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Sample records for rabbit temporomandibular joint

  1. Temporomandibular Joint, Closed

    MedlinePlus

    ... Oral Health > The Temporomandibular Joint, Closed The Temporomandibular Joint, Closed Main Content Title: The Temporomandibular Joint, Closed Description: The temporomandibular joint connects the lower ...

  2. Temporomandibular Joint Dysfunction

    MedlinePlus

    The temporomandibular joint (TMJ) connects your jaw to the side of your head. When it works well, it enables you to ... For people with TMJ dysfunction, problems with the joint and muscles around it may cause Pain that ...

  3. Effect of unilateral mandibular distraction osteogenesis on mandibular morphology in rabbits with antigen-induced temporomandibular joint arthritis.

    PubMed

    Andersen, K; Pedersen, T K; Svendsen, P; Hauge, E M; Schou, S; Nørholt, S E

    2015-08-01

    Aim was to evaluate effect of unilateral distraction osteogenesis (DO) on mandibular morphology in rabbits with antigen-induced arthritis in the temporomandibular joint (TMJ). Forty 8-week-old rabbits were divided into four groups. In groups A,C, arthritis was induced in the right TMJ. Groups A,B underwent DO. Group D served as control group. Cephalometric analysis of mandibular angle, mandibular ramus height, mandibular collum height, and total posterior mandibular height was done on CT-scans preoperatively (T0), after distraction (T1), and at euthanasia (T2). Two-factor ANOVA evaluated the effect of DO and antigen-induced arthritis. No effect of DO or arthritis was observed on mandibular angle or mandibular collum height. For T0-T1, DO increased mandibular ramus height 12.3% (95% CI 5.2-19.4%) in group B (P=0.001) and total posterior mandibular height 6.2% (95% CI 0.3-12.1%) in group A (P=0.04) and 10.0% (95% CI 4.3-15.7%) in group B (P=0.001). For T1-T2, no significant changes occurred in arthritic rabbits (group A). In conclusion, DO increased total posterior mandibular height in rabbits with arthritis. Postoperatively, no significant effect of DO was observed in rabbits with arthritis. Mandibular DO could be a viable treatment modality in patients with TMJ-arthritis. PMID:25835759

  4. Temporomandibular Joint Disorder

    MedlinePlus

    ... 2008 Previous Next Related Articles: Temporomandibular Joint Disorder (TMD) Are You Biting Off More Than You Can Chew? Equilibration May Lessen TMD Pain Fender-benders: Source of TMD? First Comes ...

  5. Rabbit model for osteoarthrosis of the temporomandibular joint as a basis for assessment of outcomes after intervention.

    PubMed

    Artuzi, Felipe Ernesto; Langie, Renan; Abreu, Maíra Cavallet de; Quevedo, Alexandre Silva; Corsetti, Adriana; Ponzoni, Deise; Puricelli, Edela

    2016-06-01

    Osteoarthritis can be induced in the temporomandibular joint (TMJ) by primary or secondary trauma, or overloading of the joint. We have therefore systematically evaluated the histological progression of experimental osteoarthritis induced by a high concentration of monosodium iodoacetate into the rabbit TMJ. These findings may contribute to the establishment of a protocol to investigate the benefits of treatment of osteoarthritis of the TMJ. We used 21 male New Zealand rabbits; the 15 in the test group were given an intra-articular injection of monosodium iodoacetate 10mg/ml into the right TMJ and were killed after 60 (n=5), 80 (n=5), and 100 days (n=5). The six in the control group were given an injection of saline into the right TMJ. The assessment system for osteoarthritis based on six grades was used for the histological analysis of severity. The model was effective in producing histological changes in the cartilage consistent with those found in osteoarthritis at all time points. The within-group analysis indicated that the disease did not progress after 60 days. The successful induction of osteoarthritis in this way, its stabilisation after 60 days, and the appropriate size of the animal suggest that this experimental model is ideal for future studies of the effectiveness of treatment in osteoarthritis of the TMJ. PMID:26872897

  6. Imaging the temporomandibular joint

    SciTech Connect

    Katzberg, R.W.; Manzione, J.V.; Westesson, P.L.

    1988-01-01

    This book encompasses all imaging modalities as they apply to the Temporomandibular Joint and its disorders. The volume employs correlative line drawings to elaborate on diagnostic images. It helps teach methods of TMJ imaging and describes findings identified by different imaging modalities to both radiologists and dental clinicians.

  7. Temporomandibular joint dislocation

    PubMed Central

    Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal; Singh, Shreya

    2015-01-01

    Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation. PMID:26668447

  8. Temporomandibular joint dislocation.

    PubMed

    Sharma, Naresh Kumar; Singh, Akhilesh Kumar; Pandey, Arun; Verma, Vishal; Singh, Shreya

    2015-01-01

    Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. In this article, we discuss the comprehensive review of the different treatment modalities in managing TMJ dislocation. PMID:26668447

  9. Response properties of temporomandibular joint mechanosensitive neurons in the trigeminal sensory complex of the rabbit.

    PubMed

    Suzuki, Osuke; Tsuboi, Akito; Tabata, Takayoshi; Takafuji, Yasuo; Sakurai, Takeshi; Watanabe, Makoto

    2012-10-01

    The neurophysiological properties of neurons sensitive to TMJ movement (TMJ neurons) in the trigeminal sensory complex (Vcomp) during passive movement of the isolated condyle were examined in 46 rabbits. Discharges of TMJ neurons from the rostral part of the Vcomp were recorded with a microelectrode when the isolated condyle was moved manually and with a computer-regulated mechanostimulator. A total of 443 neurons responding to mechanical stimulation of the face and oral cavity were recorded from the brainstem. Twenty-one TMJ neurons were detected rostrocaudally from the dorsal part of the trigeminal principal sensory nucleus (NVsnpr), subnucleus oralis of the trigeminal spinal nucleus, and reticular formation surrounding the trigeminal motor nucleus. Most of the TMJ neurons were located in the dorso-rostral part of the NVsnpr. Of the TMJ units recorded, 90 % were slowly adapting and 26 % had an accompanying resting discharge. The majority (86 %) of the TMJ units responded to the movement of the isolated condyle in the anterior and/or ventral directions, and half were sensitive to the condyle movement in a single direction. The discharge frequencies of TMJ units increased as the condyle displacement and constant velocity (5 mm/s) increased within a 5-mm anterior displacement of the isolated condyle. Based on these results, we conclude that sensory information is processed by TMJ neurons encoding at least joint position and displacement in the physiological range of mandibular displacement. PMID:22855309

  10. Posttraumatic temporomandibular joint disorders.

    PubMed

    Giannakopoulos, Helen E; Quinn, Peter D; Granquist, Eric; Chou, Joli C

    2009-05-01

    The temporomandibular joint (TMJ) has many essential functions. None of its components are exempt from injury. Facial asymmetry, malocclusion, disturbances in growth, osteoarthritis, and ankylosis can manifest as complications from trauma to the TMJ. The goals of initial treatment include achievement of pretraumatic function, restoration of facial symmetry, and resolution of pain. These same objectives hold true for late repairs and reconstruction of the TMJ apparatus. Treatment is demanding, and with opposing approaches. The following article explores various treatment options for problems presenting as a result of a history of trauma to the TMJ. PMID:22110802

  11. Radiographic anatomy of the rabbit skull with particular reference to the tympanic bulla and temporomandibular joint: Part 1: Lateral and long axis rotational angles.

    PubMed

    King, A M; Cranfield, F; Hall, J; Hammond, G; Sullivan, M

    2010-11-01

    Radiography is frequently used to investigate otitis media and dental disease in rabbits, although there are few detailed reports regarding the radiographic anatomy of the rabbit skull. The aim of this study was to document rabbit skull radiographic anatomy, with particular reference to the tympanic bulla (TB) and temporomandibular joint (TMJ), and to identify views that allowed optimal assessment of these areas. Equipment was used that allowed repeatable positioning of skulls at known rotational angles in lateral (lateral to rostrocaudal) and long axis (lateral to ventrodorsal) directions. The views were repeated with lead markers attached to anatomical features and cadaver heads. The TB could be best examined between 30° and 60° in both planes. The TMJ was best visualised between 70° and 90° in a lateral direction, particularly along a true rostrocaudal plane, but could not be imaged well at any of the long axis rotational angles. Similar images were obtained using cadavers. PMID:19853482

  12. Human temporomandibular joint morphogenesis.

    PubMed

    Carini, Francesco; Scardina, Giuseppe Alessandro; Caradonna, Carola; Messina, Pietro; Valenza, Vincenzo

    2007-01-01

    Temporomandibular joint morphogenesis was studied. Ranging in age of fetuses examined was from 6 to14 weeks' gestation. Our results showed the condyle so first element that appear between 6 degrees and 8 degrees week (condylar blastema). After a week appear temporal elements. Disk appear at the same time of glenoid blastema and it reaches an advanced differentation before of the condyle and temporal element, so these don't effect machanical compression on mesenchyma where we find the disk. So we think that the disk result of genetic expression and it isn't the result of mechanical compression. The inferior joint cavity appear to 12 week. The superior joint cavity appear to 13-14 week. In conclusion, the appearance of the condyle is the first event during TMJ morphogenesis, with its initial bud, in form of a mesenchymal thickening, becoming detectable between the sixth and eight week of development, when all the large joints of the limbs are already well defined. PMID:18333411

  13. Radiographic anatomy of the rabbit skull, with particular reference to the tympanic bulla and temporomandibular joint. Part 2: Ventral and dorsal rotational angles.

    PubMed

    King, A M; Cranfield, F; Hall, J; Hammond, G; Sullivan, M

    2010-11-01

    This is the second part of a two-part study to document rabbit skull radiographic anatomy with particular reference to the temporomandibular joint (TMJ) and tympanic bulla (TB), and identify views that allowed their optimal visualisation. Equipment was used that allowed repeatable positioning of skulls at known rotational angles in ventral (rostrocaudal to ventrodorsal) with the mouth closed and open, and dorsal (rostrocaudal to dorsoventral position) directions. The views were repeated with lead markers attached to anatomical features and cadaver heads. The TBs were visible between 40° and 90° from rostrocaudal in both directions, but opening the mouth did not improve visualisation. The TMJs were visible until 40° in a ventral direction, but only 20° in a dorsal one. Opening the mouth slightly altered the regions of the joint being skylined, but did not otherwise enhance imaging of this region. PMID:19717319

  14. Inaudible temporomandibular joint vibrations.

    PubMed

    Widmalm, Sven E; Bae, Hanna E K; Djurdjanovic, Dragan; McKay, Duane C

    2006-07-01

    The aim was to test the hypothesis that inaudible vibrations with significant amounts of energy increasing during jaw movements can be recorded in the temporomandibular joint (TMJ) area. Twenty one subjects, who could perform wide opening movements without feeling discomfort, 12 with and 9 without TMJ sounds audible at conventional auscultation with a stethoscope, were included. Recordings were made during opening-closing, 2/s without tooth contact, and during mandibular rest, using accelerometers with a flat frequency response between the filter cutoff frequencies 0.1 Hz and 1000 Hz. The signals were digitized using a 24 bits card and sampled with the rate 96000 Hz. Power spectral analyses, and independent and paired samples t-tests were used in the analysis of the vibration power observed in frequency bands corresponding to audible and inaudible frequencies. An alpha-level of 5% was chosen for accepting a difference as being significant. In the group with audible sounds, about 47% of the total vibration energy was in the inaudible area below 20 Hz during opening-closing and about 76% during mandibular rest. In the group without audible sounds, the corresponding proportions were significantly different, 85% vs. 69%. The energy content of the vibrations, both those below and those above 20 Hz, increased significantly during jaw movement in both groups. Furthermore, percentage of signal energy above 20 Hz showed a noticeable increase in the group of subjects with audible sounds. This can physically be explained by decreased damping properties of damaged tissues surrounding the TMJ. Vibrations in the TMJ area can be observed with significant portions in the inaudible area below 20 Hz both during mandibular rest and during jaw movements whether or not the subjects have audible joint sounds. Further studies are needed to identify sources and evaluate possible diagnostic value. PMID:16933462

  15. [Gout in the temporomandibular joint].

    PubMed

    Deferm, J T; Barkhuysen, R; de Rooy, J; Coppen, C; Merkx, M Aw

    2016-06-01

    A 76-year-old woman, with a medical history of diabetes mellitus and hypertension, presented herself to an oral and maxillofacial surgeon with a sudden pre-auricular swelling of the right temporomandibular joint. As a result of the atypical clinical appearance and signs of local destruction in the initial panoramic x-ray, a malign process was first eliminated from consideration. With the aid of extensive diagnostics and an open biopsy, the diagnosis of gout was established. PMID:27275659

  16. Temporomandibular Joint Disorders and Orofacial Pain.

    PubMed

    Ahmad, Mansur; Schiffman, Eric L

    2016-01-01

    Temporomandibular disorders (TMD) affect 5% to 12% of the United States population. This article discusses common conditions related to temporomandibular joints, including disc displacements, inflammatory disturbances, loose joint bodies, traumatic disturbances, and developmental conditions. Also addressed are the appropriate imaging modalities and diagnostic criteria for TMD. PMID:26614951

  17. Management of temporomandibular joint ankylosis.

    PubMed

    Movahed, Reza; Mercuri, Louis G

    2015-02-01

    Temporomandibular joint (TMJ) ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life threatening when struggling to acquire an airway in an emergency. Trauma is the most common cause of TMJ ankylosis, followed by infection. Diagnosis of TMJ ankylosis is usually made by clinical examination and imaging studies. The management goal in TMJ ankylosis is to increase the patient's mandibular function, correct associated facial deformity, decrease pain, and prevent reankylosis. PMID:25483442

  18. Rheumatoid arthritis affecting temporomandibular joint

    PubMed Central

    Sodhi, Amandeep; Naik, Shobha; Pai, Anuradha; Anuradha, Ardra

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ) is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT) has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT) in diagnosing the bony changes in the early phase of the disease. PMID:25684928

  19. Characteristics of temporomandibular joint in patients with temporomandibular joint complaint

    PubMed Central

    Li, Yanfeng; Guo, Xiaoqian; Sun, Xiaoxue; Wang, Ning; Xie, Min; Zhang, Jianqiang; Lv, Yuan; Han, Weili; Hu, Min; Liu, Hongchen

    2015-01-01

    Introduction: This study was to investigate whether there was statistical difference between the bilateral temporomandibular joint (TMJ) in patients with unilateral TMJ pain or joint sounds, using cone beam computed tomography (CBCT). Methods: TMJ CBCT images of 123 cases were used to preliminarily determine the indicators suitable for the measuring method. TMJ CBCT image reconstruction was performed and 19 indicators were measured. Thirty-six cases without TMJ complaint served as controls. The comparison of bilateral TMJs was analyzed by paired t-test to find out the indicators without statistical significance. Twenty-nine patients with unilateral TMJ pain or joint sounds who underwent CBCT at the hospital were enrolled for the comparative study. The measured values were analyzed by paired t-test to determine the indicators with statistical difference. Results: In the control group, only radius value of bilateral TMJ was different statistically (P < 0.05). In the TMJ complaint group, the vertical 60° joint space of the bilateral TMJ was statistically different (P < 0.05) and the rest of the measured values showed no statistical difference. Conclusions: In the patients with unilateral TMJ pain or joint sounds, the vertical 60° joint space of the symptomatic side was significantly increased comparing with the asymptomatic side. PMID:26629112

  20. [Condylar fracture and temporomandibular joint ankylosis].

    PubMed

    Zhang, Yi

    2016-03-01

    This article summarized the advances in treatment and research of temporomandibular joint surgery in the last 5 years which was presented in "The 2nd Condyle Fracture and Temporomandibular Joint Ankylosis Symposium". The content includes 5 parts: non-surgical treatment of children condyle fracture and long-term follow-up, the improvement of operative approach for condyle fracture and key techniques, the importance and the method for the simultanesous reduction of disc in condylar fracture treatment, the development of traumatic temporomandibular joint ankylosis similar to hypertrophic non-union and the improved safety and accuracy by applying digital surgery in joint surgery. PMID:26980648

  1. Engineering Alloplastic Temporomandibular Joint Replacements

    PubMed Central

    Sinno, Hani; Tahiri, Youssef; Gilardino, Mirko; Bobyn, Dennis

    2011-01-01

    Temporomandibular disorders (TMD) are part of a heterogeneous group of pathologies that manifest with a constellation of signs and symptoms. They are the most frequent cause of chronic orofacial pain and are prevalent in 12% of the general population. Despite the debilitating nature of these disorders, there is no standardization for treatment of the diseased temporomandibular joint (TMJ). In this review, we present an overview of the functional anatomy of the TMJ and the engineering concepts that must be understood to better understand the indications for surgical management, the types of available treatments and the requirements for reconstruction. A comparison is made of the clinical outcomes with autogenous versus alloplastic reconstruction, including a history of alloplastic materials and the design features of currently available implants. Emphasis is made on material selection, modulus, stiffness, notch sensitivity and modularity. For the treatment of TMD, engineered TMJ alloplastic replacements have had considerable promise with additional room for improvement using new materials and recent design concepts. PMID:22363183

  2. Condylar hyperplasia following unilateral temporomandibular joint replacement.

    PubMed

    Machon, V; Levorova, J; Hirjak, D; Foltan, R

    2015-06-01

    Total joint replacement of the temporomandibular joint (TJR) can be associated with intraoperative and postoperative complications. We report herein the occurrence of a postoperative open bite malocclusion, the result of condylar hyperplasia affecting the non-operated joint at 1 year after unilateral total joint replacement. PMID:25662429

  3. Temporomandibular joint diagnostics using CBCT

    PubMed Central

    Abrahamsson, A-K; Kristensen, M; Arvidsson, L Z

    2015-01-01

    The present review will give an update on temporomandibular joint (TMJ) imaging using CBCT. It will focus on diagnostic accuracy and the value of CBCT compared with other imaging modalities for the evaluation of TMJs in different categories of patients; osteoarthritis (OA), juvenile OA, rheumatoid arthritis and related joint diseases, juvenile idiopathic arthritis and other intra-articular conditions. Finally, sections on other aspects of CBCT research related to the TMJ, clinical decision-making and concluding remarks are added. CBCT has emerged as a cost- and dose-effective imaging modality for the diagnostic assessment of a variety of TMJ conditions. The imaging modality has been found to be superior to conventional radiographical examinations as well as MRI in assessment of the TMJ. However, it should be emphasized that the diagnostic information obtained is limited to the morphology of the osseous joint components, cortical bone integrity and subcortical bone destruction/production. For evaluation of soft-tissue abnormalities, MRI is mandatory. There is an obvious need for research on the impact of CBCT examinations on patient outcome. PMID:25369205

  4. Management Of Condylar And Synovial Hyperplasias With Pulsed Er: YAG Laser In The Temporomandibular Joints Of New Zealand Rabbits

    NASA Astrophysics Data System (ADS)

    El-Hadedi, M.; Badr, Y.; Gheith, M.

    2009-09-01

    The pulsed Er: YAG laser has recently emerged as an alternative to the mechanical instruments in surgery and medicine its wave length is close to the strong peak in the absorption spectrum of water, this feature combined with the high water content of biological tissues result in delivering of optical energy in an area of small optical extent and this enables highly controlled precise ablation with minimal thermal damage to the surrounding tissues. The aim of this study is to evaluate the role of Er: YAG laser in management of induced condylar and synovial hyperplasias in the TMJ of new Zealand rabbits. 12 New Zealand rabbits were divided into two groups for laser high condylar shave and laser synovectomy using Er: YAG laser 2.9 μm with parameters 250 mJ, 20 Hz frequency and 1 mm beam diameter. Histopathologial and ultramicroscopic assessments were performed at four weeks and six weeks postoperative. using this wave length with theses parameters was safe to perform high condylar shave and synovectomy.

  5. Temporomandibular joint multidisciplinary team clinic.

    PubMed

    Ahmed, Nabeela; Poate, Tim; Nacher-Garcia, Cristina; Pugh, Nicola; Cowgill, Helen; Page, Lisa; Matthews, N Shaun

    2014-11-01

    Patients with dysfunction of the temporomandibular joint (TMJ) commonly present to oral and maxillofacial departments and are increasingly being managed by a subspecialist group of surgeons. We review the outcomes of patients attending a specialist TMJ multidisciplinary team (MDT) clinic. All patients are simultaneously reviewed by a consultant oral and maxillofacial surgeon, consultant in oral medicine, specialist physiotherapist, and maxillofacial prosthetist, and they can also see a consultant liaison psychiatrist. They are referred from primary, secondary, and tertiary care when medical and surgical treatment in the routine TMJ clinic has failed, and are triaged by the attending maxillofacial surgeon. On discharge they are returned to the care of the referring practitioner. We review the outcomes of patients attending this clinic over a 2-year period and show improvements in pain scores and maximal incisal opening, as well as quality of life outcome measures. All units in the UK with an interest in the management of diseases of the TMJ should consider establishing this type of clinic and should use available resources and expertise to maximise outcomes. PMID:25179688

  6. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  7. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  8. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Total temporomandibular joint prosthesis. 872.3940... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is intended to...

  9. Temporomandibular joint internal derangements: CT diagnosis

    SciTech Connect

    Helms, C.A.; Vogler, J.B. III; Morrish, R.B. Jr.; Goldman, S.M.; Capra, R.E.; Proctor, E.

    1984-08-01

    Two hundred patients with suspected displaced temporomandibular joint meniscus were studied with computed tomography. In 75 cases confirmation of the CT diagnosis was subsequently obtained via surgery or arthrography; correlation was found in 73 cases (97%), with one false-negative and one false-positive examination. When meniscus displacement was graded as mild, moderate, or severe, those cases diagnosed as moderate or severe were more likely to require surgery. The technique and interpretation of this technique is described; in most cases CT can replace arthrography in diagnosing displaced temporomandibular joint menisci.

  10. Temporomandibular joint dislocation: experiences from Zaria, Nigeria

    PubMed Central

    Fomete, Benjamin; Obiadazie, Athanasius Chukwudi; Idehen, Kelvin; Okeke, Uche

    2014-01-01

    Objectives Dislocation of the temporomandibular joint may occur for various reasons. Although different invasive methods have been advocated for its treatment, this study highlights the value of non-invasive treatment options even in chronic cases in a resource-poor environment. Materials and Methods A seven-year retrospective analysis of all patients managed for temporomandibular joint dislocation in our department was undertaken. Patient demographics, risk factors associated with temporomandibular joint dislocation and treatment modalities were retrieved from patient records. Results In all, 26 patients were managed over a seven-year period. Males accounted for 62% of the patients, and yawning was the most frequent etiological factor. Conservative treatment methods were used successfully in 86.4% of the patients managed. Two (66.7%) of the three patients who needed surgical treatment developed complications, while only one (5.3%) patient who was managed conservatively developed complications. Conclusion Temporomandibular joint dislocation appears to be associated with male sex, middle age, yawning, and low socio-economic status, although these observed relationships were not statistically significant. Non-invasive methods remain an effective treatment option in this environment in view of the low socio-economic status of the patients affected. PMID:25045637

  11. Predisposition for temporomandibular joint disorders: loose ligaments.

    PubMed

    Deodato, Francesco; Trusendi, Raffaello; Giorgetti, Roberto; Scalese, Marco U

    2006-07-01

    Loose ligaments are often a predisposing factor of temporomandibular joint (TMJ) disorders. This causal factor was analyzed in 701 subjects presenting at the TMJ and Posture Center of Siena University with TMJ pain or dysfunction. Along with the conventional jaw examination, a Carter and Wilkinson test as modified by Beighton was also done. We found a correlation among the parameters of age, gender, TMJ disorder, joint pain, muscle pain, and loose ligaments. PMID:16933458

  12. Imaging of the temporomandibular joint: An update

    PubMed Central

    Bag, Asim K; Gaddikeri, Santhosh; Singhal, Aparna; Hardin, Simms; Tran, Benson D; Medina, Josue A; Curé, Joel K

    2014-01-01

    Imaging of the temporomandibular joint (TMJ) is continuously evolving with advancement of imaging technologies. Many different imaging modalities are currently used to evaluate the TMJ. Magnetic resonance imaging is commonly used for evaluation of the TMJ due to its superior contrast resolution and its ability to acquire dynamic imaging for demonstration of the functionality of the joint. Computed tomography and ultrasound imaging have specific indication in imaging of the TMJ. This article focuses on state of the art imaging of the temporomandibular joint. Relevant normal anatomy and biomechanics of movement of the TMJ are discussed for better understanding of many TMJ pathologies. Imaging of internal derangements is discussed in detail. Different arthropathies and common tumors are also discussed in this article. PMID:25170394

  13. Direct sagital computed tomography of the temporomandibular joint

    SciTech Connect

    Manzione, J.V.; Seltzer, S.E.; Katzberg, R.W.; Hammerschlag, S.B.; Chiango, B.F.

    1983-01-01

    Temporomandibular joint dysfunction is a common clinical problem that has been reported to affect 4%-28% of adults. Temporomandibular joint arthrography has shown that many of these patients have intraarticular abnormalities involving the meniscus. A noninvasive test that could demonstrate the meniscus as well as bony abnormalities of the joint would be an important advance. In an attempt to develop such a noninvasive test, we have performed direct sagittal computed tomography (CT) on cadaver temporomandibular joints and have correlated the images with anatomic sections. We are currently applying this technique clinically and report one representative example in which direct sagittal computed tomography of the temporomandibular joint accurately demonstrated an anteriorly displaced meniscus.

  14. Imaging Approach to Temporomandibular Joint Disorders.

    PubMed

    Morales, H; Cornelius, R

    2016-03-01

    Internal derangement is the most common temporomandibular joint disorder. Degenerative osteoarthritis and trauma are next in frequency. Less common pathology includes rheumatoid arthritis, synovial chondromatosis, calcium pyrophosphate dehydrate deposition disease, pigmented villonodular synovitis, tumors, infection, and osteonecrosis. We provide a systematic approach to facilitate interpretation based on major anatomic structures: disc-attachments, joint space, condyle, and lateral pterygoid muscle. Relevant graphic anatomy and state of the art imaging are discussed in correlation with current clinical and therapeutic highlights of pathologic entities affecting the joint. PMID:26374243

  15. Radiation dose in temporomandibular joint zonography

    SciTech Connect

    Coucke, M.E.; Bourgoignie, R.R.; Dermaut, L.R.; Bourgoignie, K.A.; Jacobs, R.J. )

    1991-06-01

    Temporomandibular joint morphology and function can be evaluated by panoramic zonography. Thermoluminescent dosimetry was applied to evaluate the radiation dose to predetermined sites on a phantom eye, thyroid, pituitary, and parotid, and the dose distribution on the skin of the head and neck when the TMJ program of the Zonarc panoramic x-ray unit was used. Findings are discussed with reference to similar radiographic techniques.

  16. Laser arthroscopy of the temporomandibular joint.

    PubMed

    Gerard, N; Hendler, B H

    1995-04-01

    Laser surgery is very different than traditional surgery. The clinician must be familiar with the physical properties of the laser to use this instrument safely and properly. Various lasers are available for use in oral and maxillofacial surgery and dentistry, namely the carbon dioxide laser, the neodymium:yttrium-aluminum-garnet laser, and the holmium: yttrium-aluminum-garnet laser (Ho:YAG). Only the Ho:YAG laser has been used with effectiveness in temporomandibular joint arthroscopic surgery. PMID:8935004

  17. Quantitative Radiological Diagnosis Of The Temporomandibular Joint

    NASA Astrophysics Data System (ADS)

    Jordan, Steven L.; Heffez, Leslie B.

    1989-05-01

    Recent impressive technological advances in imaging techniques for the human temporomandibular (tm) joint, and in enabling geometric algorithms have outpaced diagnostic analyses. The authors present a basis for systematic quantitative diagnoses that exploit the imaging advancements. A reference line, coordinate system, and transformations are described that are appropriate for tomography of the tm joint. These yield radiographic measurements (disk displacement) and observations (beaking of radiopaque dye and disk shape) that refine diagnostic classifications of anterior displacement of the condylar disk. The relevance of these techniques has been clinically confirmed. Additional geometric invariants and procedures are proposed for future clinical verification.

  18. Intrauterine temporomandibular joint dislocation: prenatal sonographic evaluation.

    PubMed

    Çil, Ahmet Said; Bozkurt, Murat; Bozkurt, Duygu Kara

    2014-09-01

    Congenital temporomandibular joint (TMJ) diseases are very rare disorders and are usually diagnosed in childhood. Developmental disorders of the TMJ such as hypoplasia, hyperplasia, and aplasia of the TMJ compartments are characterized by TMJ dysfunction. In childhood, these patients experience recurrent dislocation, pain, and malocclusion. We present the case of a 25-week fetus with unilateral TMJ dislocation with fluid retention in the joint diagnosed by ultrasonography. To the best of our knowledge, this is the first case of TMJ dislocation diagnosed by ultrasonographic evaluation during the prenatal period. PMID:23669613

  19. Intrauterine Temporomandibular Joint Dislocation: Prenatal Sonographic Evaluation

    PubMed Central

    Çil, Ahmet Said; Bozkurt, Murat; Bozkurt, Duygu Kara

    2014-01-01

    Congenital temporomandibular joint (TMJ) diseases are very rare disorders and are usually diagnosed in childhood. Developmental disorders of the TMJ such as hypoplasia, hyperplasia, and aplasia of the TMJ compartments are characterized by TMJ dysfunction. In childhood, these patients experience recurrent dislocation, pain, and malocclusion. We present the case of a 25-week fetus with unilateral TMJ dislocation with fluid retention in the joint diagnosed by ultrasonography. To the best of our knowledge, this is the first case of TMJ dislocation diagnosed by ultrasonographic evaluation during the prenatal period. PMID:23669613

  20. Temporomandibular joint involvement in ankylosing spondylitis

    PubMed Central

    Arora, Pallak; Amarnath, Janardhan; Ravindra, Setru Veerabhadrappa; Rallan, Mandeep

    2013-01-01

    Frequency of temporomandibular joint (TMJ) involvement in patients with ankylosing spondylitis (AS) has varied from 4% to 35%. It is more common in men and produces generalised stiffness in involved joints. Clinician should be suspicious of AS when a patient reports with painful restricted movements of joint, neck or back and with no trauma history. Conventional radiographic methods have allowed the demonstration of TMJ abnormalities in patients with AS, but CT is necessary to establish joint space relations and bony morphology. We describe a case of severe AS with TMJ involvement in a 40-year-old female patient and demonstrated TMJ changes on CT. A CT was able to demonstrate articular cartilage changes, disc- and joint abnormalities. Thus, if conventional radiographs in a symptomatic patient with rheumatic diseases are unable to demonstrate changes, CT can provide valuable additional information of the changes in the TMJ. PMID:23645650

  1. Temporomandibular joint: true sagittal computed tomography with meniscus visualization

    SciTech Connect

    Sartorix, D.J.; Neumann, C.H.; Riley, R.W.

    1984-01-01

    Accessory patient support equipment was constructed that allows patient positioning for true sagittal projection of the temporomandibular joint using a GE 8800 CT/T scanner. Range of motion abnormalities, osseous alterations of the mandibular condyle and temporal bone, joint-space narrowing, and meniscal configuration may be demonstrated. The technique has potential advantages over other CT projections and sagittal reconstruction for evaluation of temporomandibular joint dysfunction.

  2. Septic Arthritis in the Temporomandibular Joint

    PubMed Central

    Al-Khalisy, Hassan Mahdi; Nikiforov, Ivan; Mansoora, Qurat; Goldman, John; Cheriyath, Pramil

    2015-01-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare event that has only been reported a few dozen times worldwide. This case is remarkable for septic arthritis of the TMJ joint in an otherwise healthy male. Case Report: A 24-year-old male presented to the emergency department with periauricular swelling, erythema, fever, myalgia's and generalized joint pain. He had previously sought medical attention and was placed on ciprofloxacin. However, he developed facial swelling and a rash and had to discontinue the antibiotic. On physical exam the patient had a large swelling and tenderness in his left periauricular area, with erythema and deviation of the right mandible which limited his ability to open the mouth. A computed tomography showed mild asymmetric soft tissue swelling in the left pharyngeal region but did not show joint effusion. Subsequent magnetic resonance imaging did show effusion of the joint space. The effusion was drained, and the synovial fluid was submitted for gram stain, culture, and sensitivity. The cultures grew menthicillin sensitive Staphyloccocus Aureus. The patient was discharged to complete a two week course of intravenous (IV) Ceftriaxone and IV Vancomycin via home infusion. Conclusion: Septic Arthritis of the TMJ is a rare event with very specific clinical symptoms. Due to the low sensitivity of the computed tomography scan, magnetic resonance imaging should be considered when computed tomography scan is negative for TMJ effusion. PMID:26713295

  3. Absorbed doses from temporomandibular joint radiography

    SciTech Connect

    Brooks, S.L.; Lanzetta, M.L.

    1985-06-01

    Thermoluminescent dosimeters were used in a tissue-equivalent phantom to measure doses of radiation absorbed by various structures in the head when the temporomandibular joint was examined by four different radiographic techniques--the transcranial, transorbital, and sigmoid notch (Parma) projections and the lateral tomograph. The highest doses of radiation occurred at the point of entry for the x-ray beam, ranging from 112 mrad for the transorbital view to 990 mrad for the sigmoid notch view. Only the transorbital projection a radiation dose to the lens of the eye. Of the four techniques evaluated, the lateral tomograph produced the highest doses to the pituitary gland and the bone marrow, while the sigmoid notch radiograph produced the highest doses to the parotid gland.

