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ORHAN K, ÖZEMRE M, KÖSEOĞLU SEÇGİN C, KARSLIOĞLU H, KAMBUROGLU K, GÜR GG, VURAL S. Comparison of Panoramic, Lateral Skull Projection and CBCT Images in Detection of Mandibular Condyle Fractures. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.881763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Iskanderani D, Alstergren P, Ekberg EC, Shi XQ, Hellén-Halme K. Web-based educational programme for temporomandibular joint assessment with cone-beam computed tomography. J Oral Rehabil 2020; 47:1330-1336. [PMID: 32757414 DOI: 10.1111/joor.13065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To develop and evaluate an educational web-based programme for temporomandibular joint (TMJ) assessment using cone-beam computed tomography (CBCT). METHODS A web-based educational programme was designed for TMJ assessment using CBCT images. Fifteen CBCT cases of the TMJ (three-dimensional reconstructed volumes) and an assessment module based on image analysis criteria in the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were added to the programme. Thirty-six undergraduate dental students were invited to test the programme by assessing all cases twice: before and after 2 months of training. Participants submitted written subjective evaluations of the programme. RESULTS The web-based programme can be accessed on Malmö University webpage (www.cbct-tmj.mau.se). Despite limited CBCT learning in their undergraduate training and not using the programme in the 2-month interval, the students were able to correctly diagnose 80% of the cases at the second assessment. Their diagnoses, however, did not differ significantly from the first assessment. Overall, the students were satisfied with the programme and considered it user-friendly. CONCLUSION The web-based educational programme that was developed in the present study and tested by dental students could be a useful educational tool for TMJ assessment using CBCT.
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Affiliation(s)
- Durer Iskanderani
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Ewa Carin Ekberg
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Xie-Qi Shi
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Division of Oral Maxillofacial Radiology, Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Kristina Hellén-Halme
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
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High resolution MRI for quantitative assessment of inferior alveolar nerve impairment in course of mandible fractures: an imaging feasibility study. Sci Rep 2020; 10:11566. [PMID: 32665667 PMCID: PMC7360624 DOI: 10.1038/s41598-020-68501-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/24/2020] [Indexed: 11/30/2022] Open
Abstract
The purpose of this study was to evaluate a magnetic resonance imaging (MRI) protocol for direct visualization of the inferior alveolar nerve in the setting of mandibular fractures. Fifteen patients suffering from unilateral mandible fractures involving the inferior alveolar nerve (15 affected IAN and 15 unaffected IAN from contralateral side) were examined on a 3 T scanner (Elition, Philips Healthcare, Best, the Netherlands) and compared with 15 healthy volunteers (30 IAN in total). The sequence protocol consisted of a 3D STIR, 3D DESS and 3D T1 FFE sequence. Apparent nerve-muscle contrast-to-noise ratio (aNMCNR), apparent signal-to-noise ratio (aSNR), nerve diameter and fracture dislocation were evaluated by two radiologists and correlated with nerve impairment. Furthermore, dislocation as depicted by MRI was compared to computed tomography (CT) images. Patients with clinically evident nerve impairment showed a significant increase of aNMCNR, aSNR and nerve diameter compared to healthy controls and to the contralateral side (p < 0.05). Furthermore, the T1 FFE sequence allowed dislocation depiction comparable to CT. This prospective study provides a rapid imaging protocol using the 3D STIR and 3D T1 FFE sequence that can directly assess both mandible fractures and IAN damage. In patients with hypoesthesia following mandibular fractures, increased aNMCNR, aSNR and nerve diameter on MRI imaging may help identify patients with a risk of prolonged or permanent hypoesthesia at an early time.
