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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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Jaber M, Khalid A, Gamal A, Faisal R, Mathew A, Ingafou M. A Comparative Study of Condylar Bone Pathology in Patients with and without Temporomandibular Joint Disorders Using Orthopantomography. J Clin Med 2023; 12:5802. [PMID: 37762743 PMCID: PMC10531578 DOI: 10.3390/jcm12185802] [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: 06/23/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
This study aimed to compare condylar bony pathology in patients with and without temporomandibular joint disorder (TMD) using orthopantomography at Ajman University dental clinics between 2017 and 2021. Patient data from the Ajman University archives were collected after obtaining ethical approval. OPG (orthopantomogram) views were evaluated for potential TMJ pathology. Three independent observers underwent calibration and image analysis, with their agreement level calculated using Kappa statistics (score 0.781). Condylar changes were coded from 0 to 6. Statistical tests such as the Mann-Whitney Test, Kruskal-Wallis test, Spearman's correlation, and logistic regression analysis were used to analyze the data. The inter-examiner reliability for OPG was 0.903, and intra-examiner reliability was 0.908. The most common condylar bony changes observed in OPG views were flattening and osteophyte. Female participants had a higher prevalence of all bony changes. Temporomandibular Disorder (TMD) can manifest with symptomatic and detectable bony changes in OPG views. The prevalence of temporomandibular disorder appeared similar between genders, but differences were observed regarding the number of teeth lost, with unilateral tooth loss being more common. Interestingly, bruxism did not seem to significantly impact of temporomandibular disorder patients.
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Affiliation(s)
- Mohamed Jaber
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (M.J.); (M.I.)
- Centre of Medical and Bio-Allied Health Sciences Research (CMBHSR), Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Alaa Khalid
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (M.J.); (M.I.)
- Centre of Medical and Bio-Allied Health Sciences Research (CMBHSR), Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Amena Gamal
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (M.J.); (M.I.)
- Centre of Medical and Bio-Allied Health Sciences Research (CMBHSR), Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Raghad Faisal
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (M.J.); (M.I.)
- Centre of Medical and Bio-Allied Health Sciences Research (CMBHSR), Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Asok Mathew
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (M.J.); (M.I.)
- Centre of Medical and Bio-Allied Health Sciences Research (CMBHSR), Ajman University, Ajman P.O. Box 346, United Arab Emirates
| | - Mohamed Ingafou
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman P.O. Box 346, United Arab Emirates; (M.J.); (M.I.)
- Centre of Medical and Bio-Allied Health Sciences Research (CMBHSR), Ajman University, Ajman P.O. Box 346, United Arab Emirates
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Alhammadi MS, Almashraqi AA, Thawaba AA, Fayed MMS, Aboalnaga AA. Dimensional and positional temporomandibular joint osseous characteristics in normodivergent facial patterns with and without temporomandibular disorders. Clin Oral Investig 2023; 27:5011-5020. [PMID: 37358688 PMCID: PMC10492742 DOI: 10.1007/s00784-023-05120-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 06/08/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE This study evaluated the dimensional and positional osseous temporomandibular joint features in normodivergent facial patterns with and without temporomandibular disorders. METHODS A total of 165 adult patients were divided into two groups: group 1 (n = 79 patients; 158 joints): temporomandibular disorders patients and group 2 (n = 86 patients; 172 joints): non-temporomandibular disorders patients. Three-dimensional positional and dimensional temporomandibular joint characteristics, including glenoid fossa, mandibular condyles, and joint spaces, were assessed by cone beam computed tomography. RESULTS The glenoid fossa positions in the three orthogonal planes and height showed statistical significance between the two studied groups. The temporomandibular disorders patients showed higher horizontal and vertical condyle inclinations while anteroposterior inclination was less, and the condyle was positioned more superior, anterior, and lateral in the glenoid fossa. The condyle width and length showed no significance between the two groups, while condyle height was smaller in temporomandibular disorders patients. Anterior and medial joint spaces increased while the superior and posterior joint spaces reduced in temporomandibular disorders patients. CONCLUSION There were significant differences between the patients with and without temporomandibular joint disorders in terms of mandibular fossa positions and height as well as condylar positions and inclinations in horizontal and vertical planes together with reduced condylar height and reduced posterior and superior joint spaces in the temporomandibular disorders patients. CLINICAL RELEVANCE The temporomandibular disorder is a multifactorial disorder in which one of these factors is the dimensional and positional characteristics of the temporomandibular joints; including or excluding this factor requires a comprehensive three-dimensional investigation of patients with TMD compared to the normal group under the condition that the facial pattern is average as a confounding factor.
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Affiliation(s)
- Maged S. Alhammadi
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Abeer A. Almashraqi
- Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Ahmed A. Thawaba
- Orthodontic Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mona M. Salah Fayed
- Department of Orthodontics, Faculty of Dentistry, Cairo University and Vice Dean for Postgraduate Studies and Research, Faculty of Dentistry, MSA University, Cairo, Egypt
| | - Amira A. Aboalnaga
- Department of Orthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Chung MK, Wang S, Alshanqiti I, Hu J, Ro JY. The degeneration-pain relationship in the temporomandibular joint: Current understandings and rodent models. FRONTIERS IN PAIN RESEARCH 2023; 4:1038808. [PMID: 36846071 PMCID: PMC9947567 DOI: 10.3389/fpain.2023.1038808] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Temporomandibular disorders (TMD) represent a group of musculoskeletal conditions involving the temporomandibular joints (TMJ), the masticatory muscles and associated structures. Painful TMD are highly prevalent and conditions afflict 4% of US adults annually. TMD include heterogenous musculoskeletal pain conditions, such as myalgia, arthralgia, and myofascial pain. A subpopulations of TMD patients show structural changes in TMJ, including disc displacement or degenerative joint diseases (DJD). DJD is a slowly progressing, degenerative disease of the TMJ characterized by cartilage degradation and subchondral bone remodeling. Patients with DJD often develop pain (TMJ osteoarthritis; TMJ OA), but do not always have pain (TMJ osteoarthrosis). Therefore, pain symptoms are not always associated with altered TMJ structures, which suggests that a causal relationship between TMJ degeneration and pain is unclear. Multiple animal models have been developed for determining altered joint structure and pain phenotypes in response to various TMJ injuries. Rodent models of TMJOA and pain include injections to induce inflammation or cartilage destruction, sustained opening of the oral cavity, surgical resection of the articular disc, transgenic approaches to knockout or overexpress key genes, and an integrative approach with superimposed emotional stress or comorbidities. In rodents, TMJ pain and degeneration occur during partially overlapping time periods in these models, which suggests that common biological factors may mediate TMJ pain and degeneration over different time courses. While substances such as intra-articular pro-inflammatory cytokines commonly cause pain and joint degeneration, it remains unclear whether pain or nociceptive activities are causally associated with structural degeneration of TMJ and whether structural degeneration of TMJ is necessary for producing persistent pain. A thorough understanding of the determining factors of pain-structure relationships of TMJ during the onset, progression, and chronification by adopting novel approaches and models should improve the ability to simultaneously treat TMJ pain and TMJ degeneration.
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Affiliation(s)
- Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, Program in Neuroscience, Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, United States
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Mohamed HN, Ashmawy MS, Ekladious MEEY, Farid MM. Analysis of the relationship between condylar changes and anterior disc displacement with reduction: a preliminary study. Oral Radiol 2023; 39:154-163. [PMID: 35556200 PMCID: PMC9813084 DOI: 10.1007/s11282-022-00617-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/14/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To predict temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDWR) from condylar shape, position, and dimensions obtained from CBCT images. METHODS This cross-sectional study was performed on 17 patients suffering from temporomandibular disorders diagnosed by history taking according to the chart of the American Association of orthodontists, clinical examination according to the Helkimo index and MRI. CBCT and MRI examinations were performed within one-week interval. Disc position, diagnosed by MRI was used as the gold standard. TMJs with posterior disc displacement or anterior disc displacement without reduction were excluded. Qualitative and quantitative analyses were performed on CBCT images to find the correlation between condylar variables and ADDWR. A logistic regression model was created to estimate ADDWR from condylar dimensions (height, width and depth). RESULTS Condylar shape and condylar position in the glenoid fossa were significantly correlated with ADDWR (P < 0.05). Condylar width, height and depth were significantly smaller in condyles with ADDWR compared to condylar dimensions in normal disc position. Logistic regression analysis could be used to predict the probability of anterior disc displacement with reduction from condylar dimensions. CONCLUSION Condylar shape, position, and dimensions assessed by CBCT are significantly correlated with ADDWR of the TMJ. Substituting the values of condylar width, height and depth in the equation suggests the probability of ADDWR.
