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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 2024; 42:611-619. [PMID: 35061575 DOI: 10.1080/08869634.2022.2028115] [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] [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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Berry K, Padilla M, Mitrirattanakul S, Enciso R. Temporomandibular joint findings in CBCT images: A retrospective study. Cranio 2024; 42:519-524. [PMID: 34895101 DOI: 10.1080/08869634.2021.2015102] [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] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate radiological characteristics of the temporomandibular joint. METHODS Retrospective study of images of 20-80 year-old patients. Two independent clinicians analyzed the images, and a radiological score was obtained, considering sclerosis, osteophites, cysts, and erosion. RESULTS Seventy eight percent of the joints belonged to females. The main complaints were pain and headache (54.5%) and reduced motion (21.2%). The most common diagnoses were disc dislocation with reduction (35.9%), myofascial pain (20.7%), and osteoarthritis (15.2%). The majority of the joints (96.5%) showed degeneration, with an average radiological score of 3.86 ± 1.47 (0-8). Non-parametric tests showed that females had significantly higher radiological scores (p = 0.014), and TMD-joint patients had higher scores than TMD-muscle patients (p = 0.013). No statistically significant association between radiological scores and chief complaint. CONCLUSION There were differences among the radiological findings between genders and joint/ muscle TMD, as well as across diagnoses, as expected.
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Affiliation(s)
- Kevin Berry
- Master of Science Program Herman Ostrow School of Dentistry of, Los Angeles, CA, USA
| | - Mariela Padilla
- Herman Ostrow School of Dentistry of, Division of Periodontology, Diagnostic Sciences and Dental Hygiene, Herman Ostrow School of Dentistry, Los Angeles, CA, USA
| | - Somsak Mitrirattanakul
- Faculty of Dentistry, Mahidol University, Department of Masticatory Science, Bangkok, Thailand
| | - Reyes Enciso
- Division of Dental Public Health and Pediatric Dentistry, Herman Ostrow School of Dentistry of University of Southern California, Los Angeles, CA, USA
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3
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Fagundes RJ, Felipe BC, Couto MK, Silva MC, Iwaki LCV. The relation between persistent foramen tympanicum and degenerative bone alterations in temporomandibular joint region. Oral Radiol 2024; 40:445-453. [PMID: 38587690 DOI: 10.1007/s11282-024-00749-3] [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: 02/08/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES The aim of this study was to evaluate, using cone-beam computed tomography (CBCT), the relationship of persistent foramen tympanicum (PFT) with degenerative changes in the temporomandibular joint (TMJ) and the presence of pneumatized glenoid fossae and articular eminences. METHOD Two experienced oral and maxillofacial radiologists evaluated 510 CBCT scans, from which 94 patients were divided into two groups: G1-patients with PFT and G2-control group. The location of the PFT, presence, or absence of degenerative TMJ changes and morphology were evaluated. Similarly, all images were evaluated for the presence of pneumatized articular eminence and glenoid fossa. The Chi-square test and Fisher's Exact test were used for the categorical variables. A multinomial logistic regression model was performed for subgroup analysis. To assess the estimation-chance occurrence of TMJ alterations the Odds Ratio analysis was used. RESULTS Statistically significant results were found for erosion, planning, and subchondral cyst. Regarding TMJ morphology, significant results were found for: round, flat, and others. Moreover, it was possible to observe that patients who had the PFT were approximately 48 times more likely to manifest TMJ alterations and approximately 3 times more likely to manifest articular eminence pneumatization. CONCLUSION Since individuals who have FTP have a greater chance of having TMJ and PEA changes, it is important for the dental radiologist to be aware of these signs in CBCT scans for a correct diagnosis. TRIAL REGISTRATION NUMBER CAAE: 34328214.3.0000.0104 (11/30/2014).
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Affiliation(s)
- Ruth Jorge Fagundes
- Department of Dentistry, State University of Maringa, Mandacaru Avenue, Maringa, Parana, 1550, 87080-000, Brazil
| | - Beatriz Caio Felipe
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
| | - Matheus Kawana Couto
- Department of Dentistry, State University of Maringa, Mandacaru Avenue, Maringa, Parana, 1550, 87080-000, Brazil.
| | - Mariliani Chicarelli Silva
- Department of Dentistry, State University of Maringa, Mandacaru Avenue, Maringa, Parana, 1550, 87080-000, Brazil
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Hilgenberg-Sydney PB, Zanlorenzi FF, Cunha CO. Comparative analysis of temporomandibular joint morphology in degenerative joint disease: A cone-beam CT study in patients with and without arthralgia. Saudi Dent J 2024; 36:756-760. [PMID: 38868090 PMCID: PMC11167655 DOI: 10.1016/j.sdentj.2024.03.005] [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: 09/24/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 06/14/2024] Open
Abstract
This cross-sectional study aimed to compare, by using Cone-Beam Computed Tomography (CBCT), temporomandibular joint (TMJ) morphology among patients with degenerative joint disease (DJD) with or without arthralgia, as well as a control group. METHODS Thirty-one patients and their respective CBCT TMJ exams were assessed. These individuals were selected from an Orofacial Pain Service and classified into three groups based on the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD): group 1 (10 patients with TMJ DJD and arthralgia), group 2 (11 patients with TMJ DJD without pain), and group 3 (the control group, consisting of 10 healthy individuals without any signs or symptoms of TMD). A second examiner, who was calibrated and blinded for the patient's diagnosis, evaluated the CBCT images. RESULTS Group 1 showed a statistically significant association with the variables of erosion (p = 0.003) and osteophyte (p = 0.04) on the condyle surface, as well as concentric condyle position with reduced joint space (p = 0.01). The Kappa concordance index between the clinical diagnosis of DC/TMD and CBCT images was k = 0.134 (p ≤ 0.001). CONCLUSION The presence of erosion, osteophyte, and concentric condyle position with reduced joint space was statistically associated with DJD and ongoing TMJ joint pain.
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Affiliation(s)
- Priscila Brenner Hilgenberg-Sydney
- Federal University of Paraná, Health Sciences Center, Department of Restorative Dentistry, Avenida Pref., Lothario Meissner, 632, Jardim Botânico, Curitiba, Paraná, Brazil
| | - Fernanda Farago Zanlorenzi
- Federal University of Paraná, Health Sciences Center, Department of Restorative Dentistry, Avenida Pref., Lothario Meissner, 632, Jardim Botânico, Curitiba, Paraná, Brazil
| | - Carolina Ortigosa Cunha
- Universidade do Sagrado Coração, Health Science Center, R. Irmã Arminda, 10-50, Jardim Brasil, Bauru, São Paulo, Brazil
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Hu X, Sujanamulk B, Lakshmi CR, Li C. Age and Gender-related Morphometric Assessment and Degenerative Changes of Temporomandibular Joint in Symptomatic Subjects and Controls using Cone Beam Computed Tomography (CBCT): A Comparative Analysis. Curr Med Imaging 2024; 20:1-12. [PMID: 38389339 DOI: 10.2174/0115734056248617231002110417] [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: 04/10/2023] [Revised: 07/19/2023] [Accepted: 08/11/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND The temporomandibular joint diseases have been associated with various predisposing factors. Joint spaces, articular eminence height and inclination, and the shapes of the condylar and glenoid fossa have all been shown to vary in temporomandibular joint diseases (TMD) patients. Advanced imaging techniques like cone beam computed tomography (CBCT) have been employed to estimate these parameters. AIMS AND OBJECTIVES The aim of the current study was to investigate the condylar morphology, condylar and glenoid fossa shapes, and assessment of joint spaces, such as anterior, posterior, superior, lateral, and medial spaces, through CBCT slices in coronal and sagittal planes and compare them between the control group and TMD group. MATERIALS AND METHODS A cross-sectional study was planned where 80 joints in 40 patients were assessed for the above parameters; group I consisted of healthy patients, and group II included those with temporomandibular joint diseases (TMDs). The articular eminence height and inclination were assessed on the midsagittal section. The condylar changes and shapes of the glenoid fossa and condyles, as well as the joint spaces, were assessed on the selected coronal and sagittal sections. RESULTS The condylar fossa had a triangular shape in the TMJ group and an oval shape in the control group. The results were highly significant (P = 0.000**). A highly significant difference in morphological parameters, such as AJS, PJS, SJS, MJS, LJS, articular eminence height, and inclination, was found between the two groups (P = 0.000**). The association of morphological parameters, such as AJS, PJS, SJS, MJS, LJS, and articular eminence height and inclination were compared with condylar and glenoid fossa shapes, where the association of superior joint space and articular eminence inclination was observed. A highly significant difference was noted between the two groups with regard to all the parameters with P=0.00*. CONCLUSION The articular eminence inclination, as well as the superior joint space, were found to be associated with the glenoid and condyle fossa shapes in the TMJ group. These observations would, therefore, help in the early diagnosis of temporomandibular joint diseases.
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Affiliation(s)
- Xiaoyin Hu
- Department of Imaging, The First People's Hospital of Lianyungang, Lianyungang, Jiangsu Province, 222002, China
| | - Bhavana Sujanamulk
- Department of Oral Medicine and Radiology, DRS Sudha and Negeswararao Siddhartha Institute of Dental Sciences, Chinnoutpalli, Gannavaram, Andhra Pradesh, India
| | - Chintamaneni Raja Lakshmi
- Department of Oral Medicine and Radiology, DRS Sudha and Negeswararao Siddhartha Institute of Dental Sciences, Chinnoutpalli, Gannavaram, Andhra Pradesh, India
| | - Changhui Li
- Department of Radiology, People's Hospital of Luxian County, Luzhou, Sichuan Province, 646100, China
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Schadow JE, Maxey D, Smith TO, Finnilä MAJ, Manske SL, Segal NA, Wong AKO, Davey RA, Turmezei T, Stok KS. Systematic review of computed tomography parameters used for the assessment of subchondral bone in osteoarthritis. Bone 2024; 178:116948. [PMID: 37926204 DOI: 10.1016/j.bone.2023.116948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/04/2023] [Accepted: 10/19/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To systematically review the published parameters for the assessment of subchondral bone in human osteoarthritis (OA) using computed tomography (CT) and gain an overview of current practices and standards. DESIGN A literature search of Medline, Embase and Cochrane Library databases was performed with search strategies tailored to each database (search from 2010 to January 2023). The search results were screened independently by two reviewers against pre-determined inclusion and exclusion criteria. Studies were deemed eligible if conducted in vivo/ex vivo in human adults (>18 years) using any type of CT to assess subchondral bone in OA. Extracted data from eligible studies were compiled in a qualitative summary and formal narrative synthesis. RESULTS This analysis included 202 studies. Four groups of CT modalities were identified to have been used for subchondral bone assessment in OA across nine anatomical locations. Subchondral bone parameters measuring similar features of OA were combined in six categories: (i) microstructure, (ii) bone adaptation, (iii) gross morphology (iv) mineralisation, (v) joint space, and (vi) mechanical properties. CONCLUSIONS Clinically meaningful parameter categories were identified as well as categories with the potential to become relevant in the clinical field. Furthermore, we stress the importance of quantification of parameters to improve their sensitivity and reliability for the evaluation of OA disease progression and the need for standardised measurement methods to improve their clinical value.
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Affiliation(s)
- Jemima E Schadow
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
| | - David Maxey
- Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom.
| | - Toby O Smith
- Warwick Medical School, University of Warwick, United Kingdom.
| | - Mikko A J Finnilä
- Research Unit of Health Science and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Sarah L Manske
- Department of Radiology, McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Neil A Segal
- Department of Rehabilitation Medicine, The University of Kansas Medical Center, Kansas City, United States.
| | - Andy Kin On Wong
- Joint Department of Medical Imaging, University Health Network, Toronto, Canada; Schroeder's Arthritis Institute, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada.
| | - Rachel A Davey
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Australia.
| | - Tom Turmezei
- Department of Radiology, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom; Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
| | - Kathryn S Stok
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia.