  4. Temporomandibular joint replacement: a New Zealand perspective.

    PubMed

    Murdoch, B; Buchanan, J; Cliff, J

    2014-05-01

    Alloplastic total temporomandibular joint replacement (TMJ TJR) has been performed in New Zealand utilizing the TMJ Concepts patient-fitted system since 2000. The data analysed in this study were collected retrospectively from questionnaires sent to all maxillofacial surgeons in New Zealand who had implanted TMJ Concepts devices between 2000 and 2011. A total of 63 devices were implanted in 42 patients (13 males, 29 females) during this 12-year period. The primary indication for TMJ TJR was end-stage joint disease resulting from ankylosis and arthritis. The mean age of the patients was 47 years (range 7-80 years). The most common complication reported was transient facial nerve impairment in 4.8% of the patients. Objective results, measured as the maximal incisional opening, improved by a mean of 17.3mm (P<0.01); 90% of patients reported improved quality of life. New Zealand oral and maxillofacial surgeons have concluded that TMJ TJR using the TMJ Concepts prosthesis is a reliable treatment option for the management of end-stage TMJ disease. PMID:24332584

  5. Osteochondritis dissecans of the temporomandibular joint.

    PubMed

    Campos, P S F; Freitas, C E; Pena, N; Gonzalez, M O D; Almeida, S M; Mariz, A C R; Lorens, F G L

    2005-05-01

    A case is reported of a 43-year-old female patient presenting bilateral osteochondritis dissecans (OCD) of the temporomandibular joint (TMJ), in different stages for each side, associated with avascular necrosis (AVN) of the right condyle. Additionally observed was anterior disk displacement without reduction for both sides. We have proposed an adaptation of the previous classification of OCD for cases affecting the TMJ. We have also stressed the fundamental role of panoramic radiography on the diagnosis of stage 3 and stage 4 OCD of the TMJ. In relation to MRI, we have recommended sagittal (slice thickness of 2 mm) and coronal (slice thickness of 1 mm) fast spin-echo proton density-weighted sequences to better identify bone lesions (stage 1 and 2) and also localize osteochondral loose bodies; and coronal (slice thickness of 1 mm) fat-suppressed fast spin-echo T2 weighted sequence to better evaluate OCD (stable or unstable) and the features of the occasionally associated AVN (acute or chronic). PMID:15897292

  6. [Total temporomandibular joint replacement with alloplastic prosthesis].

    PubMed

    García-Huerta, Marco Antonio; Romero-Flores, Jovita; Mena-Gómez, Eddy

    2012-01-01

    Three total temporomandibular joint (TMJ) replacement surgeries were performed on two patients with TMJ ankylosis using W. Lorenz system. The first surgery was performed on a female patient with osseous ankylosis who had no mandibular movement since she was 18 months old. The second surgery was on a patient with fibrous ankylosis who had an interincisive opening distance of 12 mm. Her condition was the result of a three year old subcondylar fracture which didn't receive any treatment. The first patient had total replacement of both TMJs, while the other just one TMJ. The follow up until today has been of eight months with an interincisive opening of 29 mm in the first patient and 34 mm in the other. There has not been any mandibular deviation during opening, nor postoperative pain in both cases. Facial nerve affection was not permanent in both patients. For all of this, we can conclude that total TMJ replacement is an effective treatment with stable results in patients with TMJ ankylosis. PMID:23234748

  7. Inflammatory pseudotumour of the temporomandibular joint.

    PubMed

    Ghavami, Y; Yau, A Y; Ziai, K; Maducdoc, M M; Djalilian, H R

    2015-01-01

    Head and neck inflammatory pseudotumors (IPs) are rare, idiopathic, non-neoplastic lesions that most commonly affect the orbit, but may involve other areas such as the larynx, oropharynx, paranasal sinuses, and meninges. We report the case of a 55-year-old man who presented with progressive left-sided hearing loss, aural fullness, and otalgia. Computed tomography and magnetic resonance imaging (MRI) detected a soft-tissue mass in the left temporomandibular joint (TMJ). Histopathologic examination showed overlying squamous epithelium with hyperkeratosis, parakeratosis, subepithelial fibrosis, and chronic inflammatory infiltrate, which were consistent with an IP. Radiologic images and MRI indicated an ill-defined soft tissue involving the roof and posterior aspect of the TMJ, extending into the anterior external auditory canal. Our case was treated with a 2-week course of high dose prednisone (1 mg/kg) and a 2-week taper with resolution of symptoms. Two years after treatment, the patient shows no evidence of recurrence on MRI. PMID:26891541

  8. Mouse genetic models for temporomandibular joint development and disorders

    PubMed Central

    Suzuki, A; Iwata, J

    2016-01-01

    The temporomandibular joint (TMJ) is a synovial joint essential for hinge and sliding movements of the mammalian jaw. Temporomandibular joint disorders (TMD) are dysregulations of the muscles or the TMJ in structure, function, and physiology, and result in pain, limited mandibular mobility, and TMJ noise and clicking. Although approximately 40–70% adults in the USA have at least one sign of TMD, the etiology of TMD remains largely unknown. Here, we highlight recent advances in our understanding of TMD in mouse models. PMID:26096083

  9. Temporomandibular joint dysfunction in various rheumatic diseases.

    PubMed

    Aceves-Avila, F J; Chávez-López, M; Chavira-González, J R; Ramos-Remus, C

    2013-01-01

    Temporomandibular disorder (TMD) is an inclusive term in which those conditions disturbing the masticatory function are embraced. It has been estimated that 33% of the population have signs of TMD, but less than 5% of the population will require treatment. The objective of this study was to measure the frequency of TMD in rheumatoid arthritis (RA), osteoarthrosis (OA), ankylosing spondylitis (AS) and systemic lupus erythematosus, and to define the limitations in everyday's life that patients perceive when present. A six-month survey of consecutive outpatients in a rheumatology clinic in a teaching hospital in Mexico was carried out. We defined TMD as: 1) the presence of pain; 2) difficulty on mouth opening, chewing or speaking; 3) the presence of non-harmonic movements of the temporomaxilar joints. All three characteristics had to be present. Z test was used to define differences between proportions. We present the results of 171 patients. Overall, 50 patients had TMD according to our operational definition (29.24%). Up to 76% of the sample had symptoms associated with the condition. TMD is more frequent in OA and in AS (29.24% vs 38% OA, P=0.009; 39% AS; P=0.005). We found no association between the severity of TMD and the request for specific attention for the discomfort produced by the condition. Only 8 of 50 (16%) patients with TMD had requested medical help for their symptoms, and they were not the most severe cases. TMD is more frequent in RA and OA. Although it may produce severe impairment, patients seem to adapt easily. PMID:23884028

  10. Temporomandibular joint computed tomography: development of a direct sagittal technique

    SciTech Connect

    van der Kuijl, B.; Vencken, L.M.; de Bont, L.G.; Boering, G. )

    1990-12-01

    Radiology plays an important role in the diagnosis of temporomandibular disorders. Different techniques are used with computed tomography offering simultaneous imaging of bone and soft tissues. It is therefore suited for visualization of the articular disk and may be used in patients with suspected internal derangements and other disorders of the temporomandibular joint. Previous research suggests advantages to direct sagittal scanning, which requires special positioning of the patient and a sophisticated scanning technique. This study describes the development of a new technique of direct sagittal computed tomographic imaging of the temporomandibular joint using a specially designed patient table and internal light visor positioning. No structures other than the patient's head are involved in the imaging process, and misleading artifacts from the arm or the shoulder are eliminated. The use of the scanogram allows precise correction of the condylar axis and selection of exact slice level.

  11. Surgical treatment of temporomandibular joint ankyloses: meniscus conservation and relocation.

    PubMed

    Rinna, Claudio; Reale, Gabriele; Calvani, Francesco; Cascone, Piero

    2013-03-01

    Ankylosis of the temporomandibular joint is a serious complication, mainly after trauma and local or systemic infection. In rare cases, ankylosis is associated with systemic disease such as ankylosing spondylitis, rheumatoid arthritis, and psoriasis. According to the functional restriction and the provoked disturbances of facial growth in the youth, an early and effective therapy is desirable. There is a wide variety of surgical approaches to temporomandibular joint ankylosis, ranging from chondro-osseous grafts to prothesis. In the article the authors present the clinical case of a 60-year-old patient who, at the age of 6, accidentally fell from a height of about 2 m. In 60 years old, after removing the temporomandibular ankylosis with surgical technique, patient showed a marked improvement of mandibular kinetics. PMID:23524812

  12. An Interesting Case of Gunshot Injury to the Temporomandibular Joint

    PubMed Central

    Pires, Mário Sergio Medeiros; Giongo, Caroline Comis; Antonello, Guilherme de Marco; Couto, Ricardo Torres do; Filho, Ruy de Oliveira Veras; Junior, Otacílio Luiz Chagas

    2014-01-01

    The head and face are relatively common sites of gunshot injury, and the temporomandibular joint is often affected. These wounds usually produce major deformity and functional impairment, particularly when the temporomandibular joint is affected or when structures such as the facial nerve are damaged. Complications may include mandibular displacement at maximum mouth opening and in protrusion, limited mouth opening, limited lateral movement of the jaw, anterior open bite, and, more rarely, temporomandibular ankylosis. Projectiles that strike the mandible usually cause comminuted fractures; maxillary wounds, in turn, are most commonly perforating. The present report describes a case of gunshot injury in which the projectile lodged within the mandibular fossa but did not cause any fractures. Oral and maxillofacial trauma surgeons must be aware of the different types of gunshot injury, as they produce distinct patterns of tissue destruction due to projectile trajectory and release of kinetic energy into surrounding tissue. PMID:25709756

  13. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... reconstruct the temporomandibular joint. (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food... approved PMA or a declared completed PDP in effect before being placed in commercial distribution....

  14. 21 CFR 872.3940 - Total temporomandibular joint prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... reconstruct the temporomandibular joint. (b) Classification. Class III. (c) Date PMA or notice of completion of a PDP is required. A PMA or a notice of completion of a PDP is required to be filed with the Food... approved PMA or a declared completed PDP in effect before being placed in commercial distribution....

  15. Duplex Doppler ultrasound study of the temporomandibular joint

    PubMed Central

    Stagnitti, A.; Marini, A.; Impara, L.; Drudi, F.M.; Lo mele, L.; Lillo Odoardi, G.

    2012-01-01

    Introduction The anatomy and physiology of the temporomandibular joint can be studied clinically and by diagnostic imaging. Magnetic resonance imaging (MRI), radiography (X-ray) and computed tomography (CT) have thus for many years contributed to the study of the kinetics in the mandibular condyle. However, also duplex Doppler ultrasound (US) examination is widely used in the study of structures during movement, particularly vascular structures. Materials and methods A total of 30 patients were referred by the Department of Orthodontics to the Department of Radiological, Oncological and Pathological Sciences, University of Rome “La Sapienza”. All patients underwent duplex Doppler ultrasound (US) examination of the temporomandibular joint using Toshiba APLIO SSA-770A equipment and duplex Doppler multi-display technique, which allows simultaneous display of US images and color Doppler signals. A linear phased array probe with crystal elements was used operating at a basic frequency of 6 MHz during pulsed Doppler spectral analysis and 7.5 MHz during US imaging. Results In normal patients a regular alternation in the spectral Doppler waveforms was obtained, while in patients with temporomandibular joint meniscus dysfunction there was no regularity in the sum of the Fourier series with an unsteady waveform pattern related to irregular movements of the temporomandibular joint. Conclusions In all cases duplex Doppler US examination proved able to differentiate between normal and pathological patients and among the latter this technique permitted identification of the most significant aspects of the dysfunctional diseases. PMID:23397016

  16. Rationale of arthroscopic surgery of the temporomandibular joint

    PubMed Central

    Murakami, KenIchiro

    2013-01-01

    Arthroscopic surgery has been widely used for treatment of temporomandibular joint (TMJ) internal derangements and diseases for the last 40 years. Although 626 articles have been hit by Pubmed search in terms of “TMJ arthroscopic surgery”, this review article is described based on distinguished publishing works and on my experiences with TMJ arthroscopic surgery and related research with an aim to analyse the rationale of arthroscopic surgeries of the temporomandibular joint. With arthrocentesis emerging as an alternative, less invasive, treatment for internal derangement with closed lock, the primary indication of arthroscopic surgery seems to be somewhat limited. However, the value of endoscopic inspection and surgery has its position for both patient and physician with its long-term reliable results. PMID:25737901

  17. Oral splint for temporomandibular joint disorders with revolutionary fluid system

    PubMed Central

    Srivastava, Rahul; Jyoti, Bhuvan; Devi, Parvathi

    2013-01-01

    Temporomandibular joint (TMJ) diseases and disorders refer to a complex and poorly understood set of conditions, manifested by pain in the area of the jaw and associated muscles and limitations in the ability to make the normal movements of speech, facial expression, eating, chewing, and swallowing. The conventional soft occlusal splint therapy is a much safer and effective mode of a conservative line of therapy in comparison to the surgical therapy for temporomandibular joint disorders (TMD). The purpose of this article is to review the Aqualizer™, an hydrostatic oral splint, as accurate, effective treatment and differential diagnostic tool in TMD that allow treating the patient's pain quickly and accurately saving valuable treatment time. The review article has been prepared doing a literature review from the world-wide web and pubmed/medline. PMID:24019797

  18. Regional 3D superimposition to assess temporomandibular joint condylar morphology

    PubMed Central

    Schilling, J; Gomes, L C R; Benavides, E; Nguyen, T; Paniagua, B; Styner, M; Boen, V; Gonçalves, J R; Cevidanes, L H S

    2014-01-01

    Objectives: To investigate the reliability of regional three-dimensional registration and superimposition methods for assessment of temporomandibular joint condylar morphology across subjects and longitudinally. Methods: The sample consisted of cone beam CT scans of 36 patients. The across-subject comparisons included 12 controls, mean age 41.3 ± 12.0 years, and 12 patients with temporomandibular joint osteoarthritis, mean age 41.3 ± 14.7 years. The individual longitudinal assessments included 12 patients with temporomandibular joint osteoarthritis, mean age 37.8 ± 16.7 years, followed up at pre-operative jaw surgery, immediately after and one-year post-operative. Surface models of all condyles were constructed from the cone beam CT scans. Two previously calibrated observers independently performed all registration methods. A landmark-based approach was used for the registration of across-subject condylar models, and temporomandibular joint osteoarthritis vs control group differences were computed with shape analysis. A voxel-based approach was used for registration of longitudinal scans calculated x, y, z degrees of freedom for translation and rotation. Two-way random intraclass correlation coefficients tested the interobserver reliability. Results: Statistically significant differences between the control group and the osteoarthritis group were consistently located on the lateral and medial poles for both observers. The interobserver differences were ≤0.2 mm. For individual longitudinal comparisons, the mean interobserver differences were ≤0.6 mm in translation errors and 1.2° in rotation errors, with excellent reliability (intraclass correlation coefficient >0.75). Conclusions: Condylar registration for across-subjects and longitudinal assessments is reliable and can be used to quantify subtle bony differences in the three-dimensional condylar morphology. PMID:24170802

  19. Diagnosis of temporomandibular joint (TMJ) ankylosis in children.

    PubMed

    Shetty, Priya; Thomas, Ann; Sowmya, B

    2014-01-01

    Temporomandibular joint (TMJ) ankylosis involves fusion of the mandibular condyle with the base of the skull. It results in functional, esthetic, and psychosocial limitations, if it affects children at an early age. Hence, it is important to recognize and diagnose the pathology and provide immediate treatment alternatives to improve the patient condition. In this case report, we highlight the diagnostic perspective of TMJ ankylosis in children, and the use of 3D computed tomography as an effective diagnostic aid. PMID:25001450

  20. Current concepts in the pathogenesis of traumatic temporomandibular joint ankylosis

    PubMed Central

    2014-01-01

    Traumatic temporomandibular joint (TMJ) ankylosis can be classified into fibrous, fibro-osseous and bony ankylosis. It is still a huge challenge for oral and maxillofacial surgeons due to the technical difficulty and high incidence of recurrence. The poor outcome of disease may be partially attributed to the limited understanding of its pathogenesis. The purpose of this article was to comprehensively review the literature and summarise results from both human and animal studies related to the genesis of TMJ ankylosis. PMID:25189735

  1. Dislocation of the Temporomandibular Joint and Relocation Procedures.

    PubMed

    White, Thomas; Hedderick, Viki; Ramponi, Denise R

    2016-01-01

    Temporomandibular joint (TMJ) dislocation requires prompt medical attention due to the crucial impact of airway, nutrition acquisition, and communication. Recognition of this injury by the practitioner, based on clinical presentation and history, is paramount for identification of accurate diagnosis and prompt treatment of TMJ dislocation. Relocation or reduction methods vary on the basis of the severity of the injury and whether it is an acute or chronic dislocation. PMID:27482989

  2. Effects of several temporomandibular disorders on the stress distributions of temporomandibular joint: a finite element analysis.

    PubMed

    Liu, Zhan; Qian, Yingli; Zhang, Yuanli; Fan, Yubo

    2016-01-01

    The aim of this study was to evaluate stress distributions in the temporomandibular joints (TMJs) with temporomandibular disorders (TMDs) for comparison with healthy TMJs. A model of mandible and normal TMJs was developed according to CT images. The interfaces between the discs and the articular cartilages were treated as contact elements. Nonlinear cable elements were used to simulate disc attachments. Based on this model, seven models of various TMDs were established. The maximum stresses of the discs with anterior, posterior, medial and lateral disc displacement (ADD, PDD, MDD and LDD) were 12.09, 9.33, 10.71 and 6.07 times magnitude of the identically normal disc, respectively. The maximum stresses of the posterior articular eminences in ADD, PDD, MDD, LDD, relaxation of posterior attachments and disc perforation models were 21, 59, 46, 21, 13 and 15 times greater than the normal model, respectively. TMDs could cause increased stresses in the discs and posterior articular eminences. PMID:25587737

  3. Value of the nuclear medical scan in the diagnosis of temporomandibular joint disease

    SciTech Connect

    Craemer, T.D.; Ficara, A.J.

    1984-10-01

    A total of 125 patients with temporomandibular joint complaints underwent nuclear medical scans of their joints as part of their diagnostic work-ups. The scan results were compared with the radiographic and arthrogram findings of these patients. The results suggest that the nuclear medical scan is not a highly reliable diagnostic aid for the majority of temporomandibular joint patients.

  4. Management of the Temporomandibular Joint after Ablative Surgery

    PubMed Central

    Bredell, Marius; Grätz, Klaus; Obwegeser, Joachim; Gujer, Astrid Kruse

    2014-01-01

    Management of the temporomandibular joint in ablative head and neck surgery is controversial with no standardized approach. The aim of the study was to establish risk-based guidelines for the management of the temporomandibular joint after ablative surgery. Analysis of all patients' records receiving ablative surgery involving the temporomandibular joint in the Department of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zürich, from 2001 to 2012, was performed, identifying 15 patients and 14 reconstructive procedures. A literature search was done identifying all relevant literature on current approaches. Applicable cohorts were constructed, and relevant risks were extrapolated. Evaluated studies are not uniform in their reporting with nonhomogeneous patient groups. A diverse approach is used in the management of these patients with complications such as infection, ankylosis, limited mouth opening, plate penetration in the skull base, and plate loosening. Risk factors for complications appear to be radiation, costochondral graft, disk loss, and plate use alone. Clinical data suggest use of a plate with metal condyle reconstructions and previous radiation therapy as potential risks factors. Employing literature evidence and cumulated clinical data, a risk-based flowchart was developed to assist surgical decision making. Risk factors such as radiation, disk preservation, and soft tissue conditions are important complication-associated factors when planning surgery. Free vascularized fibula grafts appear to have the least complications that must be weighed against donor site morbidity. PMID:25379124

  5. Chitosan-Based Thermosensitive Hydrogel for Controlled Drug Delivery to the Temporomandibular Joint.

    PubMed

    Talaat, Wael M; Haider, Mohamed; Kawas, Sausan Al; Kandil, Nadia G; Harding, David R K

    2016-05-01

    Intra-articular injections of hyaluronic acid (HA) and corticosteroids have been extensively used in treating temporomandibular disorders. However, rapid clearance from the site of injection is a major concern that is commonly managed by frequent dosing, which is not without complications. This study aimed to determine the suitability of thermosensitive chitosan-based hydrogels for intra-articular controlled release of drugs in the rabbit temporomandibular joint (TMJ). A series of hydrogels were prepared using different chitosan (Ch) to β-glycerophosphate (β-GP) ratios. The gelation time, swelling ratio, the shape, and surface morphology of the prepared gels were investigated to select the formulation with optimum characteristics. The left TMJ in 13 adult male New Zealand white rabbits was injected with 0.2 mL of Chitosan/β-glycerophosphate/HA while the right TMJ was injected with 0.2 mL of control solution of HA. Hyaluronic acid concentrations in experimental and control groups were measured using Hyaluronan Quantikine Enzyme-Linked Immunosorbent Assay Kit. In vitro characterization showed that both the Ch:β-GP ratio and incorporation of HA had a significant effect on gelation time, degree of swelling, and surface morphology of the hydrogels. No morphological changes were observed in the joints in both groups. The mean concentration of HA in the experimental joints after 7 days (1339.79 ± 244.98 μg/g) was significantly higher than that in the control (474.52 ± 79.36 μg/g). In conclusion, the chitosan-based thermosensitive hydrogel can be considered as a promising controlled drug release system to the TMJ in a rabbit model that would potentially overcome many of the current limitations of intra-articular formulations. PMID:27100649

  6. Neurology of the temporomandibular joints: an experimental study.

    PubMed Central

    Clark, R. K.

    1976-01-01

    Experiments on anaesthetized cats are described in which the reflex effects of stimulation of the mechanoreceptors in the temporomandibular joints on the ipsilateral and contralateral mandibular muscles were studied. The effects on this reflex activity and on dynamic manidublar muscle activity of the production of temporary and permanent dysfunction of the mechanoreceptors in different regions of the joint capsule were also studied. The significance of the findings in relation to the maintenance of normal jaw posture and the disturbance of mandibular muscular function by trauma, disease, and malocclusion is discussed. PMID:1259326

  7. Management of the temporomandibular joint in rheumatoid disorders.

    PubMed

    Sidebottom, A J; Salha, R

    2013-04-01

    This article summarises the rheumatoid diseases that particularly affect the temporomandibular joint (TMJ): psoriatic arthropathy, ankylosing spondylitis, and rheumatoid arthritis. Management is by a joint approach between rheumatologists and maxillofacial surgeons with a specific interest in diseases of the TMJ who give early surgical advice. Steroid injections, whilst useful in the short term, are not useful for long term or repeated treatment, and may lead to collapse of the joint and development of a deformed anterior open bite. These disorders should be managed primarily using standard conservative regimens, and failure to respond should lead to diagnostic or therapeutic arthroscopy and appropriate surgical treatment. When ankylosis develops or the joint collapses, a replacement joint should be considered and patients should be referred to an appropriately trained surgeon. PMID:22658606

  8. Early magnetic resonance imaging control after temporomandibular joint arthrocentesis

    PubMed Central

    Ângelo, David Faustino; Sousa, Rita; Pinto, Isabel; Sanz, David; Gil, F. Monje; Salvado, Francisco

    2015-01-01

    Temporomandibular joint (TMJ) lysis and lavage arthrocentesis with viscosupplementation are an effective treatment for acute disc displacement (DD) without reduction. Clinical success seems to be related to multiple factors despite the lack of understanding of its mechanisms. The authors present a case report of 17-year-old women with acute open mouth limitation (12 mm), right TMJ pain-8/10 visual analog scale, right deviation when opening her mouth. The clinical and magnetic resonance imaging (MRI) diagnosis was acute DD without reduction of right TMJ. Right TMJ arthrocentesis was purposed to the patient with lysis, lavage, and viscosupplementation of the upper joint space. After 5 days, a new MRI was performed to confirm upper joint space distension and disc position. Clinical improvement was obtained 5 days and 1 month after arthrocentesis. Upper joint space increased 6 mm and the disc remained displaced. We report the first early TMJ MRI image postoperative, with measurable upper joint space. PMID:26981483

  9. Early magnetic resonance imaging control after temporomandibular joint arthrocentesis.

    PubMed

    Ângelo, David Faustino; Sousa, Rita; Pinto, Isabel; Sanz, David; Gil, F Monje; Salvado, Francisco

    2015-01-01

    Temporomandibular joint (TMJ) lysis and lavage arthrocentesis with viscosupplementation are an effective treatment for acute disc displacement (DD) without reduction. Clinical success seems to be related to multiple factors despite the lack of understanding of its mechanisms. The authors present a case report of 17-year-old women with acute open mouth limitation (12 mm), right TMJ pain-8/10 visual analog scale, right deviation when opening her mouth. The clinical and magnetic resonance imaging (MRI) diagnosis was acute DD without reduction of right TMJ. Right TMJ arthrocentesis was purposed to the patient with lysis, lavage, and viscosupplementation of the upper joint space. After 5 days, a new MRI was performed to confirm upper joint space distension and disc position. Clinical improvement was obtained 5 days and 1 month after arthrocentesis. Upper joint space increased 6 mm and the disc remained displaced. We report the first early TMJ MRI image postoperative, with measurable upper joint space. PMID:26981483

  10. Body posture evaluations in subjects with internal temporomandibular joint derangement.

    PubMed

    Munhoz, Wagner Cesar; Marques, Amélia Pasqual

    2009-10-01

    The aim of this study was to verify possible relationships between global body posture and temporomandibular joint internal derangement (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Body posture was assessed using the analysis of muscle chains on several photographs. Results show a higher frequency of lifted shoulders (p=0.04) and of changes in the antero-internal hip chain (p=0.02) in the test group, but no further differences were found significant between the control and test groups. The test group was then divided into three subgroups according to the Helkimo index of temporomandibular disorder severity. Again, no significant differences were found between the subgroups. However, there was a trend noticed in the group with the most severe dysfunction, to present a forward head and shoulders posture. Results are discussed in light of previous studies using the same sample. PMID:19891257

  11. Ear pain following temporomandibular surgery originating from the temporomandibular joint or the cranial nervous tissue? A case report.

    PubMed

    Geerse, Wouter K; von Piekartz, Harry J M

    2015-02-01

    A patient presenting with local pain and limitation of movement in the temporomandibular region following surgery of the left temporomandibular joint (TMJ) is described. Manual techniques like distraction of the TMJ combined with motor control exercises to restore TMJ function were not sufficient to relieve the patient's symptoms and her orofacial functions. However, during manual assessment and treatment of cranial nervous tissue, in this case the auriculotemporal nerve and its interface, pain was relieved and orofacial functions improved. PMID:24948551

  12. Temporomandibular joints: high-resolution computed tomographic evaluation

    SciTech Connect

    Thompson, J.R.; Christiansen, E.; Hasso, A.N.; Hinshaw, D.B. Jr.

    1984-01-01

    High-resolution computed tomography of the temporomandibular joint (TMJ) was performed in 43 patients. Exquisite detail of the face, skull base, and TMJs was obtained with CT using soft tissue and bone algorithms, narrow collimation, and multiplanar images. In 10 patients clinically suspected of joint derangement, CT results were in close agreement with surgical findings and arthrography in 13/15 joints. CT showed indirect signs of disc dislocation, and the dislocated disc itself in 81% of affected joints. In two patients, arthrography with CT proved to be more helpful than conventional arthrography alone. CT without intra-articular contrast material provided information not appreciated on conventional radiogaphs in 28 patients (65%) and was particularly helpful in evaluating patients with disc pathosis and trauma. Early experience with CT of the TMJ shows that it is an excellent method of evaluation at acceptable radiation exposure levels that adds essential information not seen on standard radiographs.

  13. Genetic Influences on Temporomandibular Joint Development and Growth.

    PubMed

    Hinton, Robert J; Jing, Junjun; Feng, Jian Q

    2015-01-01

    The temporomandibular joint (TMJ) is a small synovial joint at which the mandible articulates with the skull during movements involved in speaking and mastication. However, the secondary cartilage lining its joint surfaces is indicative of a very different developmental history than limb cartilages. This review summarizes our current knowledge of genes that regulate the formation of primary components of the TMJ, as well as genes that regulate postnatal growth of the TMJ. Although the TMJ is regulated by some of the same genes that are important in limb joints, others appear unique to the TMJ or have different actions. Runx2, Sox9, and members of the TGF-β/BMP family are critical drivers of chondrogenesis during condylar cartilage morphogenesis, and Indian hedgehog (Ihh) is important for formation of the articular disc and cavitation. Osterix (Osx) is a critical regulator of endochondral bone formation during postnatal TMJ growth. PMID:26589922

  14. Imaging of Temporomandibular Joint: Approach by Direct Volume Rendering

    PubMed Central

    Caradonna, Carola; Bruschetta, Daniele; Vaccarino, Gianluigi; Milardi, Demetrio

    2014-01-01

    Background: The purpose of this study was to conduct a morphological analysis of the temporomandibular joint, a highly specialized synovial joint that permits movement and function of the mandible. Materials and Methods: We have studied the temporom-andibular joint anatomy, directly on the living, from 3D images obtained by medical imaging Computed Tomography and Nuclear Magnetic Resonance acquisition, and subsequent re-engineering techniques 3D Surface Rendering and Volume Rendering. Data were analysed with the goal of being able to isolate, identify and distinguish the anatomical structures of the joint, and get the largest possible number of information utilizing software for post-processing work. Results: It was possible to reproduce anatomy of the skeletal structures, as well as through acquisitions of Magnetic Resonance Imaging; it was also possible to visualize the vascular, muscular, ligamentous and tendinous components of the articular complex, and also the capsule and the fibrous cartilaginous disc. We managed the Surface Rendering and Volume Rendering, not only to obtain three-dimensional images for colour and for resolution comparable to the usual anatomical preparations, but also a considerable number of anatomical, minuter details, zooming, rotating and cutting the same images with linking, graduating the colour, transparency and opacity from time to time. Conclusion: These results are encouraging to stimulate further studies in other anatomical districts. PMID:25664280

  15. Temporomandibular Joint Hypermobility Manifestation Based on Clinical Observations

    PubMed Central

    Nosouhian, Saeid; Haghighat, Abbas; Mohammadi, Iman; Shadmehr, Elham; Davoudi, Amin; Badrian, Hamid

    2015-01-01

    Background: Joint range of motion might affected by some factors like laxity and increase joint mobility. Generalized joint hypermobility and temporomandibular joint hypermobility (TMJH) are reported as risk factors for temporomandibular disorders. The aim of this study was to survey the etiological factors of TMJH and its relations to habitual status. Materials and Methods: In this cross-sectional descriptive study, 69 patients with TMJH were involved. After profiling personal information and medical history, the patients were divided into three groups based on their maximum mouth opening (MMO) as follow: (Light) MMO of 50-55 mm, (moderate): MMO between 55 and 65 mm, (severe) MMO >65 mm. For subjective observations, patients were asked to fill the prepared questionnaire. The objective evaluations conducted by a specialist. Finally, all the data subjected Chi-Square test by using SPSS software version 22 at a significant level of 0.05. Results: TMJH was more common in women (74.2%). The light group had significant differences with other groups in the discomfort of TMJ and TMJ sound (P < 0.05). Furthermore, sever group manifested highest percentage of masticatory pains, significantly (P < 0.05). Conclusion: It can be concluded that pain in TMJ would have a correlation with MMO. PMID:26464530

  16. Bilateral Temporomandibular Joint Replacement Using Computer-Assisted Surgical Simulation and Three-Dimensional Printing.