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Iskanderani D, Nilsson M, Alstergren P, Shi XQ, Hellen-Halme K. Evaluation of a low-dose protocol for cone beam computed tomography of the temporomandibular joint. Dentomaxillofac Radiol 2020; 49:20190495. [PMID: 32250642 PMCID: PMC7461740 DOI: 10.1259/dmfr.20190495] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Evaluation of cone beam CT (CBCT) examination with a low-dose scanning protocol for assessment of the temporomandibular joint (TMJ). METHODS 34 adult patients referred for CBCT imaging of the TMJ underwent two examinations with two scanning protocols, a manufacturer-recommended protocol (default) and a low-dose protocol where the tube current was reduced to 20% of the default protocol. Three image stacks were reconstructed: default protocol, low-dose protocol, and processed (using a noise reduction algorithm) low-dose protocol. Four radiologists evaluated the images. The Sign test was used to evaluate visibility of TMJ anatomic structures and image quality. Receiver operating characteristic analyzes were performed to assess the diagnostic accuracy. κ values were used to evaluate intraobserver agreement. RESULTS With the low-dose and processed protocols, visibility of the TMJ anatomical structures and overall image quality were comparable to the default protocol. No significant differences in radiographic findings were found for the two low-dose protocols compared to the default protocol. The area under the curves (Az) averaged for the low-dose and processed protocols, according to all observers, were 0.931 and 0.941, respectively. Intraobserver agreement was good to very good. CONCLUSION For the CBCT unit used in this study, the low-dose CBCT protocol for TMJ examination was diagnostically comparable to the manufacturer-recommended protocol, but delivered a five times lower radiation dose. There is an urgent need to evaluate protocols for CBCT examinations of TMJ in order to optimize them for a radiation dose as low as diagnostically acceptable (the as low as diagnostically acceptable principle recommended by NCRP).
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Affiliation(s)
- Durer Iskanderani
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mats Nilsson
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Department of Medical Radiation Physics, Skåne University Hospital, Malmö, Sweden
| | - Per Alstergren
- Department of Orofacial Pain and Jaw Function, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Xie-Qi Shi
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden.,Division of Oral Maxillofacial Radiology, Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway.,Section of Oral Diagnostics and Surgery, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Kristina Hellen-Halme
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
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Jain S, Choudhary K, Nagi R, Shukla S, Kaur N, Grover D. New evolution of cone-beam computed tomography in dentistry: Combining digital technologies. Imaging Sci Dent 2019; 49:179-190. [PMID: 31583200 PMCID: PMC6761063 DOI: 10.5624/isd.2019.49.3.179] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/24/2019] [Accepted: 05/08/2019] [Indexed: 02/06/2023] Open
Abstract
Panoramic radiographs and computed tomography (CT) play a paramount role in the accurate diagnosis, treatment planning, and prognostic evaluation of various complex dental pathologies. The advent of cone-beam computed tomography (CBCT) has revolutionized the practice of dentistry, and this technique is now considered the gold standard for imaging the oral and maxillofacial area due to its numerous advantages, including reductions in exposure time, radiation dose, and cost in comparison to other imaging modalities. This review highlights the broad use of CBCT in the dentomaxillofacial region, and also focuses on future software advancements that can further optimize CBCT imaging.
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Affiliation(s)
- Supreet Jain
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Sakri, Bilaspur, India
| | - Kartik Choudhary
- Department of Pedodontics and Preventive Dentistry, Mansarovar Dental College, Bhopal, India
| | - Ravleen Nagi
- Department of Oral Medicine and Radiology, Swami Devi Dayal Hospital and Dental College, Panchkula, India
| | - Stuti Shukla
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Sakri, Bilaspur, India
| | - Navneet Kaur
- Department of Periodontology, National Dental College and Hospital, Dera Bassi, Mohali, India
| | - Deepak Grover
- Department of Periodontology, National Dental College and Hospital, Dera Bassi, Mohali, India
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Aydin U, Gormez O, Yildirim D. Cone-beam computed tomography imaging of dentoalveolar and mandibular fractures. Oral Radiol 2019; 36:217-224. [PMID: 31102106 DOI: 10.1007/s11282-019-00390-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 05/06/2019] [Indexed: 11/28/2022]
Abstract
Three-dimensional imaging methods have an important role in the diagnosis of dentomaxillofacial fractures that can not be seen on the plain films. Cone-beam computed tomography (CBCT) is one of the three-dimensional imaging methods and has facilitated dental professionals' access to cross-sectional imaging. CBCT units allow different technical parameters and the data acquired by CBCT, can be reformatted. Osseous structures are correctly examined with this technique but the technique is not useful for the examination of soft tissues. Therefore, the purpose of its use should be based on the expected diagnostic gain. The aim of this review is to present the use of CBCT with different multi-planar reformatted sections and three-dimensional reconstructions of dentoalveolar and mandibular fractures.