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Younan KZ, Krueger GF, Zimmer R, Hernández PAG, Fontanella VRC, Miguens SAQ. Bibliometric analysis and diagnostic efficacy of cone-beam computed tomography studies published in Imaging Science in Dentistry from 2011 to 2022. Imaging Sci Dent 2023; 53:335-344. [PMID: 38174036 PMCID: PMC10761290 DOI: 10.5624/isd.20230106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 01/05/2024] Open
Abstract
Purpose This bibliometric analysis aimed to provide a comprehensive overview of the characteristics, trends, and level of diagnostic efficacy of studies on cone-beam computed tomography (CBCT) published in Imaging Science in Dentistry (ISD) from 2011 to 2022. Materials and Methods Publications related to CBCT identified in the electronic collection of ISD were selected according to eligibility criteria by 2 independent reviewers who collected data on the characteristics of the articles (year, authors, and country). The type and topic of studies were analyzed using VOSviewer v.1.6.18 (Centre for Science and Technology Studies, Leiden University, Leiden, Netherlands). The research articles were classified according to the hierarchical scale of diagnostic efficacy. Results Of the 236 articles included, most were from South Korea and Brazil. Bong-Hae Cho and Yun-Hoa Jung were the most prolific authors on the topic of CBCT. The most frequently published types of studies were cross-sectional and laboratory-based. The most popular topics WERE related to the diagnosis of pathologies and/or alterations, as well as anatomical variations. On the diagnostic efficacy scale, most studies were rated level 1 (technical efficacy) or 2 (diagnostic accuracy efficacy). Conclusion A steady increase was observed in publications related to CBCT, which are of both clinical and academic interest. The trends in these publications were analyzed, revealing that most are cross-sectional studies primarily exploring the capabilities of CBCT in diagnosing pathologies and/or changes in the oral and maxillofacial complex. These studies were typically classified as level 1 or 2 on the diagnostic efficacy scale.
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Affiliation(s)
- Kelda Zanchi Younan
- Graduate Program in Dentistry, Lutheran University of Brazil, Canoas, Rio Grande do Sul, Brazil
| | | | - Roberto Zimmer
- Graduate Program in Dentistry, Lutheran University of Brazil, Canoas, Rio Grande do Sul, Brazil
| | - Pedro Antonio González Hernández
- Department of Oral and Maxillofacial Surgery, Graduate Program in Dentistry, Lutheran University of Brazil, Canoas, Rio Grande do Sul, Brazil
| | | | - Sergio Augusto Quevedo Miguens
- Department of Oral Medicine, Graduate Program in Dentistry, Lutheran University of Brazil, Canoas, Rio Grande do Sul, Brazil
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Huang J, Lai Y, Li J, Zhao L. Loss of miR-204 and miR-211 shifts osteochondral balance and causes temporomandibular joint osteoarthritis. J Cell Physiol 2023; 238:2668-2678. [PMID: 37697972 PMCID: PMC10841301 DOI: 10.1002/jcp.31120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/08/2023] [Accepted: 08/29/2023] [Indexed: 09/13/2023]
Abstract
Temporomandibular joint (TMJ) osteoarthritis (OA) is a common type of TMJ disorders causing pain and dysfunction in the jaw and surrounding tissues. The causes for TMJ OA are unknown and the underlying mechanism remains to be identified. In this study, we generated genetically-modified mice deficient of two homologous microRNAs, miR-204 and miR-211, both of which were confirmed by in situ hybridization to be expressed in multiple TMJ tissues, including condylar cartilage, articular eminence, and TMJ disc. Importantly, the loss-of-function of miR-204 and miR-211 caused an age-dependent progressive OA-like phenotype, including cartilage degradation and abnormal subchondral bone remodeling. Mechanistically, the TMJ joint deficient of the two microRNAs demonstrated a significant accumulation of RUNX2, a protein directly targeted by miR-204/-211, and upregulations of β-catenin, suggesting a disrupted balance between osteogenesis and chondrogenesis in the TMJ, which may underlie TMJ OA. Moreover, the TMJ with miR-204/-211 loss-of-function displayed an aberrant alteration in both collagen component and cartilage-degrading enzymes and exhibited exacerbated orofacial allodynia, corroborating the degenerative and painful nature of TMJ OA. Together, our results establish a key role of miR-204/-211 in maintaining the osteochondral homeostasis of the TMJ and counteracting OA pathogenesis through repressing the pro-osteogenic factors including RUNX2 and β-catenin.
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Affiliation(s)
- Jian Huang
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Yumei Lai
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Jun Li
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
| | - Lan Zhao
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL 60612, USA
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Almpani K, Tran H, Ferri A, Hung M. Assessment of condylar anatomy and degenerative changes in temporomandibular joint disorders - A scoping review. J Oral Biol Craniofac Res 2023; 13:764-780. [PMID: 38028230 PMCID: PMC10665941 DOI: 10.1016/j.jobcr.2023.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/05/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Temporomandibular disorders (TMDs) are a group of conditions that cause pain and dysfunction in the temporomandibular joint (TMJ) and muscles that control mandibular movement. In most cases, the etiology is unclear and is considered multifactorial. Recent research suggests that some forms of TMD could be associated with specific TMJ morphological characteristics. This study aims to provide a review of the reported anatomical and degenerative morphological condylar characteristics of subjects with a clinical diagnosis of TMD as described with the use of CBCT imaging, as well as the detection of potential predisposing anatomical factors. This review was developed and reported in accordance with the PRISMA-ScR Checklist. A comprehensive search was performed in five databases. Reports were screened by two independent reviewers based on preselected inclusion and exclusion criteria. 45 studies were included in this review. The most frequently reported degenerative changes associated with TMD were condylar surface erosion, flattening, osteophytes, and sclerosis. Anatomical characteristics included a small condylar size and a posterior position of the condylar head in the TMJ. The anterosuperior area of the condylar head appears to be the most frequently affected. More studies are required to determine potential specific predisposing anatomical characteristics.
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Affiliation(s)
- Konstantinia Almpani
- Roseman University of Health Sciences College of Dental Medicine, 10894 S River Front Pkwy, South Jordan, UT, 84095, USA
| | - Huy Tran
- Roseman University of Health Sciences Advanced Education in Orthodontics and Dentofacial Orthopedics, 4 Sunset Way Bldg B, Henderson, NV, 89014, USA
| | - Anna Ferri
- Roseman University of Health Sciences Library, 11 Sunset Way, Henderson, NV, 89014, USA
| | - Man Hung
- Roseman University of Health Sciences College of Dental Medicine, 10894 S River Front Pkwy, South Jordan, UT, 84095, USA
- Roseman University of Health Sciences Advanced Education in Orthodontics and Dentofacial Orthopedics, 4 Sunset Way Bldg B, Henderson, NV, 89014, USA
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Vasegh Z, Safi Y, Azar MS, Ahsaie MG, Arianezhad SM. Assessment of bony changes in temporomandibular joint in patients using cone beam computed tomography - a cross sectional study. Head Face Med 2023; 19:47. [PMID: 37898789 PMCID: PMC10612346 DOI: 10.1186/s13005-023-00392-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/11/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND AND AIM The aim of this study is to evaluate the changes in the temporomandibular joint (TMJ) in patients with temporomandibular disorder (TMD) and the relationship between age, sex, and types of TMJ change using Cone Beam Computed Tomography (CBCT). METHODS AND MATERIAL CBCT records of 200 patients (123 women and 67 men) were retrieved and assessed. Right and left TMJs were evaluated separately, resulting in a total of 400 TMJs. The images were analyzed using On demand 3D Application The radiographic findings were classified as erosion, proliferative changes mainly, including flattening and osteophytes of the condyle, sclerosis, Ely cyst, hypoplasia and hyperplasia of the condyles, ankylosis, and joint cavity. Data analysis was performed using descriptive statistics, paired T-tests, and repeated measure ANOVA (Analysis of Variance) in SPSS Software. RESULTS The most prevalent types of condylar bony changes observed was osteophyte (63.5%) followed by flattening of the articular surface (42%), erosion (40%), ankylosis (10%) and sclerosis (10%). 7.5% of joints showed hyperplastic condyles but only 2% showed hypoplasia. The least prevalent change observed was Ely Cyst (1%). Osteophyte was the most prevalent change observed in all age groups and both sexes except for men aged 31 ~ 50, where flattening was more frequent. A statistically significant difference was found between sex and prevalence of erosion in the age group of 10 ~ 30 (P = 0.001); as well as between sex and condylar hyperplasia in the same age group. CONCLUSION Based on the findings of this research, the prevalence of bony changes of TMJ from highest to lowest is as follows: osteophyte, flattening of the articular surface, erosion, ankylosis, sclerosis, hyperplastic condyles, hypoplastic condyles and Ely Cyst. CBCT is an accurate 3 dimensional imaging modality for assessment of TMJ bony structures.
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Affiliation(s)
- Zahra Vasegh
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Safi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Sanaei Azar
- DDS, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mitra Ghazizadeh Ahsaie
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Marjan Arianezhad
- Resident of Oral and Maxillofacial Radiology, Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahid Beheshti University of Medical Sciences, Daneshju Blv, Velenjak St, Tehran, Iran.
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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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Ju HM, Kim HW, Choi SY, Jeon HM, Jeong SH, Ahn YW, Ok SM. A Comparison of the Condyle and Articular Eminence in Asian Juvenile Idiopathic Osteoarthritis Patients with Unilateral and Bilateral TMJ Involvement: A Retrospective Case-Control Study. J Clin Med 2023; 12:5566. [PMID: 37685631 PMCID: PMC10489145 DOI: 10.3390/jcm12175566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/10/2023] Open
Abstract
This study compared the condylar volume, length, and articular eminence (AE) characteristics of normal individuals to those with unilateral and bilateral juvenile idiopathic osteoarthritis (JOA). The 116 patients were divided into four groups: Control (n = 16), affected condyle of unilateral JOA (Aff-Uni) (n = 36), non-affected condyle of JOA (NonAff-uni) (n = 36), and bilateral JOA (Bilateral) (n = 28). The differences in condyle volume and length and AE were analyzed using ANOVA and Bonferroni post-hoc tests. The results showed that Bilateral had a significantly different condylar volume, especially in the condylar head (p < 0.01), specifically the middle, anterior, and medial parts (p < 0.05). Condylar length also differed among the groups, with differences observed between the control group and the other three groups, as well as between the bilateral group and the other three groups (p < 0.01). AE total volume differed between the control group and Aff-Uni. In the detailed comparison, Aff-Uni and NonAff-Uni were smaller than the control group in the posterior, lateral, and medial sections (p < 0.05). In conclusion, depending on the involvement of unilateral or bilateral JOA, there were differences in condylar volume and AE when compared to the normal control group. Therefore, a prognosis should be evaluated by distinguishing between patients with unilateral and bilateral JOA.
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Affiliation(s)
- Hye-Min Ju
- Department of Oral Medicine, School of Dentistry, Pusan National University, Dental and Life Science Institute, Yangsan-si 50612, Republic of Korea; (H.-M.J.); (S.-H.J.); (Y.-W.A.)
| | - Hee-Won Kim
- Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan-si 50612, Republic of Korea; (H.-W.K.); (S.-Y.C.)
| | - Seo-Young Choi
- Department of Oral Medicine, Pusan National University Dental Hospital, Dental Research Institute, Yangsan-si 50612, Republic of Korea; (H.-W.K.); (S.-Y.C.)
| | - Hye-Mi Jeon
- Dental Clinic Center, Pusan National University Hospital, Busan 49241, Republic of Korea;
| | - Sung-Hee Jeong
- Department of Oral Medicine, School of Dentistry, Pusan National University, Dental and Life Science Institute, Yangsan-si 50612, Republic of Korea; (H.-M.J.); (S.-H.J.); (Y.-W.A.)
| | - Yong-Woo Ahn
- Department of Oral Medicine, School of Dentistry, Pusan National University, Dental and Life Science Institute, Yangsan-si 50612, Republic of Korea; (H.-M.J.); (S.-H.J.); (Y.-W.A.)
| | - Soo-Min Ok
- Department of Oral Medicine, School of Dentistry, Pusan National University, Dental and Life Science Institute, Yangsan-si 50612, Republic of Korea; (H.-M.J.); (S.-H.J.); (Y.-W.A.)