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Affiliation(s)
- Hadeer Nasser Mohamed
- grid.7269.a0000 0004 0621 1570Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Ain Shams University, Monazamet El Wehda El Afriqeya St., Cairo, Egypt
| | - Mostafa S. Ashmawy
- grid.7269.a0000 0004 0621 1570Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Ain Shams University, Monazamet El Wehda El Afriqeya St., Cairo, Egypt
| | | | - Mary Medhat Farid
- grid.7269.a0000 0004 0621 1570Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Ain Shams University, Monazamet El Wehda El Afriqeya St., Cairo, Egypt
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Aboalnaga AA, Amer NM, Alhammadi MS, Fayed MMS. Positional and dimensional TMJ characteristics in different temporomandibular disorders: A cross-sectional comparative study. Cranio 2022:1-9. [PMID: 35061575 DOI: 10.1080/08869634.2022.2028115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To investigate the morphological and positional temporomandibular joint (TMJ) characteristics of different temporomandibular disorders (TMDs). METHODS One hundred forty-three TMD patients were divided into three groups: Group 1: Myalgia (M), Group 2: Disc displacement with reduction (DDWR), and Group 3: Disc displacement without reduction (DDWOR). Three-dimensional positional and dimensional parameters of the TMJ, including mandibular fossa, condyle, and TMJ spaces were evaluated using cone beam computed tomography (CBCT). The significance level was p < 0.05. RESULTS Mandibular condyles were significantly positioned in more vertical, posterior, and medial directions, with the reduced condylar width in the DD groups (p < 0.001). Anterior joint space was significantly higher in the DDWR group than the myalgia group; the superior joint spaces were more reduced in DD groups than the myalgia group. CONCLUSION Patients diagnosed with disc displacement showed significantly different condylar positions and joint spaces compared to the myalgia group in a skeletally comparable sample.
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Affiliation(s)
- Amira A Aboalnaga
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nehal M Amer
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Maged S Alhammadi
- Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Mona M Salah Fayed
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Ouni I, Ammar S, Charfeddine A, Chouchen F, Mansour L. Evaluation of condylar changes in relation to various malocclusions: A systematic review. SAUDI JOURNAL OF ORAL SCIENCES 2021. [DOI: 10.4103/sjoralsci.sjoralsci_25_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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8
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MRI characteristics of the asymptomatic temporomandibular joint in patients with unilateral temporomandibular joint disorder. Oral Radiol 2020; 37:469-475. [PMID: 32946019 DOI: 10.1007/s11282-020-00483-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 08/29/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To determine the association between unilateral temporomandibular joint disorder (TMD) and the presence of imaging abnormalities in the contralateral, asymptomatic joint. METHODS MRI studies of 219 subjects with symptoms of unilateral TMD were examined for signs of disc displacement, osteoarthritis, disc deformation, and effusion in both temporomandibular joints (TMJ). The Chi-Square test and stepwise logistic regression analysis were performed. RESULTS Disc displacement, osteoarthritis, disc deformation, and effusion were more common on the symptomatic side. However, in the category of disc displacement with a reduction in open mouth position (DDWR), the difference was not significant between the symptomatic and the asymptomatic TMJs. Stepwise logistic regression showed that the presence of any imaging abnormality other than DDWR was related to osteoarthritis and disc deformity on the symptomatic side. On the other hand, the presence of any MRI abnormality (including DDWR) on the asymptomatic side was related only to the presence of osteoarthritis on the symptomatic side. CONCLUSIONS Unilateral symptomatic TMD is related to the presence of imaging abnormalities on the contralateral, asymptomatic side, suggesting that the development and progression of joint changes in symptomatic and contralateral asymptomatic TMJs are interrelated.
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Xiong X, Yin X, Liu F, Qin D, Liu Y. Magnetic resonance imaging-guided disc-condyle relationship adjustment via articulation: a technical note and case series. J Int Med Res 2020; 48:300060520951052. [PMID: 32847435 PMCID: PMC7457669 DOI: 10.1177/0300060520951052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
A normal disc-condyle relationship is crucial to the health and function of the temporomandibular joint. We herein introduce a novel technique that can precisely and rapidly restore the disc-condyle relationship. An initial bite rim was made, and the patient was instructed to wear this bite rim during magnetic resonance imaging (MRI) scanning. A quick MRI scan was performed, and the disc-condyle relationship and direction and vector of the displacement was measured. Adjustments to the mandible position were made on an articulator based on the measurements, after which a second bite rim was made. A second quick preview MRI scan was immediately performed, and the images were evaluated and measured again. Additional adjustments were made as needed, and the preview scan was repeated until an ideal disc-condyle relationship was achieved. Once a good disc-condyle relationship was acquired, the mandible position was recorded as the treatment mandible position, and a splint was fabricated. MRI visualization enabled precise and very fine adjustment of the disc-condyle relationship by articulating. This technique might help to simplify the clinical process and improve treatment effectiveness.
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Affiliation(s)
- Xin Xiong
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoli Yin
- Department of Orthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fang Liu
- Department of Prosthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Danqing Qin
- Department of Prosthodontics, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yang Liu
- Department of Temporomandibular Joint, State Key Laboratory of Oral Disease, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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10
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Long-term Changes of Temporomandibular Joint Osteoarthritis on Computed Tomography. Sci Rep 2020; 10:6731. [PMID: 32317672 PMCID: PMC7174364 DOI: 10.1038/s41598-020-63493-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 03/30/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to understand long-term changes of the osteoarthritic temporomandibular joint (TMJ) condyle using computed tomography (CT) and to verify its correlation with clinical characteristics of temporomandibular disorders. Eighty-nine patients (152 joints; 76 female, 13 male) who had taken follow-up CTs (mean follow-up period: 644.58 ± 325.71 days) at least once in addition to their initial evaluation were selected. Cross-sectional demographic and clinical data and longitudinal CT images were collected. Data were analyzed by analysis of variance and logistic regression. Overall destructive change index (number of TMJ condyle sections in which destructive change was observed) decreased from 1.56 to 0.66. Improvement was seen in 93 joints (61.2%) and 27 joints (17.8%) worsened. In the pain positive group, both initial and final destructive change index were significantly higher compared to the pain negative group (p = 0.04). Occlusal stabilization splint therapy and nonsteroidal anti-inflammatory drug administration showed a significant effect on improving the prognosis of TMJ osteoarthritis (p = 0.015 and 0.011). In conclusion, TMJ osteoarthritis showed long-term improvement in the majority of cases. TMJ osteoarthritis accompanied by pain showed unfavorable prognosis with additional bone destruction. Occlusal stabilization splint and nonsteroidal anti-inflammatory drug administration were beneficial on the prognosis of TMJ osteoarthritis.