    PubMed

    Ryu, Jaeyoung; Cho, Jinyong; Kim, Hyeon Min

    2016-07-01

    The dental occlusion is the important reference for replacement of the temporomandibular joint. If a patient does not have normal occlusion, few considerations are needed for temporomandibular joint replacement. The custom-made prosthesis, typically fabricated with a stereolithographic model, is probably the optimized solution currently available. However the ready-made stock from Biomet Microfixation System (Jacksonville, FL) is the only available product, which is authorized by the government ministry in South Korea, for replacement of the temporomandibular joint. This report presents a patient with the problems that were retrognathic "bird face" profile subsequent to severe bilateral condylar resorption and temporomandibular joint ankylosis without enough natural teeth for occlusion. Bilateral temporomandibular joint replacement using the ready-made prosthesis was done by reestablishing the mandibular position with new occlusion and improved facial profile via the virtual surgical planning and stereolithographic model simulation. PMID:27315318

  17. Septic arthritis of the temporomandibular joint: a case report

    PubMed Central

    2016-01-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature. PMID:27595091

  18. A conservative surgical approach to temporomandibular joint ankylosis.

    PubMed

    Guarda-Nardini, Luca; Cocilovo, Francesco; Olivo, Marco; Ferronato, Giuseppe; Manfredini, Daniele

    2014-05-01

    The current article describes a case of a patient with temporomandibular joint (TMJ) ankylosis undergoing surgery performed with a tailored technique for condylar reshaping. A patient with posttraumatic bilateral TMJ ankylosis underwent interpositional arthroplasty with temporalis fascia, and focus was put on the need to maintain the vertical height of the mandible. The postoperative course was uneventful, and positive outcomes were kept during a 1-year follow-up span. The adoption of surgical strategies aiming at restoring a condylar shape as similar as possible to the natural one may be important in the light of the search for surgeries providing and/or recreating normal function of the TMJ. PMID:24705240

  19. Septic arthritis of the temporomandibular joint: a case report.

    PubMed

    Yang, Sung-Won; Cho, Jin-Yong; Kim, Hyeon-Min

    2016-08-01

    Septic arthritis of the temporomandibular joint (TMJ) is a rare disease. The most common symptoms of this disease are acute malocclusion, limited mouth opening, swelling, and tenderness of affected TMJ. These symptoms are often confused with internal derangement of the articular disc, rheumatoid arthritis, retrodiscitis, or osteoarthritis. Therefore, differential diagnosis by image examination is required. Usually, antimicrobial treatment and surgical drainage by needle aspiration, arthroscopy, or arthrotomy are effective treatment approaches. In this study, a patient who was diagnosed with septic arthritis was treated with arthrocentesis and antibiotics without significant complications. We present a case report with a review of the literature. PMID:27595091

  20. Bilateral Traumatic Temporomandibular Joint Luxation in a Rat

    PubMed Central

    Shientag, Lisa J; Rosenthal, Karen L; Chandler, Heidi K; Wheeler, Suzanne M

    2011-01-01

    Bilateral temporomandibular joint (TMJ) luxation was diagnosed postmortem in a female, 6-mo-old CD rat (Rattus norvegicus) after probable head entrapment and subsequent disentanglement from a protective jacket. Clinical antemortem signs included inability to close her mouth, prehend food and drink water, anxiety, and linear skin erosions extending down the right and left commissures of the mouth. Radiography revealed rostral displacement of the mandible with concomitant malocclusion. The combination of clinical signs, acute nature of the presentation, and torn appearance of the protective jacket were strongly indicative of a traumatic etiology. To our knowledge, this is the first reported case of TMJ luxation in a rat. PMID:22330578

  1. Component Approach to the Temporomandibular Joint and Coronoid Process

    PubMed Central

    Pfaff, Miles J.; Clune, James; Steinbacher, Derek

    2014-01-01

    Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar. PMID:25383157

  2. Component approach to the temporomandibular joint and coronoid process.

    PubMed

    Pfaff, Miles J; Clune, James; Steinbacher, Derek

    2014-12-01

    Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar. PMID:25383157

  3. Deficient cytokine control modulates temporomandibular joint pain in rheumatoid arthritis.

    PubMed

    Ahmed, Neveen; Catrina, Anca I; Alyamani, Ahmed O; Mustafa, Hamid; Alstergren, Per

    2015-08-01

    The aim was to investigate how endogenous cytokine control of tumor necrosis factor (TNF) influences temporomandibular joint (TMJ) pain in relation to the role of anti-citrullinated peptide antibodies (ACPA) in patients with rheumatoid arthritis (RA). Twenty-six consecutive patients with TMJ RA were included. Temporomandibular joint pain intensity was assessed at rest, on maximum mouth opening, on chewing, and on palpation. Mandibular movement capacity and degree of anterior open bite (a clinical sign of structural destruction of TMJ tissues) were also assessed. Systemic inflammatory activity was assessed using the Disease Activity Score in 28 joints (DAS28) for rheumatoid arthritis. Samples of TMJ synovial fluid and blood were obtained and analyzed for TNF, its soluble receptor, soluble TNF receptor II (TNFsRII), and ACPA. A high concentration of TNF in relation to the concentration of TNFsRII in TMJ synovial fluid was associated with TMJ pain on posterior palpation on maximum mouth opening. The ACPA concentration correlated significantly to the TNF concentration, but not to the TNFsRII concentration, indicating that increased inflammatory activity is mainly caused by an insufficient increase in anti-inflammatory mediators. This study indicates that TMJ pain on palpation in patients with RA is related to a deficiency in local cytokine control that contributes to increased inflammatory activity, including sensitization to mechanical stimuli over the TMJ. PMID:26010823

  4. Pigmented Villonodular Synovitis of the Temporomandibular Joint: A Unique Presentation.

    PubMed

    Pianosi, Kiersten; Rigby, Matthew; Hart, Robert; Trites, Jonathan; Taylor, S Mark

    2016-04-01

    Pigmented villonodular synovitis (PVNS) is a rare and benign proliferative disorder of synovium with potentially locally aggressive growth and invasion of the bone. Occurring within the joints, tendon sheaths, and bursae, it is most commonly a monoarticular disease affecting large joints. In particular, most cases of PVNS occur in the knee. PVNS of the temporomandibular joint (TMJ) is a highly rare disorder, with approximately 60 cases reported. Herein, we present a unique case of an elderly male presenting with ear pain and subsequently diagnosed with PVNS of the TMJ with a history of trauma to the area. Initial imaging of the TMJ and the surrounding region looked concerning for invasive and/or malignant disease, but an open biopsy confirmed PVNS. PMID:27200236

  5. Pigmented Villonodular Synovitis of the Temporomandibular Joint: A Unique Presentation

    PubMed Central

    Rigby, Matthew; Hart, Robert; Trites, Jonathan; Taylor, S. Mark

    2016-01-01

    Summary: Pigmented villonodular synovitis (PVNS) is a rare and benign proliferative disorder of synovium with potentially locally aggressive growth and invasion of the bone. Occurring within the joints, tendon sheaths, and bursae, it is most commonly a monoarticular disease affecting large joints. In particular, most cases of PVNS occur in the knee. PVNS of the temporomandibular joint (TMJ) is a highly rare disorder, with approximately 60 cases reported. Herein, we present a unique case of an elderly male presenting with ear pain and subsequently diagnosed with PVNS of the TMJ with a history of trauma to the area. Initial imaging of the TMJ and the surrounding region looked concerning for invasive and/or malignant disease, but an open biopsy confirmed PVNS. PMID:27200236

  6. Synovial Chondromatosis of the Temporomandibular Joint Successfully Treated by Surgery.

    PubMed

    Pinto, Aécio Abner Campos; Ferreira e Costa, Rafael; de Sousa, Sílvia Ferreira; Chagas, Marcelo Roncalli Pinheiro; do Carmo, Maria Auxiliadora Vieira; de Lacerda, Júlio César Tanos

    2015-12-01

    Synovial chondromatosis (SC) is a chronic process, defined as a reactive cartilaginous proliferation, characterized by formation of cartilaginous nodules, usually loose in the joint space of the synovial membrane. It mainly affects large joints such as knee, hip, shoulder, and elbow, commonly in male patients. However, its manifestation in the Temporomandibular joint (TMJ), is a rare finding, occurring predominantly in females. This paper reports a case of a woman who presented to the service of Stomatology complaining of mouth opening limitations and pain in her left pre-auricular region. After clinical and radiographic analyses, the condition was diagnosed as SC of the TMJ. The loose bodies within the TMJ were removed under general anesthesia. Histological and follow-up features of this lesion are also discussed. To our knowledge, this is the second report of SC of the TMJ in Brazil. PMID:25912648

  7. Multidetector computed tomography of temporomandibular joint: A road less travelled

    PubMed Central

    Pahwa, Shivani; Bhalla, Ashu Seith; Roychaudhary, Ajoy; Bhutia, Ongkila

    2015-01-01

    This article reviews the imaging anatomy of temporomandibular joint (TMJ), describes the technique of multi-detector computed tomography (MDCT) of the TMJ, and describes in detail various osseous pathologic afflictions affecting the joint. Traumatic injuries affecting the mandibular condyle are most common, followed by joint ankylosis as a sequel to arthritis. The congenital anomalies are less frequent, hemifacial microsomia being the most commonly encountered anomaly involving the TMJ. Neoplastic afflictions of TMJ are distinctly uncommon, osteochondroma being one of the most common lesions. MDCT enables comprehensive evaluation of osseous afflictions of TMJ, and is a valuable tool for surgical planning. Sagittal, coronal and 3D reformatted images well depict osseous TMJ lesions, and their relationship to adjacent structures. PMID:25984518

  8. Magnetic resonance imaging of the temporomandibular joint in children with juvenile idiopathic arthritis.

    PubMed

    Meyers, Arthur B; Laor, Tal

    2013-12-01

    For more than a century, it has been known that juvenile idiopathic arthritis (JIA) can affect the temporomandibular joint. With advances in medical imaging in more recent decades, there has been an increase in awareness of the spectrum of pathology that can affect the temporomandibular joint in children with JIA. This pathology can lead to symptoms ranging from decreased chewing ability, jaw and facial pain, headaches and malocclusion to craniofacial morphological changes such as a retrognathic mandible. The purpose of this review is to suggest an MR imaging protocol for the temporomandibular joint and to illustrate normal and abnormal appearances of the joint in children with JIA. PMID:24257698

  9. Stem Cells for Temporomandibular Joint Repair and Regeneration.

    PubMed

    Zhang, Shipin; Yap, Adrian U J; Toh, Wei Seong

    2015-10-01

    Temporomandibular Disorders (TMD) represent a heterogeneous group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles and/or associated structures. They are a major cause of non-dental orofacial pain. As a group, they are often multi-factorial in nature and have no common etiology or biological explanations. TMD can be broadly divided into masticatory muscle and TMJ disorders. TMJ disorders are characterized by intra-articular positional and/or structural abnormalities. The most common type of TMJ disorders involves displacement of the TMJ articular disc that precedes progressive degenerative changes of the joint leading to osteoarthritis (OA). In the past decade, progress made in the development of stem cell-based therapies and tissue engineering have provided alternative methods to attenuate the disease symptoms and even replace the diseased tissue in the treatment of TMJ disorders. Resident mesenchymal stem cells (MSCs) have been isolated from the synovia of TMJ, suggesting an important role in the repair and regeneration of TMJ. The seminal discovery of pluripotent stem cells including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) have provided promising cell sources for drug discovery, transplantation as well as for tissue engineering of TMJ condylar cartilage and disc. This review discusses the most recent advances in development of stem cell-based treatments for TMJ disorders through innovative approaches of cell-based therapeutics, tissue engineering and drug discovery. PMID:26123357

  10. Congenital Temporomandibular Joint Ankylosis: Case Report and Literature Review.

    PubMed

    Cheong, Ryan Chin Taw; Kassam, Karim; Eccles, Simon; Hensher, Robert

    2016-01-01

    Congenital temporomandibular joint (TMJ) ankylosis is an uncommon condition that presents itself at or soon after birth in the absence of acquired factors that could have contributed to the ankylosis such as infection and trauma. The experience of managing one such case is reported in light of a review of the literature on this condition. Key management principles include adequate removal of the ankylotic mass, costochondral grafting, and post-op physiotherapy. Most patients reported in the literature with the condition experienced relapse. This echoes our own experience where there was recurrence of the ankylosis. However, after removal of the ankylotic mass, the patient maintains a satisfactory maximal incisal opening (MIO) till the present day. The additional challenges faced in the congenital form in addition to the already complex management of acquired paediatric temporomandibular joint ankylosis are (1) much earlier insult to the TMJ, (2) reduced opportunity for neuromuscular development of the muscles of mastication, and (3) reduced compliance with postoperative physiotherapy programmes due to the younger age of these patients. PMID:27190665

  11. Congenital Temporomandibular Joint Ankylosis: Case Report and Literature Review

    PubMed Central

    Cheong, Ryan Chin Taw; Kassam, Karim; Eccles, Simon; Hensher, Robert

    2016-01-01

    Congenital temporomandibular joint (TMJ) ankylosis is an uncommon condition that presents itself at or soon after birth in the absence of acquired factors that could have contributed to the ankylosis such as infection and trauma. The experience of managing one such case is reported in light of a review of the literature on this condition. Key management principles include adequate removal of the ankylotic mass, costochondral grafting, and post-op physiotherapy. Most patients reported in the literature with the condition experienced relapse. This echoes our own experience where there was recurrence of the ankylosis. However, after removal of the ankylotic mass, the patient maintains a satisfactory maximal incisal opening (MIO) till the present day. The additional challenges faced in the congenital form in addition to the already complex management of acquired paediatric temporomandibular joint ankylosis are (1) much earlier insult to the TMJ, (2) reduced opportunity for neuromuscular development of the muscles of mastication, and (3) reduced compliance with postoperative physiotherapy programmes due to the younger age of these patients. PMID:27190665

  12. Effects of COX-2 inhibitor in temporomandibular joint acute inflammation.

    PubMed

    Schütz, T C B; Andersen, M L; Tufik, S

    2007-05-01

    Since it is recognized that cyclo-oxygenase-2 mediates nociception and the sleep-wake cycle as well, and that acute inflammation of the temporomandibular joint (TMJ) results in sleep disturbances, we hypothesized that cyclo-oxygenase-2 inhibitor would restore the sleep pattern in this inflammatory rat model. First, sleep was monitored after the injection of Freund's adjuvant (FA group) or saline (SHAM group) into the rats' temporomandibular joint. Second, etoricoxib was co-administered in these groups. The Freund's adjuvant group showed a reduction in sleep efficiency, in rapid eye movement (REM), and in non-REM sleep, and an increase in sleep and REM sleep latency when compared with the SHAM group, while etoricoxib substantially increased sleep quality in the Freund's adjuvant group. These parameters returned progressively to those found in the SHAM group. Etoricoxib improved the sleep parameters, suggesting the involvement of the cyclo-oxygenase-2 enzyme in acute inflammation of the TMJ, specifically in REM sleep. PMID:17452571

  13. Fibrous Ankylosis of the Temporomandibular Joint in a Young Child.

    PubMed

    Figueiredo, Nigel R; Meena, Manoj; Dinkar, Ajit D; Khorate, Manisha M

    2015-01-01

    Temporomandibular joint (TMJ) ankylosis is an intracapsular union of the disccondyle complex to the temporal articular surface that restricts mandibular movements, including fibrous adhesions or bony fusion between the condyle, disc, glenoid fossa, and articular eminence. The leading causes include trauma and infection. It can be a serious and disabling condition that leads to difficulties in mastication, swallowing, speaking, esthetics and oral hygiene. Disturbances of facial and mandibular growth and acute compromise of the airway invariably result in physical and psychological disability. Treatment should be initiated as soon as the condition is recognized, with the main objective of re-establishing joint function and harmonious jaw function. The purpose of this report is to describe a case of unilateral fibrous ankylosis of the right TMJ in a three-year-old girl. PMID:26349799

  14. Temporomandibular joint disorders' impact on pain, function, and disability.

    PubMed

    Chantaracherd, P; John, M T; Hodges, J S; Schiffman, E L

    2015-03-01

    The aim of this study was to determine the association between more advanced stages of temporomandibular joint (TMJ) intra-articular disorders ("TMJ intra-articular status"), representing a transition from normal joint structure to TMJ disc displacement with and without reduction (DDwR and DDwoR) to degenerative joint disease (DJD), and patient-reported outcomes of jaw pain, function, and disability ("TMD impact"). This cross-sectional study included 614 cases from the RDC/TMD Validation Project with at least one temporomandibular disorder (TMD) diagnosis. TMJ intra-articular status was determined by 3 blinded, calibrated radiologists using magnetic resonance imaging and computed tomography as one of normal joint structure, DDwR, DDwoR, or DJD, representing the subject's most advanced TMJ diagnosis. TMD impact was conceptualized as a latent variable consisting of 1) pain intensity (Characteristic Pain Index from the Graded Chronic Pain Scale [GCPS]), 2) jaw function (Jaw Functional Limitation Scale), and 3) disability (Disability Points from GCPS). A structural equation model estimated the association of TMJ intra-articular status with the latent measure TMD impact as a correlation coefficient in all TMD cases (n = 614) and in cases with a TMD pain diagnosis (n = 500). The correlations between TMJ intra-articular status and TMD impact were 0.05 (95% confidence interval [CI], -0.04 to 0.13) for all TMD cases and 0.07 (95% CI, -0.04 to 0.17) for cases with a pain diagnosis, which are neither statistically significant nor clinically relevant. Conceptualizing worsening of TMJ intra-articular disorders as 4 stages and characterizing impact from TMD as a composite of jaw pain, function, and disability, this cross-sectional study found no clinically significant association. Models of TMJ intra-articular status other than ours (normal structure → DDwR → DDwoR → DJD) should be explored. PMID:25572112

  15. The arterial blood supply of the temporomandibular joint: an anatomical study and clinical implications

    PubMed Central

    Caradonna, Carola; Caradonna, Domenico; Anastasi, Giuseppe; Milardi, Demetrio; Favaloro, Angelo; De Pietro, Anita; Angileri, Tommaso Maurizio; Caradonna, Luigi; Cutroneo, Giuseppina

    2013-01-01

    Purpose The aim of this study was to analyze three-dimensional images of the arterial supply to the temporomandibular joint. Materials and Methods Ten patients (five men and five women, mean age 36 years) without signs or symptoms of temporomandibular disorders, who underwent contrast-enhanced computed tomographic (CT) scanning with intravenous contrast, were studied. The direct volume rendering technique of CT images was used, and a data set of images to visualize the vasculature of the human temporomandibular joint in three dimensions was created. After elaboration of the data through post-processing, the arterial supply of the temporomandibular joint was studied. Results The analysis revealed the superficial temporal artery, the anterior tympanic artery, the deep temporal artery, the auricular posterior artery, the transverse facial artery, the middle meningeal artery, and the maxillary artery with their branches as the main arterial sources for the lateral and medial temporomandibular joint. Conclusion The direct volume rendering technique was found to be successful in the assessment of the arterial supply to the temporomandibular joint. The superficial temporal artery and maxillary artery ran along the lateral and medial sides of the condylar neck, suggesting that these arteries are at increased risk during soft-tissue procedures such as an elective arthroplasty of the temporomandibular joint. PMID:23525363

  16. Coronal joint spaces of the Temporomandibular joint: Systematic review and meta-analysis

    PubMed Central

    Silva, Joana-Cristina; Pires, Carlos A.; Ponces-Ramalhão, Maria-João-Feio; Lopes, Jorge-Dias

    2015-01-01

    Introduction The joint space measurements of the temporomandibular joint have been used to determine the condyle position variation. Therefore, the aim of this study is to perform a systematic review and meta-analysis on the coronal joint spaces measurements of the temporomandibular joint. Material and Methods An electronic database search was performed with the terms “condylar position”; “joint space”AND”TMJ”. Inclusionary criteria included: tomographic 3D imaging of the TMJ, presentation of at least two joint space measurements on the coronal plane. Exclusionary criteria were: mandibular fractures, animal studies, surgery, presence of genetic or chronic diseases, case reports, opinion or debate articles or unpublished material. The risk of bias of each study was judged as high, moderate or low according to the “Cochrane risk of bias tool”. The values used in the meta-analysis were the medial, superior and lateral joint space measurements and their differences between the right and left joint. Results From the initial search 2706 articles were retrieved. After excluding the duplicates and all the studies that did not match the eligibility criteria 4 articles classified for final review. All the retrieved articles were judged as low level of evidence. All of the reviewed studies were included in the meta-analysis concluding that the mean coronal joint space values were: medial joint space 2.94 mm, superior 2.55 mm and lateral 2.16 mm. Conclusions the analysis also showed high levels of heterogeneity. Right and left comparison did not show statistically significant differences. Key words:Temporomandibular joint, systematic review, meta-analysis. PMID:26330944

  17. Manual therapy of the mandibular accessory ligaments for the management of temporomandibular joint disorders.

    PubMed

    Cuccia, Antonino Marco; Caradonna, Carola; Caradonna, Domenico

    2011-02-01

    Temporomandibular joint disorders are characterized by chronic or acute musculoskeletal or myofascial pain with dysfunction of the masticatory system. Treatment modalities include occlusal splints, patient education, activity modification, muscle and joint exercises, myofascial therapy, acupuncture, and manipulative therapy. In the physiology of the temporomandibular joint, accessory ligaments limit the movement of the mandible. A thorough knowledge of the anatomy of accessory ligaments is necessary for good clinical management of temporomandibular joint disorders. Although general principles regarding the anatomy of the ligaments are relatively clear, very little substantiated information on the dimension, orientation, and function of the ligaments has been published, to the authors' knowledge. The authors review the literature concerning the accessory ligaments of the temporomandibular joint and describe treatment options, including manual techniques for mobilizing the accessory ligaments. PMID:21357496

  18. Pseudotumor in the temporomandibular joint: A case report

    PubMed Central

    Yoshitake, Hiroyuki; Kayamori, Kou; Nakamura, Ryosuke; Wake, Sou; Harada, Kiyoshi

    2015-01-01

    Introduction Neoplastic disease in the temporomandibular joint (TMJ) is a rare condition and is difficult to differentiate from temporomandibular disorders (TMD) based on symptoms and simple X-ray examinations. Potential differential diagnoses include synovial chondromatosis and pseudotumor, both of which are also relatively rare in the TMJ. Presentation of case We report a case of pseudotumor of the TMJ that was difficult to differentiate from synovial chondromatosis in a 71-year-old woman with a chief complaint of pain in the left TMJ. MRI of the right TMJ initially led to diagnosis of synovial chondromatosis. Extirpation of the lesion was performed under general anesthesia. Histopathological findings of the resected specimen revealed inflammatory granulation tissue without cellular atypism. Discussion The pathological findings for the resected specimen were compatible with pseudotumor of the TMJ. These findings were not supportive of synovial chondromatosis or other tumor diseases. Conclusion This case illustrates the importance of careful examination of a mass lesion in the TMJ for differentiation from other TMJ-related diseases. PMID:26298241

  19. Diagnostic accuracy of double-contrast arthrotomography of the temporomandibular joint: correlation with postmortem morphology

    SciTech Connect

    Westesson, P.L.; Rohlin, M.

    1984-09-01

    The diagnostic accuracy of double-contrast arthrotomography in the evaluation of internal derangement of the temporomandibular joint is unknown. Therefore, findings from double-contrast arthrotomograms of 48 temporomandibular joint autopsy specimens were correlated with postmortem morphology seen from dissections or cryosections. Arthrotomographic diagnosis was confirmed in 41 joints, signifying a diagnostic accuracy of 85%. Misinterpretations were made in seven joints. False-positive reports due to observation errors can be avoided with improved knowledge of the joint anatomy as well as with increased experience in the technique. False-negative examinations were due to limitation of the tomographic reproduction of the lateral part of the joint.

  20. [MRI of the temporomandibular joint--the gold standard].

    PubMed

    Barmeir, E; Teich, S; Gutmcher, Z

    2014-04-01

    MRI has been established as the imaging modality of choice for the evaluation of temporomandibular joint disorders (TMD), as it allows for a noninvasive detailed evaluation of the joint that is not otherwise available. During the last decade, the introduction of dynamic (cine-mode) MR imaging has made functional evaluation feasible in addition to the morphologic study of the joint. The major advantage of MRI is its ability to study the articular disc and its congruity as well as its location relative to the condyle in both closed- and open-mouth positions. Due to its high contrast resolution, MRI is unique in demonstrating joint effusion, bone edema and sclerosis, rupture of the retrodiscal layers and impairment of the lateral pterigoid muscle. In Mor-Mar Imaging Center we performed during the last two years MRI studies of the TMJ in 234 subjects, 172 (74%) female and 62 (26%) male patients. The average age of the patients was 29 years. In this article we present our experience in the evaluation of TMD and review the main indications and findings. In addition, our experience in optimizing the MRI sequence protocols in both static and dynamic modes are discussed. MRI examinations provide the clinician with anatomic and physiologic information that can guide treatment decisions. It has a special role in monitoring and evaluating treatment results, both conservative and surgical. PMID:25252468

  1. Can orthodontic relapse be blamed on the temporomandibular joint?

    PubMed Central

    Wolford, Larry M

    2014-01-01

    There are many temporomandibular joint (TMJ) conditions that can cause orthodontic treatment instability and relapse. These conditions are often associated with dentofacial deformities, malocclusion, TMJ pain, headaches, myofascial pain, TMJ and jaw functional impairment, ear symptoms, etc., Many of these TMJ conditions can cause progressive and continuous changes in the occlusion and jaw relationships. Patients with these conditions may benefit from corrective orthodontic and surgical intervention. The difficulty for many clinicians may lie in identifying the presence of a TMJ condition, diagnosing the specific TMJ pathology, and selecting the proper treatment for that condition. This paper will discuss the most common TMJ pathologies that can adversely affect orthodontic stability and outcomes as well as present the treatment considerations to correct the specific TMJ conditions and associated jaw deformities to provide stable and predictable treatment results. PMID:25426452

  2. Osteochondroma with secondary synovial chondromatosis in the temporomandibular joint.

    PubMed

    Wang, Yiwen; Li, Lingzhi; Chen, Minjie; Yang, Chi

    2016-05-01

    Osteochondroma with secondary synovial chondromatosis is rare in the temporomandibular joint (TMJ), so we retrospectively reviewed 210 such patients who presented to our hospital from 2001-2013. The final sample included 3 patients with secondary synovial chondromatosis (mean (SD) age 40 (??) years), all of whom had symptoms of disorders of the TMJ. Condylar neoplasms and loose bodies were found during operation. Histopathological examination showed a bony growth capped with hyaline cartilage and clustering chondrocytes, with partial calcification and ossification of the loose bodies, and primary osteochondroma with secondary synovial chondromatosis was diagnosed. There were no recurrences during a follow-up that ranged from 3 months to 5 years. The presence of loose calcified bodies in osteochondroma is a possible sign of secondary synovial chondromatosis. PMID:26320566

  3. SAPHO syndrome of the temporomandibular joint associated with sudden deafness.

    PubMed

    Marsot-Dupuch, K; Doyen, J E; Grauer, W O; de Givry, S C

    1999-05-01

    We report a case of arthritis of the temporomandibular joint (TMJ) associated with sclerosing osteomyelitis of the mandible and temporal bone, causing deafness. The presence of a palmoplantar pustulosis established the diagnosis of SAPHO syndrome. SAPHO (an acronym referring to synovitis, acne, palmoplantar pustulosis, hyperostosis, and osteitis) syndrome is defined by the association of characteristic osteoarticular and dermatologic manifestations, with diffuse sclerosing osteomyelitis of the mandible being a part of this entity. We review the literature of SAPHO syndrome with mandibular manifestations and discuss the mechanisms of inflammatory spread from the TMJ to the cochlea. To our knowledge, this is the first description of skull base involvement in a patient with SAPHO syndrome leading to sudden deafness. PMID:10369364

  4. Temporomandibular Joint Ankylosis as a Complication of Neonatal Septic Arthritis

    PubMed Central

    Al-Saadi, Noor J.; Bakathir, Abdulaziz A.; Al-Hashmi, Ahmed K.; Al-Ismaili, Mohammad I.

    2015-01-01

    Temporomandibular joint (TMJ) ankylosis as a complication of neonatal septic arthritis is rarely reported in the literature. We report two clinical cases of unilateral TMJ ankylosis occurring in paediatric patients subsequent to neonatal septic arthritis. The first case was a 15-month-old male infant who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in May 2010. According to the published English scientific literature, he is the youngest person yet to be diagnosed with this condition. The second case was a five-year-old female who presented to the Al-Nahda Hospital, Muscat, Oman, in October 2011. Both cases presented with facial asymmetry and trismus. They subsequently underwent gap arthroplasty and interpositional temporalis muscle and fascia grafts which resulted in an immediate improvement in mouth opening. Postoperatively, the patients underwent active jaw physiotherapy which was initially successful. Both patients were followed up for a minimum of two years following their surgeries. PMID:26629387

  5. Detection of degenerative disease of the temporomandibular joint by bone scintigraphy: concise communication

    SciTech Connect

    Goldstein, H.A.; Bloom, C.Y.

    1980-10-01

    Nine patients with facial pain were evaluated with limited bone scans. The scintigrams correlated with microscopy in all patients, although radiographs correlated with microscopy in only five patients. The degenerative disease process in the temporomandibular joint was more extensive in the patients with radiographic and scintigraphic abnormalities than in those with scintigraphic abnormalities alone. The limited bone scan appears useful in detecting early degenerative changes in the temporomandibular joint.

  6. Lubricin protects the temporomandibular joint surfaces from degeneration.

    PubMed

    Hill, Adele; Duran, Juanita; Purcell, Patricia

    2014-01-01

    The temporomandibular joint (TMJ) is a specialized synovial joint essential for the mobility and function of the mammalian jaw. The TMJ is composed of the mandibular condyle, the glenoid fossa of the temporal bone, and a fibrocartilagenous disc interposed between these bones. A fibrous capsule, lined on the luminal surface by the synovial membrane, links these bones and retains synovial fluid within the cavity. The major component of synovial fluid is lubricin, a glycoprotein encoded by the gene proteoglycan 4 (Prg4), which is synthesized by chondrocytes at the surface of the articular cartilage and by synovial lining cells. We previously showed that in the knee joint, Prg4 is crucial for maintenance of cartilage surfaces and for regulating proliferation of the intimal cells in the synovium. Consequently, the objective of this study was to determine the role of lubricin in the maintenance of the TMJ. We found that mice lacking lubricin have a normal TMJ at birth, but develop degeneration resembling TMJ osteoarthritis by 2 months, increasing in severity over time. Disease progression in Prg4-/- mice results in synovial hyperplasia, deterioration of cartilage in the condyle, disc and fossa with an increase in chondrocyte number and their redistribution in clusters with loss of superficial zone chondrocytes. All articular surfaces of the joint had a prominent layer of protein deposition. Compared to the knee joint, the osteoarthritis-like phenotype was more severe and manifested earlier in the TMJ. Taken together, the lack of lubricin in the TMJ causes osteoarthritis-like degeneration that affects the articular cartilage as well as the integrity of multiple joint tissues. Our results provide the first molecular evidence of the role of lubricin in the TMJ and suggest that Prg4-/- mice might provide a valuable new animal model for the study of the early events of TMJ osteoarthritis. PMID:25188282

  7. Change of range of motion of the temporomandibular joint after correction of mild scoliosis.

    PubMed

    Park, Yongnam; Bae, Youngsook

    2014-08-01

    [Purpose] This study aimed to verify the change in range of motion of the temporomandibular joint on correction of scoliosis. [Subjects and Methods] This study examined 31 male and female participants in their 20s and 30s with a spinal curve degree of 10° or greater. The subjects performed therapeutic exercise based on the pilates exercise system, which is known to be effective in mitigating the spinal curve for patients with scoliosis. All participants completed an 8-week therapeutic exercise regimen to alleviate the scoliosis in which exercise was performed, the exercise was done three times a week for 8 weeks and each session lasted 60 minutes. Among them, 19 participants were selected as an experiment group, whose symptoms were mitigated significantly, and 12 participants who did not undergo the exercise were identified as a control group. All subject was assessed for spinal curve degree, apparent leg length discrepancy, and deviation and range of motion of the temporomandibular joint before and after the study. [Results] In the experimental group, the apparent leg length discrepancy and the deviation of the temporomandibular joint were significantly decreased after the exercise, and the ROM in the temporomandibular joint was significantly increased. In intergroup comparisons, all variables showed a significant difference. [Conclusion] The findings suggest that as the spinal curve degree decreases significantly, the range of motion and deviation in the temporomandibular joint showed a significant change, indicating that mild scoliosis may be a negative factor affecting the deviation and range of motion of the temporomandibular joint. PMID:25202172

  8. Absence of the articular disc in the tasmanian devil temporomandibular joint.

    PubMed

    Hayashi, K; Sugisaki, M; Kino, K; Ishikawa, T; Sugisaki, M; Abe, S

    2013-12-01

    The articular disc of the temporomandibular joint is a constant structure in mammals. According to Parsons' report in 1900, however, it is absent in four animals: the armadillo, two kinds of monotremes and the Tasmanian devil. Thereafter, no research was performed to confirm this observation. The aim of this study was to determine by anatomical and histological examination whether the Tasmanian devil has an articular disc in its temporomandibular joint. Six fresh frozen corpses and one dry skull of Tasmanian devils were obtained from the School of Zoology, University of Tasmania. The corpses were dissected and the morphology of the temporomandibular joint was carefully observed by gross anatomical and histological examination. The structure of the temporomandibular joint of the dry skull was examined macroscopically and by micro-computed tomography. In all cases, absence of the articular disc in the Tasmanian devil temporomandibular joint was morphologically confirmed. The surface layer of both the condyle and the glenoid fossa comprised a thick fibrous tissue. Micro-computed tomography revealed dense and fine trabecular bone in the condyle. The thick fibrous tissue covering the condyle and high-density trabecular bone in the condyle might play a role in absorption against powerful mastication and heavy loading of the Tasmanian devil temporomandibular joint. PMID:23438215

  9. High-resolution arthrosonography of the temporomandibular joint with video and computer support

    NASA Astrophysics Data System (ADS)

    Sader, Robert; Zeilhofer, Hans-Florian U.; Deppe, Herbert; Horch, Hans-Henning; Kling, Bettina

    1995-05-01

    Ultrasound imaging of the temporomandibular joint has been problematic due to the lower frequency of the transducers used up to the present time. Imaging of temporomandibular joint structures being utilizable for diagnosis and therapy was only possible through time-consuming and expensive radiological image yielding procedures (computertomography, magnetic resonance imaging). 84 temporomandibular joints in 42 patients were examined clinically, radiologically, by axiographic tracing, magnetic resonance imaging and ultrasound imaging. An ultrasound unit was used with a high- frequency 13MHz transducer. The temporomandibular joint was examined preauricularily; by this the lateral section of the joint could be represented. The image sequences in functional condylus movements were taped via a video output into a film recorder. Selected ultrasound images from the beginning to the end of the movement could then be digitalized and read into a personal computer to be evaluated. The computer then calculated a line of movement and the angle of the joint's course. By ultrasound imaging the joint space could be represented and measured clearly. Compared with the space measured in the magnetic resonance image the value determined by ultrasonography was a tenth power more exact. The computer-supported image analysis of the condylus movements led to an exact presentation of the condylus course. The sonographically determined condylar guidance corresponded to the value traced by axiography with high significance within a range of 3 degrees. The temporomandibular joint's disc could be localized just as exactly as with the magnetic resonance imaging. The use of a 13MHz transducer offers a new low-cost method of noninvasive dynamic imaging of important temporomandibular joint structures. The possibility of video and computer support enables movement analysis and opens new possibilities in the morphological and functional evaluation of the temporomandibular joint.

  10. Synovial fluid dynamics with small disc perforation in temporomandibular joint.

    PubMed

    Xu, Y; Zhan, J; Zheng, Y; Han, Y; Zhang, Z; Xi, Y; Zhu, P

    2012-10-01

    The articular disc plays an important role as a stress absorber in joint movement, resulting in stress reduction and redistribution in the temporomandibular joint (TMJ). The flow of synovial fluid in the TMJ may follow a regular pattern during movement of the jaw. We hypothesised that the regular pattern is disrupted when the TMJ disc is perforated. By computed tomography arthrography, we studied the upper TMJ compartment in patients with small disc perforation during jaw opening-closing at positions from 0 to 3 cm. Finite element fluid dynamic modelling was accomplished to analyse the pattern of fluid flow and pressure distribution during the movements. The results showed that the fluid flow in the upper compartment generally formed an anticlockwise circulation but with local vortexes with the jaw opening up to 2 cm. However, when the jaw opening-closing reached 3 cm, an abnormal flow field and the fluid pressure change associated with the perforation may increase the risk of perforation expansion or rupture and is unfavourable for self-repair of the perforated disc. PMID:22582815

  11. Effects of Enzymatic Degradation after Loading in Temporomandibular Joint

    PubMed Central

    Asakawa-Tanne, Y.; Su, S.; Kunimatsu, R.; Hirose, N.; Mitsuyoshi, T.; Okamoto, Y.; Tanaka, E.; Tanne, K.