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13
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Shao B, Li CX, Liu X, Pataer P, Gong ZC. Investigation of Morphologic Changes in Temporomandibular Joint With Anterior Disk Displacement Based on 3-Dimensional Reconstructive Imaging. J Craniofac Surg 2023; 34:1271-1277. [PMID: 36730117 DOI: 10.1097/scs.0000000000009139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 09/18/2022] [Indexed: 02/03/2023] Open
Abstract
The objective of this study was to measure the association between the disk position and condylar alteration in patients diagnosed with anterior disk displacement (ADD) of temporomandibular joint (TMJ). A retrospective cross-sectional study was designed, dividing into 4 groups: normal articular disk position (NADP) of unilateral ADD patients (n=10), ADD with reduction (ADDwR, n=16), ADD without reduction (ADDwoR, n=24), and healthy volunteers (HV, n=30) based on magnetic resonance imaging and cone-beam computed tomography. After morphologic parameters were calculated from 3-dimensional reconstructive images, differences in parameters with respect to ADD status were tested with analysis of variance and Fisher least significant difference multiple comparisons were performed. Condylar volume of ADDwR, ADDwoR, NADP, and HVs were 1768.29±404.19, 1467.13±438.20, 1814.48±753.60, and 1914.66±476.48 mm, respectively, showing a significant downward trend from healthy disk to a displaced one ( P <0.05). Same trend also found in condylar superficial area, with the condylar superficial area of the ADDwR, ADDwoR, NADP, and HVs were 842.56±138.78 mm, 748.52±157.42 mm, 842.87±263.00 mm, and 892.73±164.19 mm, respectively. From NADP to ADDwR to ADDwoR, superior joint space (SJS) was declined, [SJS (NADP) (2.10±0.91 mm) > SJS (ADDwR) (1.85±0.61 mm) > SJS (ADDwoR) (1.50±0.50 mm), P =0.034]; medial joint space was significantly associated with the different disk displacement types ( P(HV-ADDwR) =0.001; P(HV-ADDwoR) =0.021; P(NADP-ADDwR) =0.022; P(ADDwR-ADDwoR) =0.001). Our findings suggest that condylar volume and superficial area, and superior and medial joint space, albeit with a small sample size, are significantly associated with different disk displacement types, detection of which might therefore be worth exploring for assessing ADD.
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Affiliation(s)
- Bo Shao
- Oncological Department of Oral and Maxillofacial Surgery, Xinjiang Medical University Affiliated First Hospital, School of Stomatology, Stomatological Research Institute of Xinjiang Uygur Autonomous Region, Xinjiang Medical University, Urumqi, China
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14
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Dias GM, Grossmann E, Carvalho ACP, Devito KL, Dos Santos MF, Ferreira LA. MRI changes and clinical characteristics in temporomandibular joints with displacement of the articular disk without reduction - a cross-sectional observational study. Cranio 2023:1-10. [PMID: 37097122 DOI: 10.1080/08869634.2023.2203039] [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: 04/26/2023]
Abstract
OBJECTIVES This study examined changes in magnetic resonance imaging (MRI) of temporomandibular joints (TMJ) with anterior displacement disk without reduction (DDwoR) and its correlation to clinical symptoms. METHODS 190 individuals with DDwoR were evaluated according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and MRI. Pain's chronicity/intensity and limited mouth opening (locking) were correlated with: TMJ degeneration (MRI T1), effusion (T2), disc's shape and position (proton density). RESULTS In 103 TMJ with DDwoR, hemiconvex shape (41.6%), sclerosis (45.6%) and mild effusion (47.6%) were the most prevalent findings. There was not association (p > .05) between: different DDwoR positions with pain's intensity/chronicity; effusion with locking. Disk deformation was associated with degeneration (p = .034) and pain's intensity (p = .006). Locking was associated with degeneration (p = .05). CONCLUSIONS Condylar osteodegeneration is often related to DDwoR. Locking by DDwoR is associated with severe levels of chronic pain and articular disk deformation.
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Affiliation(s)
- Glaucia Marques Dias
- Programa de pós-graduação em Medicina (Radiologia) [Graduate program in Medicine (Radiology)], Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Eduardo Grossmann
- Centro de Dor e Deformidade Orofacial (CENDDOR) [Orofacial Pain and Deformity Center], Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| | - Antonio Carlos Pires Carvalho
- Programa de pós-graduação em Medicina (Radiologia) [Graduate program in Medicine (Radiology)], Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Karina Lopes Devito
- Faculdade de Odontologia [School of Dentistry], Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Marcos Fabio Dos Santos
- Instituto de Ciências Biológicas (ICB) [Institute of Biological Sciences], Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brasil
| | - Luciano Ambrosio Ferreira
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora [School of Medical and Health Sciences of Juiz de Fora] - Suprema (FCMS), Hospital Maternidade Therezinha de Jesus, Juiz de Fora, MG, Brasil
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GLX351322, a Novel NADPH Oxidase 4 Inhibitor, Attenuates TMJ Osteoarthritis by Inhibiting the ROS/MAPK/NF- κB Signaling Pathways. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2023; 2023:1952348. [PMID: 36756301 PMCID: PMC9902131 DOI: 10.1155/2023/1952348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 12/27/2022] [Accepted: 01/10/2023] [Indexed: 01/31/2023]
Abstract
As a degenerative disease in joints, temporomandibular joint osteoarthritis (TMJOA) is characterized by progressive cartilage degradation, subchondral bone remodeling, and chronic synovitis, severely undermining functions and quality of life in patients. NADPH oxidase 4 (NOX4) contributes to reactive oxygen species (ROS) production and inflammatory pathway activation in osteoarthritis, which has attracted increasing attention in research in recent years. GLX351322 (GLX), a novel NOX4 inhibitor, exerts a protective effect on chondrocytes. However, whether it has a therapeutic effect on ROS production and inflammatory responses in synovial macrophages remains to be evaluated. In this study, we examined the effect of GLX on LPS-induced ROS production and inflammatory responses in vitro and on complete Freund's adjuvant (CFA)-induced TMJ inflammation in vivo. We found that GLX could depress LPS-induced intracellular ROS production and inflammatory response without cytotoxicity by inhibiting the ROS/MAPK/NF-κB signaling pathways. In line with in vitro observations, GLX markedly attenuated the synovial inflammatory reaction in the TMJ, thus protecting the condylar structure from severe damage. Taken together, our results suggest that GLX intervention or NOX4 inhibition is a promising curative strategy for TMJOA and other inflammatory diseases.
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Esfehani M, Tofangchiha M, Poorsayyah N, Rahimi H, Kholafazadeh S, Radfar S, Pagnoni F, Reda R, Testarelli L. Relationship between Posterior Permanent Dentition Pattern and Radiographic Changes of the Mandibular Condyle. Methods Protoc 2022; 5:mps5060097. [PMID: 36548139 PMCID: PMC9785119 DOI: 10.3390/mps5060097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/18/2022] [Accepted: 11/30/2022] [Indexed: 12/09/2022] Open
Abstract
This study assessed the relationship between posterior permanent dentition and radiographic changes of the mandibular condyle. This descriptive, cross-sectional study was conducted on 300 panoramic radiographs of patients over 40 years of age (188 females and 112 males). Panoramic radiographs were evaluated for condylar changes such as flattening, subcortical sclerosis, subcortical cyst, erosion, osteophytes, and generalized sclerosis. Presence of muscle pain and temporomandibular joint (TMJ) pain and sounds, and history of TMJ trauma were also assessed. The occlusal scheme of posterior teeth was analyzed according to the Eichner's index. The frequency of condylar changes was calculated in the right and left sides, and their association with posterior permanent dentition was analyzed by the Chi-square test (alpha = 0.05). The frequency of flattening, muscle pain, TMJ sounds, and erosion was 11.7%, 9.7%, 5.7%, and 3.7% in the right side, respectively. The frequency of flattening, muscle pain, erosion, and subcortical cyst was 12%, 9.3%, 5%, and 5% in the left side, respectively. The frequency of bilateral muscle pain, flattening, TMJ sounds, and TMJ pain was 18%, 16.7%, 11.7%, and 9.3%, respectively. Cases with TMJ trauma, generalized sclerosis, and osteophytes were few. According to the Eichner's index, most patients with condylar changes had classes A and B, and a smaller percentage had class C. No significant difference was noted between healthy individuals and those with condylar changes regarding dentition patterns. No relationship existed between condylar changes and posterior permanent dentition pattern.
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Affiliation(s)
- Mahsa Esfehani
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Qazvin University of Medical Sciences, Qazvin 4199-15315, Iran
| | - Marayam Tofangchiha
- Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin 4199-15315, Iran
- Correspondence: (M.T.); (R.R.)
| | - Neda Poorsayyah
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin 4199-15315, Iran
| | - Haniyeh Rahimi
- Department of Orthodontics, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin 4199-15315, Iran
| | - Sarvin Kholafazadeh
- Department of Orthodontics, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin 4199-15315, Iran
| | - Sina Radfar
- Department of Endodontics, Faculty of dentistry, Tabriz University of Medical Sciences, Tabriz 51666-14713, Iran
| | - Francesco Pagnoni
- Department of Oral and Maxillofacial Sciences, Sapienza University (University of Rome), 00161 Rome, Italy
| | - Rodolfo Reda
- Department of Oral and Maxillofacial Sciences, Sapienza University (University of Rome), 00161 Rome, Italy
- Correspondence: (M.T.); (R.R.)
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, Sapienza University (University of Rome), 00161 Rome, Italy
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Dhabale GS, Bhowate RR. Cone-Beam Computed Tomography for Temporomandibular Joint Imaging. Cureus 2022; 14:e31515. [DOI: 10.7759/cureus.31515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
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Kumar P, Dammani B, Mahajani MJ, Vadvadgi VH, Jawade R, Patil MV. A Two-Year Follow-Up Assessment of Decreasing Crestal Bone Levels Around Dental Implants in Patients Rehabilitated With Mandibular Implant Overdentures. Cureus 2022; 14:e29044. [PMID: 36237773 PMCID: PMC9553015 DOI: 10.7759/cureus.29044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/10/2022] [Indexed: 11/18/2022] Open
Abstract
Aim: This two-year follow-up study was aimed to evaluate declining crestal bone levels around dental implants in patients rehabilitated with mandibular implant-supported overdentures. A three-dimensional advanced radiographic tool, cone beam computed tomography (CBCT), was utilized as radiographic aid in this study. Materials & Methods: A total of 15 patients wearing mandibular implants supported overdentures were studied for two years. Randomization and strict inclusion/exclusion criteria were followed during study execution. Complete dentures were fabricated with standard methods, which were later anchored by a bilateral implant in the mandibular jaw. Bone loss at all four surfaces in all studied implants was estimated by the cone beam computed tomography (CBCT) technique. These assessments were done at postoperative follow-up periods of six, 12, 18, and 24 months. Duly signed and informed consent was obtained from all participating patients. Statistical Analysis and Results: The statistical analysis was completed by the software IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. All relevant data was entered into it to be analyzed with suitable statistical tests. Out of all 15 studied patients, 11 were male, and four were female. P-value was very significant for the age range 35-40 years (0.01). In all instances, the lingual surface showed minimum, while the distal surface showed maximum bone loss when seen at all postoperative phases. Grossly, the mean bone loss ranged between 0.14-0.45. P-value was highly significant for the measurements made at the lingual and distal sides of implants (for both B and D positions). A comparison of both study groups by one-way ANOVA confirmed a highly significant p-value for estimations done between the groups (0.001). Conclusion: Within the limitations of the study, the authors confirmed that crestal bone levels showed a clear decreasing pattern in the postoperative phases. Since these deleterious processes can compromise long-term prosthesis success, operators should consider all these facts while planning to implant an overdenture prosthesis in the lower jaw.