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Lee PP, Stanton AR, Schumacher AE, Truelove E, Hollender LG. Osteoarthritis of the temporomandibular joint and increase of the horizontal condylar angle: a longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:339-350. [PMID: 30709753 DOI: 10.1016/j.oooo.2018.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/08/2018] [Accepted: 12/19/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Our previous study of patients with unilateral temporomandibular joint (TMJ) osteoarthritis (OA) showed that the affected joints had greater horizontal condylar angle (HCA) compared with the contralateral unaffected joints. However, it was unclear whether the HCA changes preceded or were the result of OA changes. The aim of this longitudinal study was to investigate the relationship between HCA and OA progression. STUDY DESIGN In total, 127 patients (with or without TMJ disorders) completed baseline and follow-up examinations (average time to follow-up 7.9 years). Generalized estimating equation models were used to account for correlation of observations within the same patients. RESULTS (1) HCA was greater in OA-affected joints than in unaffected joints (P = .04). (2) Increased HCA at follow-up was associated with change in joint status from no OA to OA. (P = .001). (3) Baseline HCA value alone did not predict future OA diagnosis. (4) All OA changes in fossa/articular eminence morphology, and some combinations of condylar changes, were associated with a greater HCA. (5) OA diagnosis was associated with pain during maximum opening (P = .005) and pain history (P = .002). (6) Aging alone was not correlated with increased HCA. CONCLUSIONS Clinical progression of OA preceded increases in HCA. HCA alone did not predict OA development.
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Affiliation(s)
- Peggy P Lee
- Assistant Professor, Assistant Program Director, Oral and Maxillofacial Radiology Residency Program, Department of Oral Medicine, University of Washington, Seattle, WA, USA.
| | - Alexander R Stanton
- Dental Student, Department of Oral Medicine, University of Washington, Seattle, WA, USA
| | - Austin E Schumacher
- PhD Student, Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Edmond Truelove
- Professor, Department of Oral Medicine, University of Washington, Seattle, WA, USA
| | - Lars G Hollender
- Professor Emeritus, Department of Oral Medicine, University of Washington, Seattle, WA, USA
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12
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Gupta D, Sheikh S, Pallagatti S, Singh R, Aggarwal A. Correlation of Condylar Translation During Maximal Mouth Opening with Presence of Signs of Temporomandibular Joint Disorders in an Asymptomatic Population of 18-25 Years Age Group of Northern India. Open Dent J 2018; 12:770-781. [PMID: 30369987 PMCID: PMC6182881 DOI: 10.2174/1745017901814010770] [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: 04/30/2018] [Revised: 07/18/2018] [Accepted: 09/11/2018] [Indexed: 11/22/2022] Open
Abstract
Objective(s): The objective of this study was to determine the frequency of “subluxation” and presence of clinical signs of Temporomandibular Joint Disorder (TMD) in asymptomatic individuals and its distribution according to age and sex. Materials and Methods: The material investigated comprised of 200 asymptomatic subjects with 400 joints. The subjects were divided into two groups of 18-25 years and 50-60 years of age consisting of equal number of males and females. Clinical examination involved measurement of maximal inter-incisal distance, joint sounds and deviation. For radiological examination, Temporomandibular Joint (TMJ) open mouth close mouth view option (TMJ1/2) was used on a Digital Panoramic Machine. All the radiographs were traced to assess subluxation and anterior translation of the condyle. The statistical analysis was carried out using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, version 15.0 for Windows). Results: The prevalence of the signs of TMDs in the asymptomatic population was found to be very high and more predominant in females as compared to males. Furthermore, the older age group had comparatively less signs of TMDs. It was of interest that the subjects presenting with clinical signs of TMD were significantly less as compared to the subjects presenting with subluxation. The value of anterior translation was found to be more in females in the younger age group as compared to the males. Similarly, it was more in males as compared to females in older age group. But the mean anterior translation difference in females in 18-25 years and 50-60 years showed a statistically significant difference with P-value 0.017. Conclusion: Subluxation is a very common feature found in almost all the subjects in this study with a high prevalence. Hence, we may assume that the increased incidence of TMDs could be a direct result of the phenomena of subluxation. The decrease in mandibular length could be the cause of decreased mouth opening and increased subluxation.
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Affiliation(s)
- Deepak Gupta
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Soheyl Sheikh
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Shambulingappa Pallagatti
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Ravinder Singh
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Amit Aggarwal
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
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Prevalence of degenerative joint disease of the temporomandibular joint: a systematic review. Clin Oral Investig 2018; 23:2475-2488. [DOI: 10.1007/s00784-018-2664-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 09/25/2018] [Indexed: 11/27/2022]
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14
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Memis S, Candirli C, Kerimoglu G. Short term histopathological effects of GaAlAs laser on experimentally induced TMJ osteoarthritis in rabbits. Braz Oral Res 2018; 32:e90. [PMID: 30110088 DOI: 10.1590/1807-3107bor-2018.vol32.0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 07/18/2018] [Indexed: 10/13/2023] Open
Abstract
The aim of this study was to evaluate the biostimulation (BS) effect of the gallium-aluminum-arsenide (GaAlAs) diode laser by histopathology with an experimental osteoarthritis (OA) model in the temporomandibular joints (TMJ) of rabbits, in the early period. GaAlAs diode laser is used for pain reduction in TMJ disorders. Twenty-four adult male New Zealand white rabbits were randomly divided into three equal groups: Control Group (CG), Study Group 1 (SG-1), and Study Group 2 (SG-2). Mono-iodoacetate (MIA) was administered to the right TMJs of all rabbits. The rabbits did not undergo any treatment for four weeks to allow the development of osteoarthritis. In SG-1, laser BS was applied to the rabbits at 940 nm, 5 W, and 15 J/cm2 in continuous wave mode at 48-hour intervals for 14 sessions; and in SG-2, laser BS was applied with the same parameters at 24-hour intervals for 28 sessions. Laser BS was not applied to the rabbits in CG. All rabbits were sacrificed simultaneously. The TMJ cartilage, osteochondral junction, chondrocyte appearance, and subchondral ossification were evaluated histopathologically. There was no statistically significant difference between the groups in terms of cartilage, osteochondral junction, chondrocyte appearance, and subchondral ossification values (p > 0.05). The laser BS protocol used in the study had no positive histopathological effects on TMJ OA in the early period.
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Affiliation(s)
- Sadi Memis
- Abant Izzet Baysal University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Bolu, Turkey
| | - Celal Candirli
- Karadeniz Technical University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Trabzon, Turkey
| | - Gokcen Kerimoglu
- Karadeniz Technical University, Faculty of Medicine, Department of Histology and Embryology, Trabzon, Turkey
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Matsubara R, Yanagi Y, Oki K, Hisatomi M, Santos KC, Bamgbose BO, Fujita M, Okada S, Minagi S, Asaumi J. Assessment of MRI findings and clinical symptoms in patients with temporomandibular joint disorders. Dentomaxillofac Radiol 2018; 47:20170412. [PMID: 29451403 DOI: 10.1259/dmfr.20170412] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To investigate the correlations among various temporomandibular joint (TMJ) findings on MRI and the relationships between MRI findings and symptoms. METHODS 425 patients (850 TMJs) with temporomandibular joint disorders (TMDs) who underwent MRI were enrolled. Oblique sagittal proton density-weighted and T2 weighted images in open- and closed-mouth positions were evaluated. MRI findings included disc configuration, disc position, condylar morphology, bone marrow pattern, and joint effusion. Symptoms included TMJ pain, TMJ noise, and limitation of mouth opening. For statistical analyses, Spearman's rank correlation coefficient and logistic regression analysis were applied. RESULTS Folded disc, disc displacement without reduction (DDWOR), and osteophytes had significant negative correlations with other normal MRI findings (p < 0.01). DDWOR and marrow edema were associated with TMJ pain. Conversely, osteophytes [odds ratio (OR): 0.52; 95% CI (0.30-0.90)] and combination-type condylar degeneration [OR: 0.45; 95% CI (0.24-0.83)] were associated with decreased risk of TMJ pain. Condylar flattening was positively associated with TMJ noise [OR: 5.25; 95% CI (1.44-19.07)] and negatively associated with limitation of mouth opening [OR: 0.34; 95% CI (0.11-0.99)]. High-grade joint effusion was significantly associated with TMJ pain and noise. CONCLUSIONS DDWOR and high-grade joint effusion (an indicator of inflammation in the articular cavity) were associated with TMD symptoms. This finding suggests that treatment strategy for DDWOR and decreasing inflammation might lessen clinical TMD symptoms. Condylar degeneration was not associated with indicators of inflammation or TMJ symptoms. These results suggest that patients with TMD symptoms should undergo initial MRI to allow rapid selection of appropriate therapies.
