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1

Temporomandibular Joint Disorder  

MedlinePLUS

... news feeds delivered directly to your desktop! more... Temporomandibular Joint Disorder Article Chapters Temporomandibular Joint Disorder What ... men. Updated: November 2008 Previous Next Related Articles: Temporomandibular Joint Disorder (TMD) Are You Biting Off More ...

2

The identification of temporomandibular joint disease through the masticatory cycle.  

PubMed

The purpose of this study was to determine, by analyzing the masticatory cycle, the presence of TMJ disease prior to initiating any orthodontic treatment. Masticatory data from 80 pre-orthodontic patients were recorded in the frontal and sagittal planes and then analyzed and compared with the pre-established healthy masticatory data of Maruyama et al. 40% of the sample group presented with signs and/or symptoms of masticatory dysfunction and/or temporomandibular joint abnormalities (TMJA). Using Student's t test we found significant differences in the means for all seven parameters measured. Patients with TMJA exhibited significantly slower closing, occlusal and total cycle times, but faster opening. It was usually possible to determine which joint was compromised by the disease from the data. PMID:15839580

Learreta, Jorge A; Bono, Andrea E; Maffia, Graciela; Beas, Jorge

2005-01-01

3

Jacob's disease associated with temporomandibular joint dysfunction: a case report.  

PubMed

Jacob's disease is regarded a rare condition in which a joint formation is established between an enlarged mandibular coronoid process and the inner aspect of the zygomatic body. Chronic temporomandibular joint (TMJ) disk displacement has been proposed as etiological factor of coronoid process enlargement. We present a 23-year-old woman with long-standing TMJ dysfunction and restricted interincisal opening, who developed a progressive zygomatic asymmetry. The patient underwent treatment by intraoral coronoidectomy and homolateral TMJ arthroscopy in the same surgery. The histopathological diagnosis of the coronoid sample was cartilage-capped exostoses with presence of articular fibrous cartilage. Although the low prevalence of this entity, it should be considered as a possible diagnosis in patients with progressive limitation of mouth opening, although a TMJ syndrome may be present as a cause of this entity. PMID:15876963

Capote, Ana; Rodríguez, Francisco J; Blasco, Ana; Muñoz, Mario F

2005-01-01

4

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 ...

5

Clinical, radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases  

Microsoft Academic Search

The aim of this study was to investigate the condition of the temporomandibular joint (TMJ) in patients with different rheumatic diseases, and report correlations between the clinical, radiographic and magnetic resonance imaging (MRI) findings. The 67 patients were divided into four groups: 16 with rheumatoid arthritis (RA), 15 with mixed connective tissue disease (MCTD), 18 with ankylosing spondylitis (AS) and

L. M. J. Helenius; P. Tervahartiala; I. Helenius; J. Al-Sukhun; L. Kivisaari; R. Suuronen; H. Kautiainen; D. Hallikainen; C. Lindqvist; M. Leirisalo-Repo

2006-01-01

6

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

SciTech Connect

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.

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

1984-10-01

7

Posttraumatic Temporomandibular Joint Disorders  

PubMed Central

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

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

2009-01-01

8

Rheumatoid arthritis affecting temporomandibular joint  

PubMed Central

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.

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

2015-01-01

9

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

PubMed

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

Dimitroulis, G

2014-08-01

10

Surgical Management of Temporomandibular Joint Ankylosis in Ankylosing Spondylitis  

PubMed Central

Relatively few patients develop such severe degenerative temporomandibular joint (TMJ) disease that they require total joint replacement. Current indications include those conditions involving condylar bone loss such as degenerative (osteoarthritis) or inflammatory joint disease (ankylosing spondylitis, rheumatoid, and psoriatic). Ankylosis of the temporomandibular joint (TMJ) secondary to ankylosing spondylitis remains an under investigated entity. We aim to provide an overview of treatment objectives, surgical procedures, and our experience with total TMJ replacement for this condition. PMID:21547039

Felstead, Andrew M.; Revington, Peter J.

2011-01-01

11

Temporomandibular joint diagnostics using CBCT.  

PubMed

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

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

2015-01-01

12

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Total temporomandibular joint prosthesis. 872.3940 Section 872...872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is...

2011-04-01

13

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false Total temporomandibular joint prosthesis. 872.3940 Section 872...872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is...

2012-04-01

14

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2014 CFR

...2014-04-01 false Total temporomandibular joint prosthesis. 872.3940 Section 872...872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a device that is...

2014-04-01

15

21 CFR 872.3940 - Total temporomandibular joint prosthesis.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 false Total temporomandibular joint prosthesis. 872.3940...Devices § 872.3940 Total temporomandibular joint prosthesis. (a) Identification. A total temporomandibular joint prosthesis is a...

2010-04-01

16

Surgery-first approach on patients with temporomandibular joint disease by intraoral vertical ramus osteotomy.  

PubMed

Orthognathic surgery followed by postsurgical orthodontics without presurgical orthodontic treatment, known as the surgery-first approach (SFA), has become favored recently. The advantages of this surgical approach include total treatment time reduction, psychological benefit from a limited duration of unesthetic orthodontic appliances, and a more effective orthodontic movement of the dentition postoperatively through a regional acceleratory phenomenon. SFA has been previously described in the literature as a surgical technique with Le Fort I osteotomy and sagittal split ramus osteotomy (SSRO), which helps maintain postoperative occlusion with rigid fixation; however, patients with temporomandibular joint disorder (TMD) are better candidates for the intraoral vertical ramus osteotomy (IVRO) surgical technique instead of SSRO. The authors report 2 cases with excellent surgical outcomes and resolution of TMD symptoms on patients with mandibular prognathism via SFA using IVRO technique. PMID:22771403

Park, Kyung-Ran; Kim, Sang Yoon; Park, Hyung-Sik; Jung, Young-Soo

2013-12-01

17

Temporomandibular Joint Disorders  

MedlinePLUS Videos and Cool Tools

... jaw joint. TMJ disorders can cause headaches, ear pain, bite problems, clicking sounds, locked jaws, and other ... three main categories: Muscle Disorders These disorders include pain in the muscles that control jaw function, as ...

18

Management of temporomandibular joint ankylosis.  

PubMed

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

Movahed, Reza; Mercuri, Louis G

2015-02-01

19

Strapping for temporomandibular joint dysfunction.  

PubMed

Temporomandibular joint dysfunction (TMJD) is a common problem seen in many of the dental clinics. Management of this depends on an accurate diagnosis of the cause for the TMJD. Physical therapy and rehabilitation play a vital role in the management of these dysfunctions. Physical therapy is useful in treating post-traumatic stiffness of the TMJ while strapping of the TMJ for a dysfunction along with conventional physical therapy is of benefit in terms of reduction in click, decrease in pain, and an improvement in function. PMID:18797110

Babu, Abraham Samuel; John, Sandhya Mary; Unni, Amith

2008-01-01

20

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

PubMed

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

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

2003-10-01

21

Etiological factors of temporomandibular joint disorders  

PubMed Central

The temporomandibular joint receives its name from the two bones that enter into its formation, namely the temporal bone and the mandible. This complex synovial system is composed of two temporomandibular joints together with their articulating ligaments and masticatory muscles. This articulation affects other synovial joints that relate specifically to masticatory function. The causes of temporomandibular disorders are complex and multifactorial. There are numerous factors that can contribute to temporomandibular disorders. In some instances a single factor may serve one or all of these roles. Iatrogenic injuries can act as both initiating as well as predisposing factors. The term craniomandibular disorder is used synonymously with the term temporomandibular disorders and is considered a major cause of nondental pain in the orofacial pain region. The successful management of temporomandibular disorders is dependent on identifying and controlling the contributing factors. The temporomandibular disorders are more common in females, the reason is not clearly known. The following article provides detailed information regarding temporomandibular joint disorders. PMID:22639496

Sharma, Shalender; Gupta, D. S.; Pal, U. S.; Jurel, Sunit Kumar

2011-01-01

22

Temporomandibular Joint Dysfunction: A Dental Overview  

PubMed Central

Temporomandibular joint dysfunction is common and often acutely painful. Because of the large and diverse symptom complex created by this disorder, patients frequently first seek relief from their physician rather than their dentist. In this article temporomandibular joint (TMJ) dysfunction is defined and the presenting signs and symptoms are discussed. Their etiology is described in relation to the anatomy of the temporomandibular joint. Examination techniques can help in the differential diagnosis. Current treatment ranges from heat, local anesthesia and ultrasound to anxiolytics, transcutaneous nerve stimulation and nutritional supplementation. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6Fig. 7Fig. 8 PMID:21274225

Hillier, Clyde D.

1985-01-01

23

Temporomandibular joint: disorders, treatments, and biomechanics.  

PubMed

Temporomandibular joint (TMJ) is a complex, sensitive, and highly mobile joint. Millions of people suffer from temporomandibular disorders (TMD) in USA alone. The TMD treatment options need to be looked at more fully to assess possible improvement of the available options and introduction of novel techniques. As reconstruction with either partial or total joint prosthesis is the potential treatment option in certain TMD conditions, it is essential to study outcomes of the FDA approved TMJ implants in a controlled comparative manner. Evaluating the kinetics and kinematics of the TMJ enables the understanding of structure and function of normal and diseased TMJ to predict changes due to alterations, and to propose more efficient methods of treatment. Although many researchers have conducted biomechanical analysis of the TMJ, many of the methods have certain limitations. Therefore, a more comprehensive analysis is necessary for better understanding of different movements and resulting forces and stresses in the joint components. This article provides the results of a state-of-the-art investigation of the TMJ anatomy, TMD, treatment options, a review of the FDA approved TMJ prosthetic devices, and the TMJ biomechanics. PMID:19252985

Ingawalé, Shirish; Goswami, Tarun

2009-05-01

24

[Temporomandibular joint primitive tumors and pseudo tumors].  

PubMed

The temporomandibular joint (TMJ) can be the site of bone, cartilaginous, or synovial tumors. There is no well-defined histological classification. We listed all benign tumors, malignant primitive tumors, and rare pseudo tumors of the TMJ. We provide a list to help for the diagnosis and the differential diagnosis of non-tumoral lesions by far the most frequent. PMID:23711211

Oukabli, M; Chibani, M; Ennouali, H; Hemmaoui, B; Albouzidi, A

2013-02-01

25

Temporomandibular joint dislocation: experiences from Zaria, Nigeria  

PubMed Central

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

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

2014-01-01

26

Effect of methotrexate on the temporomandibular joint and facial morphology in juvenile rheumatoid arthritis patients  

Microsoft Academic Search

Juvenile rheumatoid arthritis is a disease characterized by chronic inflammation in one or more joints; it affects children and adolescents up to 18 years of age. This disease may cause significant skeletal joint destruction, and the temporomandibular joint, like other joints, may become severely affected resulting in aberrant mandibular growth, abnormal dentofacial development, and\\/or altered orofacial muscle function. Methotrexate is

Didem O. Ince; Akgun Ince; Terry L. Moore

2000-01-01

27

Imaging of the temporomandibular joint: An update.  

PubMed

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

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

2014-08-28

28

Radiation dose in temporomandibular joint zonography  

SciTech Connect

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.

Coucke, M.E.; Bourgoignie, R.R.; Dermaut, L.R.; Bourgoignie, K.A.; Jacobs, R.J. (Department of Orthodontics, Universitair Ziekenhuis, Ghent (Belgium))

1991-06-01

29

Oral splint for temporomandibular joint disorders with revolutionary fluid system.  

PubMed

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

Srivastava, Rahul; Jyoti, Bhuvan; Devi, Parvathi

2013-05-01

30

Oral splint for temporomandibular joint disorders with revolutionary fluid system  

PubMed Central

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

Srivastava, Rahul; Jyoti, Bhuvan; Devi, Parvathi

2013-01-01

31

Pigmented villonodular synovitis of the temporomandibular joint.  

PubMed

Pigmented villonodular synovitis (PVNS) is a proliferative disorder that affects synovium-lined joints, bursae, and tendon sheaths. It appears in both diffuse and localized forms, depending on the extent of synovial involvement. PVNS rarely involves the temporomandibular joint (TMJ); when it does, it manifests clinically as a slowly growing and painless preauricular mass that resembles a parotid tumor. TMJ dysfunction, paresthesia, and/or hearing loss can result. We present a case of a large extra-articular PVNS of the TMJ, and we review the literature. PMID:23904309

Giannakopoulos, Helen; Chou, Joli C; Quinn, Peter D

2013-07-01

32

Quantitative Radiological Diagnosis Of The Temporomandibular Joint  

NASA Astrophysics Data System (ADS)

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.

