CLINICAL RELEVANCE Most patients with TMJ clicking usually postpone seeking treatment until the clicking truly disturbs or there is a concomitant presence of TMJ pain. Understanding the variables associated with this concomitance can be important in clinical practice.
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Affiliation(s)
- Rodrigo Lorenzi Poluha
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru, 17012-901, Brazil.
| | - Giancarlo De la Torre Canales
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru, 17012-901, Brazil
| | - Leonardo Rigoldi Bonjardim
- Bauru Orofacial Pain Group, Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru, 17012-901, Brazil
| | - Paulo César Rodrigues Conti
- Bauru Orofacial Pain Group, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Al. Octávio Pinheiro Brisola, 9-75, Bauru, 17012-901, Brazil
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Poluha RL, De la Torre Canales G, Bonjardim LR, Conti PCR. Somatosensory and psychosocial profile of patients with painful temporomandibular joint clicking. J Oral Rehabil 2020; 47:1346-1357. [DOI: 10.1111/joor.13081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Rodrigo Lorenzi Poluha
- Bauru Orofacial Pain Group Department of Prosthodontics Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Giancarlo De la Torre Canales
- Bauru Orofacial Pain Group Department of Prosthodontics Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Leonardo Rigoldi Bonjardim
- Bauru Orofacial Pain Group Department of Biological Sciences Bauru School of Dentistry University of São Paulo Bauru Brazil
| | - Paulo César Rodrigues Conti
- Bauru Orofacial Pain Group Department of Prosthodontics Bauru School of Dentistry University of São Paulo Bauru Brazil
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Temporomandibular Joints' Morphology and Osteoarthritic Changes in Cone-Beam Computed Tomography Images in Patients with and without Reciprocal Clicking-A Case Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103428. [PMID: 32423066 PMCID: PMC7277452 DOI: 10.3390/ijerph17103428] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/12/2020] [Accepted: 05/12/2020] [Indexed: 12/24/2022]
Abstract
Background: Patients referred for orthodontic treatment often present symptoms of temporomandibular joints’ disorders (TMD), predominantly clicking. The objective was to analyze the morphology of the temporomandibular joints in cone-beam computed tomography (CBCT) images based on the presence of reciprocal clicking before orthodontic treatment. Methods: 105 participants took part in the study. 210 temporomandibular joints (TMJs) were allocated into one of two groups regarding the presence of reciprocal clicking. Morphology of condyle’s head, glenoid fossa, and articular eminence as well as condylar head position in the glenoid fossa and osteoarthritic changes in the area of the condylar head were examined for each TMJ in the CBCT images. Statistical analysis was performed with STATISTICA version 12.0. The following tests were performed: U-Mann Whitney, Kruskal-Wallis, t-Student, and chi-square. The statistical significance level was p = 0.05 for all the measurements included. Results: Significantly smaller condylar A-P dimension (p = 0.040) characterized temporomandibular joints with reciprocal clicking. Condyles were substantially more often positioned posteriorly (p = 0.043) and were significantly more often accompanied by subcortical cysts and pathologic osteoarthritic bone changes (p < 0.001). Conclusions: The early stages of internal derangements stay with alterations in morphology and position of TMJs as well as with the presence of osteoarthritic changes.
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Derwich M, Mitus-Kenig M, Pawlowska E. Interdisciplinary Approach to the Temporomandibular Joint Osteoarthritis-Review of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E225. [PMID: 32397412 PMCID: PMC7279162 DOI: 10.3390/medicina56050225] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 04/28/2020] [Accepted: 05/06/2020] [Indexed: 02/07/2023]
Abstract
Background and objectives: There are an increasing number of patients applying for dental treatment who suffer from temporomandibular joint osteoarthritis (TMJOA). Osteoarthritis may be the cause of the pain in the area of temporomandibular joints, but its course may also be absolutely asymptomatic. The aim of this study was to present an interdisciplinary approach to TMJOA, including current diagnostics and treatment modalities on the basis of the available literature. Materials and Methods: PubMed and Scopus databases were analyzed using the keywords: ((temporomandibular joint AND osteoarthritis) AND imaging) and ((temporomandibular joint AND osteoarthritis) AND treatment). The bibliography was supplemented with books related to the temporomandibular joint. After screening 2450 results, the work was based in total on 98 publications. Results and Conclusions: Osteoarthritis is an inflammatory, age-related, chronic and progressive degenerative joint disease. Magnetic resonance imaging (MRI) and cone-beam computed tomography (CBCT), together with clinical symptoms, play significant roles in TMJOA diagnosis. Current MRI techniques seem to be clinically useful for assessment of bony changes in temporomandibular joint (TMJ) disorders. Treatment of TMJOA requires a complex, interdisciplinary approach. TMJOA treatment includes the cooperation of physiotherapists, rheumatologists, gnathologists, orthodontists and quite often also maxillofacial surgeons and prosthodontists. Sometimes additional pharmacotherapy is indicated. Thorough examination of TMJ function and morphology is necessary at the beginning of any orthodontic or dental treatment. Undiagnosed TMJ dysfunction may cause further problems with the entire masticatory system, including joints, muscles and teeth.
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Affiliation(s)
- Marcin Derwich
- Department of Orthodontics, Medical University of Lodz, 90-419 Lodz, Poland;
| | - Maria Mitus-Kenig
- Department of Prophylaxis and Experimental Dentistry, Jagiellonian University in Krakow, 31-007 Krakow, Poland;
| | - Elzbieta Pawlowska
- Department of Orthodontics, Medical University of Lodz, 90-419 Lodz, Poland;
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