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Affiliation(s)
- Risa Matsubara
- 1 Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan
| | - Yoshinobu Yanagi
- 2 Department of Dental Informatics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan
| | - Kazuhiro Oki
- 3 Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan
| | - Miki Hisatomi
- 4 Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital , Okayama , Japan
| | - Karina Cp Santos
- 5 Department of Stomatology, School of Dentistry, University of Sao Paulo , Sao Paulo , Brazil
| | - Babatunde O Bamgbose
- 1 Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan.,6 Oral Diagnostic Sciences, Faculty of Dentistry, Bayero University , kano , Nigeria
| | - Mariko Fujita
- 7 Preliminary Examination Room, Okayama University Hospital , Okayama , Japan
| | - Shunsuke Okada
- 4 Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital , Okayama , Japan
| | - Shogo Minagi
- 3 Department of Occlusal and Oral Functional Rehabilitation, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan.,8 Department of Occlusal and Oral Funtional Rehabilitation, Okayama University Hospital , Okayama , Japan
| | - Junichi Asaumi
- 1 Department of Oral and Maxillofacial Radiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University , Okayama , Japan.,4 Department of Oral Diagnosis and Dentomaxillofacial Radiology, Okayama University Hospital , Okayama , Japan.,7 Preliminary Examination Room, Okayama University Hospital , Okayama , Japan
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Bäck K, Ahlqwist M, Hakeberg M, Dahlström L. Occurrence of signs of osteoarthritis/arthrosis in the temporomandibular joint on panoramic radiographs in Swedish women. Community Dent Oral Epidemiol 2017; 45:478-484. [DOI: 10.1111/cdoe.12312] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 05/11/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Karin Bäck
- Department of Behavioral and Community Dentistry; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
| | - Margareta Ahlqwist
- Department of Oral and Maxillofacial Radiology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
| | - Lars Dahlström
- Department of Behavioral and Community Dentistry; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Göteborg Sweden
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17
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Bae S, Park MS, Han JW, Kim YJ. Correlation between pain and degenerative bony changes on cone-beam computed tomography images of temporomandibular joints. Maxillofac Plast Reconstr Surg 2017; 39:19. [PMID: 28730147 PMCID: PMC5496923 DOI: 10.1186/s40902-017-0117-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 05/20/2017] [Indexed: 12/27/2022] Open
Abstract
Background The aim of this study was to assess correlation between pain and degenerative bony changes on cone-beam computed tomography (CBCT) images of temporomandibular joints (TMJs). Methods Two hundred eighty-three temporomandibular joints with degenerative bony changes were evaluated. Pain intensity (numeric rating scale, NRS) and pain duration in patients with degenerative joint disease (DJD) were also analyzed. We classified condylar bony changes on CBCT into five types: osteophyte (Osp), erosion (Ero), flattening (Fla), subchondral sclerosis (Scl), and pseudocyst (Pse). Results Degenerative bony changes were the most frequent in the age groups of 10~19, 20–29, and 50~59 years. The most frequent pain intensity was “none” (NRS 0, 34.6%) followed by “annoying” (NRS 3–5, 29.7%). The most frequent condylar bony change was Fla (219 joints, 77.4%) followed by Ero (169 joints, 59.7%). “Ero + Fla” was the most common combination of the bony changes (12.7%). The frequency of erosion was directly proportional to NRS, but the frequency of osteophyte was inversely proportional. The prevalence of Ero increased from onset until 2 years and gradually decreased thereafter. The prevalence of Osp, Ero, and Pse increased with age. Conclusions Osp and Ero can be pain-related variables in degenerative joint disease (DJD) patients. “Six months to 2 years” may be a meaningful time point from the active, unstable phase to the stabilized late phase of DJD.
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Affiliation(s)
- SunMee Bae
- Department of Oral Medicine and Diagnosis, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 South Korea
| | - Moon-Soo Park
- Department of Oral Medicine and Diagnosis, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 South Korea
| | - Jin-Woo Han
- Department of Oral and Maxillofacial Radiology, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, Gangneung, South Korea
| | - Young-Jun Kim
- Department of Oral Medicine and Diagnosis, Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University, 7 Jukhyun-gil, Gangneung, 25457 South Korea
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18
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Khojastepour L, Vojdani M, Forghani M. The association between condylar bone changes revealed in cone beam computed tomography and clinical dysfunction index in patients with or without temporomandibular joint disorders. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:600-605. [PMID: 28256415 DOI: 10.1016/j.oooo.2017.01.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 01/11/2017] [Accepted: 01/13/2017] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The aim of the present study was to compare cone beam computed tomography (CBCT) findings pertinent to patients with temporomandibular disorder (TMD) and patients without TMD (non-TMD), as well as to investigate the correlation between these findings and the clinical dysfunction index (Di). STUDY DESIGN In this cross-sectional study, CBCT images of temporomandibular joints (TMJs) were evaluated for condylar bone changes in 84 patients with TMD. The patients were assigned a score using Helkimo's clinical Di, ranging from 1 to 25, and were thereafter subdivided into 3 groups based on the degree of Helkimo's Di. CBCT and clinical records of sex- and age-matched non-TMD patients were used as the control group. RESULTS There was a significant difference in the prevalence of all types of bone changes between TMD and non-TMD groups (all P < .05), except for loose joint bodies. Furthermore, there was a significant correlation between the total amount of bone change and the Helkimo Di score (P < .001). CONCLUSION Evaluation of CBCT images in the present study revealed significant differences between TMD and non-TMD condyles. There was also a significant relationship between the Helkimo clinical Di and the total amount of condylar bone change in patients with TMD.
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Affiliation(s)
- Leila Khojastepour
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Science, Shiraz, Iran
| | - Mahroo Vojdani
- Biomaterial Research Center, Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Science, Shiraz, Iran
| | - Maryam Forghani
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
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19
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Massilla Mani F, Sivasubramanian SS. A study of temporomandibular joint osteoarthritis using computed tomographic imaging. Biomed J 2016; 39:201-6. [PMID: 27621122 PMCID: PMC6138784 DOI: 10.1016/j.bj.2016.06.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 11/04/2015] [Indexed: 12/14/2022] Open
Abstract
Background This study aimed to determine the various bony changes in osteoarthritis (OA) of elderly patients who are suffering from temporomandibular joint dysfunction (TMD) and to find if all the changes manifesting in generalized OA were presented in temporomandibular joint (TMJ). Methods Thirty TMJs of fifteen elderly patients who were diagnosed with TMD were selected for the study. Patient with TMD were subjected to computerized tomographic (CT) imaging, and the various bony changes in the TMJ were recorded. Results CT study of TMJ showed that there is a positive evidence of joint involvement in 80% of the cases. In this study, female patients were more commonly affected by OA than the males. The condylar changes (69.93%) are more common than the changes in the articular eminence (6.6%) and condylar fossa (10%). About 56.6% of TMJ in the study was affected by the early manifestations of the OA. Conclusion CT study showed that there is a positive evidence of TMJ involvement in the elderly patients with TMD. The results show that condylar changes are more common than the changes in the articular eminence and condylar fossa. The study also shows that most of the patients are affected by early TMJ OA; hence, initiating treatment at early stages may prevent the disease progression.