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Assessment of Condylar Shape through Digital Panoramic Radiograph among Nepalese Population: A Proposal for Classification. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6820824. [PMID: 35983245 PMCID: PMC9381274 DOI: 10.1155/2022/6820824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 12/02/2022]
Abstract
Background Panoramic radiograph is the first and most commonly advised radiograph for screening of temporomandibular joints/condyles. Different shapes of the mandible have been discussed by various authors with no consensus for a definite classification for condyle shape. This study was conducted with the objective to observe various shapes of condyles, symmetry of bilateral condyles, and variations of condyle shapes among males and females. Materials and Methods This cross-sectional study was conducted on digital panoramic radiographs available at a tertiary center of Lalitpur from 25.12.2020 to 20.06.2021 after ethical approval from the institutional review board (reference no. 077/078/27). Panoramic radiographs were selected on the basis of inclusion and exclusion criteria, and various shapes of condyles were noted on HP 15 inch flat LED monitor (1280 × 1024). The collected data was analyzed using SPSS (chi-square test: a p value of < 0.05 was considered significant). Intra- and interobserver agreement was observed for condylar shapes. Results Among the selected 850 panoramic radiographs (1700 condyles), most of them, i.e., 1343 (79%), were round/oval, followed by flattened, i.e., 149 (8.76%), diamond/angled, i.e., 93 (5.47%), crooked finger shaped, i.e., 28 (1.6%), and mixed, i.e., 46 (2.7%), and the least common shape observed was bifid, i.e., 40 (2.3%) (18 (2.1%) left condyle and 22 (2.6%) right condyle). Conclusions Six different types of condyle shapes were noted: type I, oval; type II, flat; type III, diamond; type IV, mixed; type V, bifid; and type VI, crooked finger among the study population of Lalitpur.
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20
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Zhao Y, An Y, Zhou L, Wu F, Wu G, Wang J, Chen L. Animal Models of Temporomandibular Joint Osteoarthritis: Classification and Selection. Front Physiol 2022; 13:859517. [PMID: 35574432 PMCID: PMC9095932 DOI: 10.3389/fphys.2022.859517] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 04/04/2022] [Indexed: 01/11/2023] Open
Abstract
Temporomandibular joint osteoarthritis (TMJOA) is a common degenerative joint disease that can cause severe pain and dysfunction. It has a serious impact on the quality of lives of patients. Since mechanism underlying the pathogenesis of TMJOA is not fully understood, the development of effective tools for early diagnosis and disease-modifying therapies has been hindered. Animal models play a key role in understanding the pathological process of diseases and evaluating new therapeutic interventions. Although some similarities in disease processes between animals and humans are known, no one animal model is sufficient for studying all characteristics of TMJOA, as each model has different translatability to human clinical conditions. For the past 4 decades, TMJOA animal models have been studied by numerous researchers and can be broadly divided into induced, naturally occurring, and genetically modified models. The induced models can be divided into invasive models (intra-articular injection and surgical induction) or non-invasive models (mechanical loading, high-fat diet, and sleep deprivation). Different types of animal models simulate different pathological expressions of TMJOA and have their unique characteristics. Currently, mice, rats, and rabbits are commonly used in the study of TMJOA. This review sought to provide a general description of current experimental models of TMJOA and assist researchers in selecting the most appropriate models for different kinds of research.
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Affiliation(s)
- Yuqing Zhao
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application & Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, China
| | - Yanxin An
- Department of General Surgery, The First Affiliated Hospital of Xi’an Medical University, Xi’an, China
| | - Libo Zhou
- School of Basic Medicine, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application & Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, China
| | - Fan Wu
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application & Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, China
| | - Gaoyi Wu
- School of Stomatology, Heilongjiang Key Lab of Oral Biomedicine Materials and Clinical Application & Experimental Center for Stomatology Engineering, Jiamusi University, Jiamusi, China
| | - Jing Wang
- Department of Oral Implants, School of Stomatology, National Clinical Research Center for Oral Diseases & State Key Laboratory of Military Stomatology & Shaanxi Key Laboratory of Stomatology, The Fourth Military Medical University, Xi’an, China
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi’an Jiaotong University, Xi’an, China
| | - Lei Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
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Chang MS, Choi JH, Yang IH, An JS, Heo MS, Ahn SJ. Association between Condylar Bone Density and Disk Displacement in the Temporomandibular Joint. J Clin Densitom 2022; 25:215-222. [PMID: 34391639 DOI: 10.1016/j.jocd.2021.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/22/2022]
Abstract
Measuring bone density (BD) is a common method of determining bone quality; however, the relationship between condylar BD and the occurrence of temporomandibular joint (TMJ) disorders has not been investigated. To address this knowledge gap, we aimed to investigate condylar BD in terms of TMJ disk displacement (TMJ DD) using computed tomography (CT) and magnetic resonance imaging (MRI). We classified TMJ MRI results according to the position of the disk: normal disk position (Normal), anterior disk displacement with reduction (ADDR), and anterior disk displacement without reduction (ADDNR). After retrospectively evaluating 86 female condyles, we determined the total, cortical, and trabecular BD in the upper-joint portion of the condyle and the whole condyle using CT data. To standardize condylar BD, we calculated the BD ratios by dividing the condylar BD by the cervical axis BD. The Kruskal-Wallis test analyzed the differences in BD measurements in the TMJ DD patient groups and showed significant between-group differences in condylar BD. The total and trabecular BD was significantly higher in ADDNR condyles than in Normal or ADDR condyles (Normal = ADDR < ADDNR). However, there was no significant difference in the cortical BD among the three TMJ DD groups. The BD ratios showed a similar tendency with condylar BD. These results suggest that increased condylar BD - specifically total and trabecular BD - may be significantly associated with ADDNR condyles. Our findings will help clinicians determine the course of treatment for patients with disk-related TMJ disorders.
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Affiliation(s)
- Min-Seok Chang
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jeong-Ho Choi
- Department of Orthodontics, Seoul National University Dental Hospital, Seoul, Korea
| | - Il-Hyung Yang
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jung-Sub An
- Department of Orthodontics, Seoul National University Dental Hospital, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Sug-Joon Ahn
- Department of Orthodontics and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
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22
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Assessment of the Morphology and Degenerative Changes in the Temporomandibular Joint Using CBCT according to the Orthodontic Approach: A Scoping Review. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6863014. [PMID: 35155678 PMCID: PMC8826117 DOI: 10.1155/2022/6863014] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 11/22/2021] [Indexed: 11/18/2022]
Abstract
Background. Available knowledge about disorders of temporomandibular joint structures and their association with orthodontic variables are still lacking. Objectives. This article is aimed at to identifying studies and presenting current information on the relationship between morphology diversity and the occurrence of degenerative changes in structures of the temporomandibular joint (TMJ) assessed by cone-beam computed tomography (CBCT) in the context of craniofacial morphology and malocclusion. Search Methods. The review was conducted by analyzing the PubMed (including Medline), Cochrane Library, Web of Science, and Scopus electronic databases up to November 2021 using two different comprehensive search strategies based on keywords as well as additional manual searches. Eligibility Criteria. Selection of the literature was carried out according to the PRISMA-ScR checklist. Methodological quality of the selected studies was evaluated using JBI Critical Appraisal Tool. Results. The electronic databases search revealed 3331 records. After applying the eligibility criteria and JBI assessment, a total of 33 studies were extracted and selected to the study. The review was divided into 4 parts, in which the following correlations were assessed in terms of orthodontic variables: TMJ degenerative changes, joint space and condylar position, condylar shape, TMJ articular eminence, and fossa. Conclusions. Skeletal and dental class II malocclusion with a retrognathic mandible, a hypodivergent skeletal pattern with a steep mandibular plane, and significant lateral mandibular displacement can be risk factors for developing radiographically detectable degenerative changes. Patients with skeletal and dental class III malocclusion as well as a hyperdivergent skeletal pattern may be at greater risk of TMD occurrence compared with other groups. Further studies are necessary to clarify the relationship between the position of the condylar processes and the presence of degenerative changes in the temporomandibular joints among orthodontic patients.
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Alqhtani NR, Alkhaldi MS, Alanazi AF, Alabdulsalam AS, Alenazi A, Zaman MU, Alzahrani A, Alshadwi A, Rafedah AA, AlOtaibi M. Temporomandibular Joint Space Dimensions among Saudi Patients with Temporomandibular Disorders: MRI-Based Retrospective Study. Int J Clin Pract 2022; 2022:5846255. [PMID: 35989869 PMCID: PMC9363928 DOI: 10.1155/2022/5846255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The temporomandibular joint is a complex synovial joint in the body. It is the area in which the mandible articulates with the cranium. The temporomandibular joint space is located between the articular eminence and the glenoid fossa of the temporal bone at the base of the skull and the condylar process of the mandible. This interarticular space is divided into superior joint space (1.2 ml) and inferior joint space (0.9 ml) by the articular disc. The purpose of this study is to detect and evaluate the variations in the temporomandibular joint space among patients having temporomandibular joint disorders. MATERIALS AND METHODS In this retrospective study, 60 magnetic resonance imaging scans were evaluated at King Faisal Specialist Hospital in Riyadh, Saudi Arabia, between the years 2006 and 2016. Measurements were done in sagittal view in three areas: anterior, central, and posterior areas. However, coronal view readings were recorded in two different areas: medial and lateral joint spaces. All measurements were recorded at the highest point of the condyle that is perpendicular to the opposing bone. The SPSS program was used for statistical analysis. RESULTS The central joint space values were higher than the anterior and posterior joint spaces in both coronal and sagittal views. We also found that joint spaces among male patients were higher than female patients (right side P=0.015 and left side P=0.006). It is worth mentioning that the number of temporomandibular joint disorder female patients was more than the number of male temporomandibular joint disorder patients (52 females versus 24 males). Additionally, patients who were older than 55 years old had wider joint spaces than patients who were younger than 25 years old. CONCLUSION The central joint space value was the highest among the other joint spaces on both views of magnetic resonance imaging, and the values of joint spaces among males were larger than those of females on sagittal magnetic resonance imaging. Patients with elderly temporomandibular joint disorders showed larger joint spaces than young patients. This study spotlights the importance of magnetic resonance imaging evaluation in temporomandibular joint disorder patients for a better understanding of the clinical evolution of temporomandibular disorders.
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Affiliation(s)
- Nasser Raqe Alqhtani
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Ad Dilam Rd, Ar Rashidiyah, Al-Kharj 16245, Saudi Arabia
| | - Malak Sultan Alkhaldi
- Ministry of Defense, General Dentist, Armed Forces Hospital Southern Region, P.O. Box 101, 61961 Khamis Mushayt, Saudi Arabia
| | - Alhanoof Falah Alanazi
- Alhabib Medical Group, General Dentist, Dr. Sulaiman Alhabib Hospital, P.O. Box 5612, Hamza Ibn Abdul Mutalib Street, Alsuwaidi AlGarbi, Riyadh 12994, Saudi Arabia
| | | | - Adel Alenazi
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Ad Dilam Rd, Ar Rashidiyah, Al-Kharj 16245, Saudi Arabia
| | - Mahmud Uz Zaman
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Ad Dilam Rd, Ar Rashidiyah, Al-Kharj 16245, Saudi Arabia
| | - Adel Alzahrani
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, PO Box 60169, Riyadh 11545, Saudi Arabia
| | - Ahmad Alshadwi
- Consultant of Oral and Maxillofacial Surgery, John Hopkins Aramco Health Care Services, 8131 Medical Access Rd No. 1, Gharb Al Dhahran, Dhahran 34465, Saudi Arabia
| | - Ali Al Rafedah
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam Bin Abdullaziz University, Ad Dilam Rd, Ar Rashidiyah, Al-Kharj 16245, Saudi Arabia
| | - Mohammed AlOtaibi
- Consultant-Oral and Maxillofacial Surgery Department, Prince Sultan Military Medical City, As Sulimaniyah, Riyadh 12233, Saudi Arabia
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McKay RM, Vapniarsky N, Hatcher D, Carr N, Chen S, Verstraete FJM, Cissell DD, Arzi B. The Diagnostic Yield of Cone-Beam Computed Tomography for Degenerative Changes of the Temporomandibular Joint in Dogs. Front Vet Sci 2021; 8:720641. [PMID: 34422949 PMCID: PMC8371634 DOI: 10.3389/fvets.2021.720641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/06/2021] [Indexed: 11/17/2022] Open
Abstract
Degenerative changes of the temporomandibular joint (DTMJ) may be diagnosed via cone - beam computed tomography (CBCT). However, despite advancement in CBCT imaging, correlation of DTMJ features identified on CBCT with gross and histological findings is currently limited. This study aimed to correlate CBCT findings of DTMJ of dogs with gross and histopathologic changes. Temporomandibular joints (TMJ) (n = 38) from fresh cadaver heads of asymptomatic dogs (n = 19) were examined radiologically, macroscopically, and microscopically. Association of CBCT - detected DTMJ changes with gross and histological findings were statistically evaluated via kappa statistics and ordinal logistic mixed-effects models. The radiological changes observed on CBCT included joint space narrowing, subchondral/cortical bone changes (i.e., erosions or lysis), osteophytes, and subchondral bone sclerosis. Upon macroscopic evaluation, the majority of examined specimens had mild changes with cartilage defects and osteophytes affecting <10% of the total articular surface area. Histopathologic changes comprised splitting and degeneration of the fibrous cartilage layers, subchondral bone exposure, subchondral bone sclerosis, focal subchondral bone lysis, and occasional cell death. Subchondral sclerosis was the most prevalent finding radiologically and histologically with a fair to excellent agreement. Importantly, the more severe the TMJ degenerative changes, the higher the agreement between CBCT and histology. Based on the correlative results of statistical analysis, CBCT was found to be a suitable modality to evaluate DTMJ.