    2015-01-01

    Synovial fluid of the joint decreases friction between the cartilage surfaces and reduces cartilage wear during articulation. Characteristic changes of synovial fluid have been shown in patients with osteoarthritis (OA) in the temporomandibular joint (TMJ). OA is generally considered to be induced by excessive mechanical stress. However, whether the changes in synovial fluid precede the mechanical overloading or vice versa remains unclear. In the present study, our purpose was to examine if the breakdown of joint lubrication affects the frictional properties of mandibular condylar cartilage and leads to subsequent degenerative changes in TMJ. We measured the frictional coefficient in porcine TMJ by a pendulum device after digestion with hyaluronidase (HAase) or trypsin. Gene expressions of interleukin-1β (IL-1β), cyclooxygenase-2 (COX-2), matrix metalloproteinases (MMPs), type II collagen, and histology were examined after prolonged cyclic loading by an active pendulum system. The results showed that the frictional coefficient increased significantly after HAase (35%) or trypsin (74%) treatment. Gene expression of IL-1β, COX-2, and MMPs-1, -3, and -9 increased significantly in enzyme-treated TMJs after cyclic loading. The increase in the trypsin-treated group was greater than that in the HAase-treated group. Type II collagen expression was reduced in both enzyme-treated groups. Histology revealed surface fibrillation and increased MMP-1 in the trypsin-treated group, as well as increased IL-1β in both enzyme-treated groups after cyclic loading. The findings demonstrated that the compromised lubrication in TMJ is associated with altered frictional properties and surface wear of condylar cartilage, accompanied by release of pro-inflammatory and matrix degradation mediators under mechanical loading. PMID:25503611

  12. Impact of temporomandibular joint pain in rheumatoid arthritis.

    PubMed

    Ahmed, Neveen; Mustafa, Hamid Masoud; Catrina, Anca Irinel; Alstergren, Per

    2013-01-01

    To investigate the impact of temporomandibular joint (TMJ) pain on daily activities and quality of life in relation to systemic inflammatory activity in patients with rheumatoid arthritis (RA), thirty-three consecutive outpatients with RA were included. TMJ pain intensity at rest, on maximum mouth opening, and on chewing was assessed on a 0-10 numerical rating scale. TMJ palpatory tenderness, degree of anterior open bite, the impact of TMJ pain on daily activities and quality of life were also assessed. The systemic inflammatory activity was estimated by the disease activity score 28 (DAS28), blood levels of inflammatory markers and number of painful musculoskeletal regions. TMJ pain at rest, on maximum mouth opening, and on chewing as well as DAS28 was correlated with the impact of the TMJ pain on daily activities and quality of life. Partial correlations showed a significant interaction between TMJ pain on movement and DAS28 that explained the TMJ pain impact on daily activities and quality of life to a significant degree. This study indicates that both current TMJ pain intensity and systemic inflammatory activity play roles in the impact of TMJ pain on daily living and quality of life in RA. PMID:24363501

  13. Pseudodynamic imaging of the temporomandibular joint: SE versus GE sequences

    SciTech Connect

    Masui, Takayuki; Isoda, Haruo; Mochizuki, Takao

    1996-05-01

    Pseudodynamic MR imaging of the temporomandibular joints (TMJs) has been used for the evaluation of the functional aspects of the TMJs. To evaluate the value of T1-weighted spin-echo (SE) and gradient-echo (GE) techniques, both techniques were performed in 9 asymptomatic (mean 25.7 years, 22-32 years), and 25 symptomatic (mean 44.9 years, 20-71 years) subjects with signs and symptoms of internal derangement or osteoarthrosis of the TMJs. The imaging time for the SE (180 ms / 15 ms / 110{degrees} repetition time / echo time /flip angle) and GE (fast low angle shot; FLASH, 90 ms / 12 ms / 40{degrees}) sequences was 27 and 28 s, respectively. In asymptomatic and symptomatic subjects, the confidence of the identification of the meniscal position was better on SE than GE images (3.6 {+-} 0.6 vs. 2.9 {+-} 0.9, p < 0.01, 3.2 {+-} 0.8 vs. 2.8 {+-} 0.8, p < 0.05), respectively and the sizes of the menisci were bigger on SE than GE images. The delineation of the condylar cortex was better on GE than SE images. For pseudodynamic imaging display of the TMJs, the SE images might be better than GE images to provide the stable recognition of the menisci. 17 refs., 7 figs., 5 tabs.

  14. Oral squamous cell carcinoma: an atypical presentation mimicking temporomandibular joint disorder

    PubMed Central

    Jensen, Andrea; Nolet, Paul S; Diwan, Murtaza A

    2004-01-01

    A 50-year-old female presented to a chiropractic clinic with left jaw pain consistent with temporomandibular joint disorder. Examination revealed a large ulcerated mass on the posterolateral margin of the tongue which was later diagnosed as squamous cell carcinoma. Squamous cell carcinoma is the most common of the oral cancers. These cancers are often detected late making treatment more complicated and reducing the chance of survival. In the early stages squamous cell carcinoma can be asymptomatic. Symptoms can be similar to that of temporomandibular joint disorder making examination of the patient’s mouth important to rule out oral cancers. Oral cancers should be considered when patients present to a chiropractor with pain in the area of the temporomandibular joint. Risk factors such as chronic tobacco and alcohol use should raise concern in these patients. Suspicious lesions should be referred immediately for further investigation. PMID:17549104

  15. Morphological characteristics of the temporomandibular joint in the pouch young of the Tasmanian devil.

    PubMed

    Hayashi, K; Sugisaki, M; Kino, K; Ishikawa, T; Kawashima, S; Amemiya, T

    2015-04-01

    We recently reported the absence of the articular disc, which is a constant structure in mammals, in the temporomandibular joint of the adult Tasmanian devil. However, whether the articular disc disappears with growth of the animal was unknown. The aim of this study was to determine whether a pouch young of the Tasmanian devil has the articular disc. The temporomandibular joint of a fresh carcass of the pouch young, whose crown-rump length was 43 mm, was examined microscopically and by microcomputed tomography. The absence of the articular disc in the pouch young temporomandibular joint was histologically confirmed. It is suggested that the articular disc of the Tasmanian devil is naturally absent. PMID:24809824

  16. Angioarchitecture and morphology of temporomandibular joint of Monodelphis domestica.

    PubMed

    Minucci, Matheus Silvestre; Issa, João Paulo Mardegan; Yokoyama, Fernando Yukio; Dias, Fernando José; Iyomasa, Daniela Mizusaki; Guimarães, Elaine Aparecida Del-Bel Belluz; Watanabe, Ii-Sei; Iyomasa, Mamie Mizusaki

    2016-09-01

    The opossum Monodelphis domestica presents movement of the temporomandibular joint (TMJ) reflecting adaptation to eating habits similar to movement in humans, but the structure of the TMJ is not yet known. Thus, nine young M. domestica, of both sexes were weighed, anesthetized with xylazine (10 mg kg(-1) ), and ketamine (70 mg kg(-1) ) and processed for: 1. The analyses of the macroscopic angioarchitecture after latex injection, as well as the topography of the TMJ; 2. The analysis of microvascularization after injection of Mercox resin and corrosion of soft tissue with NaOH using scanning electron microscopy and; 3. The histological evaluation of the TMJ with an optical microscope. Macroscopic analysis of the latex injected vessels revealed the distribution of the arteries from the common carotid artery, receiving branches of the superficial temporal and maxillary arteries. The mandibular condyle has the long axis in the lateral-lateral direction, and is convex in the anterior-posterior direction. Its topography was determined in relation to the eye and external acoustic meatus. With scanning electron microscopy, microvascularization consists of arterioles of varying diameter (85-15 µm) of the meandering capillary network in the retrodiscal region, and a network of straight capillaries in the TMJ anterior region. Via light microscopy the TMJ has similar histological features to those of humans. These macroscopic, microscopic and ultrastructural data from TMJ of the M. domestica could be a suitable model for TMJ physiology and pathophysiology studies for then speculate on possible human studies. Microsc. Res. Tech. 79:806-813, 2016. © 2016 Wiley Periodicals, Inc. PMID:27324400

  17. Dietary correlates of temporomandibular joint morphology in New World primates.

    PubMed

    Terhune, Claire E

    2011-11-01

    Previous analyses of the masticatory apparatus have demonstrated that the shape of the temporomandibular joint (TMJ) is functionally and adaptively linked to variation in feeding behavior and diet in primates. Building on previous research, this study presents an analysis of the link between diet and TMJ morphology in the context of functional and dietary differences among New World primates. To evaluate this proposed relationship, I used three-dimensional morphometric methods to quantify TMJ shape across a sample of 13 platyrrhine species. A broad interspecific analysis of this sample found strong relationships among TMJ size, TMJ shape, and diet, suggesting that both size and diet are significant factors influencing TMJ morphology in New World primates. However, it is likely that at least some of these differences are related to a division of dietary categories along clade lines. A series of hypotheses related to load resistance capabilities and range of motion in the TMJ were then tested among small groups of closely related taxa with documented dietary differences. These pairwise analyses indicate that some aspects of TMJ morphology can be used to differentiate among closely related species with different diets. However, not all of my predictions were upheld. The anteroposterior dimensions of the TMJ were most strongly consistent with hypothesized differences in ingestive/masticatory behaviors and jaw gape, whereas the predictions generated for variation in entoglenoid and articular tubercle height were not upheld. These results imply that while some features can be reliably associated with increased load resistance and facilitation of wider jaw gapes in the masticatory apparatus, other features are less strongly correlated with masticatory function. PMID:21920583

  18. Neocartilage integration in temporomandibular joint discs: physical and enzymatic methods

    PubMed Central

    Murphy, Meghan K.; Arzi, Boaz; Prouty, Shannon M.; Hu, Jerry C.; Athanasiou, Kyriacos A.

    2015-01-01

    Integration of engineered musculoskeletal tissues with adjacent native tissues presents a significant challenge to the field. Specifically, the avascularity and low cellularity of cartilage elicit the need for additional efforts in improving integration of neocartilage within native cartilage. Self-assembled neocartilage holds significant potential in replacing degenerated cartilage, though its stabilization and integration in native cartilage require further efforts. Physical and enzymatic stabilization methods were investigated in an in vitro model for temporomandibular joint (TMJ) disc degeneration. First, in phase 1, suture, glue and press-fit constructs were compared in TMJ disc intermediate zone defects. In phase 1, suturing enhanced interfacial shear stiffness and strength immediately; after four weeks, a 15-fold increase in stiffness and a ninefold increase in strength persisted over press-fit. Neither suture nor glue significantly altered neocartilage properties. In phase 2, the effects of the enzymatic stabilization regimen composed of lysyl oxidase, CuSO4 and hydroxylysine were investigated. A full factorial design was employed, carrying forward the best physical method from phase 1, suturing. Enzymatic stabilization significantly increased interfacial shear stiffness after eight weeks. Combined enzymatic stabilization and suturing led to a fourfold increase in shear stiffness and threefold increase in strength over press-fit. Histological analysis confirmed the presence of a collagen-rich interface. Enzymatic treatment additionally enhanced neocartilage mechanical properties, yielding a tensile modulus over 6 MPa and compressive instantaneous modulus over 1200 kPa at eight weeks. Suturing enhances stabilization of neocartilage, and enzymatic treatment enhances functional properties and integration of neocartilage in the TMJ disc. Methods developed here are applicable to other orthopaedic soft tissues, including knee meniscus and hyaline articular

  19. Effects of growth factors on temporomandibular joint disc cells.

    PubMed

    Detamore, Michael S; Athanasiou, Kyriacos A

    2004-07-01

    The effects of growth factors on cartilaginous tissues are well documented. An exception is the temporomandibular joint (TMJ) disc, where data for growth factor effects on proliferation and biosynthesis are very limited. The purpose of this study was to quantify proliferation of and synthesis by TMJ disc cells cultured in monolayer with either platelet derived growth factor-AB (PDGF), basic fibroblast growth factor (bFGF) or insulin-like growth factor-I (IGF), at either a low (10 ng/ml) or high (100 ng/ml) concentration. Proliferation was assessed with a DNA quantitation technique, collagen synthesis was measured via a hydroxyproline assay, and GAG synthesis was determined with a dimethylmethylene blue dye binding assay at 14 days. Overall, the most beneficial growth factor was bFGF, which was most potent in increasing proliferation and GAG synthesis, and also effective in promoting collagen synthesis. At the high concentration, bFGF resulted in 96% more cells than the control and 30 to 45% more cells than PDGF and IGF. PDGF and bFGF were the most potent upregulators of GAG synthesis, producing 2-3 times more GAG than the control. IGF had no significant effect on GAG production, although at its higher concentration it increased collagen production by 4.5 times over the control. Collagen synthesis was promoted by bFGF at its lower concentration, with levels 4.2 times higher than the control, whereas PDGF had no significant effect on collagen production. In general, higher concentrations increased proliferation, whereas lower concentrations favoured biosynthesis. PMID:15126139

  20. Use of indomethacin as an adjuvant to surgery for recurrent temporomandibular joint ankylosis in adults

    PubMed Central

    Bhatt, Krushna; Pandey, Sandeep; Bhutia, Ongkila; Roychoudhury, Ajoy

    2014-01-01

    Two cases with multiple recurrences of temporomandibular joint ankylosis and multiple failed interposition/gap arthroplasty procedures are presented here. Heterotopic bone formation was thought to be the reason. Indomethacin prophylaxis for prevention of heterotopic new bone formation at the osteoarthrectomy site was used as an adjuvant to surgery, in dosages of 75 mg/day for six weeks. Indomethacin is used frequently in hip and elbow arthroplasties to prevent heterotopic ossification, but its use in temporomandibular joint is not routine. The presented cases did not develop further recurrence and attained stable mouth opening over two-year follow-up after osteoarthrectomy and oral indomethacin. PMID:25937735

  1. Treatment of acute temporomandibular joint dislocation using manipulation technique for disk displacement.

    PubMed

    Yabe, Tetsuji; Tsuda, Tomoyuki; Hirose, Shunsuke; Ozawa, Toshiyuki; Kawai, Katsuya

    2014-03-01

    Temporomandibular joint dislocation is not frequently encountered, but it is often difficult to reduce the dislocation with conventional methods described in textbooks. The key points to success of reduction depend on the patient's position, route of approach, and timing of reducing each side. We apply a manipulation technique for disk displacement to the reduction that corresponds to these key points. Using our method, temporomandibular joint dislocation can be easily reduced, without using sedative or analgesics. This method is simple, convenient, and worth trying in place of the conventional method. PMID:24621705

  2. Psychoeducation Program on Strategies for Coping with Stress in Patients with Temporomandibular Joint Dysfunction

    PubMed Central

    2014-01-01

    Lack of educational projects in the available literature was an inspiration to develop a psychoeducational program. The objective was to provide patients with basic information on the contribution of stressors in the occurrence of temporomandibular joint dysfunction and educate on methods for coping with stress most commonly used in psychology. In the course of three meetings, patients are familiarised with the issue of experienced stress as a potential source of psychosomatic illnesses (in particular, temporomandibular joint dysfunction). Preliminary patients' opinions, expressed through self-report methods, indicate significant usefulness of the developed psychoeducational program for the process of treatment and the quality of patients' lives. PMID:25610871

  3. Inferior joint space arthrography of normal temporomandibular joints: Reassessment of diagnostic criteria

    SciTech Connect

    Kaplan, P.A.; Tu, H.K.; Sleder, P.R.; Lydiatt, D.D.; Laney, T.J.

    1986-06-01

    Inferior joint space arthrograms of the temporomandibular joints of 31 healthy volunteers (62 joints) were obtained to determine normal arthrographic findings. The superior margin of the anterior recess was smooth and flat in 68% of the joints and concave in 32% with the subjects' mouths closed. The concavity was the result of the anterior ridge of the meniscus impinging on the contrast material. The concave impression could be distinguished easily from an anteriorly displaced meniscus on videotaped studies, which demonstrated a smooth transition of contrast material from the anterior to the posterior recess during opening of a subject's mouth. With the mouth open, the anterior recess decreased in size, appearing as a small, crescent-shaped collection of contrast material anterior to the head of the condyle in 52 joints (84%); it remained large in ten joints (16%) at maximal mouth opening. The configuration of the posterior recess was identical to that described previously; however, with the subjects' mouths closed, it was larger than the anterior recess, contrary to most previously reported results.

  4. Gait changes after using a temporomandibular joint exerciser in patients who underwent lower limb joint surgery

    PubMed Central

    Chung, Gu-Young; Choi, Geun-Seok; Shin, Ki-Young; Park, Joon-Soo

    2016-01-01

    [Purpose] The improvements in gait of the patients with lower limb disease who used a temporomandibular joint (TMJ) exerciser were verified. [Subjects and Methods] Eleven subjects were included. Their mean age was 53.2 years. The lower limb joint angles before and after using the TMJ exerciser were measured using a gait analyzer. Before the gait experiment, the TMJ exerciser setting process and one-leg stance balance test (OLST) were repeated until the balance maintenance time improved. [Results] Because of the OLST, the mean change in the body center point after the subjects used the exerciser improved from 5.76 mm to 4.20 mm. When the TMJ exerciser was used, the joint angle range of the subjects approached that of the normal individuals. [Conclusion] According to the gait experiments, the angles of the subjects’ hips, knees, and ankle joints approached to those of the normal individuals after the subjects used the TMJ exerciser; however, the results did not completely match. The changes in the hip, knee, and ankle joint angles were statistically significant, which confirm the usefulness of the TMJ exerciser. PMID:27313377

  5. Septic Arthritis of the Temporomandibular Joint--Unusual Presentations.

    PubMed

    Lohiya, Sapna; Dillon, Jasjit

    2016-01-01

    This report describes 2 patients whose septic arthritis of the temporomandibular joint (SATMJ) presented atypically, resulting in treatment delay and complications. A 49-year-old man developed left-side facial allodynia, which was first treated unsuccessfully as trigeminal neuralgia. On day 21, the patient sustained facial trauma from a fall and presented to the emergency department (ED). Maxillofacial contrast-enhanced computed tomographic (CT) scan was suggestive of parotiditis, SATMJ, or hemarthrosis. His condition did not improve with empiric antibiotic treatment. On day 30, contrast-enhanced magnetic resonance imaging (MRI) confirmed SATMJ. Incision and drainage yielded 6 mL of pus and produced clinical improvement. Cultures grew methicillin-resistant Staphylococcus aureus, which was treated with amoxicillin plus clavulanate and sulfamethoxazole plus trimethoprim for 30 days. On day 59, the patient still had slight preauricular pain and CT-proved TMJ osteoarthritic changes. A 56-year-old woman developed right-side facial pain after a crown procedure on her right mandibular second molar. Oral prednisone (and clindamycin) produced partial relief. Her primary physician suspected temporal arteritis, but its biopsy result on day 11 was normal. Gradually, the patient developed trismus and malocclusion refractory to various medicines. On day 49, she presented to the ED. A contrast-enhanced maxillofacial CT scan suggested SATMJ. Incision and drainage yielded 30 mL of pus and produced clinical improvement. During days 50 to 57, the patient received intravenous ampicillin plus sulbactam and metronidazole. However, preauricular tenderness and drainage from the surgical incision persisted. On day 55, CT scan showed a residual abscess. Secondary debridement yielded 5 mL of pus. Culture grew coagulase-negative S aureus. On day 141, the patient still had slight preauricular pain and TMJ osteoarthritic changes on MRI. In these cases, the SATMJ diagnosis was delayed owing

  6. Biofeedback and Relaxation Therapy for Chronic Temporomandibular Joint Pain: Predicting Successful Outcomes.

    ERIC Educational Resources Information Center

    Funch, Donna P.; Gale, Elliot N.

    1984-01-01

    Randomly assigned 57 patients with chronic temporomandibular joint (TMJ) pain to receive either relaxation or biofeedback therapy. Successful patients in the relaxation condition tended to be younger and had experienced TMJ pain for a shorter period of time than the successful biofeedback patients. (BH)

  7. Temporomandibular joint ankylosis caused by chondroid hyperplasia from the callus of condylar neck fracture.

    PubMed

    Kim, Soung Min; Park, Jung Min; Kim, Ji Hyuck; Kwon, Kwang Jun; Park, Young Wook; Lee, Jong Ho; Lee, Sang Shin; Lee, Suk Keun

    2009-01-01

    A patient who complained of difficulty in opening his mouth after condylar neck fracture 1 year ago presented typical features of temporomandibular joint ankylosis in clinical and radiologic examinations. To demonstrate a possible pathogenesis of temporomandibular joint ankylosis after condylar neck fracture, the fractured condylar portion removed was examined by histologic and immunohistochemical stainings. Interpositional gap arthroplasty was performed by removing the inferomesially displaced fractured condyle, and reconstruction with subcutaneous dermis to the previous vertical height was performed immediately. The fractured condylar portion was almost intact with slight erosion of the condylar cartilage. In the hematoxylin and eosin and Masson trichrome stainings, an extensive chondroid hyperplasia with abundant hyaline cartilage was shown in the removed condylar portion. There were also hyperplastic features of the synovial membrane, which were abnormally distributed throughout the chondroid tissues. In the immunohistochemical stainings of proliferating cell nuclear antigen (PCNA) and bone morphogenetic protein (BMP)-2 and BMP-4, the chondroid tissues were conspicuously hyperplastic and strongly positive for BMP-4 but sparse for BMP-2. From these results, we think that the hyperplastic chondroid tissue was derived from the callus of the primary fractured site of the condylar neck and propose that the chondroid tissue could proliferate continuously because of synovial tissue support from around the temporomandibular joint, resulting in temporomandibular joint ankylosis. This pathogenesis is quite different from those of other diaphyseal fracture of long bones. PMID:19165036

  8. Groningen temporomandibular total joint prosthesis: an 8-year longitudinal follow-up on function and pain.

    PubMed

    Schuurhuis, Jennifer M; Dijkstra, Pieter U; Stegenga, Boudewijn; de Bont, Lambert G M; Spijkervet, Fred K L

    2012-12-01

    Total temporomandibular joint replacement is a surgical procedure for patients with severe temporomandibular joint afflictions affecting quality of life, which have not responded beneficially to previous conventional surgery. The aim of this study was to assess the long-term outcome of the Groningen temporomandibular joint (TMJ) prosthesis in patients with chronic pain and mutilated temporomandibular joints following multiple surgical procedures, with respect to prosthesis failure, the patient's postoperative level of satisfaction and longitudinal changes in maximum mouth opening, functional mandibular impairment and pain. Eight female patients were studied in whom Groningen TMJ prostheses were inserted, two unilaterally and six bilaterally. The Groningen TMJ prosthesis was mechanically successful during 8 years of follow-up in seven out of eight patients with a disc dislocation being seen in one patient (7%). Patients were satisfied, despite the limited improvement of the maximum mouth opening, and pain scores. Although the decline of MFIQ scores during 8 years of follow-up was significant compared to baseline (p=0.027), the effects of the prosthesis on maximum mouth opening, function and pain were limited. This may be due to persistent chronic pain and the adverse effects of multiple previous surgical procedures. PMID:22484125

  9. [Synovial chondromatosis of the right temporomandibular joint: report of one case].

    PubMed

    Fan, Rui-xian; Zhang, Kui-hong; Ding, Wei; Wang, Yan-ling

    2016-04-01

    Synovial chondromatosis of the temporomandibular joint(TMJ) is an extremely rare condition. A case of synovial chondromatosis with postoperative recurrence and involvement of base of skull was reported. The clinic pathological features, diagnosis and treatment were discussed with literature review. PMID:27329898

  10. Psoriatic arthritis of the temporomandibular joints with ankylosis. Literature review and case reports.

    PubMed

    Koorbusch, G F; Zeitler, D L; Fotos, P G; Doss, J B

    1991-03-01

    Psoriatic arthritis is currently defined as psoriasis associated with chronic, erosive inflammatory arthritis, which is seronegative for rheumatoid factor. A review of the etiology, pathogenesis, diagnosis, and treatment is accompanied by two unusual case reports of psoriatic arthritis affecting the temporomandibular joints with ankylosis. PMID:2011347

  11. The relationship between the temporomandibular joint capsule, articular disc and jaw muscles.

    PubMed Central

    Schmolke, C

    1994-01-01

    The anatomy of the temporomandibular joint capsule and its possible relationships to other structures near the joint are not fully understood. A 3-dimensional analysis based on sagittal, frontal and horizontal serial sections through the human temporomandibular joint region was therefore undertaken. Capsular elements which directly connect the temporal bone with the mandible were seen only on the lateral side of the joint. In the posterior, anterior and medial regions of the joint the upper and lower laminae of the articular disc are attached separately either to the temporal bone or to the mandibular condyle. The shaping of the articular cavities and the texture of the joint capsule permit movements of the articular disc predominantly in the anteromedial direction. On the entire medial side of the joint the articular disc and its capsular attachments are in close contact with the fascia of the lateral pterygoid muscle whereby a small portion of the upper head of this muscle inserts directly into the anteromedial part of the articular disc. Thus both the upper and the lower heads of the lateral pterygoid muscle are likely to influence the position of the articular disc directly during temporomandibular joint movements. Laterally, the articular disc is attached to the fascia of the masseter muscle, and part of the lateral ligament inserts into the temporalis fascia. Since these attachments are relatively weak, neither the temporalis nor the masseter muscles are considered to act directly on the articular disc; instead, via afferents from muscle spindles, they may take part in signalling the position of the temporomandibular joint components, including that of the articular disc. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 PMID:8014124

  12. MRI Slice Segmentation and 3D Modelling of Temporomandibular Joint Measured by Microscopic Coil

    NASA Astrophysics Data System (ADS)

    Smirg, O.; Liberda, O.; Smekal, Z.; Sprlakova-Pukova, A.

    2012-01-01

    The paper focuses on the segmentation of magnetic resonance imaging (MRI) slices and 3D modelling of the temporomandibular joint disc in order to help physicians diagnose patients with dysfunction of the temporomandibular joint (TMJ). The TMJ is one of the most complex joints in the human body. The most common joint dysfunction is due to the disc. The disc is a soft tissue, which in principle cannot be diagnosed by the CT method. Therefore, a 3D model is made from the MRI slices, which can image soft tissues. For the segmentation of the disc in individual slices a new method is developed based on spatial distribution and anatomical TMJ structure with automatic thresholding. The thresholding is controlled by a genetic algorithm. The 3D model is realized using the marching cube method.

  13. [The temporomandibular joint in juvenile idiopathic arthritis: what radiologists need to look for on magnetic resonance imaging].

    PubMed

    De La Hoz Polo, M; Navallas, M

    2014-01-01

    The term "juvenile idiopathic arthritis" (JIA) encompasses a group of arthritis of unknown cause with onset before the age of 16 years that last for at least 6 weeks. The prevalence of temporomandibular joint involvement in published series ranges from 17% to 87%. Temporomandibular joint involvement is difficult to detect clinically, so imaging plays a key role in diagnosis and monitoring treatment. MRI is the technique of choice for the study of arthritis of the temporomandibular joint because it is the most sensitive technique for detecting acute synovitis and bone edema. Power Doppler ultrasonography can also detect active synovitis by showing the hypervascularization of the inflamed synovial membrane, but it cannot identify bone edema. This article describes the MRI technique for evaluating the temporomandibular joint in patients with juvenile idiopathic arthritis, defines the parameters to look for, and illustrates the main findings. PMID:24792314

  14. Juvenile idiopathic arthritis and the temporomandibular joint: A comprehensive review.

    PubMed

    El Assar de la Fuente, S; Angenete, O; Jellestad, S; Tzaribachev, N; Koos, B; Rosendahl, K

    2016-05-01

    Juvenile idiopathic arthritis is the most common inflammatory rheumatic disease of childhood and represents a series of chronic inflammatory arthritides of unknown cause. Involvement of the temporomandibular joint has been reported in up to 87% of children with juvenile idiopathic arthritis when based on magnetic tomography imaging; it can be asymptomatic and may lead to severe long term complications. In this review a summary of the contemporary literature of imaging of the temporomandibular joint in children with juvenile idiopathic arthritis will be provided, including ultrasound which is a valuable method for guided joint injections, but does not necessarily allow detection of acute inflammation, cone beam computed tomography, which has emerged as a feasible and accurate low-dose alternative as compared to conventional computed tomography to detect destructive change, and magnetic resonance imaging which is considered the method of choice for assessing acute, inflammatory change, although the lack of normative standards remains a challenge in children. PMID:26924432

  15. Temporomandibular pain.

    PubMed

    Prasad, S Raghavendra; Kumar, N Ravi; Shruthi, H R; Kalavathi, S D

    2016-01-01

    Temporomandibular joint pain has various medical and dental etiological factors. The etiology of the temporomandibular joint pain is enigmatic, no single etiological factor is regarded as the cause. Its distribution is also not confined to a single area. This article presents the basic etiologic factors, its epidemiology, distribution of pain, classification of patients and the psychosocial behavior of patients suffering with temporomandibular pain. As overwhelming majority of medical and dental conditions/issues related to etiology of temporomandibular pain in patients have traditionally been presented and interpreted from the clinician's point of view. PMID:27601822

  16. Temporomandibular pain

    PubMed Central

    Prasad, S Raghavendra; Kumar, N Ravi; Shruthi, HR; Kalavathi, SD

    2016-01-01

    Temporomandibular joint pain has various medical and dental etiological factors. The etiology of the temporomandibular joint pain is enigmatic, no single etiological factor is regarded as the cause. Its distribution is also not confined to a single area. This article presents the basic etiologic factors, its epidemiology, distribution of pain, classification of patients and the psychosocial behavior of patients suffering with temporomandibular pain. As overwhelming majority of medical and dental conditions/issues related to etiology of temporomandibular pain in patients have traditionally been presented and interpreted from the clinician's point of view. PMID:27601822

  17. Acoustic characteristics of sounds from temporomandibular joints with and without effusion: an MRI study.

    PubMed

    Sano, T; Widmalm, S E; Westesson, P L; Yamaga, T; Yamamoto, M; Takahashi, K; Michi, K I; Okano, T

    2002-02-01

    Joint effusion has been associated with temporomandibular joint (TMJ) pain but can only be diagnosed by magnetic resonance imaging (MRI). For screening of patients with suspected effusion a simple and less expensive method would be desirable. We recorded joint sounds during jaw opening and closing movement from 34 TMJs with internal derangement (ID). Seventeen joints had joint effusion seen on MRI. Spectrograms of the sounds were displayed as waterfall plots showing profiles of the consecutive Hamming windows. If the profiles were similar, as judged by initial evaluation, the displayed pattern was classified as stable. If some profiles were distinctly deviating in their pattern, this was classified as unstable. Joints with effusion showed unstable sound pattern more often than joints without effusion (P < 0.001). It was concluded that TMJ sound analyses have a potential to identify joints with effusion based on their unstable sound pattern. PMID:11856395

  18. A radiographic evaluation of temporomandibular and hand (Metacarpophalangeal) / wrist joints of patients with adult rheumatoid arthritis

    PubMed Central

    Kurup, Seema; Gharote, Harshkant; Jose, Renju

    2012-01-01

    Background: A review of literature revealed that, although the involvement of temporomandibular joint (TMJ) in rheumatoid arthritis (RA) patients is not uncommon, variation in presentation persist. Comparative studies of bony changes in the right and left TMJ with the right and left peripheral hand (Metacarpophalangeal-MCP)/wrist joints have not been done, to the best of our knowledge. Materials and Methods: In this cross-sectional study, the temporomandibular and hand (MCP) and wrist joints of fifteen rheumatoid arthritis patients were evaluated with questionnaires, clinical and lab assessment and radiographically using conventional radiographs and computed tomography. Students t-test was applied for the statistical analysis of the data obtained and a P value of 0.05 was considered as statistically significant. Results: Comparisons between the right TMJ with right MCP/wrist joint and left TMJ with left MCP/wrist joint did not reveal statistically significant results. Radiographically, flattening and erosions were the common manifestations. MCP joints were more affected than the wrist, but whenever the wrist was involved, it was more likely to be bilaterally affected. Conclusions: Although the TMJ showed osseous changes of a higher grade than the hand (MCP) and wrist joints radiographically, it was observed that patients were more aware of the peripheral joint discomfort. There were no significant differences between TMJ and peripheral joints on both right and left sides. PMID:23814559

  19. Clinical-surgical treatment of temporomandibular joint disorder in a psoriatic arthritis patient

    PubMed Central

    2013-01-01

    Introduction Condylotomy is a surgical procedure that has been used as an option to treat temporomandibular disorder (TMD) patients. This technique has the advantage of avoiding intra-capsular alterations that might be found involving other surgical procedures. Its use, even when unilateral, has positive effect on treatment of both joints. Methods In order to better evaluate the benefits of a clinical-surgical treatment for TMD, the present report describes the case of a psoriatic arthritis patient. The case was clinically characterized by dental malloclusion, and imaging exams showed joint degeneration of the right mandibular condyle. The patient was treated by condylotomy technique after a prosthetic oral rehabilitation. Results No clinical-radiological signs or symptoms of progression of articular disease were observed within a period of 16 months after surgery. Furthermore, there was functional stability of the temporomandibular joint, total absence of local pain and improvement of mouth opening. Conclusion The present study suggests that condylotomy can be considered as a valid option for the management of TMD, since it has low surgical morbidity and favorable clinical outcomes. In this case, the patient had a medical diagnosis of systemic disease presenting general pain and pain at the temporomandibular joint (TMJ), in addition of causal agent of TMD (dental malloclusion). The difficulty of finding a single etiology (malocclusion vs. systemic disease) did not exclude the indication of a clinical-surgical treatment to re-establish the balance of TMJ. PMID:23556553

  20. Giant cell tumor of bone involving the temporomandibular joint and temporal bone.

    PubMed

    Akyigit, Abdulvahap; Karlidag, Turgut; Sakallioglu, Öner; Polat, Cahit; Keles, Erol

    2014-07-01

    Giant cell tumor is a primary bone tumor that usually originates from the epiphysis of the long bones and is rarely seen in the cranial region. Most frequently, the tumor develops in the sphenoid and temporal bones in the middle cranial fossa. Giant cell tumor generally shows diversity with respect to benignity, local invasiveness, and histology. Although surgical excision with negative surgical margin may lead to cure, adjuvant radiotherapy is still debated. The patient was admitted with a humming in the left ear and hearing loss. After radiologic examination, a mass with temporomandibular joint involvement as well as temporal and sphenoid bone localization was detected. The patient was diagnosed with giant cell tumor after a biopsy specimen was taken from the mass extending to the middle ear and destroying the temporomandibular joint. The current study reviewed the patient's clinical features, diagnosis, and treatment in light of the literature. PMID:25006918

  1. In vitro application of optical transmission systems in erbium:YAG laser temporomandibular joint surgery

    NASA Astrophysics Data System (ADS)

    Nuebler-Moritz, Michael; Hering, Peter; Niederdellmann, Herbert; Deuerling, Christian; Dammer, Ralf

    1995-05-01

    The experimental setup of this study is focused on the changes in temporomandibular joint tissue after irradiation with an Erbium:YAG laser. Initially, the free-running beam from the laser was focused onto freshly excised porcine tissue samples, indicating an optimum average energy density and pulse duration for the purpose of temporomandibular joint surgery of about 15 - 60 J/cm2 and 120 microsecond(s) - 240 microsecond(s) , respectively. Consecutively, an attempt was made to couple the Erbium:YAG laser beam on the one hand to optical fibers made of infrared-transmitting glasses (fluoride- and chalcogenide-based), on the other hand to a recently developed sapphire and liquid core fiber, respectively. From the preliminary observations of this investigation it appears that both the liquid core and the sapphire fiber are the most promising candidates for delivery of Erbium-YAG laser radiation in arthroscopic surgery of the craniomandibular articulation.