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Affiliation(s)
- F Massilla Mani
- Department of Oral Medicine and Radiology, Ragas Dental College and Hospital, Chennai, Tamil Nadu, India.
| | - S Satha Sivasubramanian
- Department of Oral Medicine and Radiology, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
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20
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Bristela M, Schmid-Schwap M, Eder J, Reichenberg G, Kundi M, Piehslinger E, Robinson S. Magnetic resonance imaging of temporomandibular joint with anterior disk dislocation without reposition - long-term results. Clin Oral Investig 2016; 21:237-245. [PMID: 27083157 PMCID: PMC5203833 DOI: 10.1007/s00784-016-1800-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 03/01/2016] [Indexed: 11/23/2022]
Abstract
Objectives Anterior disk dislocation (ADD) without reposition in the temporomandibular joint (TMJ) may be associated with morphological changes in the retrodiscal region of the bilaminar zone presenting as pseudo-disk (PD). The present study was initiated to investigate the development of retrodiscal fibrosis in a period of 4–8 years and to assess if patients with a PD show differences in the clinical and radiologic findings versus patients without a PD. Materials and Methods In a retrospective follow-up study of 33 consecutive patients with ADD without reposition in one or both TMJs, a clinical and MRI-supported evaluation was conducted 4 to 8 years after baseline diagnosis. Results In 45 % of the TMJs with ADD without reposition, a PD could be identified. Twenty-one of 31 patients who showed pain at the baseline examination (VAS mean 56 ± 38) were pain free. The mouth opening capacity (MO) of the mandible could be increased in 80 %. There were no statistical significant differences between patients with or without PD in these clinical features. The MRI parameters effusion and translation showed a statistical tendency for more improvement in the group with PD (p = 0.061, 0.064). Conclusion In about half of the patients, a structure corresponding to a pseudo-disk developed during follow-up. Pain and the mouth opening capacity improved in all patients independent of the development of a PD. Clinical Relevance Detection of a PD during follow-up of patients with ADD without spontaneous reposition does neither predict favorable nor worse therapy response and clinical course.
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Affiliation(s)
- M Bristela
- Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria.
| | - M Schmid-Schwap
- Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
| | - J Eder
- Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
| | | | - M Kundi
- Institute of Environmental Health, Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Wien, Austria
| | - E Piehslinger
- Department of Fixed and Removable Prosthodontics, University Clinic of Dentistry, Sensengasse 2a, 1090, Vienna, Austria
| | - S Robinson
- Diagnostic Center Urania, Laurenzerberg 2, 1010, Vienna, Austria
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21
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Zhuo Z, Cai XY. Radiological follow-up results of untreated anterior disc displacement without reduction in adults. Int J Oral Maxillofac Surg 2015; 45:308-12. [PMID: 26682646 DOI: 10.1016/j.ijom.2015.11.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 09/24/2015] [Accepted: 11/12/2015] [Indexed: 10/22/2022]
Abstract
The aim of this study was to assess the radiographic changes in untreated adults with bilateral anterior disc displacement without reduction. A cohort study was designed to compare the bone changes, effusion, disc configuration, and pseudo-disc changes on two magnetic resonance images obtained at least 24 months apart. Twenty-eight patients (22 female, six male) with a mean age of 33.1 years (range 20-57 years) were included. The mean interval between the initial visit and the follow-up visit was 36.2 months. At the initial visit, the frequencies of bone changes, effusion, disc deformation, and pseudo-disc changes were 51.79%, 35.71%, 100%, and 0%, respectively. At follow-up, the frequency of effusion had decreased significantly. The frequency of bone changes had increased significantly to 75%, but newly formed cortical bone was present in five condyles. All discs remained deformed. Pseudo-disc changes were detected in five joints. Over a long period of observation, there was a significant decrease in effusion and a significant increase in bone changes. However, some adaptive changes occurred.
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Affiliation(s)
- Z Zhuo
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - X Y Cai
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
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22
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Cömert Kiliç S, Kiliç N, Sümbüllü M. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations. Int J Oral Maxillofac Surg 2015; 44:1268-74. [DOI: 10.1016/j.ijom.2015.06.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 06/21/2015] [Accepted: 06/25/2015] [Indexed: 10/23/2022]
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Verner FS, Visconti MAPG, Junqueira RB, Dias IM, Ferreira LA, Devito KL. Performance of cone-beam computed tomography filters for detection of temporomandibular joint osseous changes. Oral Radiol 2014. [DOI: 10.1007/s11282-014-0192-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lim MJ, Lee JY. Computed tomographic study of the patterns of oesteoarthritic change which occur on the mandibular condyle. J Craniomaxillofac Surg 2014; 42:1897-902. [PMID: 25240743 DOI: 10.1016/j.jcms.2014.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 07/26/2014] [Accepted: 07/29/2014] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to investigate which parts of the articular surface of the mandibular condyle are involved in osteoarthritic (OA) change (the occurring pattern) and the relationship of these patterns to clinical signs and symptoms. The computed tomographic (CT) images and clinical records of patients with OA involvement of one or both of their temporomandibular joints (TMJs) were reviewed (OA changes confirmed by CT; 684 TMJs included). The condylar articular surface was divided into nine imaginary sections on the CT images: antero-medial (AM), antero-central (AC), antero-lateral (AL), centri-medial (CM), centri-central (CC), centri-lateral (CL), postero-medial (PM), postero-central (PC), and postero-lateral (PL) section. The occurring patterns were classified with hierarchical cluster analysis based on the distribution of the sections involved by OA changes. OA changes were observed the most frequently on the AC (62.4%) followed by the AM (55.0%), CC (48.2%), AL (43.0%), CL (43.3%), CM (33.3%), PC (28.9%), PL (25.3%), and PM (23.1%). The occurring patterns were classified into three types among which subjective joint pain (P < 0.001) and noise (P < 0.05) were more frequently reported in the entire-involved type followed by lateral- and antero-medial types in descending order, while no significant differences for age, gender, side, pain on palpation, clicking, crepitus, mouth opening range and craniomandibular index were observed. OA changes are more likely to occur on the anterior than the posterior and on the medial than the lateral surface of the mandibular condyle, while subjective joint pain and noise are more frequently reported with OA changes involving the lateral or entire part. Pain on palpation, noise, and mouth opening range were not related to the occurring pattern of OA changes.
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Affiliation(s)
- Mi-Ji Lim
- Department of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University, Daehak-ro 101, Jongno-Gu, Seoul 110-749, Republic of Korea
| | - Jeong-Yun Lee
- Department of Oral Medicine & Oral Diagnosis, School of Dentistry & Dental Research Institute, Seoul National University, Daehak-ro 101, Jongno-Gu, Seoul 110-749, Republic of Korea.
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25
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Koos B, Twilt M, Kyank U, Fischer-Brandies H, Gassling V, Tzaribachev N. Reliability of clinical symptoms in diagnosing temporomandibular joint arthritis in juvenile idiopathic arthritis. J Rheumatol 2014; 41:1871-7. [PMID: 24986847 DOI: 10.3899/jrheum.131337] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Temporomandibular joint (TMJ) arthritis, commonly considered oligoarthritic/asymptomatic, occurs frequently in children with juvenile idiopathic arthritis (JIA), and gadolinium-enhanced magnetic resonance imaging (Gd-MRI) has proved to be a sensitive diagnostic tool in this context. We compared the reliability of clinical examinations to Gd-MRI results in diagnosing the condition. METHODS Patients with JIA (134 consecutive) underwent routine clinical and Gd-MRI examinations. The clinical items examined were clicking, tenderness (TMJ/adjacent muscles), and mouth-opening capacity. Blinded MRI reading focused on inflammation (synovitis/hypertrophy). After statistical power analysis, the clinical findings for 134 healthy controls were included. Contingency analysis was used to determine the sensitivity, specificity, and frequency of clinical symptoms (JIA/healthy controls); Cohen's κ was used to establish the interrater reliability. RESULTS Statistically significant differences were observed between JIA and healthy control groups with regard to the concise screening items (power analysis > 0.95), whereas no differences in mouth-opening capacity were noted. In 80% of the patients with JIA, Gd-MRI revealed signs of TMJ arthritis, with positive correlations between concise screening items and Gd-MRI results. The average specificity was 0.81, but the sensitivity was low, at 0.42. Combining items led to a marked increase in the sensitivity (0.73). There was a high rate of both false-negative and false-positive results (corresponding to clinical underdiagnosis or overdiagnosis of TMJ arthritis). CONCLUSION Despite a relatively high specificity, clinical examination alone does not seem sufficiently sensitive to adequately detect TMJ arthritis. Thus, a relatively high number of cases will be missed or overdiagnosed, potentially leading to undertreatment or overtreatment. Gd-MRI may support correct diagnosis, thereby helping to prevent undertreatment or overtreatment.