Jordan, Steven L.; Heffez, Leslie B.

1989-05-01

33

Two Cases of Masticator Space Abscess Initially Diagnosed as Temporomandibular Joint Disorder  

Microsoft Academic Search

Diseases causing trismus or pain of the temporomandibular joint (TMJ) include temporomandibular joint disorders (TMJD), trauma, tumors and an inflammation. This report describes two cases of masticator space abscesses causing trismus and TMJ pain, which were initially diagnosed as TMJD. The first case was a 62-year-old female suffering from trismus and right-TMJ pain without swelling or redness, which was diagnosed

TAKUMI HASEGAWA; YASUYUKI SHIBUYA; SHINSUKE KUROKI; JUNICHIRO TAKEUCHI; SATOSHI YOKOO; MASAHIRO UMEDA; TAKAHIDE KOMORI

34

Tophaceous pseudogout of the temporomandibular joint: report of a case.  

PubMed

An 85-year-old man was found to have a calcified mass protruding from the joint space of the right temporomandibular joint (TMJ). Microscopically, the removed mass consisted of chondromyxoid tissue with atypical chondrocytes, resembling a cartilaginous tumor. However, the chondromyxoid tissue contained abundant deposits of rod-shaped to rhomboid crystals which proved to be calcium pyrophosphate dihydrate (CPPD) crystals. The review of the literature revealed that tophaceous pseudogout was the most common variant of CPPD deposition disease involving the TMJ. PMID:9293541

Kurihara, K; Mizuseki, K; Saiki, T; Wakisaka, H; Maruyama, S; Sonobe, J

1997-08-01

35

Atypical temporomandibular joint pain: a case report.  

PubMed

Atypical temporomandibular joint (TMJ) pain can consist of an unusual intensity, location or set of pain descriptors that do not match what is traditionally observed for TMJ capsular pain, disc displacements or arthritic conditions. Presented in this case report is an atypical pain report regarding a unilateral TMJ pain as the chief complaint. An overview of typical vs atypical TMJ pain is also reviewed to highlight unusual signs and symptoms so that the clinician can identify these atypical presentations and pursue further diagnostic approaches. PMID:25457893

Widmer, Charles G; Wold, Courtney C; Stoll, Ethan M; Dolwick, M Franklin

2014-12-01

36

Temporomandibular joint ankylosis fixation technique with ultra thin silicon sheet  

PubMed Central

Background: Temporomandibular joint ankylosis is a highly distressing condition in which the joint space is obliterated by scar tissue and the patient has an inability to open the mouth. Different autogenous and alloplastic interposition materials have been used after the resection of the ankylotic bone to achieve desirable and long lasting results. The recurrence of disease is most distressing for both patients and surgeon. We have been using ultra thin silicon sheet as our preferred material for providing proper fixation and cover to the joint. We have been encouraged by good patient compliance, no implant extrusion and favourable outcome. Materials and Methods: The clinical study included 80 patients with temporomandibular joint ankylosis, treated between April 2001 and March 2009. In all patients, temporomandibular joint ankylosis had resulted following trauma. Diagnosis was based on clinical assessment supplemented by radiographic examination consisting of a panoramic radiograph, axial and coronal computer tomography. The technique of using ultra thin silicon sheet covering whole of the joint space fixed with non-absorbable nylon 3-0 suture both medially to medial pterygoid muscle and laterally to periosteum of zygomatic arch was employed in all patients. Results: A total of 80 patients were in this study (59 males and 21 females). The aetiology of temporomandibular joint ankylosis was post-traumatic in all cases. The patients’ age ranged from 5 to 45 years. The disease was unilateral in 61 cases and bilateral in 19 cases. Twelve patients, who had previous surgery done in the form of gap arthroplasty in 6 cases, costochondral graft in 4 cases and temporalis muscle in 2 cases, presented with recurrence on the same side. The pre-op inter-incisal mouth opening ranged from 4 to 12 mm. The intraoperative inter-incisal mouth opening ranged from 28 to 46 mm. An additional procedure was done in 13 patients, including placement of costochondral graft with coronoidectomy in 4 of these cases. There was no immediate complication and no incidence of facial nerve injury. There was no extrusion of the implant in immediate and follow-up period. Conclusions: The use of alloplastic implants with less volume and proper fixation covering all the raw bone joint space prevents reunion of bone; fixation of the sheet prevents its movement and thus extrusion. PMID:22279275

Kalra, G. S.; Kakkar, Vikas

2011-01-01

37

Absorbed doses from temporomandibular joint radiography  

SciTech Connect

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.

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

1985-06-01

38

A Case of Chondrosarcoma Arising in the Temporomandibular Joint  

PubMed Central

Chondrosarcoma is a malignant tumor originating in cartilaginous cells. And there are only few reports of the case of chondrosarcoma in temporomandibular joint. We discuss a case of chondrosarcoma in temporomandibular joint in a 28-year-old man. Tumor was in contact with the dura, but en bloc resection was performed. After surgical resection of the tumor, face defect was reconstructed by rectus abdominis-free flap. And there is no recurrence after ten years from the resection.

Shingaki, Susumu; Saito, Chikara

2015-01-01

39

Mandibular height asymmetry following experimentally induced temporomandibular joint disk displacement in rabbits  

Microsoft Academic Search

Objective. The purpose of this study was to test the hypothesis that nonreducing disk displacement of the temporomandibular joint causes mandibular asymmetry.Study design. Unilateral anterior temporomandibular joint disk displacement with intact posterior disk attachment was surgically created in the right joints of seven growing rabbits. In each of seven sham animals, the right temporomandibular joint was surgically opened without any

P. E Legrell; A Isberg

1998-01-01

40

An epidemiological study of temporomandibular joint ankylosis  

PubMed Central

Introduction: The temporomandibular joint (TMJ) forms the very cornerstone of craniofacial integrity and its ankylosis in a growing child may cause problems in daily food intake, speech, appearance, and oral hygiene is affected to a major extent. It is one of the common acquired pathologies afflicting the skeleton. It is also the most overlooked and under-managed problem in children. Materials and Methods: A house to house survey was conducted between 2010 and 2011 in rural and urban areas of Lucknow. A total of 21,720 children aged between 3-15 years from 9090 houses comprising a representative sample were included. Results: Ten TMJ ankylosis cases were identified in 21,720 children. Of these, six were bilateral and four were unilateral. Male to female ratio was 1:9, with most patients (70.0%) being in the 10-15 years’ age group (mean age was 11.1 years ± 3.34). The most common cause of ankylosis was trauma for 90.0% of cases. The majority of patients (70%) were reporting the condition for the first time, with 30% patients having had previous treatment. Conclusion: TMJ ankylosis is an acquired condition in most of the cases. Birth/childhood trauma would be the major causative factor. Knowledge amongst parents, providers of health about this entity was poor. Initial management of the causative factor was poor. Mere knowledge among the general population and healthcare providers can result in primary prevention and also secondary prevention along with its successful definitive treatment. PMID:23251054

Gupta, Vinay Kumar; Mehrotra, Divya; Malhotra, Seema; Kumar, Sandeep; Agarwal, Girdhar Gopal; Pal, Uma Shanker

2012-01-01

41

Risk factors for intraoperative dislocation of the total temporomandibular joint replacement and its management.  

PubMed

Total replacement of the temporomandibular joint (TMJ) is an effective treatment for intractable pain and impaired function that is a consequence of end-stage joint disease. Prospective assessment of 138 joint replacements identified an 8% risk of intraoperative dislocation of the joint, which was associated primarily with coronoidectomy (30%) and inflammatory arthropathy (24%). Management included the use of intermaxillary elastic traction and treatment of masticatory dystonia when present. Of the 11 patients who had light elastic traction for one week, only one required further treatment for dislocation. Patients with no intraoperative dislocation did not require elastics, and joints remained stable postoperatively. PMID:24262673

Mustafa, El Muiz; Sidebottom, Andrew

2014-02-01

42

Diagnostic accuracy of film-based, TIFF, and wavelet compressed digital temporomandibular joint images  

Microsoft Academic Search

The purpose of this research was to determine if digitization and the application of various compression routines to digital\\u000a images of temporomandibular joint (TMJ) radiographs would diminish observer accuracy in the detection of specific osseous\\u000a characteristics associated with TMJ degenerative joint disease (DJD). Nine observers viewed 6 cropped hard-copy radiographic\\u000a films each of 34 TMJs (17 radiographic series). Regions of

Christopher J. Trapnell; William C. Scarfe; Jeff H. Cook; Anibal M. Silveira; Frederick J. Regennitter; Bruce S. Haskell

2000-01-01

43

Effect of chin-cup treatment on the temporomandibular joint: a systematic review.  

PubMed

Summary AIM: To systematically search the literature and assess the available evidence for the influence of chin-cup therapy on the temporomandibular joint regarding morphological adaptations and appearance of temporomandibular disorders (TMD). PMID:25179261

Zurfluh, Monika A; Kloukos, Dimitrios; Patcas, Raphael; Eliades, Theodore

2014-09-01

44

Lubricin Protects the Temporomandibular Joint Surfaces from Degeneration  

PubMed Central

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

Purcell, Patricia

2014-01-01

45

MRI in a case of osteosarcoma in the temporomandibular joint.  

PubMed

Osteosarcoma of the temporomandibular joint (TMJ) is rare. We report a case of osteosarcoma in the TMJ of a 62-year-old female, pre-operatively diagnosed to have a benign tumour, and discuss the usefulness and limits of MRI using a TMJ coil as a diagnosis. PMID:24247589

Uchiyama, Y; Matsumoto, K; Murakami, S; Kanesaki, T; Matsumoto, A; Kishino, M; Furukawa, S

2014-01-01

46

Frequency of internal derangement of the temporomandibular joint in elderly individuals.  

PubMed

Elderly patients suffer from various systemic diseases and are likely to neglect their problems with functional disorders in the masticatory system, which are of crucial importance for successful prosthetic treatment. The purpose of the study was to establish the frequency of symptoms, clinical signs and tissue-specific diagnoses of internal derangement of the temporomandibular joint in elderly subjects and their relation with respect to gender and type of prosthetic replacement. The study was conducted on 96 subjects, 48 complete denture wearers and 48 removable partial denture wearers, whose average age was 75.8 years. The diagnostic procedure used in this study was manual functional analysis consisting of specific techniques of dynamic compressions and translations in diagnosing internal derangement of the temporomandibular joint. Chi-square test for independent samples was used for statistical analysis of the results. The symptoms of internal derangement of the temporomandibular joint were found in 9.3% of the subjects, and tissue-specific diagnoses were established in 52.1% of the subjects. The most common diagnoses were osteoarthrosis, total disk displacement with stable reposition and partial anterolateral disk displacement. No statistically significant differences in the frequency of symptoms, clinical signs and tissue-specific diagnoses were found between genders (P>.05) and complete and removable partial denture wearers (P>.05). The frequency of subjective symptoms of internal derangement in the temporomandibular joint of elderly subjects was low in relation to the frequency of intracapsular tissue-specific diagnoses. PMID:14594653

Dulci?, Niksa; Panduri?, J; Kraljevi?, S; Badel, T; Celi?, R

2003-10-22

47

Surgical management of congenital deformities with temporomandibular joint malformation.  