  2. Reconstruction of Temporomandibular Joint With a Fibula Free Flap: A Case Report With a Histological Study.

    PubMed

    Fariña, Rodrigo; Campos, Pía; Beytía, Javiera; Martínez, Benjamín

    2015-12-01

    Reconstruction of the temporomandibular joint (TMJ) for congenital or acquired deformities is a major challenge for maxillofacial surgeons. The alternatives for reconstructing the TMJ include free grafts (costochondral, iliac crest, clavicle, or metatarsus), free flaps (fibula), osteogenic distraction, and alloplastic grafts. The lack of biological knowledge of cartilaginous grafts and their reaction to the environment of the TMJ is largely responsible for the inability to predict growth. This report describes the use of a free flap for TMJ reconstruction. PMID:26342950

  3. Hypohidrotic ectodermal dysplasia with ankylosis of temporomandibular joint and cleft palate: A rare presentation

    PubMed Central

    Goyal, Manisha; Pradhan, Gaurav; Gupta, Sunita; Kapoor, Seema

    2015-01-01

    The ectodermal dysplasias are a heterogenous group of diseases, which have one or more anomalies of the hair, teeth, nails, and sweat glands. Hypohidrotic ectodermal dysplasia (HED) is the most common type and is usually transmitted as an X-linked recessive trait. It is characterized by classical triad of hypotrichosis, anhidrosis/hypohidrosis, and hypodontia/anodontia. Here, we describe an Indian boy affected with HED and rare features including ankylosis of temporomandibular joint and cleft palate. PMID:25684924

  4. Condylar resorption following temporomandibular joint arthroscopy in a patient with essential thrombocythemia.

    PubMed

    Balasubramaniam, Ramesh; Van Sickels, Joseph; Falace, Donald

    2006-05-01

    Condylar resorption of the temporomandibular joint (TMJ) is a poorly understood phenomenon that is the subject of much controversy. The following case report depicts a unique case of condylar resorption (CR) in a 49-year-old female patient with essential thrombocythemia who underwent arthrocentesis of the TMJ. The exact cause of the CR is unclear but it is speculated that it was likely due to hemorrhagic and thrombotic complications during surgery secondary to an elevated platelet count. PMID:16632268

  5. The Role of Transcutaneous Electrical Nerve Stimulation in the Management of Temporomandibular Joint Disorder.

    PubMed

    Awan, Kamran Habib; Patil, Shankargouda

    2015-12-01

    Temporomandibular joint disorders (TMD) constitutes of a group of diseases that functionally affect the masticatory system, including the muscles of mastication and temporomandibular joint (TMJ). A number of etiologies with specific treatment have been identified, including the transcutaneous electrical nerve stimulation (TENS). The current paper presents a literature review on the use of TENS in the management of TMD patients. Temporomandibular joint disorder is very common disorder with approximately 75% of people showing some signs, while more than quarter (33%) having at least one symptom. An attempt to treat the pain should be made whenever possible. However, in cases with no defined etiology, starting with less intrusive and reversible techniques is prescribed. Transcutaneous electrical nerve stimulation is one such treatment modality, i.e. useful in the management of TMD. It comprises of controlled exposure of electrical current to the surface of skin, causing hyperactive muscles relaxation and decrease pain. Although the value of TENS to manage chronic pain in TMD patients is still controversial, its role in utilization for masticatory muscle pain is significant. However, an accurate diagnosis is essential to minimize its insufficient use. Well-controlled randomized trials are needed to determine the utilization of TENS in the management of TMD patients. PMID:27018034

  6. Modified T-Plate Interpositional Arthroplasty for Temporomandibular Joint Ankylosis: A New and Versatile Option

    PubMed Central

    Ahmad, Imran; Bariar, Lalit Mohan

    2015-01-01

    Background This study has been conducted with the aim of evaluating modified T-plate interpositional arthroplasty. Methods A prospective comparative study in patients admitted with temporomandibular joint ankylosis. Ankylotic temporomandibular joint arthroplasty included condylectomy gap arthroplasty in 7, temporalis muscle flap interpositional arthroplasty in 8, and modified T-plate interpositional arthroplasty in 13 cases. The patients were followed for three years. Collected data were tabulated and subjected to Fisher's exact test, chi-square test and probability estimation. Results A significant increase in interincisal distance of 32 mm was seen in 12 (92.31%) patients in the T-plate interposition group, in 2 (25%) cases of the temporalis muscle flap interposition group, and in 1 case (14.28%) of the condylectomy group at 12, 24, and 36 months. Re-ankylosis was observed in 1 case (9.69%) of the T-plate interposition group, while as it was observed in 4 (50%) cases in the temporalis muscle flap interposition group and 4 (57.14%) cases in the condylectomy group, and these differences were statistically significant. Conclusions Our clinical experience with the use of the T-plate over the past 5 years has been encouraging, and our physiotherapy technique is quite simple. Even illiterate parents can assess it easily. Hence, we recommend this easy technique that does not damage the temporalis muscle for the management of temporomandibular joint ankylosis. PMID:26618118

  7. Upregulation of lncRNA HOTAIR contributes to IL-1β-induced MMP overexpression and chondrocytes apoptosis in temporomandibular joint osteoarthritis.

    PubMed

    Zhang, Chunping; Wang, Peng; Jiang, Pengfei; Lv, Yongbin; Dong, Changxia; Dai, Xiuyu; Tan, Lixia; Wang, Zhenlin

    2016-07-25

    Temporomandibular joint osteoarthritis (TMJ OA) is a common and heterogeneous disease that causes painful and progressive joint degeneration, which restricts daily activities, including talking and chewing. Long noncoding RNAs (lncRNAs) are an important class of genes involved in various physiological and pathological functions, including osteoarthritis (OA).The present study aimed to identify the lncRNAs that are important in TMJ OA and their potential functions. Here, we found that HOTAIR was significantly upregulated in the synovial fluid of TMJ OA patients compared with that of normal controls. Increased HOTAIR was similarly observed in the synovial fluid of TMJ OA rabbits as compared to control rabbits. Furthermore, in interleukin-1β (IL-1β)-induced TMJ OA in vitro model (primary rabbit condylar chondrocytes), the expressions of matrix metalloproteinase (MMP)-1, MMP3, MMP9 and HOTAIR were all dramatically increased. Most importantly, knockdown of HOTAIR in IL-1β-induced TMJ OA in vitro model could not only reverse the IL-1β-stimulated expressions of MMP1, MMP3 and MMP9, but also significantly decrease the apoptosis rate induced by IL-1β in primary rabbit condylar chondrocytes. Our data provides new insight into the mechanisms of chondrocytes destruction in TMJ OA. PMID:27063559

  8. Development of Synovial Membrane in the Temporomandibular Joint of the Human Fetus

    PubMed Central

    Tedesco, R.C.; Arraéz-Aybar, L.A.; Klein, O.; Mérida-Velasco, J.R.; Alonso, L.G.

    2015-01-01

    The development of the synovial membrane was analyzed in serial sections of 21 temporomandibular joints of human fetuses at 9 to 13 weeks of gestation. Sections of two fetuses at 12 weeks of development were used to perform immunohistochemical expression of the markers CD68 and Hsp27 on the synovial lining. Macrophage-like type A and fibroblast-like type B cells, which express CD68 and Hsp27, respectively, were observed at the twelfth week of development. Our results suggest that the development of the synovial membrane is related to the vascularization of the joint and the formation of the articular cavities. PMID:26708184

  9. Synovial chondromatosis in the temporomandibular joint: case report with review of the literature.

    PubMed

    Ivask, Oksana; Leibur, Edvitar; Voog-Oras, Ülle

    2015-01-01

    Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare benign condition characterized by the formation of metaplastic cartilage in the synovium resulting in numerous attached and unattached osteocartilagenous (calcified) loose bodies within the joint. The purpose of this article is to present a case of SC of the TMJ and to discuss current diagnostic approaches, treatment options and relevant follow-up data. We present a case of SC in the TMJ that was confirmed by histopathological analysis and treated via arthrotomy, and present the typical imaging findings, including Computed Tomography (CT) and orthopantomography (OPTG) findings. PMID:26879402

  10. Giant Solitary Synovial Chondromatosis of the Temporomandibular Joint with Intracranial Extension

    PubMed Central

    Gil-Salú, José L.; Lázaro, Rafael; Aldasoro, José; Gonzalez-Darder, José M.

    1998-01-01

    Synovial chondromatosis are rare entities but are well-described lesions in the literature that can affect many joint areas of the body. A case of tumoral synovial chondromatosis involving the temporomandibular joint with intracranial extension through mandibular fossa is reported. As long as there was significant infratemporal and extradural invasion of the middle and posterior fossa, a transtemporal and infratemporal approach was performed and total removal of the lesions was achieved. A brief review of skull base synovial chondromatosis is presented. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10Figure 11 PMID:17171059

  11. Evaluation of body posture in individuals with internal temporomandibular joint derangement.

    PubMed

    Munhoz, Wagner Cesar; Marques, Amélia Pasqual; de Siqueira, José Tadeu Tesseroli

    2005-10-01

    Temporomandibular dysfunctions (TMD) comprise a great number of disruptions that may affect the temporomandibular joint (TMJ), the masticatory muscles, or both. TMJ internal derangement is a specific type of TMD, of which the etiology and physiopathology are broadly unknown, but have been suggested to be linked to head, neck, and body posture factors. This study aimed at verifying possible relationships between body posture and TMJ internal derangements (TMJ-id), by comparing 30 subjects presenting typical TMJ-id signs to 20 healthy subjects. Subjects' clinical evaluations included anamnesis, stomatognatic system evaluation, and plotting analysis on body posture photographs. No statistically significant differences were found between the groups. Results do not support the assertion that body posture plays a role in causing or enhancing TMD; however, these results should be cautiously considered because of the small number of subjects evaluated and the many posture variables submitted to statistical procedures that lead to high standard deviations. PMID:16353467

  12. Cyclic Tensile Strain Suppresses Catabolic Effects of Interleukin-1β in Fibrochondrocytes From the Temporomandibular Joint

    PubMed Central

    Agarwal, Sudha; Long, Ping; Gassner, Robert; Piesco, Nicholas P.; Buckley, Michael J.

    2016-01-01

    Objective To discern the effects of continuous passive motion on inflamed temporomandibular joints (TMJ). Methods The effects of continuous passive motion on TMJ were simulated by exposing primary cultures of rabbit TMJ fibrochondrocyte monolayers to cyclic tensile strain (CTS) in the presence of recombinant human interleukin-1β (rHuIL-1β) in vitro. The messenger RNA (mRNA) induction of rHuIL-1β response elements was examined by semiquantitative reverse transcriptase–polymerase chain reaction. The synthesis of nitric oxide was examined by Griess reaction, and the synthesis of prostaglandin E2 (PGE2) was examined by radioimmunoassay. The synthesis of proteins was examined by Western blot analysis of the cell extracts, and synthesis of proteoglycans via incorporation of 35S-sodium sulfate in the culture medium. Results Exposure of TMJ fibrochondrocytes to rHuIL-1β resulted in the induction of inducible nitric oxide synthase (iNOS) and cyclooxygenase 2 (COX-2), which were paralleled by NO and PGE2 production. Additionally, IL-1β induced significant levels of collagenase (matrix metalloproteinase 1 [MMP-1]) within 4 hours, and this was sustained over a period of 48 hours. Concomitant application of CTS abrogated the catabolic effects of IL-1β on TMJ chondrocytes by inhibiting iNOS, COX-2, and MMP-1 mRNA production and NO, PGE2, and MMP-1 synthesis. CTS also counteracted cartilage degradation by augmenting expression of mRNA for tissue inhibitor of metalloproteinases 2 that is inhibited by rHuIL-1β. In parallel, CTS also counteracted rHuIL-1β–induced suppression of proteoglycan synthesis. Nevertheless, the presence of an inflammatory signal was a prerequisite for the observed CTS actions, because fibrochondrocytes, when exposed to CTS alone, did not exhibit any of the effects described above. Conclusion CTS acts as an effective antagonist of rHuIL-1β by potentially diminishing its catabolic actions on TMJ fibrochondrocytes. Furthermore, CTS actions appear

  13. 'Costen's syndrome'--correlation or coincidence: a review of 45 patients with temporomandibular joint dysfunction, otalgia and other aural symptoms.

    PubMed

    Brookes, G B; Maw, A R; Coleman, M J

    1980-02-01

    Forty-five patients with temporomandibular joint dysfunction, and otalgia together with other aural symptoms (deafness, tinnitus, pressure/blockage and vertigo) were evaluated clinically and audiometrically. The theoretical mechanisms by which aural symptoms may be produced as a result of temporomandibular joint dysfunction are outlined and discussed in the light of the patients under review. The wide diversity in the incidence of additional aural symptoms apart from otalgia reported in the literature is noted, together with the general lack of full objective audiometric assessment. In 37 patients the aural symptoms were directly attributable to other coincidental otolaryngological pathology. Details of the remaining 8 cases are presented. The other aural symptoms of 4 of these patients were also probably accounted for by other coincidental otalaryngological pathology. It may be significant that 2 of the other patients were suffering from concurrent psychiatric disorders. Thus in this series at least 9% of the patients were considered to have other aural symptoms coincidental to temporomandibular joint dysfunction. This is compatible with the relatively common occurrence of both temporomandibular joint dysfunction and aural symptoms in the general population. This study leads us to believe that there is no direct aetiological basis to link temporomandibular joint dysfunction and other aural symptoms apart from otalgia. PMID:7363490

  14. Temporomandibular joint osteoarthritis: cone beam computed tomography findings, clinical features, and correlations.

    PubMed

    Cömert Kiliç, S; Kiliç, N; Sümbüllü, M A

    2015-10-01

    The aim of this study was to determine the prevalence of and associations between clinical signs and symptoms and cone beam computed tomography (CBCT) findings of temporomandibular joint osteoarthritis (TMJ-OA). Seventy-six patients (total 117 TMJ) with osteoarthritis were included in this study. Clinical signs and symptoms and CBCT findings were reviewed retrospectively. A considerable decrease in mandibular motions and mastication efficiency, and considerable increase in joint sounds and general pain complaints were observed. The most frequent condylar bony changes were erosion (110 joints, 94.0%), followed by flattening (108 joints, 92.3%), osteophytes (93 joints, 79.5%), hypoplasia (22 joints, 18.8%), sclerosis (14 joints, 12.0%), and subchondral cyst (four joints, 3.4%). Flattening of the articular eminence and pneumatization were each observed in five joints. Forty-one patients had bilateral degeneration and 35 had unilateral degeneration. Hypermobility was detected in 47 degenerative joints. Masticatory efficiency was negatively correlated with both condylar flattening and sclerosis, and general pain complaints was positively correlated with condylar flattening. Condylar erosion, flattening, osteophytes, pain, joint sounds, reduced jaw movements, and worsened mastication were common findings in TMJ-OA in the present study. Poor correlations were found between osseous changes and clinical signs and symptoms of TMJ-OA. CBCT is a powerful diagnostic tool for the diagnosis of TMJ-OA. PMID:26194774

  15. Innovative Surgical Management of the Synovial Chondromatosis of Temporo-Mandibular Joints: Highly Conservative Surgical Technique.

    PubMed

    Ionna, Franco; Amantea, Massimiliano; Mastrangelo, Filiberto; Ballini, Andrea; Maglione, Maria Grazia; Aversa, Corrado; De Cecio, Rossella; Russo, Daniela; Marrelli, Massimo; Tatullo, Marco

    2016-07-01

    Synovial chondromatosis (SC) is an uncommon disease characterized by a benign nodular cartilaginous proliferation arising from the joint synovium, bursae, or tendon sheaths. Although the temporomandibular joint is rarely affected by neoplastic lesions, SC is the most common neoplastic lesion of this joint. The treatment of this disease consists in the extraoral surgery with a wide removal of the lesion; in this study, the authors described a more conservative intraoral surgical approach. Patient with SC of temporomandibular joint typically refer a limitation in the mouth opening, together with a persistent not physiological mandibular protrusion and an appearance of a neoformation located at the right preauricular region: the authors reported 1 scholar patient. After biopsy of the neoformation, confirming the synovial chondromatosis, the patient underwent thus to the surgical excision of the tumor, via authors' conservative transoral approach, to facilitate the enucleation of the neoformation. The mass fully involved the pterygo-maxillary fossa with involvement of the parotid lodge and of the right TMJ: this multifocal extension suggested for a trans-oral surgical procedure, in the light of the suspicion of a possible malignant nature of the neoplasm. Our intraoral conservative approach to surgery is aimed to reduce the presence of unaesthetic scars in preauricular and facial regions, with surgical results undoubtedly comparable to the traditional surgical techniques much more aggressive. Our technique could be a valid, alternative, and safe approach to treat this rare and complex kind of oncological disease. PMID:27300457

  16. Use of Theraflex-TMJ topical cream for the treatment of temporomandibular joint and muscle pain.

    PubMed

    Lobo, Silvia Lobo; Mehta, Noshir; Forgione, Albert G; Melis, Marcello; Al-Badawi, Emad; Ceneviz, Caroline; Zawawi, Khalid H

    2004-04-01

    This randomized, double-blind study was designed to evaluate the effectiveness of the topical cream Theraflex-TMJ (NaBob/Rx, San Mateo, CA) in patients with masseter muscle pain and temporomandibular joint (TMJ) pain. Fifty-two subjects (5 males and 47 females) were instructed to apply a cream over the afflicted masseter muscle(s) or over the jaw joint(s) twice daily for two weeks. Theraflex-TMJ cream was used by the experimental group, while a placebo cream was used by the control group. The means of pain ratings were calculated prior to the application of the cream (baseline), after ten days of tx (period 1), and 15 days of tx (period 2) days of treatment and five days after stopping the treatment (follow-up). There was a significant decrease in reported pain levels from baseline in the experimental group for period 1 (p < 0.01), period 2 (p < 0.001), and follow-up (p < 0.01). For the control group, no significant differences were found between the different time periods (p > 0.05). There was evidence of minor side effects such as skin irritation and/or burning on the site of the application in two subjects in the experimental as well as two subjects in the control groups. The data strongly suggest that Theraflex-TMJ topical cream is safe and effective for reducing pain in the masseter muscle and the temporomandibular joint. PMID:15134414

  17. Application of the rapid prototyping technique to design a customized temporomandibular joint used to treat temporomandibular ankylosis

    PubMed Central

    Chaware, Suresh M.; Bagaria, Vaibhav; Kuthe, Abhay

    2009-01-01

    Anthropometric variations in humans make it difficult to replace a temporomandibular joint (TMJ), successfully using a standard “one-size-fits-all” prosthesis. The case report presents a unique concept of total TMJ replacement with customized and modified TMJ prosthesis, which is cost-effective and provides the best fit for the patient. The process involved in designing and modifications over the existing prosthesis are also described. A 12-year- old female who presented for treatment of left unilateral TMJ ankylosis underwent the surgery for total TMJ replacement. A three-dimensional computed tomography (CT) scan suggested features of bony ankylosis of left TMJ. CT images were converted to a sterolithographic model using CAD software and a rapid prototyping machine. A process of rapid manufacturing was then used to manufacture the customized prosthesis. Postoperative recovery was uneventful, with an improvement in mouth opening of 3.5 cm and painless jaw movements. Three years postsurgery, the patient is pain-free, has a mouth opening of about 4.0 cm and enjoys a normal diet. The postoperative radiographs concur with the excellent clinical results. The use of CAD/CAM technique to design the custom-made prosthesis, using orthopaedically proven structural materials, significantly improves the predictability and success rates of TMJ replacement surgery. PMID:19881026

  18. Evaluation of the mechanism and principles of management of temporomandibular joint dislocation. Systematic review of literature and a proposed new classification of temporomandibular joint dislocation

    PubMed Central

    2011-01-01

    Background Virtually all the articles in literature addressed only a specific type of dislocation. The aim of this review was to project a comprehensive understanding of the pathologic processes and management of all types of dislodgement of the head of the mandibular condyle from its normal position in the glenoid fossa. In addition, a new classification of temporomandibular joint dislocation was also proposed. Method and materials A thorough computer literature search was done using the Medline, Cochrane library and Embase database. Key words like temporo-mandibular joint dislocation were used for the search. Additional manual search was done by going through published home-based and foreign articles. Case reports/series, and original articles that documented the type of dislocation, number of cases treated in the series and original articles. Treatment done and outcome of treatment were included in the study. Result A total of 128 articles were reviewed out which 79 were found relevant. Of these, 26 were case reports, 17 were case series and 36 were original articles. 79 cases were acute dislocations, 35 cases were chronic protracted TMJ dislocations and 311 cases were chronic recurrent TMJ dislocations. Etiology was predominantly trauma in 60% of cases and other causes contributed about 40%. Of all the cases reviewed, only 4 were unilateral dislocation. Various treatment modalities are outlined in this report as indicated for each type of dislocation. Conclusion The more complex and invasive method of treatment may not necessarily offer the best option and outcome of treatment, therefore conservative approaches should be exhausted and utilized appropriately before adopting the more invasive surgical techniques. PMID:21676208

  19. Internal derangements of the temporomandibular joint: diagnosis by direct sagittal computed tomography

    SciTech Connect

    Manzione, J.V.; Katzberg, R.W.; Brodsky, G.L.; Seltzer, S.E.; Mellins, H.Z.

    1984-01-01

    The authors performed direct sagittal computed tomography (CT) on 4 cadaver temporomandibular joints (TMJ) and examined 51 TMJs in 47 patients clinically. The results were correlated with cadaver anatomical sections and clinical arthrographic findings. A fat plane between the bellies of the lateral pterygoid muscles, termed the ''lateral pterygoid fat pad,'' served as the anatomical basis for detection of internal derangements by CT. CT was 94% accurate in detecting meniscal derangements and 96% accurate in detecting degenerative arthritis. The authors suggest that CT rather than arthrography be employed as the primary TMJ imaging modality when internal derangement or arthritis is suspected.

  20. Alterations of the Temporomandibular Joint on Magnetic Resonance Imaging according to Growth and Development in Schoolchildren

    PubMed Central

    Tanaka, Tatsurou; Konoo, Tetsuro; Habu, Manabu; Oda, Masafumi; Kito, Shinji; Kodama, Masaaki; Kokuryo, Shinya; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Nishida, Ikuko; Morikawa, Kazumasa; Saeki, Katsura; Maki, Kenshi; Tominaga, Kazuhiro; Masumi, Shin-ichi; Terashita, Masamichi; Morimoto, Yasuhiro

    2012-01-01

    The paper explains the alterations of the temporomandibular joint (TMJ) visualized by magnetic resonance imaging (MRI) according to the growth and development of schoolchildren. Appearance and disappearance of a “double contour-like structure” (DCLS) of the mandibular condyle on MRI according to the growth and development of schoolchildren were demonstrated. In addition, possible constituents of DCLS and the significance of detection of DCLS on MRI were also speculated. The relationship between red marrow and yellow marrow in the articular eminence of temporal bone, the disappearance of DCLS, and alterations of the mandibular condyle have been elucidated. PMID:23316233

  1. Computed tomography of the meniscus of the temporomandibular joint: preliminary observations

    SciTech Connect

    Helms, C.A.; Morrish, R.B. Jr.; Kircos, L.T.; Dolwick, M.F.

    1982-12-01

    Anterior displacement of the meniscus of the temporomandibular joint (TMJ) was diagnosed in nine patients who had undergone arthrography, and they were later examined with computed tomography (CT) to see if this modality could supplant arthrography in some patients with TMJ dysfunction. The anteriorly displaced menisci were visualizsed in all nine patients by using sagittal reformations and blink mode. Four of the nine patients had the diagnosis confirmed at surgery. The precise protocol for the CT examination and how to interpret it are discussed. We are optimistic that CT may replace TMJ arthrography in selected patients.

  2. Clinical treatment of a ruptured temporomandibular joint disc: morphological changes at 5-year follow-up.

    PubMed

    Cardinal, Lucas; Porto, Felipe; Agarwal, Sachin; Grossman, Eduardo

    2014-01-01

    Osteoarthrosis is a disease that affects the temporomandibular joint (TMJ). This case report chronicles the diagnosis and treatment of a patient for whom this pathological condition was accompanied by a rupture of the articular disc. The patient presented with loud sounds in the left TMJ and an irregular mandibular occlusal plane due to condylar intrusion in the glenoid fossa on the ipsilateral side. A noninvasive treatment was selected. A 4-month follow-up revealed remission of the articular sounds, and tissue regeneration was noted. These improvements remained visible at 5-year follow-up. PMID:24598507

  3. RAPID COMMUNICATION: Nanostructured diamond film deposition on curved surfaces of metallic temporomandibular joint implant

    NASA Astrophysics Data System (ADS)

    Fries, Marc D.; Vohra, Yogesh K.

    2002-10-01

    Microwave plasma chemical vapour deposition of nanostructured diamond films was carried out on curved surfaces of Ti-6Al-4V alloy machined to simulate the shape of a temporomandibular joint (TMJ) dental implant. Raman spectroscopy shows that the deposited films are uniform in chemical composition along the radius of curvature of the TMJ condyle. Thin film x-ray diffraction reveals an interfacial carbide layer and nanocrystalline diamond grains in this coating. Nanoindentation hardness measurements show an ultra-hard coating with a hardness value of 60+/-5 GPa averaged over three samples.

  4. Stress Analysis of Anterior-Disc-Displaced Temporomandibular Joint Using Individual Finite Element Model

    NASA Astrophysics Data System (ADS)

    Tanaka, Masao; Tanaka, Eiji; Todoh, Masahiro; Asai, Daisuke; Kuroda, Yukiko

    Temporomandibular joint (TMJ) disorder relates to the biomechanical irregularity of the structual joint components, and the behavior of soft tissue components is considered as a key to understand the biomechanical condition in the TMJ. The configuration of joint components, however, closely depends on individual patients. In this study, attention has been focused on the stress and displacement of irregular TMJs with anterior disc displacement. Using biplane magnetic resonance (MR) images, typical anterior-disc-displaced (ADD) TMJ of a patient with temporomandibular disorder has been modeled individually. The stress distribution in ADD TMJs has been compared with that in normal TMJs. Parameter studies with the elastic modulus have been carried out and it revealed that the stress distribution in the TMJ is highly dependent on the connective tissue modulus as well as disc modulus in the case of ADD TMJ, and that the disc displacement due to mouth opening movement depends on disc modulus in normal TMJ but depends on retrodiscal connective tissue in ADD TMJ.

  5. Gene Expression Profiling of IL-17A-Treated Synovial Fibroblasts from the Human Temporomandibular Joint

    PubMed Central

    Hattori, Toshio; Ogura, Naomi; Akutsu, Miwa; Kawashima, Mutsumi; Watanabe, Suguru; Ito, Ko; Kondoh, Toshirou

    2015-01-01

    Synovial fibroblasts contribute to the inflammatory temporomandibular joint under pathogenic stimuli. Synovial fibroblasts and T cells participate in the perpetuation of joint inflammation in a mutual activation feedback, via secretion of cytokines and chemokines that stimulate each other. IL-17 is an inflammatory cytokine produced primarily by Th17 cells which plays critical role in the pathogenesis of numerous autoimmune and inflammatory diseases. Here, we investigated the roles of IL-17A in temporomandibular joint disorders (TMD) using genome-wide analysis of synovial fibroblasts isolated from patients with TMD. IL-17 receptors were expressed in synovial fibroblasts as assessed using real-time PCR. Microarray analysis indicated that IL-17A treatment of synovial fibroblasts upregulated the expression of IL-6 and chemokines. Real-time PCR analysis showed that the gene expression of IL-6, CXCL1, IL-8, and CCL20 was significantly higher in IL-17A-treated synovial fibroblasts compared to nontreated controls. IL-6 protein production was increased by IL-17A in a time- and a dose-dependent manner. Additionally, IL-17A simulated IL-6 protein production in synovial fibroblasts samples isolated from three patients. Furthermore, signal inhibitor experiments indicated that IL-17-mediated induction of IL-6 was transduced via activation of NFκB and phosphatidylinositol 3-kinase/Akt. These results suggest that IL-17A is associated with the inflammatory progression of TMD. PMID:26839464

  6. Clinical and MRI investigation of temporomandibular joint in major depressed patients

    PubMed Central

    Lopes, SLPC; Costa, ALF; Cruz, AD; Li, LM; de Almeida, SM

    2012-01-01

    Objective The aim of the present study was to describe the clinical and MRI findings of the temporomandibular joint (TMJ) in patients with major depressive disorders (MDDs) of the non-psychotic type. Methods 40 patients (80 TMJs) who were diagnosed as having MDDs were selected for this study. The clinical examination of the TMJs was conducted according to the research diagnostic criteria and temporomandibular disorders (TMDs). The MRIs were obtained bilaterally in each patient with axial, parasagittal and paracoronal sections within a real-time dynamic sequence. Two trained oral radiologists assessed all images. For statistical analyses, Fisher's exact test and χ2 test were applied (α = 0.05). Results Migraine was reported in 52.5% of subjects. Considering disc position, statistically significant differences between opening patterns with and without alteration (p = 0.00) and between present and absent joint noises (p = 0.00) were found. Regarding muscular pain, patients with and without abnormalities in disc function and patients with and without abnormalities in disc position were not statistically significant (p = 0.42 and p = 0.40, respectively). Significant differences between mandibular pathway with and without abnormalities (p = 0.00) and between present and absent joint noises (p = 0.00) were observed. Conclusion Based on the preliminary results observed by clinical and MRI examination of the TMJ, no direct relationship could be determined between MDDs and TMDs. PMID:22517997

  7. The relationship between unilateral mandibular angle fracture and temporomandibular joint function.

    PubMed

    Baltrusaityte, Ausra; Surna, Algimantas; Pileicikiene, Gaivile; Kubilius, Ricardas; Gleiznys, Alvydas; Zilinskas, Juozas

    2014-01-01

    PURPOSE. Aim of this study was to analyze relation of occlusal correction and alterations of temporomandibular joint function during treatment of unilateral mandibular fractures. MATERIALS AND METHODS. We compared 49 patients treated for unilateral mandibular fracture without occlusal correction with 21 patient treated for unilateral mandibular fracture along with early and consequent occlusal analysis and correction and with 49 control subjects. Patients' complaints, mandibular movements and occlusal parameters were evaluated during the period of healing. ZEBRIS ultrasound system (Jaw Motion Analyzer, Zebris Medical GmbH, Isny, Germany) was used for analysis of mandibular movements and T-Scan analyzer (Tekscan, Inc., Boston, MA, USA) was used for occlusal analysis. RESULTS. Findings of our study showed statistically significant (p<0.05) diminution of patients complaints, mandibular movement alterations and occlusal disturbances in patients who received occlusal correction during MF treatment if compared to patients treated without occlusal correction, except noises from the joint in the injured side and mandibular lateral track to the injured side in the final stage of investigation. Despite applied treatment recovery of the TMJ function was not complete and the investigated parameters remained worse if compared to the control group. CONCLUSIONS. Results of this study confirmed positive influence of early and subsequent occlusal analysis and correction during stages of MF treatment on diminution of functional alterations of the temporomandibular joint function. Timely occlusal correction improves and hastens process of rehabilitation therefore it is indispensable part of MF treatment. PMID:25471992

  8. Temporomandibular joint ankylosis as part of the clinical spectrum of Carey-Fineman-Ziter syndrome?

    PubMed

    Pasetti, Martina; Mazzoleni, Fabio; Novelli, Giorgio; Iascone, Maria; Bozzetti, Alberto; Selicorni, Angelo

    2016-08-01

    The Carey-Finema-Ziter syndrome (CFZS, MIM 254940) is an apparently autosomal recessively inherited disorder consisting of the combination of non-progressive congenital myopathy with Moebius and Pierre Robin sequence, facial anomalies and growth delay. Mental development has been described as normal or delayed. Temporomandibular joint (TMJ) ankylosis is the immobility of the joint caused by ankylotic fusion of the mandible to the cranial base or zygoma. It is a serious and disabling condition that may cause problems in mastication, digestion, speech, appearance, and oral hygiene. Most often is a true ankylosis of the TMJ but other pathological mechanisms are described (i.e., the fusion of the coronoid process to temporal bone or with the zygoma, or a variety of soft tissues disorders like Fibrodysplasia Ossificans Progressiva). Here we report a 2-year-old girl fitting with a clinical diagnosis of CFZS associated with a limited mouth opening in which temporomandibular joint ankylosis was suspected. Because it has been postulated that many clinical features in CFZS may only be secondary effects of brainstem anomalies and muscle weakness during development, the limited opening of the mouth observed in our patient could represent a rare clinical feature of CFZS itself. © 2016 Wiley Periodicals, Inc. PMID:27232676

  9. Dislocation of the temporomandibular joint meniscus: contrast arthrography vs. computed tomography

    SciTech Connect

    Thompson, J.R.; Christiansen, E.; Sauser, D.; Hasso, A.N.; Hinshaw, D.B. Jr.

    1985-01-01

    A prospective study to determine the accuracy of computed tomography (CT) for the diagnosis of dislocation of the temporomandibular joint (TMJ) meniscus was made by performing both CT and contrast arthrography on 18 joints suspected of meniscus dislocation. Arthography rather than surgery was chosen as the quality standard for comparing CT findings, as not all patients undergoing the studies underwent surgery. The results of each test were reported independently by the radiologist who obtained either all of the arthograms or all of the CT scans. For dislocation of the meniscus, there were excellent agreement between the two methods. CT seems to be nearly as accurate as arthrography for showing meniscus dislocation, is performed with lower x-ray exposure, and is noninvasive. Arthrograpy discloses more detailed information about the joint meniscus, such as perforation and maceration, and should continue to be used when this kind of information is clinically important.