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Affiliation(s)
- Bernd Koos
- From the Department of Orthodontics, and the Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany; Hospital for Sick Children, University of Toronto, Division of Rheumatology, Toronto, Ontario, Canada; University Medical Center, Children's Hospital, Rostock; Pediatric Rheumatology Research Institute (PRI), Bad Bramstedt, Germany.B. Koos, DMD, Department of Orthodontics, University Medical Center Schleswig-Holstein; M. Twilt, MD, PhD, Hospital for Sick Children, University of Toronto, Division of Rheumatology; U. Kyank, MD, University Medical Center, Children's Hospital; H. Fischer-Brandies, DMD, PhD, Department of Orthodontics, University Medical Center Schleswig-Holstein; V. Gassling, MD, DMD, Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein; N. Tzaribachev, MD, PRI.
| | - Marinka Twilt
- From the Department of Orthodontics, and the Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany; Hospital for Sick Children, University of Toronto, Division of Rheumatology, Toronto, Ontario, Canada; University Medical Center, Children's Hospital, Rostock; Pediatric Rheumatology Research Institute (PRI), Bad Bramstedt, Germany.B. Koos, DMD, Department of Orthodontics, University Medical Center Schleswig-Holstein; M. Twilt, MD, PhD, Hospital for Sick Children, University of Toronto, Division of Rheumatology; U. Kyank, MD, University Medical Center, Children's Hospital; H. Fischer-Brandies, DMD, PhD, Department of Orthodontics, University Medical Center Schleswig-Holstein; V. Gassling, MD, DMD, Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein; N. Tzaribachev, MD, PRI
| | - Ullrike Kyank
- From the Department of Orthodontics, and the Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany; Hospital for Sick Children, University of Toronto, Division of Rheumatology, Toronto, Ontario, Canada; University Medical Center, Children's Hospital, Rostock; Pediatric Rheumatology Research Institute (PRI), Bad Bramstedt, Germany.B. Koos, DMD, Department of Orthodontics, University Medical Center Schleswig-Holstein; M. Twilt, MD, PhD, Hospital for Sick Children, University of Toronto, Division of Rheumatology; U. Kyank, MD, University Medical Center, Children's Hospital; H. Fischer-Brandies, DMD, PhD, Department of Orthodontics, University Medical Center Schleswig-Holstein; V. Gassling, MD, DMD, Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein; N. Tzaribachev, MD, PRI
| | - Helge Fischer-Brandies
- From the Department of Orthodontics, and the Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany; Hospital for Sick Children, University of Toronto, Division of Rheumatology, Toronto, Ontario, Canada; University Medical Center, Children's Hospital, Rostock; Pediatric Rheumatology Research Institute (PRI), Bad Bramstedt, Germany.B. Koos, DMD, Department of Orthodontics, University Medical Center Schleswig-Holstein; M. Twilt, MD, PhD, Hospital for Sick Children, University of Toronto, Division of Rheumatology; U. Kyank, MD, University Medical Center, Children's Hospital; H. Fischer-Brandies, DMD, PhD, Department of Orthodontics, University Medical Center Schleswig-Holstein; V. Gassling, MD, DMD, Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein; N. Tzaribachev, MD, PRI
| | - Volker Gassling
- From the Department of Orthodontics, and the Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany; Hospital for Sick Children, University of Toronto, Division of Rheumatology, Toronto, Ontario, Canada; University Medical Center, Children's Hospital, Rostock; Pediatric Rheumatology Research Institute (PRI), Bad Bramstedt, Germany.B. Koos, DMD, Department of Orthodontics, University Medical Center Schleswig-Holstein; M. Twilt, MD, PhD, Hospital for Sick Children, University of Toronto, Division of Rheumatology; U. Kyank, MD, University Medical Center, Children's Hospital; H. Fischer-Brandies, DMD, PhD, Department of Orthodontics, University Medical Center Schleswig-Holstein; V. Gassling, MD, DMD, Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein; N. Tzaribachev, MD, PRI
| | - Nikolay Tzaribachev
- From the Department of Orthodontics, and the Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein, Kiel, Germany; Hospital for Sick Children, University of Toronto, Division of Rheumatology, Toronto, Ontario, Canada; University Medical Center, Children's Hospital, Rostock; Pediatric Rheumatology Research Institute (PRI), Bad Bramstedt, Germany.B. Koos, DMD, Department of Orthodontics, University Medical Center Schleswig-Holstein; M. Twilt, MD, PhD, Hospital for Sick Children, University of Toronto, Division of Rheumatology; U. Kyank, MD, University Medical Center, Children's Hospital; H. Fischer-Brandies, DMD, PhD, Department of Orthodontics, University Medical Center Schleswig-Holstein; V. Gassling, MD, DMD, Department of Oral and Maxillofacial Surgery, University Medical Center Schleswig-Holstein; N. Tzaribachev, MD, PRI
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Bilateral TMJ Involvement in Rheumatoid Arthritis. Case Rep Dent 2014; 2014:262430. [PMID: 24804125 PMCID: PMC3996894 DOI: 10.1155/2014/262430] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 02/06/2014] [Indexed: 12/02/2022] Open
Abstract
Rheumatoid arthritis (RA) is a systemic inflammatory, slowly progressive disease that results in cartilage and bone destruction. Temporomandibular joint (TMJ) involvement is not uncommon in RA, and it is present in about more than 50% of patients; however, TMJ is usually among the last joints to be involved and is associated with many varied clinical signs and symptoms. Hence, RA of TMJ presents to the dentist with great diagnostic challenges. This report presents a case of RA with bilateral TMJ involvement with its classical radiographic findings and review literature.
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Nah KS. Condylar bony changes in patients with temporomandibular disorders: a CBCT study. Imaging Sci Dent 2012; 42:249-53. [PMID: 23301212 PMCID: PMC3534180 DOI: 10.5624/isd.2012.42.4.249] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Revised: 07/21/2012] [Accepted: 09/03/2012] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Diagnosis of osteoarthritis most commonly depends on clinical and radiographic findings. The present study attempted to observe the bony changes in temporomandibular joint (TMJ) patients from all age groups. MATERIALS AND METHODS The first-visit clinical records and cone beam computed tomography (CBCT) data of 440 TMJs from 220 consecutive TMJ patients were reviewed retrospectively. RESULTS The most frequent condylar bony change observed was sclerosis (133 joints, 30.2%) followed by surface erosion (129 joints, 29.3%), flattening of the articular surface (112 joints, 25.5%), and deviation in form (58 joints, 13.2%), which included 33 TMJs in a cane-shape, 16 with a lateral or medial pole depression, 6 with posterior condylar surface flattening, and 3 with a bifid-shaped condyle. Fifty-three joints (12.0%) showed hypoplastic condyles but only 1 joint showed hyperplasia. Osteophyte was found in 35 joints (8.0%) and subcortical cyst in 24 joints (5.5%), 5 of which had surface erosion as well. One hundred nineteen joints (27.0%) had only one kind of condylar bony change, 66 joints (15.0%) had two, 52 joints (11.8%) had three, 12 joints (5.0%) had four, and 6 joints (1.4%) had five kinds of condylar bony changes at the same time. Eighty-five (65.9%) of 129 joints with surface erosion had pain recorded at the chief complaint. CONCLUSION With more widespread use of CBCT, more specific or detailed guidelines for osteoarthritis are needed.