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Affiliation(s)
- Rachel Marie McKay
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Natalia Vapniarsky
- Department of Pathology, Microbiology and Immunology, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - David Hatcher
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Nicole Carr
- Department of Animal Sciences, University of California, Davis, Davis, CA, United States
| | - Shuai Chen
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Frank J M Verstraete
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Derek D Cissell
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Boaz Arzi
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
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Phi L, Albertson B, Hatcher D, Rathi S, Park J, Oh H. Condylar degeneration in anterior open bite patients: A cone beam computed tomography study. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 133:221-228. [PMID: 34503937 DOI: 10.1016/j.oooo.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/16/2021] [Accepted: 07/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate the prevalence of condylar degeneration in patients with anterior open bites (AOB). STUDY DESIGN Cone beam computed tomography (CBCT) scans of 194 patients with AOB (108 with skeletal open bites and 86 with dental open bites) and 100 patients serving as controls were included in this retrospective study. Two oral and maxillofacial radiologists categorized each of the 588 condyles as normal, degenerative-active, or degenerative-repair. The χ2 analysis with Bonferroni adjustment was used to evaluate the relationship of condylar status (normal vs degenerative) to anterior open bites. RESULTS Of the 103 degenerative condyles, there were 59 in the group with skeletal open bites, 14 in the group with dental open bites, and 30 in the control group. Condylar degeneration occurred twice as frequently in patients with skeletal open bites as it did in the control group (P < .0001). Conversely, a greater frequency of normal condyles was found in the group of patients with dental open bites (P = .0002). The group with skeletal open bites also showed a significantly higher frequency of bilateral degenerative condyles (P = .0001). The frequency of condylar degeneration did not differ significantly between female and male individuals. CONCLUSIONS Degenerative condylar change was significantly more likely in patients with skeletal open bites and less likely in patients with dental open bites.
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Affiliation(s)
- Linda Phi
- Adjunct Assistant Professor, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Brad Albertson
- Private practice, Austin, Texas, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - David Hatcher
- Adjunct Associate Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Shikha Rathi
- Adjunct Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Joorok Park
- Assistant Professor, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA
| | - Heesoo Oh
- Professor and Chair, Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
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Panol H, Vivaldi D, Di Giosia M, Lim PF. Widespread bodily pain is not associated with the presence of painful TMJ osteoarthritis: a case control study. JOURNAL OF ORAL MEDICINE AND ORAL SURGERY 2021. [DOI: 10.1051/mbcb/2021012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Purpose: Temporomandibular Joint Arthralgia (TMJA) in the absence of osteoarthritis has not been thoroughly studied. We aimed to investigate the presence of comorbid bodily pain conditions (CBPC) in patients with TMJA with and without TMJOA and hypothesized that TMJOA is not associated with a higher presence of CBPC. Methods: This is a retrospective study involving patients at the University of North Carolina Orofacial Pain Clinic between 2010 and 2014 with TMJA according to the RDC/TMD criteria [1]. Cases fulfilled the Ahmad classification for TMJOA [2], and had TMJA (TMJA+OA), while controls had TMJA only (TMJA-OA). Data was collected from reports of Cone-Beam Computerized Tomography (CBCT). CBPC were self-reported. Results: Twenty-eight cases (TMJA+OA) and 25 controls (TMJA-OA) were included. The mean age of cases and controls (P = 0.027) and mean pain duration differed (P = 0.031). However, the gender distribution (P = 0.552), mean pain intensity (P = 0.381), mean number of painful muscles upon palpation (P = 0.759) and mean number of CBPC (P = 0.575) were not different. At least one CBPC was reported by 68% cases and 72% control subjects (P = 0.743). Conclusions: In this group of patients with TMJA, the presence of CBPC was high and not associated with the presence of TMJOA. This finding suggests that CBPC and TMJOA occur independently.
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Al-Ani Z. Temporomandibular Joint Osteoarthrosis: A Review of Clinical Aspects and Management. Prim Dent J 2021; 10:132-140. [PMID: 33722124 DOI: 10.1177/2050168420980977] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The symptoms of TMJ Osteoarthrosis/Osteoarthritis(TMJ OA) are characteristic and in most cases specific to the disorder. There is, however, an overlap of symptoms with other TMDs.Treatment of TMJ OA is generally directed towards management of the symptoms as the temporomandibular joint does retain the capacity throughout life to repair and remodel. Non-conservative and invasive treatment is only rarely necessary.It should be remembered that the mandibular condyle retains the capacity to repair and remodel throughout life and patients should be encouraged to bear this in mind. Conservative measures are usually sufficient to treat symptoms and a period of time should be allowed to elapse before undertaking a more aggressive treatment plan, which, in the overwhelming majority of patients, will not be necessary. This disorder should be approached on the terms of 'a quality of life issue' and treatment should be directed towards patient needs.
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Affiliation(s)
- Ziad Al-Ani
- Senior Lecturer, Glasgow Dental Hospital and School
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28
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Aktuna Belgin C, Serindere G, Aksoy S, Orhan K. Evaluation of the relationship between tympanic plate morphology and degenerative bone changes of condyle and articular eminence. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 122:24-28. [PMID: 32413423 DOI: 10.1016/j.jormas.2020.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/06/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION This study aimed to evaluate the relationship between tympanic plate morphology and degeneration of temporomandibular joint (TMJ) condyle and articular eminence (AE). MATERIAL AND METHODS Cone beam computed tomography images of 700 patients (345 males, 355 females) were evaluated. The prevalence and location of tympanic plate pneumatization (TPP) and foramen tympanicum (FT) were recorded. Sagittal scans of the TMJs were classified according to the degenerative bone changes of condyle and AE (flattening, osteophytes, erosion, sclerosis, and subcortical cysts). RESULTS TPP was found in 106 of 700 patients (15.2%) while FT was found in 165 (23.2%) of the patients. TPP and FT were bilateral in 52 (49.1%) patients and 46 (27.9%) patients, respectively. The mean axial diameter of FT was 2.53mm and the mean sagittal diameter was 2.52mm. The most common degenerative changes for condyle and AE were flattening. CONCLUSION To know these structures is important for surgical operations in the region of TMJ and ear to prevent complications. CBCT is useful to evaluate these anatomical landmarks and the relationship between them and the degenerative bone changes of condyle and AE.
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Affiliation(s)
- C Aktuna Belgin
- Hatay Mustafa Kemal University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, 31060 Hatay, Turkey.
| | - G Serindere
- Hatay Mustafa Kemal University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, 31060 Hatay, Turkey
| | - S Aksoy
- Near East University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Nicosia, Cyprus
| | - K Orhan
- Ankara University, Faculty of Dentistry, Department of DentoMaxillofacial Radiology, Ankara, Turkey
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Ulay G, Pekiner FN, Orhan K. Evaluation of the relationship between the degenerative changes and bone quality of mandibular condyle and articular eminence in temporomandibular disorders by cone beam computed tomography. Cranio 2020; 41:218-229. [PMID: 33272140 DOI: 10.1080/08869634.2020.1853307] [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: 10/22/2022]
Abstract
Objective: To evaluate whether there was a relationship between the degenerative bone changes and bone quality of the mandibular condyle and articular eminence in patients with temporomandibular disorder (TMD).Methods: The study group consisted of 100 patients with TMD. "Diagnostic Criteria/TMD" was used to identify the pathologies. Degenerative bone changes and bone qualities were detected by cone beam computed tomography; the bone qualities were classified using the Bone Quality Index (BQI) scale.Results: No statistically significant difference was found between degenerative bone changes and bone quality of the temporomandibular joint (TMJ) according to gender (p > 0.05). However, degenerative bone changes were more frequent than articular eminence in the mandibular condyle. BQI Type III was the most common bone quality among all types of degenerative bone changes.Discussion: Although no causality relationship was found between the bone quality and degenerative bone changes, low bone quality was found in TMD patients.
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Affiliation(s)
- Gamze Ulay
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Filiz Namdar Pekiner
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Kaan Orhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey.,Ankara University Medical Design Application and Research Center (MEDITAM), Ankara, Turkey
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Lo Giudice A, Quinzi V, Ronsivalle V, Farronato M, Nicotra C, Indelicato F, Isola G. Evaluation of Imaging Software Accuracy for 3-Dimensional Analysis of the Mandibular Condyle. A Comparative Study Using a Surface-to-Surface Matching Technique. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134789. [PMID: 32635238 PMCID: PMC7370104 DOI: 10.3390/ijerph17134789] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was to assess the accuracy of 3D rendering of the mandibular condylar region obtained from different semi-automatic segmentation methodology. A total of 10 Cone beam computed tomography (CBCT) were selected to perform semi-automatic segmentation of the condyles by using three free-source software (Invesalius, version 3.0.0, Centro de Tecnologia da Informação Renato Archer, Campinas, SP, Brazil; ITK-Snap, version2.2.0; Slicer 3D, version 4.10.2) and one commercially available software Dolphin 3D (Dolphin Imaging, version 11.0, Chatsworth, CA, USA). The same models were also manually segmented (Mimics, version 17.01, Materialise, Leuven, Belgium) and set as ground truth. The accuracy of semi-automatic segmentation was evaluated by (1) comparing the volume of each semi-automatic 3D rendered condylar model with that obtained with manual segmentation, (2) deviation analysis of each 3D rendered mandibular models with those obtained from manual segmentation. No significant differences were found in the volumetric dimensions of the condylar models among the tested software (p > 0.05). However, the color-coded map showed underestimation of the condylar models obtained with ITK-Snap and Slicer 3D, and overestimation with Dolphin 3D and Invesalius. Excellent reliability was found for both intra-observer and inter-observer readings. Despite the excellent reliability, the present findings suggest that data of condylar morphology obtained with semi-automatic segmentation should be taken with caution when an accurate definition of condylar boundaries is required.
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Affiliation(s)
- Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Vincenzo Quinzi
- Post Graduate School of Orthodontics, Department of Life, Health and Environmental Sciences, University of L’Aquila, V.le San Salvatore, 67100 L’Aquila, Italy;
| | - Vincenzo Ronsivalle
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Marco Farronato
- Department of Medicine, Surgery and Dentistry, Section of Orthodontics, University of Milan, 20122 Milan, Italy;
| | - Carmelo Nicotra
- Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, 95123 Catania, Italy; (A.L.G.); (V.R.); (C.N.)
| | - Francesco Indelicato
- Department of General Surgery and Surgical-Medical Specialties, Section of Oral Surgery and Periodontology, School of Dentistry, University of Catania, 95123 Catania, Italy;
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Section of Oral Surgery and Periodontology, School of Dentistry, University of Catania, 95123 Catania, Italy;
- Correspondence: ; Tel.: +39-095-3782453
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Schulze RKW, Drage NA. Cone-beam computed tomography and its applications in dental and maxillofacial radiology. Clin Radiol 2020; 75:647-657. [PMID: 32451060 DOI: 10.1016/j.crad.2020.04.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/16/2020] [Indexed: 12/14/2022]
Abstract
Cone-beam computed tomography (CBCT) was first used in dental and maxillofacial radiology (DMFR) at the end of the 1990s. Since then, it has been successfully established as the standard three-dimensional radiographic imaging technique in DMFR, with a wide variety of applications in this field. This manuscript briefly reviews the background information on the technology and summarises available data on effective dose and dose optimisation. In addition, typical clinical applications and indications of the technique in DMFR are presented.
