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Muacevic A, Adler JR. Review of Various Clinical Assessment Indices and Orthodontic Management for Temporomandibular Joint Disorders. Cureus 2022; 14:e30492. [PMID: 36415405 PMCID: PMC9674566 DOI: 10.7759/cureus.30492] [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: 09/16/2022] [Accepted: 10/19/2022] [Indexed: 01/25/2023] Open
Abstract
The term "temporomandibular disorders" (TMDs) refers to a variety of problems involving the muscles of the masticatory system and the jaw. The most common symptoms of TMD are pain in the face, headaches, clicking or popping in the joints, and difficulties with jaw function. The severity of TMD can be measured with a number of different scales, including the Helkimo, Craniomandibular Index (CMI), Mandibular Functional Impairment Questionnaire (MFIQ), Fonseca scale and Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) scales. The former focuses on the patient's chief complaint, while the latter takes into account secondary symptoms such as limited mobility, impaired temporomandibular joint (TMJ) function, muscle pain, and discomfort during mandibular motion. According to the severity of the issue, the results can be used to categorise the situation. To effectively treat TMD, one must first determine their index score and then formulate a treatment strategy based on that score.
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Mohamed AAS, Abotaleb B, Ahmed Abdulqader A, Hongliang D, Sakran KA, He D. Three-dimensional assessment of accuracy for open reduction and internal fixation of the subcondylar fracture and its implications on the TMJ function. J Craniomaxillofac Surg 2021; 49:1035-1043. [PMID: 34217568 DOI: 10.1016/j.jcms.2021.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 05/24/2021] [Accepted: 06/15/2021] [Indexed: 02/08/2023] Open
Abstract
This study used three-dimensional cone beam computed tomography (CBCT) to assist the accuracy of open reduction and internal fixation (ORIF) for the unilateral subcondylar fracture and the long-term temporomandibular joint (TMJ) function impairment. Bilateral TMJs were analyzed postoperatively on CBCT images, involving the following three-dimensional (3D) parameters: condylar position and inclination; circumferential joint space, ramus, and mandible length; and the volumetric joint space. The inclusion criteria for adult patients included having a displaced fracture >5°, a shortening in ramus length >2 mm, and mouth opening limitation. The non-fracture side was used as the comparison group. The Helkimo index was employed for the clinical assessment of the outcomes, while the paired student t-test and Pearson coefficient test were used to compare both sides. The study included 60 joints in 30 consecutive patients. The condylar inclination to the horizontal plane on the fracture and non-fracture sides was 9.29 ± 3.9°, 12.46 ± 4.2°, (p < 0.001) and was positively related to the subjective (Helkimo Hi) and objective (Helkimo Di) clinical outcomes. In contrast, the condylar position to the midsagittal plane in the fracture and non-fracture sides was 51.95 ± 3.5 mm, 50.17 ± 3.6 mm (P = 0.038), and was positively related to the objective outcomes. Additionally, the objective outcome was negatively related to the change of the posterior joint space. CONCLUSION: The three-dimensional assessments seem to demonstrate that the ORIF is an accurate approach for obtaining a three-dimensional reduction to the displaced subcondylar fracture.
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Affiliation(s)
- Abdo Ahmed Saleh Mohamed
- Department of Oral and Maxillofacial Surgery, Lanzhou University First Affiliated Hospital, Lanzhou University, Lanzhou, Gansu Province, China; Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, Guangdong, 510055, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen.
| | - Bassam Abotaleb
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Abbas Ahmed Abdulqader
- Department of Orthodontic, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Du Hongliang
- Department of Oral and Maxillofacial Surgery, Lanzhou University First Affiliated Hospital, Lanzhou University, Lanzhou, Gansu Province, China
| | - Karim Ahmed Sakran
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases and Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Dengqi He
- Department of Oral and Maxillofacial Surgery, Lanzhou University First Affiliated Hospital, Lanzhou University, Lanzhou, Gansu Province, China.
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