  10. Temporomandibular joint dysfunction. Connective tissue variations in skin biopsy and mitral valve function.

    PubMed

    Westling, L; Holm, S; Wallentin, I

    1992-12-01

    Ten women with temporomandibular joint dysfunction and general joint hypermobility (score, 4 to 8) and 10 symptom-free female volunteers without systemic laxity (score, 0 to 2) were selected for the study. A biopsy of connective tissue from arm skin found that the total collagen concentrations were lower and the proteoglycan values were higher in the hypermobile TMJ patients than in the control subjects. The mitral region of the heart was inspected by echocardiography. Eight patients and four controls had slightly abnormal echocardiographic findings. Two patients fulfilled the criteria for mitral valve prolapse. The patients had significantly more musculoskeletal complaints than did the controls. The study suggests an association between joint hypermobility, abnormal skin connective tissue composition, mitral valve malfunction, and musculoskeletal disorders in young women with TMJ dysfunction, especially internal derangement. PMID:1488224

  11. Fracture of the articular disc in the temporomandibular joint: two case reports

    PubMed Central

    An, S-Y

    2015-01-01

    Disc fracture of the temporomandibular joint (TMJ) is a little-known pathological condition owing to its extreme rarity. We report two cases of elderly patients who were diagnosed with disc fracture of the TMJ based on MRI, and we review related reports. On physical examination, an incomplete bite and mild joint pain were observed on the affected side in both patients. An MRI showed a complete fracture in the intermediate zone of the articular disc in the TMJ; the posterior fragment was displaced posteriorly, causing occlusal change in the closed position of the condyle and an incomplete bite. Conservative treatment including manual manipulation, physical therapy and oral appliance had no effect on the occlusal abnormality. Although the inciting cause of the disc fracture remained unclear, the degenerative changes in the joint may have been a factor by increasing the brittleness and reducing the elasticity of the disc. PMID:25308829

  12. Arthroscopic eminoplasty for habitual dislocation of the temporomandibular joint: preliminary study.

    PubMed

    Segami, N; Kaneyama, K; Tsurusako, S; Suzuki, T

    1999-12-01

    A unique surgical technique, arthroscopic eminoplasty was undertaken in 16 joints of 11 patients with habitual dislocation of the temporomandibular joint (TMJ). There were 10 joints with subluxation and 6 joints with complete dislocation in 4 male and 7 female patients with a mean age of 33 +/- 20 years. The procedure consisted of conventional diagnostic arthroscopy, followed by shaving of approximately 3 to 5 mm in height of the articular eminence with an electric motorized shaver with bone files, depending on the bone thickness as detected by preoperative imaging. The arthroscopic eminoplasty was accomplished without any peri- or postoperative complication. During the postoperative follow-up period of 19 months on average (6-36 months), all patients were free of dislocation of the TMJ, except for one joint. The patients could open their mouth 42 +/- 6 mm without arthralgia 2 weeks after surgery, and finally 47 +/- 7 mm without any subjective symptom but small joint noises (clicking or crepitus) in 10 joints. On postoperative radiographs only minor changes of the mandibular condyle were apparent in four joints. Arthroscopic eminoplasty might become a significant procedure for habitual dislocation of the TMJ and seems to produce results comparable to open arthrotomy. Further study will be required to assess this method as an acceptable modality in the future. PMID:10870759

  13. Is there a niche for arthroscopic laser surgery of the temporomandibular joint?

    NASA Astrophysics Data System (ADS)

    Nuebler-Moritz, Michael; Hering, Peter; Bachmaier, Uli; Schiessl, Robert; Rueschoff, Josef; Meister, Joerg

    1996-04-01

    The purpose of this in vitro study was to investigate and compare effects of currently available laser systems at different wavelengths (XeCl excimer laser, Holmium:YAG laser, Erbium:YAG laser) on porcine articulating facets, capsule and meniscus of the temporomandibular joint via photomacroscopy, light and scanning electron microscopy. From a critical review of the relevant literature and the preliminary observations of this investigation, it appears that the Neodymium:YAG laser is inappropriate for TMJ arthroscopic surgery with regard to the huge thermal injury caused to the remaining tissue. The Holmium:YAG laser suffers from remarkable photomechanical and photothermal side effects, whereas the Erbium:YAG laser ablates temporomandibular joint tissue efficiently with minimal adjacent damage--similar to the XeCl excimer laser, without entailing the risk of potential mutagenity. To sum up, it can be concluded that there is a clinical need for laser- assisted arthroscopic surgery of the craniomandibular articulation. Nevertheless, at present none of the available laser systems meet the medical demands completely. Currently, the Erbium:YAG laser seems to be the most suitable for TMJ arthroscopic surgery.

  14. Differential diagnostics of pain in the course of trigeminal neuralgia and temporomandibular joint dysfunction.

    PubMed

    Pihut, M; Szuta, M; Ferendiuk, E; Zeńczak-Więckiewicz, D

    2014-01-01

    Chronic oral and facial pain syndromes are an indication for intervention of physicians of numerous medical specialties, while the complex nature of these complaints warrants interdisciplinary diagnostic and therapeutic approach. Oftentimes, lack of proper differentiation of pain associated with pathological changes of the surrounding tissues, neurogenic pain, vascular pain, or radiating pain from idiopathic facial pain leads to improper treatment. The objective of the paper is to provide detailed characterization of pain developing in the natural history of trigeminal neuralgia and temporomandibular joint dysfunction, with particular focus on similarities accounting for the difficulties in diagnosis and treatment as well as on differences between both types of pain. It might seem that trigeminal neuralgia can be easily differentiated from temporomandibular joint dysfunction due to the acute, piercing, and stabbing nature of neuralgic pain occurring at a single facial location to spread along the course of the nerve on one side, sometimes a dozen or so times a day, without forewarning periods. Both forms differ significantly in the character and intensity of pain. The exact analysis of the nature, intensity, and duration of pain may be crucial for the differential diagnostics of the disorders of our interest. PMID:24995309

  15. Dexmedetomidine premedication for fiberoptic intubation in patients of temporomandibular joint ankylosis: A randomized clinical trial

    PubMed Central

    Gupta, Kumkum; Jain, Manish; Gupta, Prashant K.; Rastogi, Bhawna; Saxena, Sanjeev K.; Manngo, Aman

    2012-01-01

    Background: Fiberoptic intubation is the gold standard technique for difficult airway management in patients of temporomandibular joint. This study was aimed to evaluate the clinical efficacy and safety of dexmedetomidine as premedication with propofol infusion for fiberoptic intubation. Methods: Consent was obtained from 46 adult patients of temporomandibular joint ankylosis, scheduled for gap arthroplasty. They were enrolled for thisdouble-blind, randomized, prospective clinical trial with two treatment groups – Group D and Group P, of 23 patients each. Group D patients had received premedication of dexmedetomidine 1 μg/kg infused over 10 min followed by sedative propofol infusion and the control Group P patients were given only propofol infusion to achieve sedation. Condition achieved at endoscopy, intubating conditions, hemodynamic changes and postoperative events were evaluated as primary outcome. Results: The fiberoptic intubation was successful with satisfactory endoscopic and intubating condition in all patients. Dexmedetomidine premedication has provided satisfactory conditions for fiberoptic intubation and attenuated the hemodynamic response of fiberoptic intubation than the propofol group. Conclusion: Fiberoptic intubation was found to be easier with dexmedetomidine premedication along with sedative infusion of propofol with complete amnesia of the procedure, hemodynamic stability and preservation of patent airway. PMID:23162393

  16. Long-term stability of conservative orthodontic treatment in a patient with temporomandibular joint disorder

    PubMed Central

    Mitsui, Silvia Naomi; Yasue, Akihiro; Kuroda, Shingo; Tanaka, Eiji

    2016-01-01

    This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function. PMID:27556023

  17. Effectiveness of a Home Exercise Program in Combination with Ultrasound Therapy for Temporomandibular Joint Disorders

    PubMed Central

    Ucar, Mehmet; Sarp, Ümit; Koca, İrfan; Eroğlu, Selma; Yetisgin, Alparslan; Tutoglu, Ahmet; Boyacı, Ahmet

    2014-01-01

    [Purpose] This study compared the effectiveness of home exercise alone versus home exercise combined with ultrasound for patients with temporomandibular joint disorders. [Subjects and Methods] This study enrolled 23 female and 15 male patients who were divided randomly into two groups. The home exercise group performed a home exercise program consisting of an exercise program and patient education, and the home exercise combined with ultrasound group received ultrasound therapy in addition to the home exercise program. Pain intensity was evaluated using a visual analogue scale. Pain free maximum mouth opening was evaluated at baseline and 2 weeks after the treatment. [Results] There was no difference between the two groups in baseline values. After the treatment, the visual analogue scale decreased and pain free maximum mouth opening scores improved significantly in each group. Additionally, both values were higher in the home exercise combined with ultrasound group than in the home exercise group. [Conclusion] The combination of home exercise combined with ultrasound appears to be more effective at providing pain relief and increasing mouth opening than does home exercise alone for patients with temporomandibular joint disorders. PMID:25540479

  18. Differential Diagnostics of Pain in the Course of Trigeminal Neuralgia and Temporomandibular Joint Dysfunction

    PubMed Central

    Pihut, M.; Szuta, M.; Ferendiuk, E.; Zeńczak-Więckiewicz, D.

    2014-01-01

    Chronic oral and facial pain syndromes are an indication for intervention of physicians of numerous medical specialties, while the complex nature of these complaints warrants interdisciplinary diagnostic and therapeutic approach. Oftentimes, lack of proper differentiation of pain associated with pathological changes of the surrounding tissues, neurogenic pain, vascular pain, or radiating pain from idiopathic facial pain leads to improper treatment. The objective of the paper is to provide detailed characterization of pain developing in the natural history of trigeminal neuralgia and temporomandibular joint dysfunction, with particular focus on similarities accounting for the difficulties in diagnosis and treatment as well as on differences between both types of pain. It might seem that trigeminal neuralgia can be easily differentiated from temporomandibular joint dysfunction due to the acute, piercing, and stabbing nature of neuralgic pain occurring at a single facial location to spread along the course of the nerve on one side, sometimes a dozen or so times a day, without forewarning periods. Both forms differ significantly in the character and intensity of pain. The exact analysis of the nature, intensity, and duration of pain may be crucial for the differential diagnostics of the disorders of our interest. PMID:24995309

  19. Long-term stability of conservative orthodontic treatment in a patient with temporomandibular joint disorder.

    PubMed

    Mitsui, Silvia Naomi; Yasue, Akihiro; Kuroda, Shingo; Tanaka, Eiji

    2016-01-01

    This article reports the orthodontic treatment of a 20-year-old patient with dental crowding and temporomandibular joint disorders (TMDs). The patient presented moderate anterior crowding with a Class I molar relationship and masticatory disturbance in the mandibular position induced by previous splint therapy. Orthodontic treatment with multi-bracket appliance was initiated to correct the anterior crowding in both dental arches, after the extraction of first premolars and third molars, and also to maintain the splint-induced position of the condyles. After 26 months of treatment, an acceptable occlusion was achieved without any TMD symptoms. After 18-month retention, flattening on the right condyle was observed, possibly as an adaptative remodeling. After 16-year retention period, the occlusion was maintained without recurrence of any TMD symptoms, indicating a long-term stability of occlusion and temporomandibular joint (TMJ) components. Our results suggest the possibility of compromised treatment in patients with TMD to achieve a long-term stability in occlusion and TMJ function. PMID:27556023

  20. Signs and symptoms of temporomandibular disorders and radiologically observed abnormalities in the condyles of the temporomandibular joints of professional violin and viola players.

    PubMed

    Kovero, O; Könönen, M

    1995-04-01

    The frequency of temporomandibular disorders (TMDs) and radiologically observed abnormalities in the condyles of the temporomandibular joints (TMJs) of professional violin and viola players was investigated in 26 orchestra violinists/violists (VP group) and in their sex-, age-, and dentition-matched controls (C group). A routine clinical stomatognathic examination, a standardized interview, and radiography of the condyles were carried out for all subjects. The VP group showed a higher frequency of subjective symptoms and clinical signs of TMD, such as palpatory tenderness of masticatory muscles, TMJ clicking, painful mandibular movements, and deviation on opening or closing. There was no difference between the groups in terms of radiologic findings in the condyles. Weekly playing hours correlated positively with some signs of TMD. It is concluded that professional violin or viola playing might be a predisposing factor for TMD. PMID:7610780

  1. Temporomandibular joint arthrography: a comparison between a fluoroscopic and a nonfluoroscopic technique

    SciTech Connect

    Benson, B.W.; Langlais, R.P.; Abramovitch, K.

    1989-05-01

    A nonfluoroscopic temporomandibular joint arthrographic technique is contrasted with a more widely employed fluoroscopically guided technique. The nonfluoroscopic technique uses a posterior approach to joint injection, as contrasted with the lateral injection approach of the fluoroscopically guided technique. The advantages of the nonfluoroscopic technique are less radiation dose to the patient, less expensive and less sophisticated imaging equipment, and less potential for neurovascular trauma. The fluoroscopic technique offers greater control of the procedure, less patient and operator time, and the capability for a dynamic videofluoroscopic study. Both techniques appear to be safe and efficacious. Differences in anatomy, imaging modalities, patient radiation exposure, and potential complications are also discussed as part of this comparison.48 references.

  2. Ankylosis of temporomandibular joint caused by psoriatic arthritis: a report of four cases with literature review.

    PubMed

    Wang, Zhi Hui; Zhao, Yan Ping; Ma, Xu Chen

    2014-01-01

    Psoriatic arthritis (PsA) is an inflammatory joint disease associated with psoriasis. PsA is often confused with other diseases such as osteoarthritis and rheumatoid arthritis. PsA involving temporomandibular joints (TMJs) are uncommon: only 19 articles with 43 cases have been documented in the literature. TMJ ankylosis caused by PsA is rare, with only six cases having been reported. The authors present four cases of ankylosis of the TMJ secondary to PsA and review the literature. The findings of this study suggest that more attention should be paid to psoriasis patients with TMJ symptoms and proper treatment should be taken to prevent irreversible TMJ damage. PMID:25028690

  3. Custom Anatomical 3D Spacer for Temporomandibular Joint Resection and Reconstruction.

    PubMed

    Green, John Marshall; Lawson, Sarah T; Liacouras, Peter C; Wise, Edward M; Gentile, Michael A; Grant, Gerald Thomas

    2016-03-01

    Two cases are presented using a two-stage approach and a custom antibiotic spacer placement. Temporomandibular reconstruction can be very demanding and accomplished with a variety of methods in preparation of a total joint and ramus reconstruction with total joint prostheses (TMJ Concepts, Ventura, CA). Three-dimensional reconstructions from diagnostic computed tomography were used to establish a virtually planned resection which included the entire condyle-ramus complex. From these data, digital designs were used to manufacture molds to facilitate intraoperative fabrication of precise custom anatomic spacers from rapidly setting antibiotic-impregnated polymethyl methacrylate. Molds were manufactured using vat polymerization (stereolithography) with a photopolymer in the first case and powder bed fusion (electron beam melting) with Ti6AL4V for the second. Surgical methodology and the use of molds for intraoperative spacer fabrication for each case are discussed. PMID:26889353

  4. Estrogen receptors in the temporomandibular joint of the baboon (Papio cynocephalus): an autoradiographic study

    SciTech Connect

    Aufdemorte, T.B.; Van Sickels, J.E.; Dolwick, M.F.; Sheridan, P.J.; Holt, G.R.; Aragon, S.B.; Gates, G.A.

    1986-04-01

    Using an autoradiographic method, the temporomandibular joint (TMJ) complex of five aged female baboons was studied for the presence of receptors for estradiol-17 beta. The study was performed in an effort to learn more of the pathophysiology of this joint and in an attempt to provide a scientific basis to explain the reported preponderance of women who seek and undergo treatment for signs and symptoms referable to the TMJ. This experiment revealed that the TMJ complex contains numerous cells with receptors for estrogen, particularly the articular surface of the condyle, articular disk, and capsule. Muscles of mastication contained relatively fewer receptors. As a result, one may postulate a role for the sex steroid hormones in the maintenance, repair, and/or pathogenesis of the TMJ. Additional studies are necessary to fully determine the significance of hormone receptors in this site and any correlation between diseases of the TMJ and the endocrine status of affected patients.

  5. [Computed tomography investigation of temporomandibular joint in surgery of dento-maxillary anomalies].

    PubMed

    Popescu, M A; Dincă, O; Bucur, A

    2009-01-01

    The aim of this study was to evaluate changes in the temporomandibular joint morphology, regarding the relation between mandibular condyle and fossa, after bilateral sagittal split osteotomy in Angle class III dentomaxillary anomalies. Preserving the preoperative position of the condyle during sagittal split osteotomy is considered important to obtain skeletal and occlusal stability. Cone-beam computed tomography of 20 class III patients with mandibular prognathism were assessed before and 6 weeks after operation to evaluate changes of the condylar position. We propose a protocol for head posture and computed tomography investigation, which makes possible the comparison between cone-beam computed tomography (CBCT) in different moments at the same patient. There are no significant changes after bilateral sagittal split osteotomy regarding joint relations. PMID:19943558

  6. TNF Accelerates Death of Mandibular Condyle Chondrocytes in Rats with Biomechanical Stimulation-Induced Temporomandibular Joint Disease

    PubMed Central

    Zhang, Hongyun; Zhang, Jing; Jing, Lei; Liao, Lifan; Wang, Meiqing

    2015-01-01

    Objective To determine if temporomandibular joint chondrocyte apoptosis is induced in rats with dental biomechanical stimulation and what a role TNF takes. Methods Thirty-two rats were divided into 4 groups (n = 8/group) and exposed to incisor mal-occlusion induced by unilateral anterior crossbite biomechanical stimulation. Two groups were sampled at 2 or 4 weeks. The other two groups were treated with local injections of a TNF inhibitor or PBS into the temporomandibular joints area at 2 weeks and then sampled at 4 weeks. Twenty-four rats either served as unilateral anterior crossbite mock operation controls (n = 8/group) with sampling at 2 or 4 weeks or received a local injection of the TNF inhibitor at 2 weeks with sampling at 4 weeks. Chondrocytes were isolated from the temporomandibular joints of 6 additional rats and treated with TNF in vitro. Joint samples were assessed using Hematoxylin&eosin, Safranin O, TUNEL and immunohistochemistry staining, real-time PCR, fluorogenic activity assays and Western blot analyses. The isolated chondrocytes were also analyzed by flow cytometry. Results Unilateral anterior crossbite stimulation led to temporomandibular joint cartilage degradation, associated with an increase in TUNEL-positive chondrocytes number, caspase-9 expression levels, and the release of cytochrome c from mitochondria at 2 weeks without changes in TNF and caspase-8 levels until after 4 weeks. TNF stimulated apoptosis of the isolated chondrocytes and up-regulated caspase-8 expression, but did not change caspase-9 expression levels. Local injection of TNF inhibitor down-regulated caspase-8 expression and reduced TUNEL-positive cell number, but did not reverse cartilage thickness reduction, caspase-9 up-regulation or cytochrome c release. Conclusions Unilateral anterior crossbite stimulation induces mitochondrion-mediated apoptosis of articular chondrocytes. TNF accelerated the unilateral anterior crossbite induced chondrocytes apoptosis via death

  7. A model to simulate the mastication motion at the temporomandibular joint

    NASA Astrophysics Data System (ADS)

    Villamil, Marta B.; Nedel, Luciana P.; Freitas, Carla M. D. S.; Maciel, Anderson

    2005-04-01

    The understanding of the mastication system motion is essential to maxillofacial surgeons and dentists in the procedures concerning jaw and teeth corrections. The temporomandibular joint (TMJ), despite its complexity, is one of the most frequently used joints of the human body. The incidence of a great number of injuries in this joint is influenced not only by its regular use during the mastication, but also by the strong forces applied by the muscles and the wide range of movements it is capable to perform. In this work, we propose the development of a jaw simulator capable of reproducing the complete mastication movement. Our jaw simulator is basically composed by three triangle meshes representing the 3D model of the cranium, mandible and teeth; and an anatomically-based joint model conceived to represent the TMJ motion. The polygonal meshes describing the bones and teeth are obtained from CT images and the jaw motion is simulated using the joint model guided by a 3D motion curve obtained from the composition of the standard 2D curves available in the medical literature. The scale, height and width of these original curves are modified to simulate different kind and size of food and to represent the movements" variability depending on patient morphology (teeth, bones, joints and muscles). The evaluation of preliminary results involved the comparison of a dynamic MRI of a healthy person with the respective simulation.

  8. A simple technique for the distraction and mobilization of the temporomandibular joint condyle in nonreducing disk derangements.

    PubMed

    Harkins, S J; Marteney, J L; Cueva, L

    1987-11-01

    The clothespin traction technique described in this article is simple, inexpensive, and offers high patient compliance when used by the patient outside the clinic. This procedure may be effective in recapturing nonreducible disks and regaining range of motion in hypomobile temporomandibular joints. PMID:3479559

  9. Radiologic Techniques Used to Evaluate the Temporomandibular Joint; I. Conventional Methods

    PubMed Central

    Roberts, David; Pettigrew, James; Ram, Carol; Joseph, Peter M.

    1984-01-01

    Symptoms of temporomandibular joint pathology are present in a relatively high proportion of the population. Conventional radiographic techniques used to evaluate the morphology of the joint provide data which may be difficult to interpret. These techniques are reviewed briefly and their interpretational shortcomings are noted. Computed tomography is currently being used by some clinicians to evaluate the joint. This technique may also yield data which are difficult to interpret. Extended processing of CT data to provide three-dimensional images of the joint enhances the technique as a means of diagnosing hard tissue pathology, but despite reports in the literature detailing its use in diagnosing soft tissue pathology, CT is not optimal for this purpose. The introduction of nuclear magnetic resonance imaging provides a means of examining the soft tissues of the joint in either two- or three-dimensional images and has the advantage over all previous techniques in that the patient is not subjected to ionizing radiation during the scan process. ImagesFig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8Fig. 9 PMID:6594954

  10. Using interactive multi-media to teach the anatomy and pathology of the temporo-mandibular joint.

    PubMed

    Demirjian, A; David, B

    1995-01-01

    An interactive multi-media courseware on the Temporo-mandibular Joint is presented. All the latest technological innovations are integrated into this document to make the learning process more enjoyable for the user. We believe that the complex anatomy and physiology of this joint, and mostly its various disorders will be better understood with this interactive multi-media approach. The courseware is intended for continuing education in dentistry and medicine. PMID:8591428

  11. Identification of prostaglandin E2 and leukotriene B4 in the synovial fluid of painful, dysfunctional temporomandibular joints.

    PubMed

    Quinn, J H; Bazan, N G

    1990-09-01

    It has been hypothesized that prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) should be present in the synovial fluid of inflamed, dysfunctional temporomandibular joints. An assay to identify PGE2 and LTB4 and platelet-activating factor (PAF) was used, and a strong correlation between the levels of these lipid mediators of pain and inflammation and an index of clinical joint pathology was found. PMID:2168477

  12. Impact of functional mandibular advancement appliances on the temporomandibular joint - a systematic review

    PubMed Central

    Ivorra-Carbonell, Laura; Montiel-Company, José-María; Almerich-Silla, José-Manuel; Paredes-Gallardo, Vanessa

    2016-01-01

    Background Although many orthodontists have no doubts about the effectiveness of functional appliances for mandibular advancement, the impact on the temporomandibular joint (TMJ) is still in dispute. The objective of this systematic review is to examine the main effects on the TMJ of using functional appliances, both in healthy patients and in patients with a pre-existing disorder. Material and Methods A systematic review of the literature was conducted in accordance with the PRISMA guidelines. Only systematic reviews, meta-analyses, randomized clinical trials (RCTs), case-control studies and cohort studies were included. A detailed language-independent electronic search was conducted in the Pubmed, Scopus, Cochrane Library and Embase databases. All studies published between 2000 and 2015 were included. Results A total of 401 articles were identified. Of these, 159 were duplicates and were excluded. On reading the title and abstract, 213 articles were excluded because they did not answer the research question, leaving a total of 29 articles. These articles were read and assessed. Following critical reading of the full text, eight articles were excluded: seven because they were considered of low quality and one because it published redundant data. As a result, 21 articles were included. Conclusions After treatment with functional appliances, the condyle was found to be in a more advanced position, with remodelling of the condyle and adaptation of the morphology of the glenoid fossa. No significant adverse effects on the TMJ were observed in healthy patients and the appliances could improve joints that initially presented forward dislocation of the disk. Key words:Temporomandibular joint, TMJ, orthodontic appliances, functional, mandibular advancement, herbst appliance, bionator. PMID:27475694

  13. Magnetic Resonance Image Evaluation of Temporomandibular Joint Osteophytes: Influence of Clinical Factors and Artrogenics Changes.

    PubMed

    Grossmann, Eduardo; Remedi, Marcelo Pereira; Ferreira, Luciano Ambrosio; Carvalho, Antonio Carlos Pires

    2016-03-01

    This research aims to examine the presence of osteophyte in patients with arthrogenic temporomandibular disorders through magnetic resonance imaging (MRI); to investigate the influence of sex and clinical symptoms in its prevalence; and the position of the osteophytes in the condyle. The study was based on 100 MRI and on reports of patients, which corresponded to the evaluation of 200 joints. Patients of both sexes were aged from 18 to 82 years (average = 49.48) and were subjected to the aforementioned examination from January 2006 to March 2009. The assessment considered the type of disc displacement, the presence of effusion, bone marrow edema, condyle changes, joint noise and pain. The MRI machine used was the GE Signa HDX (General Electric, Milwaukee, WI), with T1 and T2-weighted, 1.5 T magnetic field, sagittal oblique (mouth closed, mouth open) and coronal (mouth closed) imaging, with spherical surface coil and an asymmetric matrix. All images were interpreted by an experienced radiologist. A total of 28% (n = 56) of the temporomandibular joints showed osteophytes on the anterior surface of the mandible. No relationship was found between sex and osteophytes. The authors found a statistically significant difference between osteophytes and disc displacement without reduction (P < 0.001). The presence of osteophytes suggested a possible cause and effect relationship between osteoarthritis and disc displacement without reduction; the osteophyte was always located in the anterior surface of condyle, regardless of the sex variable; no significant difference was found between osteophytes and the main complaints of the patient. PMID:26825745

  14. Viscoelastic properties of the pig temporomandibular joint articular soft tissues of the condyle and disc.

    PubMed

    Kuboki, T; Shinoda, M; Orsini, M G; Yamashita, A

    1997-11-01

    It has been suggested that a sustained loading condition such as clenching could compress the temporomandibular joint (TMJ) articular soft tissues. However, there is still no clear understanding of how the TM joint articular tissues respond under compression. To answer this question, we performed in vitro indentation tests on fresh articular discs and cartilage-bone systems of the condyles of 10 Yorkshire pigs (aged 7 months) using a self-developed indentation tester. The indenter was 5 mm in diameter and was controlled by means of a computer-aided feedback mechanism. Bilateral condyles from the same mandible were uniformly prepared; one was used for measurements under sustained compression (SC) and the other for measurements under intermittent compression (IC). The displacements of the indenter induced by a SC of 10, 20, and 30 Newtons (N, units of force) for 10 min and by an IC, also of 10, 20, and 30 N, with one-second duration and two-second intervals for 10 min were measured by means of a displacement sensor with a resolution of 0.001 mm. From these data, the indentation curves of the articular discs and the cartilage-bone systems were calculated. Both the disc and the articular cartilage showed characteristic displacement vs. time curves-namely, an instantaneous deformation upon load application, followed by a time-dependent creep phase of asymptotically increasing deformation under constant load. However, the indentation curves of the two tissues were not identical: The deformation of the articular cartilage was dose-dependent, but that of the disc was not. Moreover, the articular cartilage deformed significantly less under IC than under SC. This difference was not found in the disc. It can be concluded that both the disc and the articular cartilage of the pig temporomandibular joint have viscoelastic properties against compression; however, the disc is stiffer than the articular cartilage. PMID:9372793

  15. Engineered microporosity: enhancing the early regenerative potential of decellularized temporomandibular joint discs.

    PubMed

    Juran, Cassandra M; Dolwick, M Franklin; McFetridge, Peter S

    2015-02-01

    The temporomandibular joint (TMJ) disc is susceptible to numerous pathologies that may lead to structural degradation and jaw dysfunction. The limited treatment options and debilitating nature of severe temporomandibular disorders has been the primary driving force for the introduction and development of TMJ disc tissue engineering as an approach to alleviate this important clinical issue. This study aimed to evaluate the efficacy of laser micropatterning (LMP) ex vivo-derived TMJ disc scaffolds to enhance cellular integration, a major limitation to the development of whole tissue implant technology. LMP was incorporated into the decellularized extracellular matrix scaffold structure using a 40 W CO2 laser ablation system to drill an 8×16 pattern with a bore diameter of 120 μm through the scaffold thickness. Disc scaffolds were seeded with human neonatal-derived umbilical cord mesenchymal stem cells differentiated into chondrocytes at a density of 900 cells per mm(2) and then assessed on days 1, 7, 14, and 21 of culture. Results derived from histology, PicoGreen DNA quantification, and cellular metabolism assays indicate that the LMP scaffolds improve cellular remodeling compared to the unworked scaffold over the 21-day culture period. Mechanical analysis further supports the use of the LMP showing the compressive properties of the LMP constructs closely represent native disc mechanics. The addition of an artificial path of infiltration by LMP culminated in improved chondrocyte adhesion, dispersion, and migration after extended culture aiding in recapitulating the native TMJ disc characteristics. PMID:25319941

  16. BIOPSYCHOSOCIAL FACTORS ASSOCIATED WITH THE SUBCATEGORIES OF ACUTE TEMPOROMANDIBULAR JOINT DISORDERS*

    PubMed Central

    Dougall, Angela Liegey; Jimenez, Carmen A.; Haggard, Robbie A.; Stowell, Anna W.; Riggs, Richard R.; Gatchel, Robert J.

    2012-01-01

    Aims The purpose of this study was to assess the biopsychosocial factors associated with acute temporomandibular joint disorders (TMD) based upon the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Methods Participants were assessed in community-based dental clinics, and evaluated by trained clinicians on physical and psychosocial measures. A total of 207 subjects were evaluated. Patients’ high-risk versus low-risk status for potentially developing chronic TMD was also determined. Analyses of variance and chi square analyses were applied to these data. Results Participants’ characteristic pain intensity differed among RDC/TMD Axis I diagnoses. They also significantly varied in their: self-reported graded chronic pain; depression; somatization, pain inclusive; somatization, pain excluded, and physical well-being. In addition, participants with differing RDC/TMD Axis I diagnoses varied in self-reported pain during their chewing performance. Finally, there were also significant differences in chewing performance between high-risk vs. low-risk (for developing chronic TMD) patients. Conclusions Participants with multiple diagnoses reported higher pain, as well as other symptoms, relative to participants without a TMD diagnosis. For chewing performance, participants with mutual diagnoses reported more pain compared to other participants. Finally, the risk-status of patients significantly affected chewing performance. PMID:22292135

  17. Engineered Microporosity: Enhancing the Early Regenerative Potential of Decellularized Temporomandibular Joint Discs

    PubMed Central

    Juran, Cassandra M.; Dolwick, M. Franklin

    2015-01-01

    The temporomandibular joint (TMJ) disc is susceptible to numerous pathologies that may lead to structural degradation and jaw dysfunction. The limited treatment options and debilitating nature of severe temporomandibular disorders has been the primary driving force for the introduction and development of TMJ disc tissue engineering as an approach to alleviate this important clinical issue. This study aimed to evaluate the efficacy of laser micropatterning (LMP) ex vivo-derived TMJ disc scaffolds to enhance cellular integration, a major limitation to the development of whole tissue implant technology. LMP was incorporated into the decellularized extracellular matrix scaffold structure using a 40 W CO2 laser ablation system to drill an 8×16 pattern with a bore diameter of 120 μm through the scaffold thickness. Disc scaffolds were seeded with human neonatal-derived umbilical cord mesenchymal stem cells differentiated into chondrocytes at a density of 900 cells per mm2 and then assessed on days 1, 7, 14, and 21 of culture. Results derived from histology, PicoGreen DNA quantification, and cellular metabolism assays indicate that the LMP scaffolds improve cellular remodeling compared to the unworked scaffold over the 21-day culture period. Mechanical analysis further supports the use of the LMP showing the compressive properties of the LMP constructs closely represent native disc mechanics. The addition of an artificial path of infiltration by LMP culminated in improved chondrocyte adhesion, dispersion, and migration after extended culture aiding in recapitulating the native TMJ disc characteristics. PMID:25319941

  18. A retrospective study of temporomandibular joint ankylosis secondary to surgical treatment of mandibular condylar fractures.

    PubMed

    Xiang, Guo-lin; Long, Xing; Deng, Mo-hong; Han, Qian-chao; Meng, Qing-gong; Li, Bo

    2014-03-01

    We investigated the incidence of ankylosis of the temporomandibular joint (TMJ) after open operations for fractures of the mandibular condyle, and analysed possible risk factors in a total of 385 patients with 492 condylar fractures who had been operated on in our department from 2001 to 2010. Sixteen patients developed postoperative ankylosis of the TMJ with 26 joints (5%) affected during a follow-up of 6 months-10 years. Of the 492 condylar fractures, the most common ones that were associated with postoperative ankylosis were those of the condylar head (20/248), followed by the condylar neck (6/193). Subcondylar fractures did not cause postoperative ankylosis (0/51). Among the 16 patients with postoperative ankylosis, 13 had associated anterior mandibular fractures. Long-screw (bicortical screw) fixation of fractures of the condylar head seemed to be associated with a lower incidence of postoperative ankylosis than fixation by miniplate and wire or removal of the fractured fragment. The articular discs were damaged in all ankylosed joints, and the remaining fractured fragment was found in 10 ankylosed joints after fractures of the condylar head. The results suggest that fractures of the condylar head are more prone to lead to postoperative ankylosis of the TMJ, and that the possible risk factors seem to include the technique used for fixation and damage to the disc, together with an anterior mandibular fracture with the fractured fragment remaining. PMID:24485809

  19. Temporomandibular Joint Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies

    PubMed Central

    Murphy, Meghan K.; MacBarb, Regina F.; Wong, Mark E.; Athanasiou, Kyriacos A.

    2015-01-01

    Epidemiology reports state temporomandibular joint disorders (TMD) affect up to 25% of the population, yet their etiology and progression are poorly understood. As a result, treatment options are limited and fail to meet the long-term demands of the relatively young patient population. TMD are a class of degenerative musculoskeletal conditions associated with morphological and functional deformities. In up to 70% of cases, TMD are accompanied by malpositioning of the TMJ disc, termed “internal derangement.” Though onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Due to the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient’s disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches capable of restoring joint functionality while responding to changes in the joint have become a necessity. Capable of integration and adaptation in the TMJ, one such approach, tissue engineering, carries significant potential in the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. Preceding the current trends in tissue engineering is an analysis of native tissue characterization, toward identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ. PMID:24278954

  20. Three-Dimensional Imaging of the Temporomandibular Joint in vitro and in vivo

    PubMed Central

    Roberts, D.; Pettigrew, J.; Udupa, J.