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Affiliation(s)
- R K W Schulze
- Department of Oral and Maxillofacial Surgery, Section of Oral Radiology, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - N A Drage
- Department of Dental and Maxillofacial Radiology, University Dental Hospital, Cardiff, UK
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Are Signs of Degenerative Joint Disease Associated With Chin Deviation? J Oral Maxillofac Surg 2020; 78:1403-1414. [PMID: 32304661 DOI: 10.1016/j.joms.2020.03.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/15/2020] [Accepted: 03/16/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE Degenerative joint changes commonly affect the temporomandibular joint (TMJ) and can result in chin deviation. However, the extent of degenerative TMJ changes and chin deviation has not been well-characterized. The present study sought to correlate degenerative TMJ changes with condylar volume, grayscale measures, and chin deviation. MATERIALS AND METHODS The present cross-sectional study had enrolled women with skeletal Class III malocclusion. Cone-beam computed tomography scans were acquired preoperatively. For each condyle, degenerative TMJ signs were analyzed and the condylar volume and grayscale were measured. The predictor variable was the presence of degenerative TMJ signs, classified as categorical data: 0, if none; 1, only present in 1 joint; and 2, present in both joints. The primary outcome variable was a chin deviation of 3 mm or more. Other associated variables were grouped by age, cephalometric data, and 3-dimensional condylar measurements. Descriptive bivariate statistics were computed, and univariate and multiple logistic regression analyses were conducted to identify any associations between degenerative TMJ disease and chin deviation. RESULTS We included 85 patients, who were classified into 2 groups: less than 3 mm of chin deviation (n = 43) and 3 mm or more of chin deviation (n = 42). The presence of more than 10 degenerative TMJ signs was significantly associated with the presence of 3 mm or more of chin deviation (P < .001). In multiple regression models, the presence of subcortical sclerosis in 1 joint and in both joints (adjusted odds ratio [OR], 3.698; 95% confidence interval [CI], 1.051 to 13.012; adjusted OR, 5.001; 95% CI, 1.461-17.119, respectively) correlated significantly with the presence of 3 mm or more of chin deviation (P < .05). The volume difference between the 2 condyles was significantly greater in the group with more than 10 degenerative TMJ signs and 3 mm or more of chin deviation than in the group with 10 or fewer degenerative TMJ signs and less than 3 mm of chin deviation (P = .016 and P < .001, respectively). CONCLUSIONS In women with skeletal Class III malocclusion, the presence of more than 10 degenerative TMJ signs increased the prevalence of 3 mm or more of chin deviation. The presence of subcortical sclerosis in either 1 or both joints and volume differences between the 2 condyles were associated with greater chin deviation.
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Abrahamsson AK, Arvidsson LZ, Småstuen MC, Larheim TA. Improvement of bone-erosive temporomandibular joint (TMJ) abnormalities in adolescents undergoing non-surgical treatment: a longitudinal study. Dentomaxillofac Radiol 2020; 49:20190338. [PMID: 32101476 DOI: 10.1259/dmfr.20190338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES To investigate the longitudinal changes of the imaging temporomandibular joint (TMJ) characteristics in young patients with TMJ-related symptoms and treated with non-surgical methods. The severity of self-reported symptoms at follow-up was also investigated. METHODS A cone beam CT (CBCT)/CT follow-up examination [median follow-up 4.1 (1.3-6.4) years] was performed in 22 patients with erosive TMJ abnormalities [baseline median age 16 (12-18) years]. Imaging characteristics were analyzed and the changes between the examinations were categorized as (A) improvement, (B) no change, or (C) worsening. Severity of follow-up symptoms was evaluated using Jaw Functional Limitation Scale (JFLS-8) and Graded Chronic Pain Scale (Grade 0-IV). Analyses were performed separately for left and right TMJ. Findings at baseline and follow-up were compared using McNemar test to account for dependencies. Changes in proportions of hard tissue findings between examinations were assessed using Wilcoxon signed ranks test. RESULTS A significant reduction in the proportion of patients with erosive abnormalities was found [59.1%, 95% CI (36.4-79.3) %]. Baseline erosions improved in 9/12 (75%) right and 14/15 (93%) left TMJs. About half repaired; developed an intact cortical outline. Number of joints with osteophytes increased (right: p < 0.04, left: p < 0.003). New osteophytes were mostly found in joints with erosive findings. Low or no limitation of jaw function (Jaw Functional Limitation Scale) was found in 12/22 (55%) and no or low intensity of pain (Graded Chronic Pain Scale Grade 0 or I) in 19/22 (86%) at follow-up. CONCLUSION We found a high potential for repair of erosive TMJ abnormalities. However, the patient series was small. The majority of patients assessed their symptom severity at follow-up as low.
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Affiliation(s)
- Anna-Karin Abrahamsson
- Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Linda Z Arvidsson
- Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | | | - Tore A Larheim
- Department of Maxillofacial Radiology, Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Oslo, Norway
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Cui C, Zheng L, Fan Y, Zhang J, Xu R, Xie J, Zhou X. Parathyroid hormone ameliorates temporomandibular joint osteoarthritic-like changes related to age. Cell Prolif 2020; 53:e12755. [PMID: 32154622 PMCID: PMC7162802 DOI: 10.1111/cpr.12755] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/16/2019] [Accepted: 12/17/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Ageing could be a contributing factor to the progression of temporomandibular joint osteoarthritis (TMJ OA), whereas its pathogenesis and potential therapeutic strategy have not been comprehensively investigated. MATERIALS AND METHODS We generated ageing mouse models (45-week and 60-week; 12-week mice as control) and intermittently injected 45-week mice with parathyroid hormone (PTH(1-34)) or vehicle for 4 weeks. Cartilage and subchondral bone of TMJ were analysed by microCT, histological and immunostaining. Western blot, qRT-PCR, ChIP, ELISA and immunohistochemical analysis were utilized to examination the mechanism of PTH(1-34)'s function. RESULTS We showed apparent OA-like phenotypes in ageing mice. PTH treatment could ameliorate the degenerative changes and improve bone microarchitecture in the subchondral bone by activating bone remodelling. Moreover, PTH inhibited phosphorylation level of Smad3, which can combine with p16ink4a gene promoter region, resulting in reduced senescent cells accumulation and increased cellular proliferation of marrow mesenchymal stem cells (MSCs). ELISA also showed relieved levels of specific senescent-associated secretory phenotype (SASP) in ageing mice after PTH treatment. CONCLUSIONS In summary, PTH may reduce the accumulation of senescent cells in subchondral bone by inhibiting p16ink4a and improve bone marrow microenvironment to active bone remodelling process, indicating PTH administration could be a potential preventative and therapeutic treatment for age-related TMJ OA.
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Affiliation(s)
- Chen Cui
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Liwei Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Yi Fan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Jun Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China.,School of Stomatology, Kunming Medical University, Kunming, China
| | - Ruoshi Xu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Jing Xie
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Sichuan, China
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Kim JJ, Nam H, Kaipatur NR, Major PW, Flores-Mir C, Lagravere MO, Romanyk DL. Reliability and accuracy of segmentation of mandibular condyles from different three-dimensional imaging modalities: a systematic review. Dentomaxillofac Radiol 2019; 49:20190150. [PMID: 31778321 DOI: 10.1259/dmfr.20190150] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To critically synthesize the literature surrounding segmentation of the mandibular condyle using three-dimensional imaging modalities. Specifically, analyzing the reliability and accuracy of methods used for three-dimensional condyle segmentation. METHODS Three electronic databases were searched for studies reporting the reliability and accuracy of various methods used to segment mandibular condyles from three-dimensional imaging modalities. Two authors independently reviewed articles for eligibility and data extraction. RESULTS Nine studies fulfilled the inclusion criteria. Eight studies assessed the condylar segmentation from CBCT images and limited studies were available on non-CBCT three-dimensional imaging modalities. Threshold-based volume segmentation, manual segmentation, and semi-automatic segmentation techniques were presented. Threshold-based volume segmentation reported higher accuracy when completed by an experienced technician compared to clinicians. Adequate reliability and accuracy were observed in manual segmentation. Although adequate reliability was reported in semi-automatic segmentation, data on its accuracy were lacking. CONCLUSION A definitive conclusion with regards to which current technique is most reliable and accurate to efficiently segment the mandibular condyle cannot be made with the currently available evidence. This is especially true in terms of non-CBCT imaging modalities with very limited literature available.
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Affiliation(s)
- Justin J Kim
- 1Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Hyejin Nam
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Neelambar R Kaipatur
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Paul W Major
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Carlos Flores-Mir
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Manuel O Lagravere
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
| | - Daniel L Romanyk
- Department of Orthodontics, School of Dentistry, University of Alberta, Edmonton Clinic Health Academy, 5th floor, 11405-87 Avenue NW, Edmonton, Alberta, Canada
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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: 43] [Impact Index Per Article: 8.6] [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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Shoukri B, Prieto J, Ruellas A, Yatabe M, Sugai J, Styner M, Zhu H, Huang C, Paniagua B, Aronovich S, Ashman L, Benavides E, de Dumast P, Ribera N, Mirabel C, Michoud L, Allohaibi Z, Ioshida M, Bittencourt L, Fattori L, Gomes L, Cevidanes L. Minimally Invasive Approach for Diagnosing TMJ Osteoarthritis. J Dent Res 2019; 98:1103-1111. [PMID: 31340134 PMCID: PMC6704428 DOI: 10.1177/0022034519865187] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study's objectives were to test correlations among groups of biomarkers that are associated with condylar morphology and to apply artificial intelligence to test shape analysis features in a neural network (NN) to stage condylar morphology in temporomandibular joint osteoarthritis (TMJOA). Seventeen TMJOA patients (39.9 ± 11.7 y) experiencing signs and symptoms of the disease for less than 10 y and 17 age- and sex-matched control subjects (39.4 ± 15.2 y) completed a questionnaire, had a temporomandibular joint clinical exam, had blood and saliva samples drawn, and had high-resolution cone beam computed tomography scans taken. Serum and salivary levels of 17 inflammatory biomarkers were quantified using protein microarrays. A NN was trained with 259 other condyles to detect and classify the stage of TMJOA and then compared to repeated clinical experts' classifications. Levels of the salivary biomarkers MMP-3, VE-cadherin, 6Ckine, and PAI-1 were correlated to each other in TMJOA patients and were significantly correlated with condylar morphological variability on the posterior surface of the condyle. In serum, VE-cadherin and VEGF were correlated with one another and with significant morphological variability on the anterior surface of the condyle, while MMP-3 and CXCL16 presented statistically significant associations with variability on the anterior surface, lateral pole, and superior-posterior surface of the condyle. The range of mouth opening variables were the clinical markers with the most significant associations with morphological variability at the medial and lateral condylar poles. The repeated clinician consensus classification had 97.8% agreement on degree of degeneration within 1 group difference. Predictive analytics of the NN's staging of TMJOA compared to the repeated clinicians' consensus revealed 73.5% and 91.2% accuracy. This study demonstrated significant correlations among variations in protein expression levels, clinical symptoms, and condylar surface morphology. The results suggest that 3-dimensional variability in TMJOA condylar morphology can be comprehensively phenotyped by the NN.