PubMed

This article discusses hemifacial microsomia and Treacher Collins syndrome relative to the nature of these congenital deformities as well as the clinical, radiographic, and diagnostic characteristics. These patients often have severe facial deformities with hypoplasia or aplasia of the temporomandibular joints (TMJs) and mandible. The surgical treatment options are presented, including the advantages and disadvantages of autogenous tissues versus patient-fitted total joint prostheses to reconstruct the TMJs and mandible as well as counterclockwise rotation of the maxillomandibular complex. PMID:25483449

Wolford, Larry M; Perez, Daniel E

2015-02-01

48

Skeletal pattern in subjects with temporomandibular joint disorders  

PubMed Central

Introduction To establish the skeletal pattern in subjects with malocclusions and temporomandibular disorders (TMD); to assess the relationship between craniofacial skeletal structures and TMD in subjects with malocclusions. Material and methods Sixty-four subjects with malocclusions, over 18 years of age, were included in the study. Temporomandibular disorders were clinically assessed according to the Helkimo Anamnestic Index. Subjects underwent a lateral cephalogram. Subjects were grouped according to the sagittal skeletal pattern (ANB angle) into class I, II and III. Parametric Student tests with equal or unequal variations were used (variations were previously tested with Levene test). Results Twenty-four patients with TMD (experimental sample); 40 patients without TMD (control group); interincisal angle was higher in class I and II (p < 0.05) experimental subjects; overjet was larger in experimental subjects; midline shift and Wits appraisal were broader in the experimental group in all three classes. In class III subjects, the SNB angle was higher in the experimental group (p = 0.01). Joint noises followed by reduced mandible mobility, muscular pain and temporomandibular joint (TMJ) pain were the most frequent symptoms in subjects with TMD and malocclusions. Conclusions Temporomandibular joint status is an important factor to consider when planning orthodontic treatment in patients with severe malocclusions; midline shift, large overjet and deep overbite have been associated with signs and symptoms of TMD. PMID:23515361

Alm??an, Oana Cristina; Alm??an, Horea Artimoniu; Bran, Simion; Lascu, Liana; Iancu, Mihaela; B?ciu?, Grigore

2013-01-01

49

Intraoral endoscopically assisted treatment of temporomandibular joint ankylosis: preliminary report.  

PubMed

Temporomandibular joint (TMJ) ankylosis is characterized by the formation of a bony or fibrous mass that replaces the normal articulation. To avoid a possible re-ankylosis it is mandatory to perform a radical, complete resection of the bony/fibrous mass. We treated a patient affected by right temporomandibular joint ankylosis performing the osteotomy of the ankylotic mass through a preauricular and intraoral approach under endoscopic control. Then a temporalis muscle and fascia flap were used as the interpositional material. Through the endoscope it was easy to check the medial aspect of the resection and suture the flap. At 1-year follow-up the patient had significantly increased maximal mouth opening. No evidence of relapse of the joint ankylosis was shown by radiological studies. Intraoral endoscopic assistance may be useful to make the removal of the ankylotic mass safer, and the anchorage of the temporalis muscle and fascia flap more accurate, reducing the risk of re-ankylosis. PMID:17499531

Sembronio, Salvatore; Albiero, Alberto Maria; Polini, Francesco; Robiony, Massimo; Politi, Massimo

2007-07-01

50

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

PubMed Central

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

2013-01-01

51

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

PubMed Central

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.

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

2015-01-01

52

Role of Magnetic Resonance Imaging in the Clinical Diagnosis of the Temporomandibular Joint  

Microsoft Academic Search

Temporomandibular joint (TMJ) abnormalities cannot be reliably assessed by a clinical examination. Magnetic resonance imaging (MRI) may depict joint abnormalities not seen with any other imaging method and thus is the best method to make a diagnostic assessment of the TMJ status. In patients with temporomandibular joint disorder (TMD) referred for diagnostic imaging the predominant TMJ finding is internal derangement

Tore A. Larheim

2005-01-01

53

Arthroscopy with open surgery for treatment of synovial chondromatosis of the temporomandibular joint.  

PubMed

We report a case of synovial chondromatosis of the temporomandibular joint in which both joint compartments were affected. Because of the important involvement of the medial aspect of the joint, arthrotomy was done with arthroscopic assistance. PMID:18329766

Sembronio, Salvatore; Albiero, Alberto Maria; Toro, Corrado; Robiony, Massimo; Politi, Massimo

2008-10-01

54

Regional 3D superimposition to assess temporomandibular joint condylar morphology  

PubMed Central

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

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

55

Temporomandibular joint replacement periprosthetic joint infections: a review of early diagnostic testing options.  

PubMed

The incidence of a periprosthetic joint infection is uncommon after total joint replacement. Since the clinical, psychological, and economic consequences of this complication are substantial, the development of management algorithms based on early diagnostic testing has been the subject of continued exploration in the orthopaedic literature. While there has been discussion of this topic in the total temporomandibular joint replacement literature and preliminary management algorithms have been established, no diagnostic testing protocols have been proposed or studied for the management of early and/or late periprosthetic joint infections. This paper will review the classification of periprosthetic joint infections, the associated risk factors, the clinical sensitivity and specificity of laboratory and imaging diagnostic studies and their utility in the management of early and late onset orthopaedic periprosthetic joint infections. This review may provide an initial framework for the use of early diagnostic testing for the management of total temporomandibular joint replacement periprosthetic joint infections and stimulate further investigation into this topic. PMID:25048029

Mercuri, L G

2014-10-01

56

Temporomandibular joint ankylosis in a Nigerian teaching hospital.  

PubMed

Twenty-six patients (12 males and 14 females) between two days and 41 years old with temporomandibular joint ankylosis were retrospectively reviewed. Thirty-three joints were involved; 19 unilateral and six bilateral. The aetiologies were trauma, 69.2%; infection, 15.4%; unknown, 11.5% and congenital, 3.9. The majority, 31 were intracapsular while the remaining two joints were extracapsular 51.6% were limited to the condyle, 32.2% extended to the coronoid process and the zygomatic, 9.7% extended to the sigmoid notch while the remaining 6.5% had maxillomandibular fusion. Tracheostomy (48%) was the most common mode of intubation. Gap arthroplasty was carried out in 20 joints while 11 joints had interposition arthroplasty. Postoperative complications were seven anterior open bite, three facial nerve weakness, three infections and two recurrences. PMID:21942122

Ajike, S O; Omisakin, O O

2011-03-01

57

Comparison of conventional MRI and 3D reconstruction model for evaluation of temporomandibular joint  

Microsoft Academic Search

The aim of this work was to define the diagnostic value of a method for 3D reconstruction of MRI images for the assessment\\u000a of temporomandibular joint. Sixty subjects, 42 diagnosed with unilateral temporomandibular disorders (TMD) with disc displacement\\u000a and 18 without signs or symptoms of TMD (control group) were included. All subjects had both temporomandibular joints scanned\\u000a by MRI. Three-dimensional

André L. F. Costa; Clarissa Lin Yasuda; Simone Appenzeller; Sérgio L. P. C. Lopes; Fernando Cendes

2008-01-01

58

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

PubMed

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

Geerse, Wouter K; von Piekartz, Harry J M

2015-02-01

59

Sonography of the temporomandibular joint from 60 examinations and comparison with MRI and axiography  

Microsoft Academic Search

Background and Objective: Establishing a diagnosis of temporomandibular joint disorder is mainly based on clinical assessment, functional examination, nuclear magnetic resonance imaging (MRI) and axiography. Sonographic examination was compared with MRI and axiography in assessing temporomandibular joint (TMJ) function in 55 patients. Patients and Methods: Fifty-five patients with different TMJ problems were examined clinically, by means of axiography, sonography and

Constantin Landes; Hartmut Walendzik; Cornelius Klein

2000-01-01

60

MR of 2270 TMJs: prevalence of radiographic presence of otomastoiditis in temporomandibular joint disorders  

Microsoft Academic Search

Objective: The purpose of this study is to determine the prevalence of radiographic presence of otomastoiditis while examining temporomandibular joint (TMJ) disorders in magnetic resonance images (MRI) in a series of 2270 temporomandibular joint magnetic resonance images and to examine the relationship between otomastoiditis and TMJ disorders.

Kaan Orhan; Hideyoshi Nishiyama; Sasaki Tadashi; Murakami Shumei; Souhei Furukawa

2005-01-01

61

Temporomandibular joint (TMJ) pain revisited with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)  

Microsoft Academic Search

PurposeWe aimed to assess the contrast enhancement patterns of the retrodiscal tissue with dynamic contrast-enhanced MR imaging (DCE-MRI) with respect to different temporomandibular joint disc pathologies. Additionally, we questioned the relationship between the temporomandibular joint (TMJ) pain and the contrast enhancement pattern of the retrodiscal tissue regardless of the TMJ disc position.

N. Tasali; R. Cubuk; M. Aricak; M. Ozarar; B. Saydam; H. Nur; N. Tuncbilek

62

Total reconstruction of the temporomandibular joint. Up to 8 years of follow-up of patients treated with Biomet ® total joint prostheses  

Microsoft Academic Search

12 patients underwent temporomandibular joint (TMJ) reconstruction with Biomet total joint prostheses. Indications for TMJ reconstruction included ankylosis, rheumatoid arthritis, degenerative joint disease and condylar resorption. Five patients had unilateral procedures, seven had bilateral. The follow-up ranged between 2 and 8 years. Amongst the ankylotic patients the mean jaw-opening capacity increased from 3.8mm preoperatively to 30.2mm 1 year after surgery,

A. Westermark

2010-01-01

63

Imaging of Temporomandibular Joint: Approach by Direct Volume Rendering  

PubMed Central

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.

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

2014-01-01

64

Automobilization intervention and exercise for temporomandibular joint open lock  

PubMed Central

Temporomandibular joint disorders (TMDs) are common and may cause temporomandibular joint (TMJ) locking, pain, and disability. Evidence supports use of manual therapy and exercise for treatment of TMDs including disk displacement limiting full mouth opening, TMJ ‘closed lock’. Only limited case studies describe management of TMJ ‘open lock’, a condition due to posterior disk displacement (PDD) or TMJ anterior dislocation (TMJ-AD). Reported treatment for open lock includes splinting and intraoral joint manipulation. This case report describes a novel extraoral automobilization using the mandibular elevator muscles to treat TMJ open lock in a 22-year-old male after intraoral joint mobilization failed. The exercise program used to restore neuromuscular control for post-reduction management is described. Short term results of automobilization were excellent with restored ability to swallow, speak normally, and achieve occlusion. Long term results at 14 months were good: the patient was pain-free, could swallow and speak normally, had no recurrence of TMJ locking, and minimal disability. Limited right lateral excursion range and left mandibular deviation during mouth opening indicated possible persistence of PDD. This case suggests that mandibular elevator automobilization and masticatory muscle exercise may be useful to treat TMJ open lock and should be considered to treat PDD and TMJ-AD. PMID:24179326

Hoglund, Lisa T; Scott, Brian W

2012-01-01

65

Automobilization intervention and exercise for temporomandibular joint open lock.  

PubMed

Temporomandibular joint disorders (TMDs) are common and may cause temporomandibular joint (TMJ) locking, pain, and disability. Evidence supports use of manual therapy and exercise for treatment of TMDs including disk displacement limiting full mouth opening, TMJ 'closed lock'. Only limited case studies describe management of TMJ 'open lock', a condition due to posterior disk displacement (PDD) or TMJ anterior dislocation (TMJ-AD). Reported treatment for open lock includes splinting and intraoral joint manipulation. This case report describes a novel extraoral automobilization using the mandibular elevator muscles to treat TMJ open lock in a 22-year-old male after intraoral joint mobilization failed. The exercise program used to restore neuromuscular control for post-reduction management is described. Short term results of automobilization were excellent with restored ability to swallow, speak normally, and achieve occlusion. Long term results at 14 months were good: the patient was pain-free, could swallow and speak normally, had no recurrence of TMJ locking, and minimal disability. Limited right lateral excursion range and left mandibular deviation during mouth opening indicated possible persistence of PDD. This case suggests that mandibular elevator automobilization and masticatory muscle exercise may be useful to treat TMJ open lock and should be considered to treat PDD and TMJ-AD. PMID:24179326

Hoglund, Lisa T; Scott, Brian W

2012-11-01

66

A case of pseudogout of the temporomandibular joint with giant cell reparative granuloma of the temporal bone.  