    1983-01-01

    Interpretational difficulties experienced with currently used diagnostic radiation techniques can be reduced via the use of 3-D images constructed from conventional CT data. Each 1.5 mm CT section yields interpolated sections (6 or 8) containing cubile voxels. Structures to be imaged separately are masked in the interpolated sections prior to windowing for the appropriate tissue. A special algorithm detects the surface boundary of the selected structure. The surface pixels are assigned gray levels based on their distance and attitude from the observer. When displayed, this produces a simulated 3-D image. The image can be rotated and sectioned. Rotations permit otherwise hidden surfaces to be examined. Images of two temporomandibular joints are presented, a) bony components; b) bony components + meniscus. It is concluded that the 3-D imaging process is potentially useful in diagnosing TMJ pathology. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8

  1. Ganglion and Synovial Cyst of the Temporomandibular Joint: A Case Report and Literature Review

    PubMed Central

    Hofstede, Diederik J.

    2015-01-01

    Summary: Ganglion and synovial cysts of the temporomandibular joint (TMJ) are rare. Although histopathological findings differ, clinical presentation is comparable. This study adds a case report of a ganglion of the TMJ to existing literature and a review of all available case reports on ganglion and synovial cysts of the TMJ. Including our own case report, we reviewed 49 cases of ganglion and synovial cysts of the TMJ. They occurred in a female:male ratio of 3:1, at an median age of 46 years (range, 11–64 years). Patients mainly presented with preauricular swelling and pain. After imaging, the ganglion or synovial cyst was most commonly excised under general anesthesia. No recurrences were described. PMID:26495237

  2. Ganglion and Synovial Cyst of the Temporomandibular Joint: A Case Report and Literature Review.

    PubMed

    Steen, M Willemijn; Hofstede, Diederik J

    2015-09-01

    Ganglion and synovial cysts of the temporomandibular joint (TMJ) are rare. Although histopathological findings differ, clinical presentation is comparable. This study adds a case report of a ganglion of the TMJ to existing literature and a review of all available case reports on ganglion and synovial cysts of the TMJ. Including our own case report, we reviewed 49 cases of ganglion and synovial cysts of the TMJ. They occurred in a female:male ratio of 3:1, at an median age of 46 years (range, 11-64 years). Patients mainly presented with preauricular swelling and pain. After imaging, the ganglion or synovial cyst was most commonly excised under general anesthesia. No recurrences were described. PMID:26495237

  3. Iatrogenic arteriovenous fistula of the superficial temporal artery after manual reduction of temporomandibular joint dislocation.

    PubMed

    Takeuchi, Satoru; Takasato, Yoshio

    2011-09-01

    A 33-year-old man fell from a height and was referred to our hospital. Physical examination showed a swelling in the left preauricular region without laceration. No thrill or bruit was detected at this time. A face x-ray and a computed tomographic scan showed a left temporomandibular joint (TMJ) dislocation, Le Fort I fractures, and a mandibular body fracture. Left TMJ dislocation was treated by manual reduction. Two days after admission, a swelling in the left preauricular region progressed, with thrill and bruit. Left external carotid artery angiograms showed an arteriovenous fistula with a dilated pouch near the left TMJ. The fistula was fed by the left superficial temporal artery and drained into the left superficial temporal vein. The fistula was successfully embolized using Tornado coils. This is the first case of an arteriovenous fistula of the superficial temporal artery after manual reduction of TMJ dislocation. PMID:21959481

  4. Radiographic manifestations of the temporomandibular joint in a case of Proteus syndrome

    PubMed Central

    Yilmaz, E; Kansu, Ö; Özgen, B; Akçiçek, G; Kansu, H

    2013-01-01

    Proteus syndrome is a rare disorder with progressive asymmetrical and disproportionate overgrowth of various tissues of the body. The syndrome is characterized by a wide range of malformations, including craniofacial deformities. Extraoral examination revealed several of the classical craniofacial features of Proteus syndrome: pronounced hemifacial hypertrophy, macrodactyly and hyperostosis. Intraoral examination revealed a high arched palate and gingival hyperplasia. Other findings were unilateral enlargement of the tongue, alveolar growth and dilaceration of the roots of the teeth. There were severe degenerative changes and deformities in the left temporomandibular joint but the oversized condyle was asymptomatic; there was no pain, limitation and deviation at mouth opening. Treatment was not necessary owing to the asymptomatic situation but periodic follow-up with clinical and radiographic examination was considered. The aim of this article is to describe the radiographic manifestations of an asymptomatic condyle malformation and other craniofacial, oral and dental findings in a 33-year-old female patient with known Proteus syndrome. PMID:22241876

  5. A rare case of Ramsay Hunt syndrome following temporomandibular joint surgery.

    PubMed

    Lehman, H; Rushinek, H

    2015-08-01

    Surgical approaches to the temporomandibular joint (TMJ) have been designed specifically to minimize injury to the temporal branch of the facial nerve. In spite of this, facial nerve dysfunction occurs in 1-32% of patients undergoing TMJ surgery. Ramsay Hunt syndrome is characterized by peripheral facial paralysis that often involves other cranial nerves, mostly cranial nerve VIII. The pathology is attributed to the reactivation of latent varicella zoster virus in the geniculate ganglion. The diagnosis is based mostly on history and physical findings. Surgical procedures have been known to reactivate varicella zoster virus, but Ramsay Hunt syndrome subsequent to TMJ surgery has not been described yet. This report describes a case of Ramsay Hunt syndrome associated with TMJ surgery. Because of the relatively high incidence of facial nerve dysfunction associated with TMJ surgery, patients with varicella zoster virus reactivation may initially be misdiagnosed with iatrogenic facial palsy, or vice versa. PMID:25864001

  6. Internal derangements of the temporomandibular joint: findings in the pediatric age group

    SciTech Connect

    Katzberg, R.W.; Tallents, R.H.; Hayakawa, K.; Miller, T.L.; Goske, M.J.; Wood, B.P.

    1985-01-01

    Findings in 31 pediatric patients with pain and dysfunction of the temporomandibular joint (TMJ) are reported. The average age was 14 years and the average duration of symptoms was 21.4 months. Internal derangements were found in 29 patients (94%) and degenerative arthritis in 13 (42%). In 12 patients (39%), the problem could be traced to an injury to the jaw. Secondary condylar hypoplasia was associated with the meniscal abnormality in 3 patients (10%). Further awareness of internal derangements of the TMJ in the pediatric population should permit greater recognition of their etiology. It is important that threatment be initiated as soon as possible, not only to minimize the development of osseous disease in young adults but also to prevent facial growth deformities.

  7. En bloc resection of the temporal bone and temporomandibular joint for advanced temporal bone carcinoma.

    PubMed

    Kutz, Joe Walter; Mitchell, Derek; Isaacson, Brandon; Roland, Peter S; Allen, Kyle P; Sumer, Baran D; Barnett, Sam; Truelson, John M; Myers, Larry L

    2015-03-01

    Advanced skin malignancies involving the temporal bone can involve the temporomandibular joint and glenoid fossa. Many of these tumors can be removed with a lateral temporal bone resection; however, extensive involvement of the glenoid fossa should include an en bloc resection of the temporal bone, glenoid fossa, and condyle. We describe a novel surgical approach that is an extension of a temporal bone resection that includes the glenoid fossa and condyle in an en bloc resection with the temporal bone. This procedure has been performed in 7 patients with advanced carcinoma of the temporal bone involving the glenoid fossa. There were no short-term complications as a result of the surgical approach. The addition of a middle fossa craniotomy and inclusion of the glenoid fossa and condyle as part of an en bloc resection of the temporal bone can be performed safely. PMID:25616770

  8. Synovial Cysts of the Temporomandibular Joint: An Immunohistochemical Characterization and Literature Review

    PubMed Central

    Vera-Sirera, B.; Tomás-Amerigo, J. A.; Baquero, C.; Vera-Sempere, F. J.

    2013-01-01

    Synovial cysts of the temporomandibular joint (TMJ) are very rare, and to date, only 12 cases of a synovial cyst in the TMJ region have been reported in the literature. In this paper, we present the clinicopathological and immunohistochemical characteristics of one such lesion affecting a 48-year-old woman, presented with a mass in the left preauricular region. We describe the usefulness of immunohistochemical analysis for recognizing the synovial lining, which allowed for clear differentiation between ganglion and synovial cysts. Immunohistochemical analyses can be used to diagnose synovial cysts with certainty; however, using at least two markers is advisable to distinguish the two existing synovial cell subtypes. Our findings indicate that synovial cysts of TMJ possess an internal lining dominated by type B (fibroblast-like) synoviocytes. PMID:23573446

  9. Anatomy of the temporomandibular joint in the cat: a study by microdissection, cryosection and vascular injection.

    PubMed

    Arredondo, Jorge; Agut, Amalia; Rodríguez, María Jesús; Sarriá, Ricardo; Latorre, Rafael

    2013-02-01

    The minute anatomy of the temporomandibular joint (TMJ) is of great clinical relevance in cats owing to a high number of lesions involving this articulation. However, the precise anatomy is poorly documented in textbooks and scientific articles. The aim of this study was to describe, in detail, the TMJ anatomy and its relationship with other adjacent anatomical structures in the cat. Different anatomical preparations, including vascular and articular injection, microdissection, cryosection and plastination, were performed in 12 cadaveric cats. All TMJ anatomical structures were identified and described in detail. A thorough understanding of the TMJ anatomy is essential to understand the clinical signs associated with TMJ disorders, to locate lesions precisely and to accurately interpret the results in all diagnostic imaging techniques. PMID:23015066

  10. Solid-state temporomandibular joint imaging: accuracy in detecting osseous changes of degenerative joint disease and determining condylar spatial relations.

    PubMed

    Scarfe, William C; Farman, Allan G; Silveira, Anibal; Fairbanks, Brandon W; Kelly, Paul J

    2003-10-01

    The purpose of this study was to evaluate the off-label use of an intraoral charge-coupled device (CCD) for extraoral transcranial radiography of the temporomandibular joint. Corrected linear tomograms and transcranial images made with conventional screen-film combinations and a CCD detector were compared with sectioned cadaver specimens. Radiation dosage, qualitative assessment of condylar degenerative features, and condylar position within the glenoid fossa of the 3 modalities were assessed and compared. The CCD method required special adjustments to achieve adequate quality, and it involved greater exposure than the other methods. This use of this intraoral system for extraoral imaging cannot now be recommended, but future refinements might make it more viable. PMID:14560277

  11. Management of painful temporomandibular joint clicking with different intraoral devices and counseling: a controlled study

    PubMed Central

    CONTI, Paulo César Rodrigues; CORRÊA, Ana Silvia da Mota; LAURIS, José Roberto Pereira; STUGINSKI-BARBOSA, Juliana

    2015-01-01

    Objective The benefit of the use of some intraoral devices in arthrogenous temporomandibular disorders (TMD) patients is still unknown. This study assessed the effectiveness of the partial use of intraoral devices and counseling in the management of patients with disc displacement with reduction (DDWR) and arthralgia. Materials and Methods A total of 60 DDWR and arthralgia patients were randomly divided into three groups: group I (n=20) wore anterior repositioning occlusal splints (ARS); group II (n=20) wore the Nociceptive Trigeminal Inhibition Clenching Suppression System devices (NTI-tss); and group III (n=20) only received counseling for behavioral changes and self-care (the control group). The first two groups also received counseling. Follow-ups were performed after 2 weeks, 6 weeks and 3 months. In these sessions, patients were evaluated by means of a visual analogue scale, pressure pain threshold (PPT) of the temporomandibular joint (TMJ), maximum range of motion and TMJ sounds. Possible adverse effects were also recorded, such as discomfort while using the device and occlusal changes. The results were analyzed with ANOVA, Tukey’s and Fisher Exact Test, with a significance level of 5%. Results Groups I and II showed improvement in pain intensity at the first follow-up. This progress was recorded only after 3 months in Group III. Group II showed an increased in joint sounds frequency. The PPT values, mandibular range of motion and the number of occlusal contacts did not change significantly. Conclusion The simultaneous use of intraoral devices (partial time) plus behavioral modifications seems to produce a more rapid pain improvement in patients with painful DDWR. The use of NTI-tss could increase TMJ sounds. Although intraoral devices with additional counseling should be considered for the management of painful DDWR, dentists should be aware of the possible side effects of the intraoral device’s design. PMID:26200526

  12. THE EFFECTIVENESS OF PHYSICAL FACTORS IN THE TREATMENT OF COMPRESSION-DISLOCATION DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT.

    PubMed

    Rybalov, O; Yatsenko, P; Moskalenko, P; Yatsenko, O; Lakhtin, Yu

    2016-02-01

    The aim of the study was clinical and functional assessment of the effectiveness of physical factors in the treatment of patients with compression-dislocation dysfunction of the temporomandibular joint. We observed two groups of patients. All patients were undergone the repositioning of the joint heads of the lower jaw. Patients of the index group were assigned a vibrating massage of all masseter muscles, tourmaline ceramic on the joint area and a local physical therapy. Patients in the control group had only lidocaine blockade of periarticular area twice a week. Treatment efficacy was evaluated on the eighth day after the start of the treatment according to the bioelectric activity of the genuine masseter and temporal muscles, the intensity of pain according to in Visual Analog Scale, and according to the results of the clinical examination. In most patients of the index group the electromyography data after treatment were approaching to norm, the phenomenon of dysfunction of the temporomandibular joints was reversed. In the control group the full restoration of the functional activity of muscle did not occur. The addition to the complex of therapeutic measures a vibration massage, tourmaline ceramics and local physical therapy for patients with dysfunction of the temporomandibular joints allows to get a positive effect. PMID:27001782

  13. On the anatomy of the temporomandibular joint and the muscles that act upon it: observations on the gray whale, Eschrichtius robustus.

    PubMed

    El Adli, Joseph J; Deméré, Thomas A

    2015-04-01

    The temporomandibular joint and its associated musculature are described in a neonate gray whale (Eschrichtius robustus) and serve as the basis for direct anatomical comparisons with the temporomandibular region in other clades of baleen whales (Mysticeti). Members of the right whale/bowhead whale clade (Balaenidae) are known to possess a synovial lower jaw joint, while members of the rorqual clade (Balaenopteridae) have a nonsynovial temporomandibular joint characterized by a highly flexible fibrocartilaginous pad and no joint capsule. In contrast, the gray whale possesses a modified temporomandibular joint (intermediate condition), with a vestigial joint cavity lacking a fibrous capsule, synovial membrane, and articular disk. In addition, the presence of a rudimentary fibrocartilaginous pad appears to be homologous to that seen in balaenopterid mysticetes. The intrinsic temporomandibular musculature in the gray whale was found to include a multibellied superficial masseter and a single-bellied deep masseter. The digastric and internal pterygoid muscles in E. robustus are enlarged relative to the condition documented in species of Balaenoptera. A relatively complex insertion of the temporalis muscle on the dentary is documented in the gray whale and the low, knob-like process on the gray whale dentary is determined to be homologous with the prominent coronoid process of rorquals. Comparison with the anatomy of the temporomandibular musculature in rorquals reveals an increased importance of alpha rotation of the dentary in the gray whale. This difference in muscular morphology and lines of muscle action is interpreted as representing adaptations for suction feeding. PMID:25737135

  14. Radiation dose in radiography, CT, and arthrography of the temporomandibular joint

    SciTech Connect

    Christiansen, E.L.; Moore, R.J.; Thompson, J.R.; Hasso, A.N.; Hinshaw, D.B. Jr.

    1987-01-01

    Thermoluminescent dosimetry studies were performed on a Rando Humanoid head phantom to compare radiation dosages used in temporomandibular joint examinations. Studies included transaxial and direct sagittal high-resolution CT, reduced milliamperage dynamic CT, tomoarthrography, pluridirectional and linear tomography, pantomography, transcranial plain films, and fluoroscopy. Radiation doses were determined for the brain, lens, pituitary gland, condylar marrow, and thyroid gland. Condylar marrow received doses of 64 and 52 mGy, respectively, for the GE 9800 and 8800 high-resolution scans; 21 and 17 mGy, respectively, for the dynamically sequenced scans; and 26 mGy for the GE 9800 direct sagittal sections. Tomoarthrography yielded 31 mGy and fluoroscopy 12 mGy. Other lower doses showed 5 mGy for polytomography, 3 mGy for ipsilateral joint linear tomography, 1.9 mGy for the GE 9800 slow ScoutView, 1.8 mGy for xeroradiography, 0.9 mGy for contralateral joint linear tomography, 0.3-0.4 mGy for transcranial plain films and pantomography, and 0.2 mGy for the GE 8800 ScoutView. The estimated error in this study was calculated to be +/- 15%. On a relative scale, the radiation doses from high-resolution CT and tomoarthrography are high, dynamic CT yields a medium dose, and all other tomographic and plain-film techniques yield low doses.

  15. Shox2-deficiency leads to dysplasia and ankylosis of the temporomandibular joint in Mice

    PubMed Central

    Gu, Shuping; Wei, Na; Yu, Ling; Fei, Jian; Chen, YiPing

    2010-01-01

    The temporomandibular joint (TMJ) is a unique synovial joint whose development differs from the formation of other synovial joints. Mutations have been associated with the developmental defects of the TMJ only in a few genes. In this study, we report the expression of the homeobox gene Shox2 in the cranial neural crest derived mesenchymal cells of the maxilla-mandibular junction and later in the progenitor cells and undifferentiated chondrocytes of the condyle as well as the glenoid fossa of the developing TMJ. A conditional inactivation of Shox2 in the cranial neural crest-derived cells causes developmental abnormalities in the TMJ, including dysplasia of the condyle and glenoid fossa. The articulating disc forms but fuses with the fibrous layers of the condyle and glenoid fossa, clinically known as TMJ ankylosis. Histological examination indicates a delay in development in the mutant TMJ, accompanied by a significantly reduced rate of cell proliferation. In situ hybridization further demonstrates an altered expression of several key osteogenic genes and a delayed expression of the osteogenic differentiation markers. Shox2 appears to regulate the expression of osteogenic genes and is essential for the development and function of the TMJ. The Shox2 conditional mutant thus provides a unique animal model of TMJ ankylosis. PMID:18514492

  16. Temporoparietal fascia flap and total temporomandibular joint replacement for the management of patent foramen of Huschke.

    PubMed

    Shapiro, M C; Osborn, T

    2016-08-01

    Spontaneous herniation of the condylar head into the external auditory canal (EAC) through the foramen of Huschke is extremely rare, with approximately 30 cases reported in the international literature. The typical presentation is a constellation of non-specific symptoms including otalgia, temporomandibular joint (TMJ) pain, malocclusion, otorrhea, tinnitus while chewing, and hearing loss. Clinical examination may reveal pain, granulation tissue in the EAC, or the exposed mandibular condyle with the mouth closed. With mouth opening, the tissue or exposed bone retracts anteriorly leaving an often normal-appearing EAC. Having the patient open and close the mouth while performing otoscopy will show the displacement of tissue, which is critical for diagnosis of the condition. Radiographic examination with a computed tomography scan typically reveals a discontinuous anterior wall of the EAC with visible soft tissue in the protruding in the EAC. A case of spontaneous TMJ herniation into the EAC in a 54-year-old male patient with a history of otalgia and malocclusion is reported here. Total joint replacement therapy for the treatment of this rare condition is reported, and its importance in providing a posterior mechanical stop to prevent joint relapse is discussed. PMID:27066740

  17. Congenital deformities and developmental abnormalities of the mandibular condyle in the temporomandibular joint.

    PubMed

    Kaneyama, Keiseki; Segami, Natsuki; Hatta, Toshihisa

    2008-09-01

    The temporomandibular joint (TMJ) consists of the mandibular condyle and the articular eminence of the temporal bone. The morphological development of the TMJ during prenatal life lags behind other joints in terms of both the timing of its appearance and its progress. At birth, the joint is still largely underdeveloped. There are many causes of the various growth disturbances and abnormalities of the mandibular condyle and related structures. Growth disturbances in the development of the mandibular condyle may occur in utero late in the first trimester and may result in disorders such as aplasia or hypoplasia of the mandibular condyle. Meanwhile, hyperplasia of the mandibular condyle is not visible at birth and seems to be gradually acquired during growth. In the present review article, the congenital abnormalities of the mandibular condyle are classified morphologically into three major groups and two subgroups from a clinical standpoint: (1) hypoplasia or aplasia of the mandibular condyle, including (i) primary condylar aplasia and hypoplasia, (ii) secondary condylar hypoplasia; (2) hyperplasia; and (3) bifidity. In addition, the molecular-based etiology of anomalies of the mandibular condyle is also discussed. PMID:18778456

  18. Alloplastic temporomandibular joint replacement: rationale for the use of custom devices.

    PubMed

    Mercuri, L G

    2012-09-01

    The essential life functions of mastication, speech, airway support and deglutition are supported by temporomandibular joint (TMJ) function and form. Over a lifetime, this puts the TMJ complex under more cyclical loading and unloading than any other joint. Therefore, to provide long-term effective outcomes, the TMJ total joint replacement (TJR) device selected must be capable of managing the anatomical, functional and aesthetic discrepancies that dictated its use. The primary goal of TMJ TJR is the restoration of mandibular function and form. Outcomes data confirm that any pain relief attained must be considered of only secondary benefit. Despite persistent but reduced chronic pain, increased mandibular function and form improvement have been reported, resulting in quality of life improvement for 85% of custom TMJ TJR patients studied long-term. Based on the literature and the accepted orthopaedic criteria for the development and utilisation of successful TJR devices, this paper presents a rationale for the use of custom TMJ TJR devices as a 'fitting' management option for end-stage TMJ disorders. PMID:22771166

  19. Removal of a Solitary Synovial Chondromatosis of the Temporomandibular Joint Using Arthroscopy.

    PubMed

    Pastore, Gabriel Pires; Goulart, Douglas Rangel; Pastore, Patrícia Radaic; Prati, Alexandre Javaroni

    2016-06-01

    The diagnosis of synovial chrondromatosis of temporomandibular joint (TMJ) requires a combined assessment consisting of clinical, radiologic, and histopathologic examinations. The purpose of this study is to report in 1 patient the removal of a single large cartilaginous nodule floating in the upper joint compartment using arthroscopy. A 30-year-old woman was referred to our department complaining about pain in preauricular area and restricted mouth opening. Imaging of magnetic resonance reveals anterior disc displacement and right joint effusion. Arthroscopy of TMJ was performed for diagnosis and treatment. During the arthroscopy a large loose body was identified and removed with a biopsy forceps; lavage was conducted with ringer solution. Hyaluronic acid was injected in TMJ at surgery, 1 and 3 months after surgery. Postoperative magnetic resonance imaging showed articular disc on position and no effusion. The patient was followed up of 1 year without sign and symptoms. Arthroscopic procedure of TMJ was effective in diagnosis and removal of a solitary loose body of synovial chrondromatosis. Viscosupplementation appers to offer benefits in controlling pain and functional improvements. PMID:27244213

  20. Does condylar height decrease more in temporomandibular joint nonreducing disc displacement than reducing disc displacement?

    PubMed Central

    Hu, Ying-Kai; Yang, Chi; Cai, Xie-Yi; Xie, Qian-Yang

    2016-01-01

    Abstract The aim of the study was to compare condylar height changes of anterior disc displacement with reduction (ADDwR) and anterior disc displacement without reduction (ADDwoR) in temporomandibular joint (TMJ) quantitatively, to get a better understanding of the changes in condylar height of patients with anterior disc displacement who had received no treatment, and to provide useful information for treatment protocol. This longitudinal retrospective study enrolled 206 joints in 156 patients, which were divided into ADDWR group and ADDwoR group based on magnetic resonance imaging examination. The joints were assessed quantitatively for condylar height at initial and follow-up visits. Also, both groups were further divided into 3 subgroups according to age: <15 years group, 15 to 21 years group, and 22 to 35 years group. Paired t test and independent t test were used to assess intra- and intergroup differences. The average age of the ADDwR group was 19.65 years with a mean of 9.47 months’ follow-up. The follow-up interval of the patients with ADDwoR was 7.96 months, with a mean age of 18.51 years. Condylar height in ADDwoR tended to decrease more than those in ADDwR, especially during the pubertal growth spurt and with the presence of osteoarthrosis, meaning ADDwoR could cause a severe disturbance in mandibular development. Thus, an early disc repositioning was suggested to avoid decrease in condylar height. PMID:27583909

  1. Tumors and pseudotumors at the temporomandibular joint region in pediatric patients

    PubMed Central

    Wei, Wen-Bin; Chen, Min-Jie; Yang, Chi; Qiu, Yating; Zhou, Qin

    2015-01-01

    Objective: To describe the clinical manifestations and types of, and our surgical experience with, neoplasms in the region of the temporomandibular joint (TMJ) in pediatric patients. Materials and Methods: From September 1997 to December 2013, a total of 18 patients with neoplasms in the region of the TMJ were treated at our department. They all underwent open surgeries. The clinical manifestations and radiological aspects of all the patients were reviewed. The average follow-up period was 61.8 months with a range of 12-221 months. We reviewed the history, physical examination, images, and related radiological examinations. Results: Of the 18 patients, 14 had benign tumors or pseudotumors, and four had malignant tumors. The ratio of pseudotumor to benign tumor to malignant tumor was 2.5:1:1. Limitations of mouth opening were more likely to occur with malignant tumors, and facial deformity had a higher incidence in benign tumors. Local resection was the first choice for patients with benign tumors or pseudotumors. All patients with malignant tumors underwent whole-tumor resection along the boundary, including the joint capsule, disc, and part of the temporal bone and mandible. During the follow-up period, no tumor reformation or new deformity was detected. Conclusions: In the diagnosis of masses in the TMJ region, CT and MRI play an important role. Surgical removal of the mass with/without joint attachment was sufficient to treat benign and malignant tumors. PMID:26885147

  2. Investigation of an autologous blood treatment strategy for temporomandibular joint hypermobility in a pig model.

    PubMed

    Stembirek, J; Matalova, E; Buchtova, M; Machon, V; Misek, I

    2013-03-01

    Many different surgical and non-surgical techniques are used for the treatment of temporomandibular joint (TMJ) hypermobility. One of these methods is autologous blood injection into the TMJ. The fate of the autologous blood used for treatment of recurring condylar dislocation is still not completely understood. The authors used 12 pigs (Sus scrota f. domestica) as a model species for autologous blood delivery into the TMJ. Blood injection was followed by histopathological analysis at different times after treatment (1h, 1, 2 and 4 weeks). Samples were examined by magnetic resonance imaging, macroscopic and histological methods. The deposition of the remaining blood was observed in the form of clots in the distal parts of the upper joint cavity 1h and 1 week after treatment. 2 weeks after treatment, small blood clots were still apparent in the distal part of the upper joint cavity. 4 weeks after surgery, no remnants of blood, changes or adhesions were apparent inside the TMJ. No morphological or histological changes were observed in the TMJ after the injection of autologous blood suggesting another mechanism is involved in the hypermobility treatment. PMID:22867740

  3. Morphologic and histologic changes in canine temporomandibular joint tissues following arthroscopic guided neodymium:YAG laser exposure

    SciTech Connect

    Bradrick, J.P.; Eckhauser, M.L.; Indresano, A.T. )

    1989-11-01

    A neodymium:yttrium aluminum garnet (Nd:YAG) laser beam was introduced by a quartz fiber passed arthroscopically into the superior joint space of the temporomandibular joints (TMJ) of five mongrel dogs, with one joint serving as a control without laser wounds. Immediate postoperative death and examination of the disc grossly and histologically revealed different patterns for contact and noncontact burn wounds. The wounds exhibited signs of thermal coagulation necrosis similar to those reported in other tissues. The potential implications of the adaptation of the Nd:YAG laser to TMJ arthroscopic surgery are discussed.

  4. Comparison of Serum and Salivary Antioxidants in Patients with Temporomandibular Joint Disorders and Healthy Subjects

    PubMed Central

    Lawaf, Shirin; Tabarestani, Tohid

    2015-01-01

    Objectives: Temporomandibular dysfunction (TMD) is a group of disorders in the facial region and temporomandibular joint (TMJ). Biomarkers are assumed to play a role in pain and early detection of destruction. The aim of this study was to compare the saliva and serum antioxidant levels in patients with TMD and healthy subjects. Materials and Methods: This case-control study was conducted on 28 TMD patients without pain, 28 TMD patients with pain and 28 healthy controls. The total antioxidant capacity of saliva and serum of patients was measured. Data were analyzed using ANOVA and Tamhane’s test. Results: The mean (±SD) total antioxidant capacity of serum (plasma TAC) was 0.8900 (±0.11627) mmol/L in TMD patients with pain, 1.2717 (±0.18711) mmol/L in TMD patients without pain and 1.7500(±0.18711) mmol/L in the control group. Based on ANOVA, the difference in this regard among the three groups was statistically significant (P=0.000). The mean salivary TAC was 1.34 (±0.06721) mmol/L in TMD patients with pain, 1.42 (±0.16677) mmol/L in TMD patients without pain and 1.35 (±0.11627) mmol/L in the control group. The difference in this respect among the three groups was not significant (P>0.05). Conclusion: The mean plasma TAC in TMD patients with/without pain was significantly lower than that in the control group but no significant difference was detected in salivary TAC among the three groups. PMID:26622281

  5. Review of temporomandibular joint pathology. Part I: classification, epidemiology and risk factors.

    PubMed

    Poveda Roda, Rafael; Bagan, José V; Díaz Fernández, José María; Hernández Bazán, Sergio; Jiménez Soriano, Yolanda

    2007-08-01

    Pathology of the temporomandibular joint (TMJ) affects an important part of the population, though it is not viewed as a public health problem. Between 3-7% of the population seeks treatment for pain and dysfunction of the ATM or related structures. The literature reports great variability in the prevalence of the clinical symptoms (6-93%) and signs (0-93%), probably as a result of the different clinical criteria used. In imaging studies it is common to observe alterations that have no clinical expression of any kind. Radiographic changes corresponding to osteoarthrosis are observed in 14-44% of the population. Age is a risk factor, though with some particularities. In elderly patients there is an increased prevalence of clinical and radiological signs, though also a lesser prevalence of symptoms and of treatment demands than in younger adults. Approximately 7% of the population between 12 and 18 years of age is diagnosed with mandibular pain-dysfunction. Temporomandibular dysfunction (TMD) is more frequent in females. No clear relationship has been established between occlusal alterations and TMJ disease. Only disharmony between centric relation and maximum intercuspidation, and unilateral crossbite, have demonstrated a certain TMJ disease-predictive potential. Both local and systemic hyperlaxity has been postulated as a possible cause of TMD. Parafunctional habits and bruxism are considered risk factors of TMD with odds ratios (ORs) of up to 4.8. Psychophysiological theory holds stress as a determinant factor in myofascial pain. Genetic factors and orthodontic treatment have not been shown to cause TMD. PMID:17664915

  6. Effectiveness of Physiotherapy and GaAlAs Laser in the Management of Temporomandibular Joint Disorders

    PubMed Central

    Hlinakova, Petra; Kasparova, Magdalena; Rehacek, Adam; Vavrickova, Lenka; Navrátil, Leoš

    2012-01-01

    Abstract Objective: Low-level laser therapy (LLLT) is a treatment method commonly used in physiotherapy for musculoskeletal disorders. The aim of this study was to monitor the function of temporomandibular joint (TMJ) and surrounding tissues and compare the objective measurements of the effect of LLLT. Background data: LLLT has been considered effective in reducing pain and muscular tension; thus improving the quality of patients' lives. Materials and Methods: TMJ function was evaluated by cephalometric tracing analysis, orthopantomogram, TMJ tomogram, and computer face-bow record. Interalveolar space between central incisors before and after therapy was measured. Patients evaluated pain on the Visual Analog Scale. LLLT was performed in five treatment sessions (energy density of 15.4 J/cm2) by semiconductive GaAlAs laser with an output of 280 mW, emitting radiation wavelength of 830 mm. The laser supplied a spot of∼0.2 cm2. Results: Baseline comparisons between the healthy patients and patients with low-level laser application show that TMJ pain during function is based on anatomical and function changes in TMJ areas. Significant differences were seen in the posterior and anterior face height. The results comparing healthy and impaired TMJ sagittal condyle paths showed that patients with TMJ pain during function had significantly flatter nonanatomical movement during function. After therapy, the unpleasant feeling was reduced from 27.5 to 4.16 on the pain Visual Analog Scale. The pain had reduced the ability to open the mouth from 34 to 42 mm. Conclusions: The laser therapy was effective in the improvement of the range of temporomandibular disorders (TMD) and promoted a significant reduction of pain symptoms. PMID:22551049

  7. Influence of unilateral disc displacement on the stress response of the temporomandibular joint discs during opening and mastication

    PubMed Central

    Pérez del Palomar, A; Doblaré, M

    2007-01-01

    The temporomandibular joint plays a crucial role in human mastication acting as a guide of jaw movements. During these movements, the joint is subjected to loads which cause stresses and deformations in its cartilaginous structures. A perfect balance between the two sides of the joint is essential to maintain the physiological stress level within the tissues. Therefore, it has been suggested that a derangement of the joint is a contributing factor in the development of mandibular asymmetry, especially if problems of the temporomandibular joint start in childhood or adolescence. To analyze the movement of the mandible and the stresses undergone by the discs, two finite element models of the human temporomandibular joint including the masticatory system were developed, one corresponding to a healthy joint and the other with a unilateral anterior disc displacement with their movement controlled by muscle activation. A fibre-reinforced porohyperelastic model was used to simulate the behaviour of the articular discs. The stress distribution was analyzed in both models during free opening and closing, and during the introduction of a resistant force between incisors or molars. It was found that a slight unilateral anterior disc displacement does not lead to mandibular asymmetry but to a slight decrease of the maximum gape. With the introduction of a restriction between incisors, the maximum stresses moved to the anterior band in contrast to what happened if the restriction was imposed between molars where maximum stresses were located more posteriorly. Finally, the presence of a unilateral displacement of the disc involved a strong change in the overall behaviour of the joint including also the healthy side, where the maximum stresses moved to the posterior part. PMID:17725577

  8. Stakeholder engagement analysis - a bioethics dilemma in patient-targeted intervention: patients with temporomandibular joint disorders.