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Affiliation(s)
- Ulkem Aydin
- Department of Dentomaxillofacial Radiology, Cyprus Health and Social Sciences University School of Dental Sciences, Morphou, North Cyprus
| | - Ozlem Gormez
- Department of Dentomaxillofacial Radiology, Suleyman Demirel University Faculty of Dentistry, Doğu Kampüsü, Çünür, 32000, Isparta, Turkey.
| | - Derya Yildirim
- Department of Dentomaxillofacial Radiology, Suleyman Demirel University Faculty of Dentistry, Doğu Kampüsü, Çünür, 32000, Isparta, Turkey
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The value of cone beam computed tomography in the detection of salivary stones prior to sialendoscopy. Int J Oral Maxillofac Surg 2018; 47:223-227. [DOI: 10.1016/j.ijom.2017.07.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Revised: 06/19/2017] [Accepted: 07/27/2017] [Indexed: 11/19/2022]
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Larheim TA, Abrahamsson AK, Kristensen M, Arvidsson LZ. Temporomandibular joint diagnostics using CBCT. Dentomaxillofac Radiol 2015; 44:20140235. [PMID: 25369205 DOI: 10.1259/dmfr.20140235] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost- and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome.
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Affiliation(s)
- T A Larheim
- 1 Department of Maxillofacial Radiology, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Silveira ODS, Silva FCS, Almeida CEND, Tuji FM, Seraidarian PI, Manzi FR. Utilização da tomografia computadorizada para o diagnóstico da articulação temporomandibular. REVISTA CEFAC 2014. [DOI: 10.1590/1982-0216201418013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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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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Raphael KG, Tadinada A, Bradshaw JM, Janal MN, Sirois DA, Chan KC, Lurie AG. Osteopenic consequences of botulinum toxin injections in the masticatory muscles: a pilot study. J Oral Rehabil 2014; 41:555-63. [PMID: 24836732 DOI: 10.1111/joor.12180] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 11/30/2022]
Abstract
Patients with temporomandibular muscle and joint disorder (TMJD) increasingly seek and receive treatment for their pain with botulinum toxin (BoNTA; botulinum toxin A). Used intramuscularly in therapeutic doses, it produces localised paresis. Such paresis creates risk of reduced bone mineral density, or 'disuse osteopenia'. Animal studies have frequently used BoNTA as a model of paralysis to induce bone changes within short periods. Osteopenic effects can be enduring in animals but have yet to be studied in humans. This is the first study in humans to examine bone-related consequences of BoNTA injections in the masticatory muscles, comparing oral and maxillofacial radiologists' ratings of trabecular bone patterns in the condyles of patients with TMJD exposed to multiple masticatory muscle injection sessions with BoNTA to a sample of patients with TMJD unexposed to masticatory muscle injections with BoNTA. Cone-beam computed tomography (CBCT)-derived images of bilateral condyles were evaluated in seven patients with TMJD receiving 2+ recent BoNTA treatment sessions for facial pain and nine demographically matched patients with TMJD not receiving BoNTA treatment. Two oral and maxillofacial radiologists evaluated CBCT images for evidence of trabecular changes consistent with osteopenia. Both evaluators noted decreased density in all participants exposed to BoNTA and in none of the unexposed participants (P < 0.001). No other abnormalities associated with reduced loading were detected. These findings need replication in a larger sample and over a longer time period, to ensure safety of patients with TMJD receiving multiple BoNTA injections for their pain.
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Affiliation(s)
- K G Raphael
- Department of Oral & Maxillofacial Pathology, Radiology, and Medicine, New York University College of Dentistry, New York, NY, USA
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Jaju PP, Jaju SP. Clinical utility of dental cone-beam computed tomography: current perspectives. Clin Cosmet Investig Dent 2014; 6:29-43. [PMID: 24729729 PMCID: PMC3979889 DOI: 10.2147/ccide.s41621] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Panoramic radiography and computed tomography were the pillars of maxillofacial diagnosis. With the advent of cone-beam computed tomography, dental practice has seen a paradigm shift. This review article highlights the potential applications of cone-beam computed tomography in the fields of dental implantology and forensic dentistry, and its limitations in maxillofacial diagnosis.