PubMed

Pseudogout, also known as calcium pyrophosphate dihydrate deposition disease (CPPD) with giant cell reparative granuloma (GCRG) of the temporal bone is a rare disease, which is very easy to misdiagnose. When two diseases occur simultaneously, the pathological tissue of diseases is closely associated, which complicates clinical representation and causes enormous difficulty in diagnosis and treatment. We report a case of CPPD of the temporomandibular joint accompanied by surrounding GCRG of temporal bone in a 62-year-old male. PMID:23969082

Lv, Huaiqing; Fan, Zhaomin; Han, Yuechen; Xu, Lei; Wang, Haibo

2013-01-01

67

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

PubMed

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

Meyers, Arthur B; Laor, Tal

2013-12-01

68

Relationship between joint effusion, joint pain, and protein levels in joint lavage fluid of patients with internal derangement and osteoarthritis of the temporomandibular joint  

Microsoft Academic Search

Purpose: The purpose of this study was to investigate the relationship between the presence of joint effusion, joint pain, and protein levels in joint lavage fluid (JL) of patients with internal derangement (ID) and osteoarthritis (OA) of the temporomandibular joint (TMJ).Patients and Methods: Thirty-eight joints in 26 patients with ID and OA of the TMJ were studied. Magnetic resonance imaging

Tetsu Takahashi; Hirokazu Nagai; Hiroshi Seki; Masayuki Fukuda

1999-01-01

69

The prevalence of temporomandibular joint dysfunction in the mixed dentition.  

PubMed

A functional and articular examination was carried out of 136 children (70 boys, 66 girls) aged from 6 to 12 years (6 years 1 month to 12 years 9 months), all presenting with a malocclusion in the mixed dentition and who had not yet received orthodontic treatment. The aim of the study was to examine the prevalence of signs of temporomandibular joint dysfunction (TMD) in this population and to evaluate the possible relationship between certain 'individual' parameters and TMD signs. The results showed an elevated prevalence of muscle tenderness, particularly in the lateral pterygoid muscle, which was found to be sensitive in 80.9 per cent of patients. Muscle tenderness had a tendency to increase with age and was greater on the right side. Temporomandibular joint sounds were present in 35.3 per cent of the subjects and more frequent in girls and in older children. Of the children who presented a mandibular deviation on maximal opening (19.8 per cent), 13.2 per cent had a predominance of opening deviation towards the left. Retruded contact position interferences were present in 57.4 per cent of the children and 72.1 per cent presented lateral and protrusive interferences. Assessment of the maximal amplitudes of mandibular movements did not reveal any limitations. These results indicate that few relationships exist between individual parameters and TMD signs. PMID:15222717

Tuerlings, Virginie; Limme, Michel

2004-06-01

70

Modified stethoscope for auscultation of temporomandibular joint sounds  

PubMed Central

Background: Purpose of this study was to modify the stethoscope which can auscultate the temporomandibular joint (TMJ) sounds more precisely than conventional stethoscope, and fabrication of stethoscope compatible software which analyses the auscultated sound and gives documentary evidence of that analysis in the form of graph. Materials & Methods: The conventional stethoscope was modified by attaching a custom made soundscope with a recording device which can be placed in external auditory meatus (EAM) for auscultation of TMJ sounds. When this small and smooth end of custom made soundscope of modified stethoscope is placed in EAM & connected with specially developed software it records the TMJ sounds & analyzes them in form of graph. Results: Fabrication of modified stethoscope with software records the auscultated sound as a sound wave in form of graph and analyses this sound wave graph to give graphic evidence of prominent intensity at prominent frequency as spectrum analysis graph, and duration of that sound as a sound length graph. Conclusion: The use of modified stethoscope with software increases the accuracy of auscultation of TMJ sounds without any patient’s discomfort and helps in diagnosis of TMJ disorders. The modified stethoscope with software for auscultation of TMJ sounds results in more precise auscultation & analysis of TMJ for sounds even of low intensity & frequency. How to cite the article: Dagar SR, Turakiya V, Pakhan AJ, Jaggi N, Kalra A, Vaidya V. Modified stethoscope for auscultation of temporomandibular joint sounds. J Int Oral Health 2014;6(2):40-4. PMID:24876701

Dagar, Sanjiv Rajender Singh; Turakiya, Viral; Pakhan, Ashok J; Jaggi, Nitin; Kalra, Amit; Vaidya, Vidya

2014-01-01

71

Temporomandibular joints in patients with rheumatoid arthritis using magnetic resonance imaging.  

PubMed

The aim of this study was to determine the relationship between the pathogenic duration of rheumatoid arthritis in joints other than the temporomandibular joint and bone and soft tissue involvement of the temporomandibular joint using magnetic resonance imaging. Twenty-six symptomatic patients diagnosed with rheumatoid arthritis were enrolled in this study. All patients were classified according to the duration of rheumatoid arthritis in joints other than the temporomandibular joint. The relationships between the duration of rheumatoid arthritis in these various joints and magnetic resonance findings in the temporomandibular joint were analyzed using the chi-square test. Bony changes in the mandibular condyle were observed in 43 of 52 (82.7 %) temporomandibular joints, but the frequency of such changes was not significantly correlated with the duration of rheumatoid arthritis in other joints. We found a significant correlation between the duration of rheumatoid arthritis in other joints and the type and number of bony changes in the mandibular condyle (P?temporomandibular joints. T2-weighted images demonstrated effusion in the joint space in 38 of 52 (73.1 %) temporomandibular joints. A biplanar disc configuration was the most frequent configuration in all groups. The duration of rheumatoid arthritis in other joints was significantly correlated with the mobility of the mandibular condyle (P?joints in the body (P?

Uchiyama, Yuka; Murakami, Shumei; Furukawa, Souhei

2013-11-01

72

Traumatic unilateral temporomandibular joint dislocation overlooked for more than two decades.  

PubMed

Forward dislocation of the temporomandibular joint commonly can be easily diagnosed and successfully reduced by manual repositioning. In this report, we discuss a rare case of prolonged temporomandibular dislocation that had persisted for more than 20 years because the otolaryngologist and dentist had missed the dislocation. This patient underwent open reduction and mandibular joint plasty with preoperative orthodontic therapy. It is possible that strong pain and mouth-closing disability may gradually remit and only deviated mandibular prognathism like malocclusion may persist. Therefore, abnormal occlusion warrants careful attention to temporomandibular joint dislocation. PMID:17993903

Nakashima, Mitsuko; Yano, Hiroki; Akita, Sadanori; Tokunaga, Kazuyo; Anraku, Kuniaki; Tanaka, Katsumi; Hirano, Akiyoshi

2007-11-01

73

Lateral thigh fascia lata as interpositional graft for temporomandibular joint ankylosis.  

PubMed

Successful management of temporomandibular joint (TMJ) ankylosis depends on adequate gap arthroplasty and interpositional graft; the objective is to produce a functioning pseudoarthrosis that prevents reankylosis and provides adequate mobility. Several interpositional grafts have been used for the treatment of temporomandibular joint ankylosis such as indigenous pterygomasseteric sling, temporalis muscle/fascia, auricular cartilage, fat and dermis-fat. Lateral thigh fascia lata (LTFL) graft is commonly used in neurosurgical practice and in other surgical specialities. We present a case of lateral thigh fascia lata used as interpositional graft for the treatment of a unilateral fibrous temporomandibular joint ankylosis. PMID:23997493

Alemán, Ramón Manuel; Martínez, María Guadalupe

2012-09-01

74

Condylar resorption of the temporomandibular joint: how do we treat it?  

PubMed

Condylar resorption (CR) is a common sequela of some temporomandibular joint (TMJ) abnormalities. CR can result in jaw deformities and dysfunction, malocclusion, pain, headaches, and airway obstruction. Most cases can be classified into 1 of 4 categories based on cause: (1) adolescent internal CR; (2) reactive (inflammatory) arthritis; (3) autoimmune and connective tissue diseases; and (4) other end-stage TMJ pathologic abnormality. MRI is helpful in differentiating the cause and defining treatment options. This article presents the nature and progression of the different TMJ CR pathologic abnormalities, clinical and imaging characteristics, and treatment options to produce predictable and stable outcomes. PMID:25483444

Wolford, Larry M; Gonçalves, João Roberto

2015-02-01

75

UK temporomandibular joint replacement database: report on baseline data.  

PubMed

Our goal is to establish the long-term collection of data on temporomandibular joint replacement from all centres in the UK where this is done. Currently, 16 surgeons have been identified, and 13 of them had entered data when this paper was being prepared. Data are entered online through the Snap Survey and then analysed annually. We report on 402 patients (332 (83%) female and 70 (17%) male) who had 577 joints inserted between 1994 and 2012. The main diagnoses that resulted in total joint replacement were osteoarthritis, failed operation, ankylosis, and seronegative arthritis. Preoperatively, the median (IQR) maximal incisal opening was 20 (15-26)mm (mean 20) and the median pain scores on the visual analogue scale (VAS 0-10) were 8 for both joints. The median (IQR) baseline dietary score (liquid 0 - solid 10) was 4 (3-6). A total of 173 (43%) patients had had one or more open procedure(s) before total replacement, 177 (44%) had not had open operation, and 52 (13%) had no data entered. The 3 primary systems used were the TMJ Concepts System (Ventura, USA), the Biomet System (Biomet/Lorenz Microfixation, Jacksonville, USA), and the Christensen System (TMJ Implants, Golden, USA). The median (IQR) duration of inpatient stay was 3 (2-4) days (mean 3). Follow-up data will be collected to assess patient recorded outcome measures (PROM) and objective measurements of total joint replacements in the UK from 1994 onwards. PMID:24388051

Idle, Matthew R; Lowe, Derek; Rogers, Simon N; Sidebottom, Andrew J; Speculand, Bernard; Worrall, Stephen F

2014-03-01

76

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

PubMed

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

Barmeir, E; Teich, S; Gutmcher, Z

2014-04-01

77

Metric evaluation of partially displaced temporomandibular joint disc.  

PubMed

The objective was to determine the quantitative relationship between the condyle and disc position in the glenoid fossa between two different slices of the same temporomandibular joints (TMJs) with partial anterior disc displacement (DD). The study was conducted on 40 patients with DD of TMJs (mean age, 35.5 years). The clinical diagnosis of DD was confirmed by magnetic resonance imaging. Joints from the patient groups were analyzed according to the laterality and depending on disc displacement (a total of 80 joints). Comparison was made between two different slices of 9 joints with partial DD with reduction: partial DD was analyzed in the representative centrolateral or centromedial parasagittal slice of the TMJ (TMJ partial DD--slice DD). The contralateral slice of the same joint was without DD (TMJ partial DD--slice NDD). The analysis also included 34 healthy joints without DD (TMJ NDD) of the same patients. The position of the condyle and disc was calculated using the Kurita et al. method on the parasagittal view of the TMJ. A statistically significant difference was recorded for different slices of the same TMJs with partial DD (TMJ partial DD--slice DD and TMJ partial DD--slice NDD) (p < 0.01), but no difference was found in condyle positions depending on the existence of partial DD (p > 0.05). The compared values between slice TMJ partial DD--slice NDD with the group of TMJ NDD showed no significant difference in either disc position or condyle position (p > 0.05). There were differences of disc position in various slices of the same joint with visually confirmed partial DD. The dorsocranial condyle position could not indicate partial anterior DD. PMID:25509241

Laškarin, Mirko; Badel, Tomislav; Kern, Josipa; Pavi?in, Ivana Savi?; Zadravec, Dijana

2014-09-01

78

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

PubMed

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

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

2013-12-01

79

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

NASA Astrophysics Data System (ADS)

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.

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

1995-05-01

80

Tensile characterization of porcine temporomandibular joint disc attachments.  

PubMed

The frequency and impact of temporomandibular joint (TMJ) disorders necessitate research in characterizing the joint's function. The 6 discal attachments have not yet been systematically characterized under tension. Understanding their role in joint function may guide our study of TMJ pathologies, including disc displacement. In the present study, a porcine model was used to characterize the attachments in tension anteroposteriorly and mediolaterally, based on previously identified similarities in the porcine and human masticatory behaviors and discal properties. Tensile stiffness, strength, toughness, and maximum strain were quantified. Collagen alignment was characterized via polarized light and scanning electron microscopy. Anisotropy was demonstrated in all attachments, with the exception of the anterior inferior attachment. Anteroposteriorly, the lateral attachment was stiffest (8.3 MPa) and the anterior superior was least stiff (1.4 MPa). Mediolaterally, the posterior superior attachment was stiffest (16.3 MPa) and the medial was least stiff (1.4 MPa). The greatest strain was observed in the lateral attachment in the mediolateral direction and the posterior superior attachment in the anteroposterior direction. With greatest strains in the most commonly observed directions of disc displacement, it is suggested that compromise in the posterior and lateral attachments contributes to partial lateral and anterior disc displacement. PMID:23783320

Murphy, M K; Arzi, B; Hu, J C; Athanasiou, K A

2013-08-01

81

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

SciTech Connect

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.