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Affiliation(s)
- Kyung-Soo Nah
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
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28
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Cho BH, Jung YH. Osteoarthritic changes and condylar positioning of the temporomandibular joint in Korean children and adolescents. Imaging Sci Dent 2012; 42:169-74. [PMID: 23071967 PMCID: PMC3465759 DOI: 10.5624/isd.2012.42.3.169] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 06/07/2012] [Accepted: 06/14/2012] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the prevalence of osteoarthritic changes and condylar positioning of the temporomandibular joint (TMJ) in Korean children and adolescents with or without temporomandibular disorders (TMDs). Materials and Methods A total of 101 asymptomatic and 181 symptomatic children and adolescents aged 10 to 18 years old were included in the study. Osteoarthritic changes such as flattening, sclerosis, osteophytes, or erosion, and the parasagittal positioning of the condyle were assessed using cone-beam computed tomography (CBCT) images. Results The overall prevalence of osteoarthritic changes was higher in symptomatic (26.8%) than in asymptomatic adolescents (9.9%) (p<0.05). In the symptomatic group, the frequency was higher in males (33.3%) than in females (23.0%) (p<0.05). Erosion was the most common change for the symptomatic group (15.6%), whereas sclerosis was the most common change for the asymptomatic group (5.4%). Posterior condylar position was more frequently observed in the symptomatic group (p<0.05). Erosion was more common in the samples with TMJ pain or mouth opening limitations as compared to those without them (p<0.05). Conclusion This study showed that osteoarthritic changes in TMJ were common in children and adolescents, with a much higher prevalence in symptomatic patients.
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Affiliation(s)
- Bong-Hae Cho
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University, Yangsan, Korea
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29
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Gil C, Santos KCP, Dutra MEP, Kodaira SK, Oliveira JX. MRI analysis of the relationship between bone changes in the temporomandibular joint and articular disc position in symptomatic patients. Dentomaxillofac Radiol 2012; 41:367-72. [PMID: 22241883 DOI: 10.1259/dmfr/79317853] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate bone changes in the condyle, articular eminence and glenoid fossa in relation to the position of the articular disc. METHODS 148 temporomandibular joints (TMJs) of 74 symptomatic patients who underwent MRI were evaluated. The position of the disc was classified as either normal (N), disc displacement with reduction (DDwR), disc displacement without reduction (DDwoR) and posterior displacement (PD). Bone changes were investigated in the condyle and temporal components of the TMJ and classified as osteophytosis, sclerosis or erosion. RESULTS There were no bone changes in the glenoid fossa of the temporal bone. Of the total number of TMJs studied, 94 (63.5%) were N, 34 (23%) presented DDwoR, 19 (12.8%) presented DDwR and 1 (0.7%) presented PD. The bone changes in the condyle and posterior aspect of the articular eminence were associated with the position of the disc. The bone changes in the anterior aspect of the articular eminence were not associated with the position of the disc. CONCLUSION In cases of DDwoR, bone changes in the condyles were more common. The combination of erosion and osteophytosis in the condyle and the bone changes of the posterior aspect of the articular eminence were associated with disc position.
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Affiliation(s)
- C Gil
- University of Sao Paulo, Sao Paulo, Brazil
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30
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Palconet G, Ludlow JB, Tyndall DA, Lim PF. Correlating cone beam CT results with temporomandibular joint pain of osteoarthritic origin. Dentomaxillofac Radiol 2011; 41:126-30. [PMID: 22116122 DOI: 10.1259/dmfr/60489374] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to determine whether bony changes in temporomandibular joint (TMJ) osteoarthritis (OA) is correlated with pain and other clinical signs and symptoms. METHODS Clinical data and cone beam CT (CBCT) images of 30 patients with TMJ OA were analysed. The criteria of Koyama et al (Koyama J, Nishiyama H, Hayashi T. Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofac Radiol 2007; 36: 472-477.) and Ahmad et al [Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 844-860.] were used to classify the condyles observed on the CBCT. Clinical measures included self-reported pain, mandibular range of motion, TMJ sound, pain on palpation of the TMJ and masticatory muscles, and pain on jaw function. Generalized linear modelling was used to correlate the clinical and radiographic findings and Spearman's rho was used to correlate the two classification systems. RESULTS There was poor correlation between the maximum condyle change and pain rating (Koyama: r² = 0.1443, p = 0.3995; Ahmad: r² = 0.0273, p = 0.9490), maximum mouth opening (Koyama: r² = 0.2910, p = 0.0629; Ahmad: r² = 0.2626, p = 0.0951), protrusion (Koyama: r² = 0.0875, p = 0.7001; Ahmad: r² = 0.1658, p = 0.3612), right lateral motion (Koyama: r² = 0.0394, p = 0.9093; Ahmad: r² = 0.0866, p = 0.6877) and left lateral motion (Koyama: r² = 0.0943, p = 0.6494; Ahmad: r² = 0.1704, p = 0.3236). Strong correlation was observed between Koyama et al's and Ahmad et al's classifications for average (r = 0.9216, p < 0.001) and maximum (r = 0.7694; p < 0.0001) bony change. CONCLUSIONS There was poor correlation between condylar changes (as observed on CBCT images), pain and other clinical signs and symptoms in TMJ OA.
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Affiliation(s)
- G Palconet
- University of North Carolina, Chapel Hill School of Dentistry, NC 27599-7455, USA
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Cortés D, Sylvester DC, Exss E, Marholz C, Millas R, Moncada G. Association between disk position and degenerative bone changes of the temporomandibular joints: an imaging study in subjects with TMD. Cranio 2011; 29:117-26. [PMID: 21661586 DOI: 10.1179/crn.2011.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The aim of this study was to determine the frequency and relationship between disk position and degenerative bone changes in the temporomandibular joints (TMJ), in subjects with internal derangement (ID). MRI and CT scans of 180 subjects with temporomandibular disorders (TMD) were studied. Different image parameters or characteristics were observed, such as disk position, joint effusion, condyle movement, degenerative bone changes (flattened, cortical erosions and irregularities), osteophytes, subchondral cysts and idiopathic condyle resorption. The present study concluded that there is a significant association between disk displacement without reduction and degenerative bone changes in patients with TMD. The study also found a high probability of degenerative bone changes when disk displacement without reduction is present. No association was found between TMD and condyle range of motion, joint effusion and/or degenerative bone changes. The following were the most frequent morphological changes observed: flattening of the anterior surface of the condyle; followed by erosions and irregularities of the joint surfaces; flattening of the articular surface of the temporal eminence, subchondral cysts, osteophytes; and idiopathic condyle resorption, in decreasing order.
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Cevidanes LHS, Hajati AK, Paniagua B, Lim PF, Walker DG, Palconet G, Nackley AG, Styner M, Ludlow JB, Zhu H, Phillips C. Quantification of condylar resorption in temporomandibular joint osteoarthritis. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2010; 110:110-7. [PMID: 20382043 PMCID: PMC2900430 DOI: 10.1016/j.tripleo.2010.01.008] [Citation(s) in RCA: 114] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2009] [Revised: 12/17/2009] [Accepted: 01/08/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study was performed to determine the condylar morphologic variation of osteoarthritic (OA) and asymptomatic temporomandibular joints (TMJs) and to determine its correlation with pain intensity and duration. STUDY DESIGN Three-dimensional surface models of mandibular condyles were constructed from cone-beam computerized tomography images of 29 female patients with TMJ OA (Research Diagnostic Criteria for Temporomandibular Disorders group III) and 36 female asymptomatic subjects. Shape correspondence was used to localize and quantify the condylar morphology. Statistical analysis was performed with multivariate analysis of covariance analysis, using Hotelling T(2) metric based on covariance matrices, and Pearson correlation. RESULTS The OA condylar morphology was statistically significantly different from the asymptomatic condyles (P < .05). Three-dimensional morphologic variation of the OA condyles was significantly correlated with pain intensity and duration. CONCLUSION Three-dimensional quantification of condylar morphology revealed profound differences between OA and asymptomatic condyles, and the extent of the resorptive changes paralleled pain severity and duration.
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Affiliation(s)
- L H S Cevidanes
- Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina 27599, USA.