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Affiliation(s)
- Prashant P Jaju
- Oral Medicine and Radiology, Rishiraj College of Dental Sciences and Research Center, Bhopal, India
| | - Sushma P Jaju
- Conservative Dentistry and Endodontics, Rishiraj College of Dental Sciences and Research Center, Bhopal, India
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Kaeppler G, Cornelius CP, Ehrenfeld M, Mast G. Diagnostic efficacy of cone-beam computed tomography for mandibular fractures. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 116:98-104. [PMID: 23768877 DOI: 10.1016/j.oooo.2013.04.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 03/21/2013] [Accepted: 04/04/2013] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the study was to determine the clinical efficacy of maxillofacial cone-beam computed tomography (CBCT) for the diagnosis of suspected mandibular fractures and to evaluate whether findings would lead to a change in treatment. STUDY DESIGN CBCT imaging was performed for 164 patients with suspected mandibular fractures (231 sites) but equivocal clinical and radiological findings (conventional radiography). Images were interpreted by oral and maxillofacial surgeons and treatment decisions based on pre and postimaging were compared. Linear regression analyses were performed. RESULTS For 63.2% of sites (n = 146) the suspected diagnosis was confirmed by CBCT (P < .0001; R(2) = 0.93). For 4.33% of sites (n = 10) no fracture was identified. Additional fractures were identified in 17.75% (n = 41) and additional infractures in 14.72% (n = 34). The treatment plan was altered for 9.52% of sites (n = 22). CONCLUSIONS CBCT imaging of suspected mandibular fractures resulted in a change in the treatment plan in 9.52%.
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Affiliation(s)
- Gabriele Kaeppler
- Department of Oral and Maxillofacial Radiology, Clinic for Oral and Craniomaxillofacial Surgery, Ludwig-Maximilians University of Munich, Munich, Germany.
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Parsa A, Ibrahim N, Hassan B, van der Stelt P, Wismeijer D. Influence of object location in cone beam computed tomography (NewTom 5G and 3D Accuitomo 170) on gray value measurements at an implant site. Oral Radiol 2013. [DOI: 10.1007/s11282-013-0157-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Eskandarlou A, Poorolajal J, Talaeipour AR, Talebi S, Talaeipour M. Comparison between cone beam computed tomography and multislice computed tomography in diagnostic accuracy of maxillofacial fractures in dried human skull: anin vitrostudy. Dent Traumatol 2013; 30:162-8. [DOI: 10.1111/edt.12058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2013] [Indexed: 01/03/2023]
Affiliation(s)
- Amir Eskandarlou
- Department of Dentomaxillofacial Radiology; School of Dentistry, Hamadan University of Medical Sciences; Hamadan Iran
| | - Jalal Poorolajal
- Department of Epidemiology & Biostatistics; Research Center for Health Sciences, School of Public Health, Hamadan University of Medical Sciences; Hamadan Iran
| | - Ahmad Reza Talaeipour
- Department of Dentomaxillofacial Radiology; Dental Branch, Islamic Azad University; Tehran Iran
| | - Sahar Talebi
- Department of Dentomaxillofacial Radiology; School of Dentistry, Hamadan University of Medical Sciences; Hamadan Iran
| | - Maziar Talaeipour
- Department of periodontology; Dental Branch, Islamic Azad University; Tehran Iran
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Krisjane Z, Urtane I, Krumina G, Neimane L, Ragovska I. The prevalence of TMJ osteoarthritis in asymptomatic patients with dentofacial deformities: a cone-beam CT study. Int J Oral Maxillofac Surg 2012; 41:690-5. [PMID: 22464854 DOI: 10.1016/j.ijom.2012.03.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Revised: 01/04/2012] [Accepted: 03/02/2012] [Indexed: 12/18/2022]
Abstract
Osteoarthritis of the temporomandibular joint (TMJ) can be described as non-inflammatory arthritic condition that results in degenerative changes of the joint structures. The aim of this study was to evaluate the skeletal morphology of the TMJ in patients with osteoarthritis with severe skeletal malocclusions (Class II and Class III) and patients with Class I occlusion as controls. Cone beam computed tomography images of 45 Class I, 28 Class II and 44 Class III joints of Caucasian patients were assessed for the presence of any degenerative changes in the condyle and fossa/eminence complex as described in the research diagnostic criteria for temporomandibular disorders (RDC/TMD). In all groups, the most commonly observed features were articular surface flattening and subcortical sclerosis. A combination of features that corresponds to a diagnosis of osteoarthritis was observed in 3% Class I, 43% Class II and 20% Class III patient joints. In conclusion, degenerative TMJ changes were more common in patients with skeletal jaw discrepancies, but wide inter-individual variations can be observed even in patients with clinically similar malocclusions.
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Affiliation(s)
- Z Krisjane
- Department of Orthodontics, Riga Stradins University, Riga, Latvia.
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