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

82

Concomitant treatment of mandibular ameloblastoma and bilateral temporomandibular joint osteoarthritis with bone graft and total joint prostheses.  

PubMed

Temporomandibular joint (TMJ) osteoarthritis is a degenerative disease that can create clinical problems in the masticatory musculature, jaws, occlusion, and other associated structures and is commonly accompanied by inflammatory changes and pain. Many cases of TMJ dysfunction can be managed with nonsurgical therapies, but patients with irreversible TMJ damage may require surgical intervention for repair or reconstruction. Despite various methods of TMJ reconstruction, the patient-fitted total joint prostheses may be the best option to achieve good outcomes. Multicystic ameloblastoma is a benign odontogenic neoplasm of the jaws that is found most often in the mandible, in the region of the molars, and the ramus. Ameloblastomas usually progress slowly, but are locally invasive and may cause significant morbidity and sometimes death. This report describes a case of concomitant treatment of recurrent mandibular ameloblastoma and severe bilateral TMJ osteoarthritis treated by resection of the tumor, reconstruction with bone grafting, and bilateral TMJ reconstruction in a 63-year-old woman. PMID:25511957

Rodrigues, Daniel B; Wolford, Larry M; Malaquias, Pietry; Campos, Paulo S F

2015-01-01

83

Antioxidant capacity of synovial fluid in the temporomandibular joint correlated with radiological morphology of temporomandibular disorders.  

PubMed

We investigated the correlation between the antioxidant capacity of synovial fluid and radiological findings of intra-articular structures in patients with disorders of the temporomandibular joint (TMJ). We recruited 21 patients (9 men and 12 women, aged 18-84 years of age) with such disorders, excluding myofascial pain and dysfunction syndrome, or other muscular disorders. The clinical variables recorded included age, sex, interincisal distance, and visual analogue pain scores (VAS). Radiological findings were obtained from diagnostic arthrogram and cone-beam computed tomography (CT). The antioxidant capacity of the synovial fluid was measured by chemiluminescence. Eleven patients were radiologically diagnosed with closed lock, and the remaining 10 with no closed lock. An anchored intra-articular disc was most often seen on cone-beam CT (n=19) followed by perforated disc (n=7), osteoarthrosis (n=7), and anterior disc displacement without reduction (n=5). Although there were no significant differences between antioxidant capacity and age, sex, VAS, or any findings on cone-beam CT, antioxidant capacity was significantly decreased in the patients with closed lock compared with those who did not have closed lock (p=0.02). The results suggest an association between the oxidative stress of the synovial fluid and closed-lock in disorders of the TMJ. PMID:25457626

Ishimaru, Kyoko; Ohba, Seigo; Yoshimura, Hitoshi; Matsuda, Shinpei; Ishimaru, Jun-Ichi; Sano, Kazuo

2015-02-01

84

Effects of enzymatic degradation after loading in temporomandibular joint.  

PubMed

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-1? (IL-1?), 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-1?, 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-1? 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

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

2015-02-01

85

Preliminary optical coherence tomography investigation of the temporo-mandibular joint disc  

NASA Astrophysics Data System (ADS)

Aim and objectives. The morphology and position of the temporo-mandibular disc are key issues in the diagnosis and treatment of arthrogenous temporo-mandibular disorders. Magnetic resonance imaging and arthroscopy are used today to identify: flattening of the pars posterior of the disc, perforation and/or adhesions in the pars intermedia of the disc and disc displacements. The present study proposes the investigation of the temporo-mandibular joint disc by optical coherence tomography (OCT). Material and methods. 8 human temporo-mandibular joint discs were harvested from dead subjects, under 40 year of age, and conserved in formalin. They had a normal morphology, with a thicker pars posterior (2,6 mm on the average) and a thinner pars intermedia (1mm on the average). We investigated the disc samples using two different OCT systems: an en-face OCT (time domain (TD)-OCT) system, working at 1300 nm (C-scan and B-scan mode) and a spectral OCT system (a Fourier domain (FD)-OCT) system , working at 840 nm (B-scan mode). Results. The OCT investigation of the temporo-mandibular joint discs revealed a homogeneous microstructure. The longer wavelength of the TD-OCT offers a higher penetration depth (2,5 mm in air), which is important for the analysis of the pars posterior, while the FD-OCT is much faster. Conclusions: OCT is a promising imaging method for the microstructural characterization of the temporo-mandibular disc.

M?rc?uteanu, Corina; Demjan, Enikö; Sinescu, Cosmin; Negrutiu, Meda; Motoc, Adrian; Lighezan, Rodica; Vasile, Liliana; Hughes, Mike; Bradu, Adrian; Dobre, George; Podoleanu, Adrian G.

2010-02-01

86

Stress relaxation behaviors of articular cartilages in porcine temporomandibular joint.  

PubMed

In this study, we tested the compressive stress relaxation behaviors of the mandibular condylar and temporal cartilages in the porcine temporomandibular joint (TMJ). The aim was to determine the quantitative and qualitative similarities and differences of compressive stress relaxation behaviors between the two cartilages. Ten porcine TMJs were used; the articular surface was divided into 5 regions: anterior, central, posterior, lateral and medial. Compressive relaxation test was carried out at a strain level of 5% in each region of the two cartilages. The stress relaxation was monitored over a period of 5min. In all the regions of the two cartilages, the time-dependent stress relaxation curves showed a marked drop in stress within the initial 10s, which can be fitted by a standard linear viscoelastic model. The instantaneous moduli in the temporal cartilage were dominantly larger than those in the condylar cartilage, while the condylar cartilage had slightly larger relaxation moduli than the temporal cartilage except for the medial region. The both cartilages showed the regional differences in the compressive stress relaxation behavior, and in the temporal cartilage the lateral and medial regions revealed the largest values for the instantaneous and relaxation moduli. The present results demonstrate that the viscoelastic properties of compressive stress relaxation in both cartilages are region-specific, which might have an important implication for stress distribution and transmission along with the TMJ disc. PMID:24680920

Tanaka, Eiji; Pelayo, Fernández; Kim, Namhee; Lamela, María Jesús; Kawai, Nobuhiko; Fernández-Canteli, Alfonso

2014-05-01

87

Effects of four treatment strategies for temporomandibular joint closed lock.  

PubMed

A previous randomized controlled trial (RCT) by Schiffman et al. (2007)(15) compared four treatments strategies for temporomandibular joint (TMJ) disc displacement without reduction with limited mouth opening (closed lock). In this parallel group RCT, 106 patients with magnetic resonance imaging (MRI)-confirmed TMJ closed lock were randomized between medical management, non-surgical rehabilitation, arthroscopic surgery, and arthroplasty. Surgical groups also received rehabilitation post-surgically. The current paper reassesses the effectiveness of these four treatment strategies using outcome measures recommended by the International Association of Oral and Maxillofacial Surgeons (IAOMS). Clinical assessments at baseline and at follow-up (3, 6, 12, 18, 24, and 60 months) included intensity and frequency of TMJ pain, mandibular range of motion, TMJ sounds, and impairment of chewing. TMJ MRIs were performed at baseline and 24 months, and TMJ tomograms at baseline, 24 and 60 months. Most IAOMS recommended outcome measures improved significantly over time (P?0.0003). There was no difference between treatment strategies relative to any treatment outcome at any follow-up (P?0.16). Patient self-assessment of treatment success correlated with their ability to eat, with pain-free opening ?35mm, and with reduced pain intensity. Given no difference between treatment strategies, non-surgical treatment should be employed for TMJ closed lock before considering surgery. PMID:24042068

Schiffman, E L; Velly, A M; Look, J O; Hodges, J S; Swift, J Q; Decker, K L; Anderson, Q N; Templeton, R B; Lenton, P A; Kang, W; Fricton, J R

2014-02-01

88

Early treatment of unilateral temporomandibular joint ankylosis: a multidisciplinary approach.  

PubMed

Ankylosis of temporomandibular joint is a condition in which partial or complete immobilization of mandible occurs because of fusion between mandibular condyle and skull base. This condition can be treated orthodontically, surgically, or therapeutically or by prosthodontic rehabilitation. A 10-year-old female patient presented to the Department of Oral and Maxillofacial Surgery, Gazi University Faculty of Dentistry, with limited mouth opening. She got injury in the face when she was 5 years old. Extraoral and intraoral examination findings were facial asymmetry on the left side, micrognathic mandible, and 19-mm mouth opening. After radiographic examination, ankylosis (Shawney type I) on the left side was revealed, and the patient was referred to Department of Orthodontics. After orthodontic clinical examination, we create following multidisciplinary treatment approach: (1) acrylic posterior bite block with spring application, (2) interpositional arthroplasty operation, and (3) physiotherapy (passive mouth-opening exercises). After the follow-up of 9 months, significant improvement (5 mm) was noticed in the opening of the mouth, and we decided to remove appliance and operate on the patient. Surgical procedure was performed under general anesthesia via blinded nasotracheal intubation. To prevent postoperative relapse, temporal fascia was interpositioned and sutured. Passive mouth-opening exercises were started 10 days after the surgery. Thirty-one-millimeter mouth opening was reached after the surgery and passive mouth-opening exercises. Patient's routine controls have been continued for 2 years. PMID:24769608

Ataç, Mustafa Sancar; Çakir, Merve; Yücel, Ergun; Gazio?lu, Çagri; Akkaya, Sevil

2014-05-01

89

Three-dimensional finite element analysis of the human temporomandibular joint disc  

Microsoft Academic Search

A three-dimensional finite element model of the articular disc of the human temporomandibular joint has been developed. The geometry of the articular cartilage and articular disc surfaces in the joint was measured using a magnetic tracking device. First, polynomial functions were fitted through the coordinates of these scattered measurements. Next, the polynomial description was transformed into a triangulated description to

M Beek; J. H Koolstra; L. J van Ruijven; T. M. G. J van Eijden

2000-01-01

90

MRI and arthroscopic findings in the temporomandibular joint after mandibulectomy including the unilateral condyle  

Microsoft Academic Search

In this report, the MRI and arthroscopic findings in the temporomandibular joint (TMJ) of two patients who underwent partial mandibulectomy including the condyle are presented. The disc and superior joint compartment of the affected TMJs were preserved in both patients. MRI of the affected TMJs without condyle demonstrated that the intermediate zone of the discs was located anteriorly to the

Yoshiki Hamada; Toshirou Kondoh; Norihiko Takada; Kanichi Seto

2000-01-01

91

MRI-based stereolithographic models of the temporomandibular joint: technical innovation  

Microsoft Academic Search

A new technique of manufacturing dual-colour stereolithographic models of hard and soft tissues of the temporomandibular joint (TMJ) is presented. Sagittal T1\\/PD weighted magnetic resonance (MR) images of joints with and without disc displacement were obtained in the closed and open mouth positions. Individual interactive contour identification of bony structures and the articular disc followed by binary interpolation provided the

Gerhard Undt; Klaus Wild; Gerd Reuther; Rolf Ewers

2000-01-01

92

A case of synovial chondromatosis of the temporomandibular joint secondary to preauricular trauma  

Microsoft Academic Search

Synovial chondromatosis is a rare benign arthropathy characterized by chondrometaplasia of the synovial membrane, particularly in the temporomandibular joint (TMJ). The purpose of this article is to describe an uncommon case of synovial chondromatosis arising from the inferior joint space of the TMJ with an enlarged condyle secondary to preauricular trauma in a 44-year-old healthy male. The possible role of

W. Zha; Y. F. Zhao; Y. Liu; L. Jiang

2009-01-01

93

Surgical treatment for temporomandibular joint osteoarthrosis. Case report.  

PubMed

TMJ osteoarthrosis and internal derangements are in close connection, representing a substantial portion of temporomandibular disorders. The authors wish to underline the role of surgery in the treatment of this degenerative disease to improve function and to alleviate pain. A 63 year-old woman suffering from closed-lock with reduced opening movements was accepted in our Department in March, 1995. Clinical and radiological evaluations showed bilateral closed lock and severe TMJ osteoarthrosis. Occlusal, pharmacological and physical therapy were performed for one year, without results. Bilateral condylectomy and diskectomy with arthroplasty were carried out. Immediate muscular rehabilitation after surgery was performed by the patient. Follow-up 3, 6, 12 months after surgery were carried out. Full opening movements and reduction of pain were obtained 20 days after surgery. The patient, followed-up one year after surgery, presented effective mandibular movements and adequate amelioration of clinical picture. TMJ surgery in association with physical therapy represents in selected cases an adequate procedure for the treatment of TMJ degenerative disease. PMID:9882996

Robiony, M; Demitri, V; Costa, F; Politi, M

1998-11-01

94

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

PubMed Central

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

2014-01-01

95

Computerized axial tomography in the diagnosis of internal derangements of the temporomandibular joint.  