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Osseous changes and condyle position in TMJ tomograms: impact of RDC/TMD clinical diagnoses on agreement between expected and actual findings. ACTA ACUST UNITED AC 2008; 106:e52-63. [DOI: 10.1016/j.tripleo.2008.03.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2007] [Revised: 01/30/2008] [Accepted: 03/15/2008] [Indexed: 11/17/2022]
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34
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Sano T, Yajima A, Otonari-Yamamoto M, Wakoh M, Katakura A. Interpretation of images and discrepancy between osteoarthritic findings and symptomatology in temporomandibular joint. JAPANESE DENTAL SCIENCE REVIEW 2008. [DOI: 10.1016/j.jdsr.2008.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Analysis of magnetic resonance imaging characteristics and pain in temporomandibular joints with and without degenerative changes of the condyle. Int J Oral Maxillofac Surg 2008; 37:529-34. [DOI: 10.1016/j.ijom.2008.02.011] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Revised: 01/17/2008] [Accepted: 02/29/2008] [Indexed: 11/19/2022]
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36
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Takayama Y, Miura E, Yuasa M, Kobayashi K, Hosoi T. Comparison of occlusal condition and prevalence of bone change in the condyle of patients with and without temporomandibular disorders. ACTA ACUST UNITED AC 2008; 105:104-12. [PMID: 17449297 DOI: 10.1016/j.tripleo.2006.12.033] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2006] [Revised: 12/18/2006] [Accepted: 12/31/2006] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the differences in dental and occlusal conditions, and prevalence of bone change in the condyle, between a group of patients with temporomandibular disorders (TMD) and a group of dental patients without such complaints. STUDY DESIGN A group of 504 patients with temporomandibular disorders (TMD patients) and a group of 970 patients without such complaints (dental patients), all 25 years of age or older, were compared using the criteria of age, sex, dental and occlusal condition, and prevalence of bone change in the condyle based on panoramic radiographs and imaging request forms. RESULTS In both groups, the rate of complete dental arch was high for both jaws. According to Eichner's index, the rate for group A among the dental patients was 59.6%, whereas it was 84.7% in the TMD patients (P < .01). The prevalence of bone change in the condyle was 17.7% for the TMD patients and 11.6% for the dental patients (P < .01). Eichner's group C was somewhat high for the dental patients, and group A was high for the TMD patients. However, there were no significant differences in the occlusal conditions based on the prevalence of bone change. Deformity was the most common abnormality of bone change for both the dental and the TMD patients. In the TMD patients, the rate of osteophytes was the second most common abnormal finding. Osteophytes were the highest among the average age for all abnormal bone changes in the condyle. With the TMD patients, all the changes were more commonly found in Eichner's group A. CONCLUSIONS It was demonstrated that the symptoms of TMD correlated with age, sex, and dental and occlusal conditions. However, the prevalence of bone change in the condyle correlated poorly with age, sex, and dental and occlusal condition with and without TMD.
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Affiliation(s)
- Yasuko Takayama
- The First Department of Prosthetic Dentistry, Tsurumi University School of Dental Medicine, Yokohama, Japan.
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37
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Yajima A, Sano T, Otonari-Yamamoto M, Otonari T, Ohkubo M, Harada T, Wakoh M. MR evidence of characteristics in symptomatic osteoarthritis of the temporomandibular joint: increased signal intensity ratio on proton density-weighted images of bone marrow in the mandibular condyle. Cranio 2007; 25:250-6. [PMID: 17983124 DOI: 10.1179/crn.2007.038] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The purpose of this study was to clarify the presence of pain and a correlation between pain and characteristics of signal intensity of mandibular bone marrow in temporomandibular joints (TMJ) with osteoarthritis (OA). A total of 196 joints in 98 patients with TMJ disorders were examined using magnetic resonance imaging (MRI). A pain score and signal intensity on mandibular bone marrow were analyzed in the TMJ with OA. TMJ with OA showed a higher degree of pain compared to those without (p < 0.05). During opening, the joints in the higher signal intensity group showed a significantly higher degree of pain compared to the joints in the lower signal intensity group in those with OA on proton density weighted images (p < 0.05). It was concluded that TMJ with osteoarthritis is related to pain and that a symptomatic osteoarthritic TMJ can accompany bone marrow changes in the condyle, showing an increased signal on proton density weighted images.
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Affiliation(s)
- Aya Yajima
- Dept. of Oral and Maxillofacial Radiology, Tokyo Dental College 1-2-2 Masago, Mihama-ku Chiba 261-8502, Japan.
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Ting E, Roveroni RC, Ferrari LF, Lotufo CMC, Veiga MCFA, Parada CA, Tambeli CH. Indirect mechanism of histamine-induced nociception in temporomandibular joint of rats. Life Sci 2007; 81:765-71. [PMID: 17706725 DOI: 10.1016/j.lfs.2007.07.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Revised: 07/02/2007] [Accepted: 07/17/2007] [Indexed: 10/23/2022]
Abstract
A considerable amount of evidence suggests that temporomandibular joint (TMJ) pain associated with temporomandibular disorder results, at least in part, from an inflammatory episode. Although histamine can cause pain, it is not clear whether this mediator induces nociception in the TMJ. In this study, we investigated the contribution of endogenous histamine to formalin-induced nociception in the TMJ of rats. We also investigated whether the administration of histamine induces nociception in the TMJ and, if so, whether this effect is mediated by an indirect action on primary afferent nociceptors. Local administration of the H1-receptor antagonist pyrilamine prevented formalin-induced nociception in the TMJ in a dose-dependent manner. Local administration of histamine (250 microg) in the TMJ induced nociceptive behavior that was inhibited by co-administration of the lidocaine N-ethyl bromide quaternary salt QX-314 (2%) or the selective H1-receptor antagonist pyrilamine (400 microg). Nociception induced by histamine was also inhibited by pre-treatment with sodium cromoglycate (800 microg) and by co-administration of the 5-HT(3) receptor antagonist tropisetron (400 mug), while pyrilamine (400 mug) did not inhibit nociception induced by 5-hydroxytryptamine (5-HT, 250 microg) in the TMJ. Furthermore, histamine, in a dose that did not induce nociception by itself, strongly enhanced 5-HT-induced nociception. Finally, the administration of a sub-threshold dose of 5-HT (100 microg), but not of histamine (100 microg), elicited nociception in the TMJ previously challenged with the inflammatory agent carrageenan (100 microg). In conclusion, these data suggest that histamine induces TMJ nociception by an indirect mechanism involving endogenous release of 5-HT and activation of 5-HT(3) receptors on sensory afferents. It is proposed that histamine activates the H1 receptor to induce the release of 5-HT which depolarizes the nociceptor by activating 5-HT(3) receptor.
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Affiliation(s)
- Elizabeth Ting
- Department of Physiology, Faculty of Dentistry of Piracicaba, University of Campinas, Brazil
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Shimazaki Y, Saito K, Matsukawa S, Onizawa R, Kotake F, Nishio R, Abe K. Image Quality Using Dynamic MR Imaging of the Temporomandibular Joint with True-FISP Sequence. Magn Reson Med Sci 2007; 6:15-20. [PMID: 17510538 DOI: 10.2463/mrms.6.15] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We evaluated the quality of dynamic magnetic resonance (MR) imaging of the temporomandibular joint (TMJ) in 20 normal volunteers with 40 TMJs. To confirm TMJ, we obtained static proton density weighted images (PDWI) before performing dynamic MR imaging with true-fast imaging in a steady-state precession (true-FISP) sequence. Four sequences of the first 10 volunteers were examined to determine the optimal sequence. The 4 sequences included the integrated parallel acquisition technique (iPAT) and/or fat saturation technique. The optimal sequence was then determined and performed in all 20 volunteers. The quality of imaging was evaluated, especially with respect to the conspicuity of the articular disk, mandibular condyle, articular eminence and lateral pterygoid muscle. One of 3 confidence levels was assigned for this evaluation. Neither iPAT nor fat saturation obtained the best quality imaging. Detection rates in the 20 volunteers were 83% for the articular disk, 95% for the mandibular condyle, 96% for the articular eminence and 7.5% for the lateral pterygoid muscle. We recommend dynamic MR imaging of the TMJ with the true-FISP sequence using neither iPAT nor fat saturation. Nevertheless, dynamic MR imaging was inferior to static imaging in detecting the articular disk and still requires improvement.
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