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Affiliation(s)
- B. Shoukri
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J.C. Prieto
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - A. Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M. Yatabe
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - J. Sugai
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M. Styner
- Department of Psychiatry, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - H. Zhu
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - C. Huang
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | | | - S. Aronovich
- Department Oral and Maxillofacial Surgery and Hospital Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - L. Ashman
- Department Oral and Maxillofacial Surgery and Hospital Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - E. Benavides
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - P. de Dumast
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - N.T. Ribera
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - C. Mirabel
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - L. Michoud
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Z. Allohaibi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - M. Ioshida
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - L. Bittencourt
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - L. Fattori
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - L.R. Gomes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - L. Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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Arayasantiparb R, Mitrirattanakul S, Kunasarapun P, Chutimataewin H, Netnoparat P, Sae-Heng W. Association of radiographic and clinical findings in patients with temporomandibular joints osseous alteration. Clin Oral Investig 2019; 24:221-227. [PMID: 31079244 DOI: 10.1007/s00784-019-02945-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 05/03/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To characterize the relationship between radiographic and clinical characteristics of patients with temporomandibular joint (TMJ) osseous changes. MATERIALS AND METHODS TMJ cone beam computed tomography (CBCT) images of 73 patients (142 joints) with changes in osseous component of TMJ were included in this study. Based on both clinical and radiographic findings, each TMJ was diagnosed as either non-degenerative joint disease (non-DJD) or degenerative joint disease (DJD) according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) criteria. The DJD group was further classified into two subgroups of osteoarthritis and osteoarthrosis. The data were analyzed using t test and Pearson's correlation. Level of statistical significance was set at 0.05. RESULTS Statistically significant relationships were found between TMJ crepitation sound and 4 radiographic characteristics of DJD. DJD group demonstrated statistically significant higher CBCT bone change score (BCS) and age. In contrast, there was no significant difference of BCS between osteoarthrosis and osteoarthritis groups within the DJD group. CONCLUSIONS Crepitation sounds and osseous changes in TMJ radiograph are confirmed to be important diagnostic criteria for TMJ DJD. However, degree of TMJ osseous changes does not correlate significantly with clinical pain symptom. CLINICAL RELEVANCE For TMJ DJD diagnosis, dentists should consider both clinical examination for TMJ crepitation and radiographic assessment for TMJ bony changes.
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Affiliation(s)
- Raweewan Arayasantiparb
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mahidol University, Bangkok, 10400, Thailand
| | - Somsak Mitrirattanakul
- Department of Masticatory Science, Faculty of Dentistry, Mahidol University, 6 Yothi street, Rathevi, Bangkok, 10400, Thailand.
| | - Panupol Kunasarapun
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, 10400, Thailand
| | - Harakun Chutimataewin
- Department of Oral Medicine and Periodontology, Faculty of Dentistry, Mahidol University, Bangkok, 10400, Thailand
| | | | - Worapol Sae-Heng
- Faculty of Dentistry, Mahidol University, Bangkok, 10400, Thailand
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Kahn A, Kün-Darbois JD, Bertin H, Corre P, Chappard D. Mandibular bone effects of botulinum toxin injections in masticatory muscles in adult. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:100-108. [PMID: 31227452 DOI: 10.1016/j.oooo.2019.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/29/2019] [Accepted: 03/05/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Botulinum toxin (BTX) is injected into masticatory muscles to treat various conditions. Animal studies have demonstrated bone loss at the condylar and alveolar regions of the mandible after BTX injection into masticatory muscles. The aim of the present study was to investigate mandibular bone changes in patients who received BTX injections in masticatory muscles. STUDY DESIGN Twelve adult patients who received BTX injections into masticatory muscles were included in this study. Cone beam computed tomography (CBCT) was performed before and 12 months after the injection. The condylar and alveolar regions of the mandible were analyzed by using texture analysis of the CBCT images with the run length method. Condylar cortical thickness was measured, and 3-dimensional analysis of the mandible was also performed. Six patients who did not receive BTX injections were used as controls. RESULTS A run length parameter (gray level nonuniformity) was found to be increased in condylar and alveolar bones. A significant cortical thinning was found at the anterior portion of the right condyle. Three-dimensional analysis showed significant changes in the condylar bone and at the digastric fossa. No changes in mandibular angles were found. CONCLUSIONS This study identified mandibular bone changes in adult patients who received BTX injection into masticatory muscles.
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Affiliation(s)
- Alexis Kahn
- Department of Oral and Maxillofacial surgery, Chu d'Angers, Angers, Cedex, France; Department of Oral and Maxillofacial surgery, Chu de Nantes, Nantes, Cedex 1, France
| | - Jean-Daniel Kün-Darbois
- Department of Oral and Maxillofacial surgery, Chu d'Angers, Angers, Cedex, France; Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, UNIV Angers, SFR 42-08, IRIS-IBS Institut de Biologie en Santé, Chu d'Angers, Angers, Cedex, France
| | - Helios Bertin
- Department of Oral and Maxillofacial surgery, Chu de Nantes, Nantes, Cedex 1, France
| | - Pierre Corre
- Department of Oral and Maxillofacial surgery, Chu de Nantes, Nantes, Cedex 1, France
| | - Daniel Chappard
- Groupe Etudes Remodelage Osseux et bioMatériaux, GEROM, UNIV Angers, SFR 42-08, IRIS-IBS Institut de Biologie en Santé, Chu d'Angers, Angers, Cedex, France.
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Kim JJ, Choi DS, Jang I, Cha BK, Park IW. Pierre Robin sequence with severe scoliosis in an adult: A case report of clinical and radiological features. Imaging Sci Dent 2019; 49:323-329. [PMID: 31915619 PMCID: PMC6941832 DOI: 10.5624/isd.2019.49.4.323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/30/2019] [Accepted: 11/01/2019] [Indexed: 11/18/2022] Open
Abstract
Pierre Robin sequence (PRS) is characterized by the triad of micrognathia, glossoptosis, and airway obstruction. PRS does not have a single pathogenesis, but rather is associated with multiple syndromes. This report presents the case of a 35-year-old woman with PRS and scoliosis. Among the syndromes related to PRS, cerebro-costo-mandibular syndrome (CCMS), which is characterized by posterior rib gap defects and vertebral anomalies, was suspected in this patient. However, no posterior rib gap defect was detected on radiological examinations. Although over 80 cases of CCMS have been reported to date, few cases of PRS with scoliosis alone have been reported. Therefore, this report demonstrated the clinical, radiological, and cephalometric characteristics of an adult patient with PRS and scoliosis, but without rib anomalies.
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Affiliation(s)
- Jae-Jun Kim
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Dong-Soon Choi
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Insan Jang
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - Bong-Kuen Cha
- Department of Orthodontics, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
| | - In-Woo Park
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Gangneung-Wonju National University, Gangneung, Korea
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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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Borrás-Ferreres J, Sánchez-Torres A, Gay-Escoda C. Bifid mandibular condyles: A systematic review. Med Oral Patol Oral Cir Bucal 2018; 23:e672-e680. [PMID: 30341271 PMCID: PMC6261007 DOI: 10.4317/medoral.22681] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Accepted: 10/29/2018] [Indexed: 11/20/2022] Open
Abstract
Background Bifid mandibular condyle (BMC) constitutes an extremely rare disorder characterized by a duplication of the head of the mandibular condyle. Its prevalence ranges from 0.31% to 1.82% in the published literature. Objectives The primary objective was to describe the main etiological, clinical and radiological characteristics of patients with BMCs and the existent treatment options. The secondary objective was to simultaneously include the characteristics of two new cases of BMC. Material and Methods An electronic search in Pubmed (MEDLINE), Scopus and The Cochrane Library was carried out by two independent reviewers until April 2018. Prospective or retrospective cohort studies, case series and case reports describing clinical and/or radiological characteristics of patients with BMC were included. Registered variables were demographic, etiological factors, diagnostic exam, clinical characteristics and treatment options. The results from the articles selected were organized in a Table along with the characteristics of two new cases of BMC provided by the authors. Results From a total of 431 articles found in the initial search, 68 articles were finally included. This systematic review included 216 patients and 270 BMC with an average age of 30.6 (SD=14.7) years and a women:men ratio of 1.4:1. Mediolateral condylar orientation was the most prevalent position (80.1%). Among cases with known etiology, 40.8% of cases had a history of traumatism, while 55.9% did not present any relevant medical background. Half of the symptomatic cases had history of trauma. The most common symptoms were hypomobility (22.7%), arthralgia (18.1%), articular noise (17.2%) and ankylosis (17.6%). Active monitoring and manufacturing an occlusal splint were the most frequent treatment options. Conclusions BMC may have congenital or traumatic etiology. Hypomobility and arthralgia are the most frequent symptoms and treatment options are often conservative. Key words:Bifid mandibular condyle, trifid condyle, tetrafid condyle, condylar orientation, ankyloses.
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Affiliation(s)
- J Borrás-Ferreres
- School of Medicine and Health Sciences, Campus de Bellvitge, University of Barcelona, C/ Feixa Llarga, s/n, Pavelló Govern 2 planta, Despatx 2.9, 08907 L'Hospitalet de Llobregat, Barcelona, Spain,
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Shigeno K, Sasaki Y, Otonari-Yamamoto M, Ohata H, Shibahara T. Evaluating the mandibular condyles of patients with osteoarthritis for bone marrow abnormalities using magnetic resonance T2 mapping. Oral Radiol 2018; 35:272-279. [PMID: 30484208 DOI: 10.1007/s11282-018-0357-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 08/31/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study investigated whether erosion and osteophyte correlates with condyle bone marrow abnormalities (BMA), as detected with quantitative T2 mapping. METHODS Fifty-six joints (in 44 patients) that demonstrated evidence of bony erosion (ER) or osteophytes (OS) related to disc displacement without reduction were studied with MR images. A control group of 50 joints (in 50 patients) was included. The subjects were divided into five groups; noAR (control), noBMA-ER, BMA-ER, noBMA-OS, and BMA-OS. T2 mapping was performed and the regions of interest were placed over the bone marrow at the top of the condyle. The mean T2 values of the bone marrow of the mandibular condyle were calculated for all mapping images. After assessing age-related changes in T2 values of noAR group using Pearson's product-moment, differences in median T2 values of five groups were analyzed using Kruskal-Wallis test, and Steel-Dwass test (p < 0.05). RESULTS There was no significant correlation between age and T2 value in noAR group. The median T2 values of noBMA-ER and BMA-ER groups were significantly higher than those of noAR, noBMA-OS and BMA-OS groups. Those of noBMA-OS and BMA-OS groups were significantly lower than those of noAR, noBMA-ER and BMA-ER groups. There was no significant difference between noBMA and BMA groups. CONCLUSIONS It is suggested that erosion and osteophyte of the condyle may correlate with bone marrow abnormalities. T2 mapping could be show slight marrow changes of the arthritic condyle.
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Affiliation(s)
- Kenichiro Shigeno
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba, 261-8502, Japan.
| | - Yoshinori Sasaki
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-1-14 Misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Mika Otonari-Yamamoto
- Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-1-14 Misakicho, Chiyoda-ku, Tokyo, 101-0061, Japan
| | - Hitoshi Ohata
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba, 261-8502, Japan
| | - Takahiko Shibahara
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, 1-2-2 Masago, Mihama-ku, Chiba, 261-8502, Japan
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Pucci R, Vellone V, Ramieri V, Cascone P, Della Rocca C. Histological findings in TMJ treated with high condilectomy for internal derangement. J Craniomaxillofac Surg 2018; 46:1185-1191. [PMID: 29880328 DOI: 10.1016/j.jcms.2018.05.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 04/05/2018] [Accepted: 05/03/2018] [Indexed: 12/26/2022] Open
Abstract
Intra-Articular Temporo-Mandibular Disorders (TMD) are characterized by displacement of the disc that causes the condyles to slip back over the disc thus resulting in TMJ discal damage and erosion of the condyle's bone. The etiology of temporomandibular disorder (TMD) is multidimensional: biomechanical, neuromuscular, bio-psychosocial and biological factors may contribute to the disorder. The study involved 46 joints in 27 patients with a diagnosis of Intra-Articular Temporo-Mandibular Disorders (TMD) according to Axis I of Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications and underwent surgery between 2011 and 2014. Patients were divided into three groups. Group 1 were included patients with Disc Displacement (DD) without reduction without limited opening, Group 2 patients with DD without reduction with limited opening. Finally, Group 3 included patients with Degenerative Joint Disease (DJD) TMD. In all cases, diagnosis of Intra-Articular Temporo-Mandibular Disorders (TMD) was confirmed by pre-operative examination (clinical, MRI and/or CT scan). Tissue specimens were obtained from all 50 joints for histopathology. The aim of this study was to analyse histological features of the surgical specimens obtained from patients with Intra-Articular Temporo-Mandibular Disorders who underwent surgery and assess the association with clinical findings and imaging. Preliminary results show in Group 1, fibrocartilage is preserved and regular, there are isolated outbreaks of bone resorption and focal sclerosis. In Groups 2 and 3 fibrocartilages are irregular and thickness varies widely and sclerosis is more pronounced. In early stages of TMD, the disc antero-medial displacement might play a fundamental role in the etiopathogenesis that can became an irreversible joint damage thus leading to a wide spectrum of articular symptoms and signs in TMD (Cohen et al., 2014; Hagandora and Almarza, 2012; Nah, 2012).