PubMed

Fourteen patients with a history of pain, clicking and locking of the temporomandibular joint were assessed clinically and by using computerized axial tomography (CAT). The findings of the clinical and CAT scan assessment were correlated and compared with surgical observations. Computerized axial tomography scanning proved to be a highly accurate method of assessing meniscal position. With the advent of more sophisticated methods of CAT scanning, it provides an accurate, non-invasive method of assessing the temporomandibular joint and providing a basis for more effective treatment planning of problems related to internal derangements. PMID:2393362

Anker, A H; D'Rozario, R H; Li, S

1990-06-01

96

Emerging Intra-Articular Drug Delivery Systems for the Temporomandibular Joint  

PubMed Central

Temporomandibular joint (TMJ) disorders are a heterogeneous group of diseases that cause progressive joint degeneration leading to chronic pain and reduced quality of life. Both effective pain reduction and restoration of TMJ function remain unmet challenges. Intra-articular injections of corticosteroids and hyaluronic acid are currently used to treat chronic pain, but these methods require multiple injections that increase the risk of iatrogenic joint damage and other complications. The small and emerging field of TMJ tissue engineering aims to reduce pain and disability through novel strategies that induce joint tissue regeneration. Development of methods for sustained, intra-articular release of growth factors and other pro-regenerative signals will be critical for the success of TMJ tissue engineering strategies. This review discusses methods of intra-articular drug delivery to the TMJ, as well as emerging injectable controlled release systems with potential to improve TMJ drug delivery, to encourage further research in the development of sustained release systems for both long-term pain management and to enhance tissue engineering strategies for TMJ regeneration. PMID:18835358

Mountziaris, Paschalia M.; Kramer, Phillip R.; Mikos, Antonios G.

2009-01-01

97

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

PubMed

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 cartilage. PMID:25519993

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

2015-02-01

98

Temporomandibular joint forces measured at the condyle of Macaca arctoides.  

PubMed

Forces were measured at the articular surface of the temporomandibular joint (TMJ) condyle in two stump-tail monkeys (Macaca arctoides) during chewing, incisal biting, and drinking and also during aggressive behaviors. Force was measured with a thin piezoelectric foil transducer, which was cemented over the anterior and superior surfaces of the condyle. Wires from the upper and lower surfaces of the foil were insulated between two layers of Teflon tape and run subcutaneously to a telemetry unit, which was implanted in the upper back. Force applied across the foil by the condyle was detected by the telemetry unit and transmitted to an FM radio receiver outside the animal. The FM signals were received and demodulated, and a signal proportional to the force applied between the condyle and the TMJ fossa was displayed on a chart recorder. Data were collected over an 8-day period. The animals were not constrained. The TMJ was found to be load bearing. The greatest force of 39.0 lb (17.7 kg) was measured during feisty vocal aggression. Forces ranged as high as 34.5 lb (15.7 kg) during chewing and 28.5 lb (13.0 kg) during incisal biting. Forces were greater on the working (food) side than on the nonworking (balancing) side by average ratios of 1.4 to 2.6. A large unilateral interference at the most distal molar greatly disturbed chewing. It reduced TMJ forces by 50% or more, and the monkey refused to chew on the side opposite the interference. PMID:2353676

Boyd, R L; Gibbs, C H; Mahan, P E; Richmond, A F; Laskin, J L

1990-06-01

99

Application of advanced imaging modalities for the diagnosis of metastatic adenocarcinoma of the lungs in the temporomandibular joint.  

PubMed

Several pathologies, including malignant diseases, may mimic temporomandibular disorders (TMD). Correct diagnosis is important to avoid treatment delay. Several new imaging diagnostic modalities are available and should be used accordingly. This is a case report of a 71-year-old woman with functional limitation and painful symptoms in the preauricular region. She was initially diagnosed and treated as TMD, however with no improvement of the symptoms. Advanced imaging studies were requested. Computerized tomography and magnetic resonance imaging findings were consistent with soft tissue tumor with nonhomogeneous content in the left temporomandibular joint region. Positron emission tomography showed significant radiotracer uptake in the site of the lesion as well as in the lungs, lumbar spine, and bladder, suggesting tumoral metastases. This report emphasizes the importance of imaging in the assessment and establishment of accurate differential diagnosis. Thorough knowledge of the available modalities and their indications is essential to avoid delay in treatment and improve outcomes. PMID:19464641

Shintaku, Werner H; Venturin, Jaqueline S; Yepes, Juan F

2009-06-01

100

Psoriatic arthritis and temporomandibular joint involvement - literature review with a reported case.  

PubMed

In addition to psoriasis, between 5% and 24% of patients will develop psoriatic arthritis simultaneously after or even prior to skin manifestations. Psoriatic arthritis belongs to the group of seronegative spondyloarthritis. Collaboration between a dermatologist and a rheumatologist plays a more important role in cases where there is a complete absence of clinical signs of psoriasis. Since rheumatic diseases may also involve the temporomandibular joints (TMJ), psoriatic arthritis can cause problems that are an aspect of systemic disease. In general, the clinical and radiological description of a population of patients suffering from psoriasis and/or psoriatic arthritis does not mention TMJ involvement. However, as is the case with intraoral psoriasis, psoriatic changes to the TMJ also show characteristic signs of erosion, deplaned condyles, and articular effusion. Magnetic resonance imaging has shown itself to be the gold standard in the diagnostics of joints afflicted by psoriatic arthritis and TMJ disorders, regardless of the existence of a systemic disease. This paper aims to present a review of the relevant literature describing different epidemiological, clinical, and radiological characteristics of psoriasis and psoriatic arthritis, with emphasis on the involvement of TMJs in the general manifestation of the disease, illustrated by a description of the clinical case of a 77-year-old female patient. PMID:25102797

Badel, Tomislav; Savi? Pavi?in, Ivana; Krapac, Ladislav; Zadravec, Dijana; Rosi?, Davorka

2014-01-01

101

Pigmented villonodular synovitis of the temporomandibular joint - computed tomography and magnetic resonance findings: a case report.  

PubMed

Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive and destructive disease originating in the synovial membranes. It is a proliferative disorder of unknown etiology. Involvement of the temporomandibular joint (TMJ) is very rare. Computed tomography clearly reveals areas of lytic bone erosion and sclerosis, and also clearly defines the extent of the tumor which is the focal areas of hyperdensity within the soft-tissue mass. Magnetic resonance images invariably show profound hypointensity on both T1- and T2-weighted sequences due to hemosiderin pigmentation. Additionally, high signal intensity on T2-weighted images may indicate cystic loculation of the joint fluid. This case study describes a rare case of PVNS of the TMJ with bone destruction of the mandibular condyle. Complete surgical excision of the lesion was performed through a preauricular approach with temporal extension. During the 10-year follow-up, two more operations were performed due to local recurrence and the fracture of the reconstruction plate. Total joint reconstruction with Biomet was finally performed, and the absence of disease was confirmed with a biopsy report showing fibrosis with hyalinization and mild inflammation of the excised soft tissue from the old lesion. PMID:25045642

Kim, Il-Kyu; Cho, Hyun-Young; Cho, Hyun-Woo; Seo, Ji-Hoon; Lee, Dong-Hwan; Peng, Wang

2014-06-01

102

Pigmented villonodular synovitis of the temporomandibular joint - computed tomography and magnetic resonance findings: a case report  

PubMed Central

Pigmented villonodular synovitis (PVNS) is a benign but locally aggressive and destructive disease originating in the synovial membranes. It is a proliferative disorder of unknown etiology. Involvement of the temporomandibular joint (TMJ) is very rare. Computed tomography clearly reveals areas of lytic bone erosion and sclerosis, and also clearly defines the extent of the tumor which is the focal areas of hyperdensity within the soft-tissue mass. Magnetic resonance images invariably show profound hypointensity on both T1- and T2-weighted sequences due to hemosiderin pigmentation. Additionally, high signal intensity on T2-weighted images may indicate cystic loculation of the joint fluid. This case study describes a rare case of PVNS of the TMJ with bone destruction of the mandibular condyle. Complete surgical excision of the lesion was performed through a preauricular approach with temporal extension. During the 10-year follow-up, two more operations were performed due to local recurrence and the fracture of the reconstruction plate. Total joint reconstruction with Biomet was finally performed, and the absence of disease was confirmed with a biopsy report showing fibrosis with hyalinization and mild inflammation of the excised soft tissue from the old lesion. PMID:25045642

Cho, Hyun-Young; Cho, Hyun-Woo; Seo, Ji-Hoon; Lee, Dong-Hwan; Peng, Wang

2014-01-01

103

Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery using computer-assisted surgical simulation.  

PubMed

Combined orthognathic and total joint reconstruction cases can be predictably performed in 1 stage. Use of virtual surgical planning can eliminate a significant time requirement in preparation of concomitant orthognathic and temporomandibular joint (TMJ) prostheses cases. The concomitant TMJ and orthognathic surgery-computer-assisted surgical simulation technique increases the accuracy of combined cases. In order to have flexibility in positioning of the total joint prosthesis, recontouring of the lateral aspect of the rami is advantageous. PMID:25483443

Movahed, Reza; Wolford, Larry M

2015-02-01

104

Hyperintensity signal in the joint space of the temporomandibular joint on fat-saturated T2-weighted magnetic resonance imaging  

Microsoft Academic Search

Our aim was to investigate the incidence of a hyperintense signal in the joint space of the temporomandibular joint (TMJ) on fat-saturated T2-weighted magnetic resonance images (MRIs). We studied 112 patients (224 joints) with disorders of the TMJ who were examined by T2-weighted MRI, and recorded the association between displacement of the disc and the hyperintense signal using the ?

Shinya Yura; Koji Nobata; Tsuyoshi Shima

2010-01-01

105

Management of temporomandibular joint reankylosis in syndromic patients corrected with joint prostheses: surgical and rehabilitation protocols.  

PubMed

Temporomandibular joint ankylosis (TMJA) is a severe disorder described as an intracapsular union of the disc-condyle complex to the temporal articular surface with bony fusion. The management of this disability is challenging and rarely based on surgical and rehabilitation protocols. We describe the treatment in two young adults affected by Goldenhar syndrome and Pierre Robin sequence with reankylosis after previous surgical treatments. There are three main surgical procedures for the treatment of TMJA: gap arthroplasty, interpositional arthroplasty, and joint reconstruction. Various authors have described reankylosis as a frequent event after treatment. Treatment failure could be associated with surgical errors and/or inadequate intensive postoperative physiotherapy. Surgical treatment should be individually tailored and adequate postoperative physiotherapy protocol is mandatory for success. PMID:24624260

Clauser, Luigi C; Consorti, Giuseppe; Elia, Giovanni; Tieghi, Riccardo; Galiè, Manlio

2014-03-01

106

Morphologic and Functional Changes in the Temporomandibular Joint and Stomatognathic System after  

E-print Network

after Transmandibular Surgery in Oral and Oropharyngeal Cancers: Systematic Review Mohammed Al, temporomandibular joint O ral cavity and oropharyngeal cancers are some of the most common cancers in the head and neck region.1 Treatment of upper aerodigestive tract cancers can involve surgical intervention and

Alberta, University of

107

Clinical correlation of MRI findings of internal derangements of the temporomandibular joints  

Microsoft Academic Search

We studied 131 temporomandibular joints (TMJs) in 73 patients (56 women, 17 men) with internal derangement using magnetic resonance imaging (MRI) in addition to clinical examinations.The type of TMJ sounds correlated significantly with the degree of disc displacement. Rounded and folded disc deformities caused crepitus, which was a sign of the advanced stage of anterior disc displacement without reduction. Tenderness

N Ta?kaya-Yýlmaz; M Ö?ütcen-Toller

2002-01-01

108

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

Microsoft Academic Search

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

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

1987-01-01

109

Magnetic resonance imaging in the diagnosis of intra-articular adhesions of the temporomandibular joint  

