Evaluation of Local Application of Glucosamine Sulfate and Chondroitin Sulfate on Temporomandibular Joint Response and Alleviation of Pain and Tension During the Functional Treatment of Skeletal Class II Patients: A Randomized Control Clinical Trial

OBJECTIVE

 This study was conducted to assess the effects of applying a gel of combined glucosamine sulfate and chondroitin sulfate on the temporomandibular joint (TMJ) area in patients with skeletal Class II malocclusion treated by removable functional appliances in terms of TMJ internal proportions, levels of pain, and tension.

MATERIALS AND METHODS

The study included 36 patients aged 10-13 years with skeletal Class II malocclusion due to retrusion of the mandible characterized by: 4-8 degrees of the sagittal skeletal discrepancy (ANB) angle, 4-7 mm of overjet, 72-76 degrees of the sagittal mandibular positioning (SNB) angle, and a bone maturity stage located at pubertal growth spurt. Patients were distributed to the experimental group (Twin-Block appliance + Jointance® gel) or the control group (conventional treatment with the Twin-Block appliance). An allocation ratio of 1:1 was employed. Pre- and post-treatment digital lateral cephalometric radiograms were taken, and the TMJ joint spaces were measured using the Viewbox software (dHAL Software, Kifissia, Greece). The pain and discomfort levels were evaluated using a questionnaire with a four-point Likert scale at three assessment times.

RESULTS

 The anterior and posterior glenoid and anterior condylar distances to the pterygoid vertical (PTV) reference plane significantly decreased after treatment (p<.001), and the anterior joint space decreased significantly (p<.001). In contrast, the superior distance of the condyle to the Frankfort horizontal reference plane increased significantly after treatment, and the same results were found for the posterior and superior joint spaces (p<.05). There were no significant differences between the two groups in the evaluated linear variables. No significant differences were found when comparing pain and tension levels between the two groups at each assessment time. A gradual decrease in pain and tension levels was observed between the three evaluation times in both groups.

CONCLUSIONS

 A combination of glucosamine sulfate and chondroitin sulfate did not affect the temporomandibular joint spaces, pain, and tension levels in patients with skeletal Class II malocclusions treated by removable functional appliances.

Cervical vertebra morphology in different skeletal classes. A three-dimensional computed tomography evaluation

OBJECTIVE

To describe cervical vertebra morphology in subjects with different anteroposterior jaw relationships.

MATERIALS AND METHODS

Cone-beam computed tomography images of 31 female subjects aged 19 to 41 years were evaluated. Subjects constituted two groups according to the ANB angle: group 1, skeletal Class II (ANB angle >5); and group 2, skeletal Class III (ANB angle <1). Nine linear measurements and one angular measurement were used to assess the vertebral morphology. The Mann-Whitney U-test was used for statistical analysis.

RESULTS

The mean atlas dorsal arch height was significantly shorter in Class II subjects compared with those in Class III (P < .05). The cervical vertebra morphological analysis by cone-beam computed tomography was of comparable precision to three-dimensional computed tomography evaluations. This study confirmed previous findings that Class II subjects have significantly lower atlas dorsal arch heights.

CONCLUSION

The height of the atlas dorsal arch of cervical vertebrae is affected by the anteroposterior skeletal pattern.