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Affiliation(s)
- Resi Pucci
- Maxillo-Facial Surgery Dept "Sapienza" Università di Roma, Via del Policlinico, Roma, Italy
| | - Valentino Vellone
- Maxillo-Facial Surgery Dept "Sapienza" Università di Roma, Via del Policlinico, Roma, Italy.
| | - Valerio Ramieri
- Maxillo-Facial Surgery Dept "Sapienza" Università di Roma, Via del Policlinico, Roma, Italy
| | - Piero Cascone
- Maxillo-Facial Surgery Dept "Sapienza" Università di Roma, Via del Policlinico, Roma, Italy
| | - Carlo Della Rocca
- Department of Medical-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, University of Rome "Sapienza", Italy
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Shahidi S, Salehi P, Abedi P, Dehbozorgi M, Hamedani S, Berahman N. Comparison of the Bony Changes of TMJ in Patients With and Without TMD Complaints Using CBCT. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2018; 19:142-149. [PMID: 29854888 PMCID: PMC5960734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
STATEMENT OF THE PROBLEM Temporomandibular joint disorders (TMD) may show a poor correlation between their clinical findings and radiological characteristics. PURPOSE The aim of this study was to assess the osseous alterations of temporomandibular joint (TMJ) in symptomatic and asymptomatic subjects by employing cone beam computed tomography (CBCT) images. MATERIALS AND METHOD In this study, CBCT images of 120 temporomandibular joints in 30 patients with TMJ disorder and 30 age- and sex-matched individuals without TMJ complaints were evaluated. Osteoarticular derangements of the joint were assessed by two experienced examiners. Data was statistically analyzed with SPSS software using chi-square test (p <0.05). RESULTS Out of 120 CBCT images (60 in each group), at least one osseous change was observed in 90% and 86.7% joints in symptomatic and asymptomatic subjects, respectively. There were no significant differences between symptomatic and asymptomatic subjects regarding frequency of osteoarticular changes including flattening (73.3% vs. 75%), irregularity (36.7% vs. 48.3%), sclerosis (20% vs. 8.3%), cyst (3.3% vs. 3.3%), erosion (13.3% vs. 21.7%), hypoplasia (3.3% vs. 5%), ankylosis (1.7% vs. Zero), osteophyte (43.3% vs. 40%), decrease joint space (3.3% vs. 3.3%), and increase joint space (5% vs. 5%). (p> 0.05). CONCLUSION By employing CBCT as a modern diagnostic imaging tool, findings of this study revealed that the frequency of various temporomandibular joint alterations on CBCT images is comparable in patients with and without TMD complaints, suggesting that some people with TMJ structural damage may not display clinical manifestations. Moreover, CBCT imaging might not be necessary for TMD patients and more attention should be given to clinical examination.
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Affiliation(s)
- Shoaleh Shahidi
- Dept. of Oral and Maxillofacial Radiology, Biomaterials Research Centre, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Parisa Salehi
- Orthodontic Research Centre, Dept. of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parnian Abedi
- Student of Dentistry, Students’ Research Committee, School of Dentistry, International branch, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mehrnoush Dehbozorgi
- Postgraduate Student, Dept. of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Iran.
| | - Shahram Hamedani
- Dental Research Development Centre, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Nazanin Berahman
- Postgraduate Student of Orthodontics, Dept. of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Iran
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Schnabl D, Rottler AK, Schupp W, Boisserée W, Grunert I. CBCT and MRT imaging in patients clinically diagnosed with temporomandibular joint arthralgia. Heliyon 2018; 4:e00641. [PMID: 30003149 PMCID: PMC6040602 DOI: 10.1016/j.heliyon.2018.e00641] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/24/2018] [Accepted: 05/25/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To compare cone beam computed tomography (CBCT) and magnetic resonance tomography (MRT) in patients with temporomandibular joint (TMJ) arthralgia in respect of the evaluation of bony structures, and to correlate joint space distances measured in CBCT with the morphology and the position of the disc visualized in MRT. MATERIALS & METHODS 26 temporomandibular joints (TMJs) in 13 patients clinically diagnosed with TMJ arthralgia were examined by both CBCT and MRT. All images were evaluated by use of a form. The results were compared in regard of conformability of the diagnoses of osseous structures established by each imaging method. Anterior, superior and posterior joint space distances measured in CBCT-images were related to disc morphology and position visualized in MRT. RESULTS Conformability of CBCT and MRT in the evaluation of bony TMJ structures ranged from 69.3 to 96.6 %. Osseous alterations such as erosions, osteophytes and cysts detected by CBCT could partly not be discerned by MRT. The correlation of joint space distances with disc morphology (biconcave or not biconcave) was not statistically significant. The correlation of joint space distances and disc position was statistically significant only for the superior joint distance. CONCLUSION CBCT outclasses MRT in the visualization of osseous alterations, which are diacritic in the differentiation of simple arthralgia from osteoarthritis. Therefore, CBCT imaging is appropriate in patients clinically diagnosed with TMJ arthralgia.Superior joint space distance not being the highest joint space in sagittal CBCT indicates an anterior disc displacement.For the visualization of structural changes or displacement of the disc frequently associated with osseous changes, MRT is the optimal tool. Thus, the combination of the two imaging methods allows a comprehensive diagnosis in TMJ arthralgia patients.
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Affiliation(s)
- Dagmar Schnabl
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, 6020, Austria
| | | | | | | | - Ingrid Grunert
- University Hospital of Dental Prosthetics and Restorative Dentistry, Medical University of Innsbruck, Innsbruck, 6020, Austria
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Wang DH, Yang MC, Hsu WE, Hsu ML, Yu LM. Response of the temporomandibular joint tissue of rats to rheumatoid arthritis induction methods. J Dent Sci 2017; 12:83-90. [PMID: 30895028 PMCID: PMC6395284 DOI: 10.1016/j.jds.2016.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Revised: 12/02/2016] [Indexed: 12/20/2022] Open
Abstract
Background/purpose The pathogenesis of rheumatoid arthritis (RA)-related temporomandibular joint (TMJ) disorder remains unclear. Studies have reported the change of the TMJ after complete Freund's adjuvant (CFA) injection, which is consistent with osteoarthritis. However, few studies have reported that the tissue response of the TMJ in collagen-induced arthritis (CIA) can mimic RA. The present study was aimed to investigate the TMJ response in rat models by CFA-induced arthritis and CIA to verify the proper RA-related TMJ arthritis rat model. Materials and methods In total, 24 rats were randomly divided into four groups: (1) control group; (2) type I collagen injection group; (3) CFA-induced arthritis group; and (4) CIA group. Drugs were injected on Day 0, and the rats were sacrificed on Days 7 and 35. Next, TMJ tissue was collected for hematoxylin and eosin staining, and inflammatory gene (IL-1β and MMP3) expression was investigated. Results Compared with the control group, the type I collagen injection group confirmed the negative inflammatory response through hematoxylin and eosin staining and IL-1βand MMP3 expression. Although CFA-induced arthritis and CIA groups showed inflammatory response (P < 0.05) compared with the control group, histological changes were different. The 7-day CFA-induced arthritis group showed adaptive changes and partly recovered after 35 days of induction. In contrast, 7- and 35-day CIA groups underwent a degenerative process. Conclusion Considering the study limitations, the CIA method is a proper method to study the mechanism of RA-related TMJ arthritis.
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Affiliation(s)
- Ding-Han Wang
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Mu-Chen Yang
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Wun-Eng Hsu
- Department of Stomatology, Veterans General Hospital, Taipei, Taiwan
| | - Ming-Lun Hsu
- School of Dentistry, National Yang-Ming University, Taipei, Taiwan
| | - Ling-Ming Yu
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan
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Pietra LCF, Santiago MDO, Valerio CS, Taitson PF, Manzi FR, Seraidarian PI. Uso da radiografia transcraniana para detectar alterações morfológicas no côndilo mandibular. REVISTA CEFAC 2017. [DOI: 10.1590/1982-021620171919816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: o objetivo deste estudo foi avaliar a acurácia das radiografias transcranianas (TRANS) convencionais na identificação das alterações morfológicas nos côndilos mandibulares. Métodos: a amostra consistiu em 36 côndilos mandibulares, obtidos a partir de 18 crânios secos humanos, aleatoriamente selecionados, sem identificação de idade, gênero ou etnia. Três especialistas em radiologia oral examinaram as TRANS para identificar possíveis alterações nos côndilos. Um quarto examinador realizou o exame macroscópico, que foi considerado o padrão ouro do estudo. As imagens das TRANS e os exames macroscópico foram classificados como (1) côndilos com alteração ou (0) côndilos sem alteração. A análise estatística foi realizada através do teste X 2 e da curva ROC (receiver operator characteristic). O teste Kappa intra e interexaminadores foi realizado para os examinadores 1 a 3. Resultados: o teste X2 mostrou uma associação estatisticamente significativa entre as alterações no côndilo vistas nas imagens TRANS e a presença de alterações macroscópicas (p ( 0,05). A área sob a curva ROC foi de 0,83, com 96% de sensibilidade e 70% de especificidade. O valor Kappa para a concordância intraobservador foi de 0,78, enquanto que a concordância interexaminador foi de 0,71. Conclusão: o uso de radiografias transcranianas apresentou-se como método eficaz para a detecção de alterações morfológicas no côndilo mandibular.
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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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Suenaga S, Nagayama K, Nagasawa T, Indo H, Majima HJ. The usefulness of diagnostic imaging for the assessment of pain symptoms in temporomandibular disorders. JAPANESE DENTAL SCIENCE REVIEW 2016; 52:93-106. [PMID: 28408961 PMCID: PMC5390340 DOI: 10.1016/j.jdsr.2016.04.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 04/14/2016] [Accepted: 04/26/2016] [Indexed: 12/30/2022] Open
Abstract
The causes of pain symptoms in the temporomandibular joint (TMJ) and masticatory muscle (MM) regions may not be determined by clinical examination alone. In this review, we document that pain symptoms of the TMJ and MM regions in patients with temporomandibular disorders (TMDs) are associated with computed tomography and magnetic resonance (MR) findings of internal derangement, joint effusion, osteoarthritis, and bone marrow edema. However, it is emphasized that these imaging findings must not be regarded as the unique and dominant factors in defining TMJ pain. High signal intensity and prominent enhancement of the posterior disk attachment on fat saturation T2-weighted imaging and dynamic MR imaging with contrast material are closely correlated with the severity of TMJ pain. Magnetic transfer contrast, MR spectroscopy, diffusion tensor imaging, and ultrasonography findings have helped identify intramuscular edema and contracture as one of the causes of MM pain and fatigue. Recently, changes in brain as detected by functional MR neuroimaging have been associated with changes in the TMJ and MM regions. The thalamus, the primary somatosensory cortex, the insula, and the anterior and mid-cinglate cortices are most frequently associated with TMD pain.
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Affiliation(s)
- Shigeaki Suenaga
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Kunihiro Nagayama
- Department of Orthodontics and Dentofacial Orthopedics, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Taisuke Nagasawa
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hiroko Indo
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hideyuki J. Majima
- Department of Maxillofacial Radiology, Division of Oncology, Kagoshima University Graduate School of Medical and Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
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