Microsoft Academic Search

We aimed to evaluate the value of magnetic resonance imaging (MRI) for the diagnosis of intra-articular adhesions of the temporomandibular joint (TMJ). We diagnosed 27 consecutive patients with internal derangement of the TMJ (33 TMJs) between 1 December and 31 July 2003 in our department. All patients were examined by MRI and arthroscopy. The MRI findings were recorded as “positive”,

ShanYong Zhang; Chi Yang; MinJie Chen; Xindong Fan; Bai Yun; Yan Peng; Dan Yuan

2009-01-01

110

Temporomandibular joint and masticatory muscle involvement in myotonic dystrophy: A study by magnetic resonance imaging  

Microsoft Academic Search

Objective. The purpose of this study was to evaluate the masticatory muscles and the temporomandibular joint (TMJ) by magnetic resonance imaging (MRI) in myotonic dystrophy (MD) patients. Study Design. MRI of the masticatory muscles and TMJ was performed in 15 MD patients, 11 male and 4 female, aged 16 to 53 years (mean, 31 years). Many of them had dental

Edmar Zanoteli; Helio K. Yamashita; Hideo Suzuki; Acary S. B. Oliveira; Alberto A. Gabbai

2002-01-01

111

Incidentally found and unexpected tumors discovered by MRI examination for temporomandibular joint arthrosis  

Microsoft Academic Search

We examined the frequency of incidentally found or unexpected tumors discovered at the time of magnetic resonance imaging (MRI) examinations in the temporomandibular joint (TMJ) region for patients with suspicion of TMJ arthrosis. Five MR images (T1-weighted transverse scout image and proton density and T2-weighted oblique sagittal images at the open and closed mouth) were acquired. In 2776 MRI examinations

Yoshinobu Yanagi; Jun-ichi Asaumi; Yuu Maki; Jun Murakami; Miki Hisatomi; Hidenobu Matsuzaki; Hironobu Konouchi; Yosutoshi Honda; Kanji Kishi

2003-01-01

112

Modeling of Temporomandibular Joint Function Using MRI and Jaw-Tracking Technologies – Mechanics  

Microsoft Academic Search

The study of mechanics of the temporomandibular joint (TMJ) is important because its dysfunction and breakdown could be, at least partially, of mechanical origin. The incongruity of the articular surfaces of the TMJ is compensated by a fibrocartilaginous articular disc. Its dislocation and failure seem to be closely related to the development of osteoarthritis of the TMJ. The analysis of

Luigi M. Gallo

2005-01-01

113

The evaluation of temporomandibular joint disc position in TMJ disorders using MRI  

Microsoft Academic Search

The purpose of this study was to correlate disc position and the type of disc displacement, intra-capsular effusion and degenerative changes of the condyle as demonstrated in MRI studies.In this study, 126 temporomandibular joints (TMJs) of 63 patients with TMJ disorders were investigated using clinical examination and MRI. One hundred and twelve TMJs were found to have internal derangement as

M. Ögütcen-Toller; N. Ta?kaya-Y?lmaz; F. Y?lmaz

2002-01-01

114

Magnetic resonance imaging features of the temporomandibular joint in normal dogs  

Microsoft Academic Search

Evaluation of the canine temporomandibular joint (TMJ) is important in the clinical diagnosis of animals presenting with dysphagia, malocclusion and jaw pain. In humans, magnetic resonance imaging (MRI) is the modality of choice for evaluation of the TMJ. The objectives of this study were to establish a technical protocol for performing MRI of the canine TMJ and describe the MRI

D M Macready; Silke Hecht; Linden E Craig; G A Conklin

2010-01-01

115

Individual MRI features of the temporomandibular joint are not predictive of TMJ pain  

Microsoft Academic Search

Original ArticleEmshoff R, Brandlmaier I, Bertram S, Rudisch A. Relative odds of temporomandibular joint pain as a function of magnetic resonance imaging findings of internal derangement, osteoarthrosis, effusion, and bone marrow edema. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95(4):437–45.

Charles Widmer

2004-01-01

116

Modified temporomandibular joint disc repositioning with miniscrew anchor: part I-surgical technique.  

PubMed

Anterior disc displacement is one of the most common conditions affecting the temporomandibular joint. In the authors' previous publications, they reported on the basic technical elements of disc repositioning surgery. However, the present article presents some critical modifications that have allowed the safe and successful performance of this procedure during the past 3 years. PMID:25236820

He, Dongmei; Yang, Chi; Zhang, Shanyong; Wilson, Julian J

2015-01-01

117

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

ERIC Educational Resources Information Center

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)

Funch, Donna P.; Gale, Elliot N.

1984-01-01

118

Temporomandibular joint pain: Relationship to internal derangement type, osteoarthrosis, and synovial fluid mediator level of tumor necrosis factor-?  

Microsoft Academic Search

Objectives. The purpose of this study was to investigate whether patients with temporomandibular joint (TMJ)-related pain classified as capsulitis\\/synovitis may be linked to magnetic resonance imaging (MRI) findings of internal derangement, osteoarthrosis, or the synovial fluid aspirate findings of tumor necrosis factor-? (TNF-?) level. Study Design. The study comprised 23 patients with temporomandibular disorders (TMD), who had nonchronic pain (pain

Rüdiger Emshoff; Peter Puffer; Ansgar Rudisch; Robert Gaßner

2000-01-01

119

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

NASA Astrophysics Data System (ADS)

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.

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

2012-01-01

120

Test–retest reliability of MRI-based disk position diagnosis of the temporomandibular joint  

Microsoft Academic Search

This study evaluated the test–retest reliability for determining the temporomandibular joint (TMJ) disk position, diagnosed\\u000a using magnetic resonance imaging (MRI). These assessments were done as a base-line measurement for a prospective cohort study,\\u000a which examines the risk factors for precipitation and progression of temporomandibular disorders. Fifteen subjects (mean age,\\u000a 24.2?±?0.94 years; male\\/female?=?8\\/7) were recruited from the students of Okayama University Dental

Chiyomi Nagamatsu-Sakaguchi; Kenji Maekawa; Tsuyoshi Ono; Yoshinobu Yanagi; Hajime Minakuchi; Shouichi Miyawaki; Junichi Asaumi; Teruko Takano-Yamamoto; Glenn T. Clark; Takuo Kuboki

121

Proposed graphical system of evaluating disc–condyle displacements of the temporomandibular joint in MRI  

Microsoft Academic Search

The aim of this preliminary study was to standardize the reading of magnetic resonance imaging (MRI) of the temporomandibular\\u000a joint (TMJ). The MRI was conducted on a control group of eight subjects. In this study, the analysis of joint relationships\\u000a was limited to the oblique sagittal plane, during the movement of controlled opening. The sections were analyzed by a computer-assisted

R. Benbelaïd; B. Fleiter; A. Zouaoui; J. F. Gaudy

2005-01-01

122

Septic arthritis of the temporomandibular joint successfully treated with arthroscopic lysis and lavage: case report and review of the literature.  

PubMed

Septic arthritis of the temporomandibular joint (TMJ) is infrequently reported. We present a case of septic arthritis of the TMJ following the extraction of the left upper second molar that occurred 1 week before beginning of symptoms. No evident predisposing factors were detected. Arthroscopic diagnosis of septic arthritis, lysis and lavage, and capsular stretch were performed. Cultures taken from the TMJ space grew Streptococcus sp. After 1 month of antimicrobial therapy the patient was asymptomatic and mandibular function was normal. Literature related to septic arthritis of TMJ and its treatment was reviewed. Different surgical procedures are available to treat this condition. Arthroscopy should be preferred as initial treatment on account of the possibility of drainage and accurate lavage under direct visualization of joint space, at the same time allowing confirmation of diagnostic hypotheses. Improving joint mobility with lysis of adhesions and capsular stretch in an early stage of disease may be helpful in stopping the fibrosis process. PMID:17095265

Sembronio, Salvatore; Albiero, Alberto Maria; Robiony, Massimo; Costa, Fabio; Toro, Corrado; Politi, Massimo

2007-02-01

123

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

PubMed

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

De La Hoz Polo, M; Navallas, M

2014-01-01

124

Vacuum phenomenon in the temporomandibular joint: a clinical, computed tomography and magnetic resonance case report.  

PubMed

A 28-year-old woman presented with a history of clicking and mandibular clenching. She was studied clinically and with axial and coronal CT. The patient was going through a tense emotional period and reported tightening of her teeth (clenching); she was under psychological and neurological treatment for depression including pharmacological therapy. She presented slight pain only at maximum mouth opening at the right temporomandibular joint (TMJ) and in the lateral pole on palpation; there was no coincidence between initial and maximal interocclusal contacts because of premature dental contacts. She showed occlusal group function in the right side and canine guidance in the left side with a right contact of balance, local muscular pain in the right deep masseter muscle and in the superior and middle portion of the right trapezium on palpation. On CT, a spherical area of 3 mm diameter with an average density of -647 HU (SD+/-4.7) was found in the upper and posterior area of the lower space of the right TMJ, together with a thicker lower synovial tissue. This observation was confirmed by MRI. Like other joints, the TMJ could present vacuum phenomenon images inside synovial tissue in the presence of degenerative disease. It is important for radiologists to recognize this rare entity. PMID:18460579

Moncada, G; Oyarzo, J F; Moncada, M; Marholz, C; Millas, R

2008-05-01

125

Treatment guidelines for temporomandibular joint ankylosis with secondary dentofacial deformities in adults.  

PubMed

Temporomandibular joint (TMJ) ankylosis with secondary dentofacial deformities in adult patients is a severely disfiguring condition and surgical treatment of this disease remains a great clinical challenge. Treatment goals are to restore the joint function, to improve facial appearances and to correct malocclusion, as well as to re-establishing harmony among them. Currently, various surgical techniques, such as arthroplasty with or without interpositional material, orthognathic surgery, distraction osteogenesis, autologous bone or bone replacement materials graft and plastic surgery, have been described in the literature. In most cases these techniques should be used in combination to achieve satisfactory outcomes. The biggest difficulty for most clinicians is to determine the proper sequence of these procedures because no uniform treatment protocol has been established. Based on the published literature and our own clinical experiences, we have prepared this review article to provide some guidelines for the surgical management of TMJ ankylosis with dentofacial deformities in adults, which will be modified and updated periodically to provide the best treatment options to benefit our patients. PMID:23321052

Zhu, Songsong; Wang, Dazhang; Yin, Qiudan; Hu, Jing

2013-10-01

126

Temporomandibular joint interpositional gap arthroplasty under intravenous (I.V) conscious sedation.  

PubMed

Ankylosis may be defined as the fusion of joint surfaces. Temporomandibular joint (TMJ) ankylosis is a condition that may cause chewing, digestion, speech, esthetic and psychological disorders. It is a devastating disorder resulting in inability to open the mouth. As a result of this, General anaesthesia, is very difficult to administer because laryngeal inlet is not directly visualized. Even the blind nasal intubation is difficult because of small mandible and tongue fall following relaxation. There are various techniques to overcome these challenges. At times these techniques fail and tracheostomy has to be done. All the risks associated with difficult intubation, and general anaesthesia can be avoided if the surgery is done under conscious sedation. Conscious sedation, a simple but safe and effective method of anaesthesia is described here, which allows successful temporomandibular joint interpositional gap arthroplasty. PMID:23139547

Dhasmana, Satish; Singh, Vibha; Mohammad, Shadab; Pal, U S

2009-12-01

127

Women with more severe degrees of temporomandibular disorder exhibit an increase in temperature over the temporomandibular joint  

PubMed Central

Aim The purpose of the present study was to correlate the degree of temporomandibular disorder (TMD) severity and skin temperatures over the temporomandibular joint (TMJ) and masseter and anterior temporalis muscles. Materials and methods This blind cross-sectional study involved 60 women aged 18–40 years. The volunteers were allocated to groups based on Fonseca anamnestic index (FAI) score: no TMD, mild TMD, moderate TMD, and severe TMD (n = 15 each). All volunteers underwent infrared thermography for the determination of skin temperatures over the TMJ, masseter and anterior temporalis muscles. The Shapiro–Wilk test was used to determine the normality of the data. The Kruskal–Wallis test, followed by Dunn’s test, was used for comparisons among groups according to TMD severity. Spearman’s correlation coefficients were calculated to determine the strength of associations among variables. Results Weak, positive, significant associations were found between FAI score and skin temperatures over the left TMJ (rs = 0.195, p = 0.009) and right TMJ (rs = 0.238, p = 0.001). Temperatures over the right and left TMJ were significantly higher in groups with more severe TMD (p < 0.05). Conclusion FAI score was associated with skin temperature over the TMJ, as determined by infrared thermography, in this sample. Women with more severe TMD demonstrated a bilateral increase in skin temperature.