    PubMed

    Barkhordarian, Andre; Demerjian, Gary; Jan, Allison; Sama, Nateli; Nguyen, Mia; Du, Angela; Chiappelli, Francesco

    2015-01-01

    Modern health care in the field of Medicine, Dentistry and Nursing is grounded in fundamental philosophy and epistemology of translational science. Recently in the U.S major national initiatives have been implemented in the hope of closing the gaps that sometimes exist between the two fundamental components of translational science, the translational research and translational effectiveness. Subsequent to these initiatives, many improvements have been made; however, important bioethical issues and limitations do still exist that need to be addressed. One such issue is the stakeholder engagement and its assessment and validation. Federal, state and local organizations such as PCORI and AHRQ concur that the key to a better understanding of the relationship between translational research and translational effectiveness is the assessment of the extent to which stakeholders are actively engaged in the translational process of healthcare. The stakeholder engagement analysis identifies who the stakeholders are, maps their contribution and involvement, evaluates their priorities and opinions, and accesses their current knowledge base. This analysis however requires conceptualization and validation from the bioethics standpoint. Here, we examine the bioethical dilemma of stakeholder engagement analysis in the context of the person-environment fit (PE-fit) theoretical model. This model is an approach to quantifying stakeholder engagement analysis for the design of patient-targeted interventions. In our previous studies of Alzheimer patients, we have developed, validated and used a simple instrument based on the PE-fit model that can be adapted and utilized in a much less studied pathology as a clinical model that has a wide range of symptoms and manifestations, the temporomandibular joint disorders (TMD). The temporomandibular joint (TMJ) is the jaw joint endowed with sensory and motor innervations that project from within the central nervous system and its dysfunction can

  9. Quality of life: patient-reported outcomes after total replacement of the temporomandibular joint.

    PubMed

    Kunjur, J; Niziol, R; Matthews, N S

    2016-09-01

    Since publication of the UK guidelines on total replacement of the temporomandibular joint (TMJ) in 2008 by the British Association of Oral and Maxillofacial Surgeons (BAOMS), pain scores, mouth opening, and diet have been used as markers of success. We have looked at quality of life (QoL) as another. We analysed the data from a single surgeon on patients who had had joints replaced and devised a questionnaire to find out about the subjective, functional, psychological, and social aspects of TMJ disease. A total of 18 patients who had the same operation were included (mean (range) age 50 (33 - 73) years, mean (range) follow up 30 (18 - 48) months). Jaw function and facial aesthetics had improved, and patients needed less analgesia. Overall, they reported a better QoL with improvements in mood and social interaction, and the activities of daily life were easier. The NHS uses QoL questionnaires to measure success in fields such as orthopaedic surgery, but currently we know of no nationally accepted questionnaire that measures success after total replacement of the TMJ. PMID:27209222

  10. Spontaneously developed osteoarthritis in the temporomandibular joint in STR/ort mice

    PubMed Central

    KUMAGAI, KENICHI; SUZUKI, SATSUKI; KANRI, YORIAKI; MATSUBARA, RYOTA; FUJII, KEISUKE; WAKE, MASAHIRO; SUZUKI, RYUJI; HAMADA, YOSHIKI

    2015-01-01

    Temporomandibular joint (TMJ) osteoarthritis is typically a slowly progressive asymmetric disease. Little is known regarding the natural destruction of TMJ articular tissues. The aim of the present study was to investigate morphological changes in the TMJ of STR/ort mice, known to be the model for spontaneous osteoarthritis in the knee joint, and to evaluate STR/ort mice as a suitable animal model for TMJ osteoarthritis. TMJs from 32 STR/ort mice euthanized at 30, 40, 50 or 60 weeks of age, and from 6 CBA mice euthanized at 30, 40 or 60 weeks of age were examined. Toluidine blue and tartrate-resistant acid phosphatase staining were used to assess histological changes in the articular cartilage. Morphological changes in the articular cartilage of the TMJ were evaluated using microcomputed tomography. At the age of 40–50 weeks, 17 (68%) of the 25 STR/ort mice had loss of articular cartilage on histology, with cavitation and erosion of the exposed bone and gradual changes in condylar shape. Furthermore, osteoarthritic morphological changes, and structural alterations were observed by microcomputed tomography. The STR/ort mouse strain appears to develop spontaneous osteoarthritis-like lesions in the TMJ with age, and would be a useful model to study the pathogenesis of TMJ osteoarthritis. PMID:26171147

  11. Severe proliferative congenital temporomandibular joint ankylosis: a proposed treatment protocol utilizing distraction osteogenesis.

    PubMed

    Bartlett, Scott P; Reid, Russell R; Losee, Joseph E; Quinn, Peter D

    2006-05-01

    The classical treatment for temporomandibular joint (TMJ) ankylosis in children: 1) joint release; 2) arthroplasty; 3) reconstruction; and 4) postoperative physical therapy (PT), is often unsuccessful. Postoperative physical therapy is difficult in the young patient due to poor cooperation. Moreover, there is a subgroup of patients who have a refractory congenital proliferative bony process that is the cause of their disease. In these patients, a role for distraction osteogenesis (DO) has been defined. We present a series of young patients with congenital proliferative TMJ ankylosis. Some have failed classic treatment. In such cases, DO is used to expand the mandibular size and soft tissue matrix. This creates a static open bite, facilitates mid-facial growth, and avoids compromise of the airway, speech, nutrition, and oral hygiene. To maintain these objectives, mandibular DO may be repeated as the child matures. Once skeletal maturity is reached, DO is used to normalize occlusion and further expand the soft tissue envelope prior to definitive reconstruction and aggressive post-op PT. In seven patients, this protocol has been used. Five patients are currently in the active phase of growth and undergoing interim treatment with mandibular DO. Two patients have reached skeletal maturity and have completed the protocol of DO with definitive arthroplasty and reconstruction. DO is a valuable aid in the treatment of the problematic child with congenital proliferative TMJ ankylosis. Interim DO, prior to definitive arthroplasty and reconstruction, can provide a static open bite that prevents progressive deformity and its associated functional disturbances. PMID:16770209

  12. Total alloplastic temporomandibular joint reconstruction using Biomet stock prostheses: the University of Florida experience.

    PubMed

    Sanovich, R; Mehta, U; Abramowicz, S; Widmer, C; Dolwick, M F

    2014-09-01

    The purpose of this study was to report the subjective and objective outcomes of temporomandibular joint (TMJ) replacement with Biomet stock prostheses at a single institution in Florida. In this retrospective study, patients who underwent TMJ replacement using a Biomet stock prosthesis from 2005 to 2012 were analyzed. Subjective (pain, diet) and objective (maximal incisal opening) information was obtained. In addition, a quality of life measure was obtained pre- and postoperatively. Significance was set at <0.01. Thirty-six patients (26 bilateral, 6 left, and 4 right) who underwent TMJ replacement using a Biomet stock prosthesis were eligible for the study. Maximal incisal opening improved from 26.1mm preoperatively to a mean of 34.4mm postoperatively. The pain score decreased from 7.9 preoperatively to a mean of 3.8 postoperatively. Diet restriction decreased from 6.8 preoperatively to a mean of 3.5 postoperatively. Quality of life improved from a median of 4 preoperatively to a postoperative median of 2. Four implants were removed/replaced because of heterotopic bone formation, infection, and/or loose hardware. Follow-up ranged from 6 to 83 months. Overall, TMJ reconstruction using the Biomet stock joint is effective and safe in this patient population. PMID:24861472

  13. Transforming growth factor beta 3 involved in the pathogenesis of synovial chondromatosis of temporomandibular joint

    PubMed Central

    Li, Yingjie; El.Mozen, Loaye Abdelaziz; Cai, Hengxing; Fang, Wei; Meng, Qinggong; Li, Jian; Deng, Mohong; Long, Xing

    2015-01-01

    Synovial chondromatosis (SC) of temporomandibular joint is rare proliferative disorder featured by the formation of cartilaginous nodules in synovium and joint space. Transforming growth factor beta 3 (TGF-β3) is closely related to chondrogenic differentiation, and might participate in pathogenesis of SC. We discovered that increased quantity of synoviocytes and blood vessels were observed in SC synovium. The vessel wall and sublining fibroblasts were stained positively by the antibodies against TGF-β3, fibroblast growth factor 2 (FGF-2), and CD34. In loose bodies (LBs), TGF-β3 was mainly expressed in chondrocytes and FGF-2 was expressed in chondrocytes, fibroblasts, and vessel walls. Expressions of TGF-β1, TGF-β3, FGF-2, Sox9, Wnt-4, Foxc2, and VEGF-A mRNA were significantly higher in SC synovium. Stimulation of TGF-β3 on synoviocytes increased alkaline phosphatase (ALP) activity and expressions of chondrogenic genes (Sox9, Col2α1, Aggrecan, Wnt-4, and Wnt-11), osteogenic genes (Runx2, Foxc2, osteocalcin, and Col1α1), and VEGF-A, but failed to influence FGF-2 expression. However, the addition of FGF-2 increased TGF-β3 expression. In conclusion, TGF-β3 existed in synovium and LBs of SC, and was responsible for the pathogenesis of SC. PMID:25742744

  14. Transforming growth factor beta 3 involved in the pathogenesis of synovial chondromatosis of temporomandibular joint.

    PubMed

    Li, Yingjie; El Mozen, Loaye Abdelaziz; Cai, Hengxing; Fang, Wei; Meng, Qinggong; Li, Jian; Deng, Mohong; Long, Xing

    2015-01-01

    Synovial chondromatosis (SC) of temporomandibular joint is rare proliferative disorder featured by the formation of cartilaginous nodules in synovium and joint space. Transforming growth factor beta 3 (TGF-β3) is closely related to chondrogenic differentiation, and might participate in pathogenesis of SC. We discovered that increased quantity of synoviocytes and blood vessels were observed in SC synovium. The vessel wall and sublining fibroblasts were stained positively by the antibodies against TGF-β3, fibroblast growth factor 2 (FGF-2), and CD34. In loose bodies (LBs), TGF-β3 was mainly expressed in chondrocytes and FGF-2 was expressed in chondrocytes, fibroblasts, and vessel walls. Expressions of TGF-β1, TGF-β3, FGF-2, Sox9, Wnt-4, Foxc2, and VEGF-A mRNA were significantly higher in SC synovium. Stimulation of TGF-β3 on synoviocytes increased alkaline phosphatase (ALP) activity and expressions of chondrogenic genes (Sox9, Col2α1, Aggrecan, Wnt-4, and Wnt-11), osteogenic genes (Runx2, Foxc2, osteocalcin, and Col1α1), and VEGF-A, but failed to influence FGF-2 expression. However, the addition of FGF-2 increased TGF-β3 expression. In conclusion, TGF-β3 existed in synovium and LBs of SC, and was responsible for the pathogenesis of SC. PMID:25742744

  15. Temporomandibular joint health status in war veterans with post-traumatic stress disorder

    PubMed Central

    Mottaghi, Ahmad; Zamani, Elham

    2014-01-01

    Background and Aim: The objective of this study was to determine the prevalence of signs and symptoms of temporomandibular joint dysfunction (TMJD) in the Iran/Iraq war veterans suffering from post-traumatic stress disorder. Materials and Methods: A total of 120 subjects in the age range of 27 to 55 years were included; it included case group (30 war veterans with PTSD) and three control groups (30 patients with PTSD who had not participated in the War, 30 healthy war veterans, and 30 healthy subjects who had not participated in the War). All subjects underwent a clinical TMJ examination that involved the clinical assessment of the TMJ signs and symptoms. Results: The groups of veterans had high prevalence of TMJD signs and symptoms vs. other groups; history of Trauma to joint was significantly higher in subjects who had participated in the war compare with subjects who had not participated in the war (P = 0.0006). Furthermore, pain in palpation of masseter, temporal, pterygoideus, digastric, and sternocleidomastoid muscles in the groups of veterans was significantly greater than other groups (P < 0.0001). Clicking noise during mouth chewing was significantly different between groups (P = 0.01). And, there was significant difference in the frequencies of maximum opening of the mouth between groups (P = 0.001). Conclusion: The results of this study showed that subjects’ war veterans with PTSD have significantly poorer TMJ functional status than the control subjects. PMID:25077153

  16. Inflammatory mediators and radiographic changes in temporomandibular joints of patients with rheumatoid arthritis.

    PubMed

    Voog, Ulle; Alstergren, Per; Eliasson, Sören; Leibur, Edvitar; Kallikorm, Riina; Kopp, Sigvard

    2003-02-01

    The aim of this study was to investigate the relation between the inflammatory mediators tumor necrosis factor alpha (TNFalpha) and serotonin (5-HT), the inflammatory markers erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as well as rheumatoid factor (RF) and thrombocyte particle concentration (TPC) in blood versus temporomandibular joint (TMJ) radiographic changes in patients with clinical TMJ involvement by rheumatoid arthritis (RA). Twenty patients were included. Venous blood was collected for quantification of the mediators, markers, and TPC. The radiographic signs of erosion, flattening, sclerosis, subchondral pseudocyst, and osteophyte as well as radiographic grade were investigated with computed tomography. The median (IQR) plasma levels of TNFalpha and 5-HT were 0 (13) pg/ mL and 13 (22) nmol/L, respectively, while serum level of 5-HT was 1360 874) nmol/L ESR, CRP, and TPC were abnormally high in 53%, 250%, and 15% of the patients, respectively. The most frequent radiographic signs were sclerosis (75%), erosion (50%), and flattening (30%). Erosion was found to be associated with high TPC and flattening with high plasma level of TNFalpha. In conclusion, patients with clinical TMJ involvement by RA show an association between high level of TPC and TNFalpha in plasma versus radiographic signs of joint bone destruction. PMID:12635783

  17. Comparison of the outcomes of three surgical treatments for end-stage temporomandibular joint disease.

    PubMed

    Dimitroulis, G

    2014-08-01

    The aim of this study was to determine whether there are any differences between condylectomy, rib grafts, and prosthetic joints (Biomet TMJ stock prosthesis) with regard to outcomes for patients with end-stage temporomandibular joint (TMJ) disease. Fifty-six of a total 127 patients who presented with category 5 end-stage TMJ disease over 3 years (2010-2013) agreed to participate in this retrospective, comparative, cohort study. Patients were divided into four groups: preoperative (n=16), condylectomy (n=8), rib graft (n=16), and prosthetic joint (n=16). They were assessed for major postoperative complications (i.e., return to theatre) and maximum range of mandibular motion, and all completed a specific quality of life (QOL) questionnaire. Whilst the condylectomy group demonstrated the best mandibular range of motion (P<0.01), rib graft patients were more likely to experience complications (43.8%) necessitating a return to theatre. The prosthesis group recorded the best mean aggregate QOL score, but the difference compared to the rib graft and condylectomy groups was not statistically significant. The results of this study suggest that for dentate patients, prosthetic joints are highly dependable with no returns to theatre and favourable QOL outcomes. For edentulous patients, condylectomies alone also appear to work well. Future TMJ prosthetic designs should focus on improving mandibular range of motion, as the current stock prosthesis allows only a restricted range, no better than that achieved with rib graft (P>0.05) and far less than that achieved with condylectomy (P<0.01). PMID:24629849

  18. Osteoarthritis of the temporo-mandibular joint in free-living Soay sheep on St Kilda.

    PubMed

    Arthur, Colin; Watt, Kathryn; Nussey, Daniel H; Pemberton, Josephine M; Pilkington, Jill G; Herman, Jeremy S; Timmons, Zena L; Clements, Dylan N; Scott, Philip R

    2015-01-01

    Osteoarthritis (OA) is a common degenerative disease of synovial joints with the potential to cause pathology and welfare issues in both domestic and wild ruminants. Previous work has identified OA of the elbow joint in domestic sheep, but the prevalence of OA of the jaw and in particular the temporomandibular joint (TMJ) has not been previously reported. Following up a previous report of a single case of TMJ OA in a free-living population of Soay sheep on St Kilda in the Outer Hebrides, an archive of 2736 jaw bones collected from this population between 1985 and 2010 was surveyed. Evidence of TMJ OA was found in 35 sheep. Of these, 15 cases were unilateral (11 right side, 4 left side) and the remaining 20 were bilateral. TMJ pathology was much more common in females than males: only 3/35 cases were in males, with overall prevalence at 2.3% for females and 0.2% in males. Radiographic examination of TMJ with OA revealed extensive bone re-modelling with osteophytosis, particularly of the condyle of the mandible. There was a highly significant age-dependence in TMJ OA incidence among age classes: 30/35 cases occurred in geriatric sheep (aged 7 years or more; 11.1% prevalence within this age class), four in adults (2-6 years old; 0.9% prevalence), one in yearlings (0.3% prevalence) and none in lambs. The low incidence in males was confounded by sex differences in longevity: while 18% of females sampled died in the geriatric age class, only 2% of males did so. Although the low prevalence of the pathology limited the ability to test its association with other traits, it was possible to examine relationships with reproductive performance measures amongst geriatric females with and without TMJ OA. Although there were trends towards lower fecundity and lower lamb birth weight in the breeding season prior to death, these were not statistically significant. PMID:25458883

  19. Diagnostic concordance between MRI and electrovibratography of the temporomandibular joint of subjects with disc displacement disorders

    PubMed Central

    Deregibus, A; Castroflorio, T; De Giorgi, I; Burzio, C; Debernardi, C

    2013-01-01

    Objectives: The aim of this study is to evaluate the diagnostic concordance of MRI and electrovibratography (EVG) of the temporomandibular joint (TMJ) in the diagnosis of articular disc displacement with reduction (ADDwR) and articular disc displacement without reduction (ADDw/oR). Methods: 50 patients (12 males, 38 females; mean age 37.46 ± 15.64 years) with a hypothesis of disc displacement were selected. For each patient an MRI of the TMJ was performed. MRIs were evaluated sorting the 100 TMJs by kind of pathology (no pathology, ADDwR, ADDw/oR, and joint hypermobility). Afterwards, the patients had an EVG exam. The EVG exams were performed with vibration transducers over each TMJ, enabling simultaneous, bilateral recording of vibrations emanating from joint sounds during the opening and closing movements. The presence of a sound peak was compared with the MRI diagnosis of ADDwR, while a multipeak aspect was compared with ADDw/oR diagnosis using Cohen's kappa test. Results: The presence of a peak-shaped track has high specificity for ADDwR (90.27%). The Cohen's kappa calculated for the ADDwR was 0.5615 (good–moderate). The presence of a multipeak-shaped track has low specificity (65.22%) and sensitivity (70.42%). The Cohen's kappa calculated for the ADDw/oR was 0.2992 (poor). Conclusions: The present study recommends the use of EVG to support the clinical diagnosis of a disc displacement with reduction when MRI is not available or when subjects cannot be investigated by MRI. PMID:23420863

  20. Single stage treatment of ankylosis of the temporomandibular joint using patient-specific total joint replacement and virtual surgical planning.

    PubMed

    Haq, Jahrad; Patel, Nishma; Weimer, Katherine; Matthews, N Shaun

    2014-04-01

    Ankylosis of the temporomandibular joint (TMJ) is a debilitating condition that can result in pain, trismus, and a poor quality of life. It can be caused by injury, infection, and rheumatoid disease. Current management includes gap arthroplasty, interpositional arthroplasty, and reconstruction. Traditionally, joints are reconstructed using stock implants, or the procedure is done in two stages with an additional computed tomography (CT) scan between the resective and reconstructive procedures and use of stereolithographic models to aid the design of the definitive prostheses. We describe a technique for the resection of ankylosis and reconstruction of the joint in a single operation using virtually designed custom-made implants. Five patients with ankylosis of the TMJ had a single stage operation with reconstruction between 2010 and 2012. All had preoperative high-resolution CT with contrast angiography. During an international web-based teleconference between the surgeon and the engineer a virtual resection of the ankylosis was done using the reconstructed CT images. The bespoke cutting guides and implants were designed virtually at the same time and were then manufactured precisely using computer-aided design and manufacture (CAD-CAM) over 6 weeks. After release of the ankylosis and reconstruction, the patients underwent an exercise regimen to improve mouth opening. Follow-up was for a minimum of 6 months. Four patients had one operation, and one patient had two. Median/Mean maximum incisal opening increased from 0.6mm before operation to 25 mm afterwards (range 23-27), and there was minimal surgical morbidity. This new method effectively treats ankylosis of the TMJ in a single stage procedure. Fewer operations and hospital stays, and the maintenance of overall clinical outcome are obvious advantages. PMID:24480620

  1. Expression of MMP-2 and MMP-9 in the rat trigeminal ganglion during the development of temporomandibular joint inflammation

    PubMed Central

    Nascimento, G.C.; Rizzi, E.; Gerlach, R.F.; Leite-Panissi, C.R.A.

    2013-01-01

    Orofacial pain is a prevalent symptom in modern society. Some musculoskeletal orofacial pain is caused by temporomandibular disorders (TMDs). This condition has a multi-factorial etiology, including emotional factors and alteration of the masticator muscle and temporomandibular joints (TMJs). TMJ inflammation is considered to be a cause of pain in patients with TMD. Extracellular proteolytic enzymes, specifically the matrix metalloproteinases (MMPs), have been shown to modulate inflammation and pain. The purpose of this investigation was to determine whether the expression and level of gelatinolytic activity of MMP-2 and MMP-9 in the trigeminal ganglion are altered during different stages of temporomandibular inflammation, as determined by gelatin zymography. This study also evaluated whether mechanical allodynia and orofacial hyperalgesia, induced by the injection of complete Freund's adjuvant into the TMJ capsule, were altered by an MMP inhibitor (doxycycline, DOX). TMJ inflammation was measured by plasma extravasation in the periarticular tissue (Evans blue test) and infiltration of polymorphonuclear neutrophils into the synovial fluid (myeloperoxidase enzyme quantification). MMP expression in the trigeminal ganglion was shown to vary during the phases of the inflammatory process. MMP-9 regulated the early phase and MMP-2 participated in the late phase of this process. Furthermore, increases in plasma extravasation in periarticular tissue and myeloperoxidase activity in the joint tissue, which occurred throughout the inflammation process, were diminished by treatment with DOX, a nonspecific MMP inhibitor. Additionally, the increases of mechanical allodynia and orofacial hyperalgesia were attenuated by the same treatment. PMID:24270905

  2. Methotrexate pharmacotherapy for implant-related temporomandibular joint pain: a case report.

    PubMed

    Edwards, J Paul; Peterson, Erik J; Durham, Justin; Nixdorf, Donald R

    2014-08-01

    This article presents a patient experiencing several years of pain associated with bilateral failed temporomandibular joint (TMJ) Proplast/Teflon fossa prostheses. Despite surgical removal of the prostheses and comprehensive conservative management, including typical pharmacotherapy approaches for chronic pain, pain was still not relieved, and management was revised to target a putative chronic inflammatory disorder. Methotrexate was prescribed because of its known efficacy for inflammation and pain reduction in rheumatoid arthritis. Titration of methotrexate dosage over 5 months to a weekly dose of 20 mg resulted in reduced pain intensity at rest, increased pain-free maximal jaw opening, and a reduction in the sensory component of the McGill Pain Questionnaire. Maximum assisted jaw opening remained the same, as did the palpation tenderness of both TMJs and of the masseter and temporalis muscles. Methotrexate pharmacotherapy may represent a viable option when conservative treatments have failed to provide significant pain relief in patients who have had Proplast/Teflon TMJ implants. PMID:25047933

  3. Computed tomographic findings in dogs and cats with temporomandibular joint disorders: 58 cases (2006–2011)

    PubMed Central

    Arzi, Boaz; Cissell, Derek D.; Verstraete, Frank J. M.; Kass, Philip H.; DuRaine, Grayson D.; Athanasiou, Kyriacos A.

    2013-01-01

    Objective To describe CT findings in dogs and cats with temporomandibular joint (TMJ) disorders. Design Retrospective case-series. Animals 41 dogs and 17 cats. Procedures Medical records and CT images of the skull were reviewed for dogs and cats that were examined at a dentistry and oral surgery specialty practice between 2006 and 2011. Results Of 142 dogs and 42 cats evaluated, 41 dogs and 17 cats had CT findings consistent with a TMJ disorder. In dogs, the most common TMJ disorder was osteoarthritis; however, in most cases, there were other TMJ disorders present in addition to osteoarthritis. Osteoarthritis was more frequently identified at the medial aspect rather than the lateral aspect of the TMJ, whereas the frequency of osteoarthritic involvement of the dorsal and ventral compartments did not differ significantly. In cats, fractures were the most common TMJ disorder, followed by osteoarthritis. Clinical signs were observed in all dogs and cats with TMJ fractures, dysplasia, ankylosis, luxation, and tumors; however, only 4 of 15 dogs and 2 of 4 cats with osteoarthritis alone had clinical signs. Conclusions and Clinical Relevance Results indicated that TMJ disorders are frequently present in combination. Osteoarthritis was the most common TMJ disorder in dogs and the second most common TMJ disorder in cats. Computed tomography should be considered as a tool for the diagnosis of TMJ disorders in dogs and cats with suspected orofacial disorders and pain. PMID:23234284

  4. Zurich pediatric distractor for ramal condylar unit distraction in temporomandibular joint ankylosis.

    PubMed

    Sahoo, Brig N K; Roy, I D; Sharma, Rohit; Kaur, Maj Preeti

    2016-01-01

    Temporomandibular joint (TMJ) Ankylosis is an extremely disabling condition characterized by difficulty or inability to open the mouth resulting in facial asymmetry, malocclusion and dental problems. Surgical excision of the ankylosed mass is the only treatment option available to gain mouth opening. The loss in vertical height of ramus following release of ankylosis is difficult to manage in both unilateral and bilateral TMJ ankylosis. Out of all the methods to restore this height Distraction Osteogenesis (DO) is gaining popularity because of predictable gain in the length without any associated morbidity. Recurrent bilateral TMJ ankylosis in a 32 year old male was treated by osteoarthrectomy and temporal fascia interpositioning arthroplasty. Bilateral reconstruction of ramal condylar unit (RCU) was carried out by Zurich paediatric distractor (KLS Martin, Tuttlingen Germany). Following a latency period of 7 days distraction was carried out at a rate of 1mm/day for 8 days. Distractors were removed after 12 weeks of consolidation period. The case was followed up for 12 months during which the mouth opening was maintained at 38 mm and there was no anterior open bite. PMID:27563617

  5. Diagnostic index of three-dimensional osteoarthritic changes in temporomandibular joint condylar morphology.

    PubMed

    Gomes, Liliane R; Gomes, Marcelo; Jung, Bryan; Paniagua, Beatriz; Ruellas, Antonio C; Gonçalves, João Roberto; Styner, Martin A; Wolford, Larry; Cevidanes, Lucia

    2015-07-01

    This study aimed to investigate imaging statistical approaches for classifying three-dimensional (3-D) osteoarthritic morphological variations among 169 temporomandibular joint (TMJ) condyles. Cone-beam computed tomography scans were acquired from 69 subjects with long-term TMJ osteoarthritis (OA), 15 subjects at initial diagnosis of OA, and 7 healthy controls. Three-dimensional surface models of the condyles were constructed and SPHARM-PDM established correspondent points on each model. Multivariate analysis of covariance and direction-projection-permutation (DiProPerm) were used for testing statistical significance of the differences between the groups determined by clinical and radiographic diagnoses. Unsupervised classification using hierarchical agglomerative clustering was then conducted. Compared with healthy controls, OA average condyle was significantly smaller in all dimensions except its anterior surface. Significant flattening of the lateral pole was noticed at initial diagnosis. We observed areas of 3.88-mm bone resorption at the superior surface and 3.10-mm bone apposition at the anterior aspect of the long-term OA average model. DiProPerm supported a significant difference between the healthy control and OA group ([Formula: see text]). Clinically meaningful unsupervised classification of TMJ condylar morphology determined a preliminary diagnostic index of 3-D osteoarthritic changes, which may be the first step towards a more targeted diagnosis of this condition. PMID:26158119

  6. Changes in Temporomandibular Joint Dysfunction Symptoms Following Massage Therapy: A Case Report

    PubMed Central

    Pierson, Melissa Joan

    2011-01-01

    Purpose The objective of this case report was to describe the effects that massage therapy had on a woman with temporomandibular joint dysfunction. Participant The 26-year-old woman’s primary symptoms were pain, decreased range of motion, clicking, and crepitus. These symptoms were reportedly associated with emotional stress and bruxism. Intervention Ten 45-minute massage therapy treatments were administered over a five-week period. The client’s progress was monitored by an initial, midway, and final assessment, using range of motion testing, personal interview, an orthopedic test, and postural analysis. Progress was also evaluated by the use of a daily journal. The client participated in a home care routine consisting of stretches, self-massage, postural training, a proprioception exercise, and hydrotherapy. Results Results include an increase in maximal opening from 3.1 cm to 3.8 cm, an overall increase in neck range of motion, a decrease in muscle hypertonicity using the Wendy Nickel’s Scale, a decrease in pain from 7/10 to 3/10 on a numerical pain scale, and a decline in stress. Conclusion Although the client in this report experienced positive results, more extensive studies are needed to understand the effects of massage on TMD. PMID:22211156

  7. Injecting vascular endothelial growth factor into the temporomandibular joint induces osteoarthritis in mice

    PubMed Central

    Shen, Pei; Jiao, ZiXian; Zheng, Ji Si; Xu, Wei Feng; Zhang, Shang Yong; Qin, An; Yang, Chi

    2015-01-01

    It is unclear whether vascular endothelial growth factor (VEGF) can initiate osteoarthritis (OA) in the temporomandibular joint (TMJ). In this study we evaluated the effects of intra-articular injection of exogenous VEGF in the TMJ in mice on the early stage. Forty-eight male Sprague-Dawley mice were equally divided into 3 groups. In the vegf group, the mice received an injection of VEGF solution (50 μL) in the TMJ once a week over a period of 4 weeks. In the sham group, the mice received an injection of saline (50 μL). The control group did not receive any injection. Four mice from each group were sacrificed at 1, 2, 4, and 8 weeks. Gradual prominent cartilage degeneration was observed in the vegf group. Additionally, this group showed higher expressions of metalloproteinase (MMP)-9, MMP-13, receptor activator of nuclear factor-kappa-B ligand (RANKL), and a higher number of apoptotic chondrocytes and VEGF receptor 2 (VEGFR2)-positive chondrocytes. Micro-computed tomography (CT) revealed prominent subchondral bone resorption in the vegf group, with a high number of osteoclasts in the subchondral bone. In vitro study demonstrated that VEGF can promote osteoclast differentiation. In conclusion, our study found that VEGF can initiate TMJ OA by destroying cartilage and subchondral bone. PMID:26531672

  8. Electromyographic power spectrum of jaw muscles during clenching in unilateral temporomandibular joint osteoarthritis patients.

    PubMed

    Park, I H; McCall, W D; Chung, J W

    2012-09-01

    The relationship between temporomandibular joints (TMJ) osteoarthritis and masticatory muscle disorders is poorly understood. The data are sparse, the results are conflicting, and electromyographic (EMG) power spectrum analysis has not been used. The aims of this study were to compare the differences in EMG power spectrum during, and pressure pain thresholds (PPTs) before and after, sustained clenching in patients with unilateral TMJ osteoarthritis and healthy control subjects. Nineteen patients with unilateral TMJ osteoarthritis without masticatory muscle pain and 20 control subjects were evaluated. We measured EMG amplitudes at maximum voluntary contraction, median frequency from the EMG power spectrum during sustained clenching at 70% and PPTs before and after the clenching in both temporalis and masseter muscles. There were no significant differences in PPT decrease between muscles or between groups during sustained clenching. There were no significant differences in maximum voluntary contraction EMG activity ratios of affected to unaffected sides between groups, or of masseter to temporalis muscles between affected and unaffected side of patients with TMJ osteoarthritis. Median frequencies decreased from the beginning to the end of the sustained clench, and the interaction between group and clench was significant: the median frequency decrease was larger in the osteoarthritis group. Our results suggested that masticatory muscles of patients with unilateral TMJ osteoarthritis are more easily fatigued during sustained clenching than normal subjects. PMID:22672238

  9. Imaging modalities to access bony tumors and hyperplasic reactions of the temporomandibular joint.

    PubMed

    Shintaku, Werner H; Venturin, Jaqueline S; Langlais, Robert P; Clark, Glenn T

    2010-08-01

    Benign and malignant tumors in the temporomandibular joint (TMJ) are rare. However, when a patient presents with clinical findings such as altered occlusion or facial asymmetry, a morphologic alteration in the condyle should be ruled out. The differential diagnosis for benign hyperplastic bony lesions in the TMJ should include condylar hyperplasia, osteochondroma, osteoma, chondroma, and osteoblastoma. If malignant features are present, chondrosarcoma and osteosarcoma should be considered. For the differential diagnosis, imaging is the most noninvasive method to evaluate the integrity of the TMJ. Imaging can be classified as morphologic or functional according to the information provided. The current scientific data have shown that panoramic images have 97% sensitivity and 45% specificity for identifying hyperplastic conditions in the TMJ. The sensitivity and specificity of medical computed tomography (CT) and cone-beam CT is 70% and 100%, and 80% and 100%, respectively, for the detection of bony abnormalities. To differentiate benign and malignant bony tumors, magnetic resonance imaging has a sensitivity and specificity of 44% and 95%, respectively. The corresponding percentages for single positron emission CT are 91% and 94%, for single positron emission CT/CT are 100% and 100%, for positron emission tomography are 88% and 72%, and for positron emission tomography/CT are 100% and 97%. The combination of morphologic and functional (single positron emission CT and positron emission tomography) modalities appears to improve the sensitivity and specificity to assess a hyperplastic condyle, facilitating treatment planning and providing a better prognosis for the patient. PMID:20452115

  10. Use of adipose stem cells and polylactide discs for tissue engineering of the temporomandibular joint disc

    PubMed Central

    Mäenpää, Katja; Ellä, Ville; Mauno, Jari; Kellomäki, Minna; Suuronen, Riitta; Ylikomi, Timo; Miettinen, Susanna

    2010-01-01

    There is currently no suitable replacement for damaged temporomandibular joint (TMJ) discs after discectomy. In the present study, we fabricated bilayer biodegradable polylactide (PLA) discs comprising a non-woven mat of poly(L/D)lactide (P(L/D)LA) 96/4 and a P(L/DL)LA 70/30 membrane plate. The PLA disc was examined in combination with adipose stem cells (ASCs) for tissue engineering of the fibrocartilaginous TMJ disc in vitro. ASCs were cultured in parallel in control and chondrogenic medium for a maximum of six weeks. Relative expression of the genes, aggrecan, type I collagen and type II collagen present in the TMJ disc extracellular matrix increased in the ASC-seeded PLA discs in the chondrogenic medium. The hypertrophic marker, type X collagen, was moderately induced. Alcian blue staining showed accumulation of sulphated glycosaminoglycans. ASC differentiation in the PLA discs was close to that observed in pellet cultures. Comparison of the mRNA levels revealed that the degree of ASC differentiation was lower than that in TMJ disc-derived cells and tissue. The pellet format supported the phenotype of the TMJ disc-derived cells under chondrogenic conditions and also enhanced their hyalinization potential, which is considered part of the TMJ disc degeneration process. Accordingly, the combination of ASCs and PLA discs has potential for the development of a tissue-engineered TMJ disc replacement. PMID:19474082