Dibai-Filho, Almir Vieira; Costa, Ana Cláudia de Souza; Packer, Amanda Carine; de Castro, Ester Moreira; Rodrigues-Bigaton, Delaine

2014-01-01

128

Osteoarthritis-like damage of cartilage in the temporomandibular joints in mice with autoimmune inflammatory arthritis  

PubMed Central

Summary Objective To study temporomandibular joint (TMJ) involvement in an autoimmune murine model of rheumatoid arthritis (RA), a disease characterized by inflammatory destruction of the synovial joints. Although TMJ dysfunction is frequently found in RA, TMJ involvement in RA remains unclear, and TMJ pathology has not been studied in systemic autoimmune animal models of RA. Methods Proteoglycan (PG) aggrecan-induced arthritis (PGIA) was generated in genetically susceptible BALB/c mice. TMJs and joint tissues/cartilage were harvested for histological and immunohistochemical analyses and RNA isolation for quantitative polymerase chain reaction. Serum cytokine levels were measured in mice with acute or chronic arthritis, and in non-arthritic control animals. Results Despite the development of destructive synovitis in the limbs, little or no synovial inflammation was found in the TMJs of mice with PGIA. However, the TMJs of arthritic mice showed evidence of aggrecanase- and matrix metalloproteinase-mediated loss of glycosaminoglycan-containing aggrecan, and in the most severe cases, structural damage of cartilage. Serum levels of pro-inflammatory cytokines, including interleukin (IL)-1?, were elevated in arthritic animals. Expression of the IL-1? gene was also high in the inflamed limbs, but essentially normal in the TMJs. Local expression of genes encoding matrix-degrading enzymes (aggrecanases and stromelysin) was upregulated to a similar degree in both the limbs and the TMJs. Conclusion We propose that constantly elevated levels of catabolic cytokines, such as IL-1?, in the circulation (released from inflamed joints) create a pro-inflammatory milieu within the TMJ, causing local upregulation of proteolytic enzymes and subsequent loss of aggrecan from cartilage. PMID:21262368

Ghassemi-Nejad, S.; Kobezda, T.; Rauch, T.A.; Matesz, C.; Glant, T.T.; Mikecz, K.

2011-01-01

129

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

NASA Astrophysics Data System (ADS)

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.

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

1995-05-01

130

CASE REPORT Temporomandibular Joint Arthroplasty With Human Amniotic Membrane: A Case Report  

PubMed Central

This case reports the usage of human amniotic membrane combined with a costochondral graft as an interpositional material in temporomandibular joint reconstruction for the first time in humans. Because of the favorable outcome 20 months postoperatively, it has to be considered as an approach bringing to light the antiadhesive potential of amniotic membrane. This case report must be regarded as initial spadework and should motivate other institutions to intensify their clinical research in this field. Because of the fact that currently used interpositional materials do not prevent the recurrence of temporomandibular joint ankylosis sufficiently, it is of great interest to establish a proper therapeutic intervention fulfilling these demands. Furthermore, the demonstrated antiadhesive properties of amniotic membrane highlight its multifaceted field of application. Nevertheless, further studies have to prove the findings reported in our case. PMID:23573337

Bauer, Florian; Hingsammer, Lukas M.; Wolff, Klaus-Dietrich; Kesting, Marco R.

2013-01-01

131

CASE REPORT Temporomandibular Joint Arthroplasty With Human Amniotic Membrane: A Case Report.  

PubMed

This case reports the usage of human amniotic membrane combined with a costochondral graft as an interpositional material in temporomandibular joint reconstruction for the first time in humans. Because of the favorable outcome 20 months postoperatively, it has to be considered as an approach bringing to light the antiadhesive potential of amniotic membrane. This case report must be regarded as initial spadework and should motivate other institutions to intensify their clinical research in this field. Because of the fact that currently used interpositional materials do not prevent the recurrence of temporomandibular joint ankylosis sufficiently, it is of great interest to establish a proper therapeutic intervention fulfilling these demands. Furthermore, the demonstrated antiadhesive properties of amniotic membrane highlight its multifaceted field of application. Nevertheless, further studies have to prove the findings reported in our case. PMID:23573337

Bauer, Florian; Hingsammer, Lukas M; Wolff, Klaus-Dietrich; Kesting, Marco R

2013-01-01

132

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

PubMed

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

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

2014-10-23

133

Response properties of trigeminal ganglion mechanosensitive neurons innervating the temporomandibular joint of the rabbit  

Microsoft Academic Search

The primary mechanosensitive neurons innervating the temporomandibular joint (TMJ neurons) may play an important role in controlling\\u000a mandibular movement and position. The purpose of the study was to investigate the neurophysiological properties of TMJ neurons\\u000a during passive movement of the isolated condyle in 55 rabbits and the intact condyle in 29 rabbits. Discharges of TMJ neurons\\u000a from the trigeminal ganglion

Akito Tsuboi; Yasuo Takafuji; Shintaro Itoh; Kazuki Nagata; Takayoshi Tabata; Makoto Watanabe

2009-01-01

134

Temporomandibular joint involvement in juvenile idiopathic arthritis: clinical predictors of magnetic resonance imaging signs  

Microsoft Academic Search

The aim of the study was to define clinical predictors of magnetic resonance imaging (MRI) findings of temporomandibular joint\\u000a (TMJ) involvement in juvenile idiopathic arthritis (JIA). Forty-six patients, aged 2.08–36.7 years, with JIA (oligoartitular\\u000a 18, polyarticular 17, systemic type 11) were examined with standard plain and contrast-enhanced sequences. Of 88 TMJs examined,\\u000a an abnormal condyle was observed in 32%, flattened articular

Maria I. Argyropoulou; Persefoni N. Margariti; Aikaterini Karali; Loukas Astrakas; Sapfo Alfandaki; Paraskevi Kosta; Antigoni Siamopoulou

2009-01-01

135

False-positive 131I uptake by the temporomandibular joint effusion.  

PubMed

A 59-year-old man with papillary thyroid carcinoma underwent total thyroidectomy and received 2 separate 100-mCi doses of 131I about 5 months apart. A whole-body scan 4 days after the second dose revealed a focal uptake in the left temporomandibular joint (TMJ). The subsequent MRI examination demonstrated that the site of elevated iodine activity was caused by a TMJ effusion. PMID:24107815

Zhang, Min; Zhang, Yifan; Huang, Wei; Li, Biao

2013-10-01

136

3-D sonography for diagnosis of disk dislocation of the temporomandibular joint compared with MRI  

Microsoft Academic Search

This study determines the value of three-dimensional (3-D) sonography for the assessment of disk dislocation of the temporomandibular joint (TMJ). Sixty-eight patients (i.e.,136 TMJ) with clinical dysfunction were examined by 272 sonographic 3-D scans. An 8- to 12.5-MHz transducer, angulated by step-motor, was used after picking a volume box on 2-D scan; magnetic resonance imaging followed immediately. Every TMJ was

Constantin A. Landes; Wojciech A. Goral; Robert Sader; Martin G. Mack

2006-01-01

137

Reactive arthritis of the temporomandibular joints and cervical spine in a child  

Microsoft Academic Search

BACKGROUND: Temporomandibular joint (TMJ) arthritis is frequently seen in children with chronic arthritis. It has rarely been described in a non-infectious acute setting. We report a case of reactive arthritis isolated to the TMJs and cervical spine. CASE PRESENTATION: A 6-year-old Native American boy hospitalized for treatment of lymphadenitis and aseptic meningitis had an incidental brain magnetic resonance imaging (MRI)

Bita Arabshahi; Kevin M Baskin; Randy Q Cron

2007-01-01

138

An adolescent case of skeletal maxillary protrusion with osteoarthritis of the temporomandibular joint  

Microsoft Academic Search

This article is designed to report the treatment of an adolescent patient, aged 13 years and 5 months, with maxillary protrusion and temporomandibular joint-osteoarthritis (TMJ-OA). MRI showed anterior disk displacement without reduction in both TMJs and the left condyle revealed a flattened-structure with undefined cortical bone. TMJ pain disappeared 4 months after splint therapy, and the initiation of orthodontic treatment

Masahiko Michida; Nobuaki Tanaka; Kotaro Tanimoto; Kazuo Tanne

2010-01-01

139

Evaluation of Korean teenagers with temporomandibular joint disorders  

PubMed Central

Objectives This study aims to evaluate the severity and pattern of symptoms exhibited by teenage Korean temporomandibular disorder (TMD) patients. Materials and Methods Among patients with an association of TMDs, teenage patients (11-19 years) who answered the questionnaire on the research diagnostic criteria for TMD (RDC/TMD) were recruited. Results The ratio of patients who visited our clinic with a chief complaint of clicking sound (34.5%) or temporomandibular pain (36.6%) at the initial diagnosis (examination) was the highest. In the evaluation of the depression index, 75.8% of the subjects were normal, 12.9% were moderate, and 11.3% were severe. With regard to non-specific physical symptoms (including pain), 66.5% of the subjects were normal, 17.0% were moderate, and 16.5% were severe. Concerning non-specific physical symptoms (excluding pain), 70.6% of the subjects were normal, 14.4% were moderate, and 15.0% were severe. In terms of the graded chronic pain score, high disability (grade III, IV) was found in 9.3% of the subjects. Conclusion Among teenage TMD patients, a portion have clinical symptoms and experience severe psychological pressure; hence requiring attention and treatment, as well as understanding the psychological pressure and appropriate treatments for dysfunction. PMID:24471050

Lee, Ji-Young; Kim, Young-Kyun; Yun, Pil-Young

2013-01-01

140

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

PubMed

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

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

2014-04-01

141

Continuous ropivacaine infusion vs transdermal fentanyl for providing postoperative analgesia following temporomandibular joint interpositional gap arthroplasty  

PubMed Central

Aim The purpose of this study was to evaluate the postoperative pain control and mouth opening in patients undergoing temporomandibular joint interpositional gap arthroplasty by either placing an epidural catheter in the incision wound and infusing ropivacaine 0.25% or by using a transdermal fentanyl patch. Materials and Methods: The study was prospective, randomized and double blind. Eighty patients belonging to American Society of Anesthesiologists grade I and II, 18–32 years of age, scheduled for temporomandibular joint interpositional gap arthroplasty were randomized into 2 groups; ropivacaine group (G rop): to receive 0.25% ropivacaine infusion and transdermal fentanyl group (G tf): to receive transdermal fentanyl patch. For postoperative pain (Visual Analog Score [VAS]) and analgesic requirements were assessed 2, 4 and 8 h after surgery and each morning, until and 4 days after surgery. Results: Time to first analgesic requirement was found to be significantly (P < 0.0001) higher in G rop (49 ± 6.7) as compared with G tf (32 ± 9.1) VAS were also significantly lower in G rop throughout the postoperative period. Postoperatively, mouth opening was better in G rop as compared with G tf, which was statistically significant. Conclusion: It was concluded that by placing an epidural catheter at the incision wound and continuously infusing with ropivacaine 0.25% effectively controls the postoperative pain in patients undergoing temporomandibular joint interpositional gap arthroplasty and provides better postoperative mouth opening. PMID:22442580

Dhasmana, Satish; Singh, Vibha; Pal, U.S.

2010-01-01

142

Osteoarthritis in Temporomandibular Joint of Col2a1 Mutant Mice  

PubMed Central

Objective Col2a1 gene mutations cause premature degeneration of knee articular cartilage in disproportionate micromelia (Dmm) and spondyloepiphesial dysplasia congenita (sedc) mice. The present study analyzes the temporomandibular joint (TMJ) in Col2a1 mutant mice in order to provide an animal model of TMJ osteoarthritis (OA) that may offer better understanding of the progression of this disease in humans. Design Dmm/+ mice and controls were compared at two, six, nine and 12 months. Craniums were fixed, processed to paraffin sections, stained with Safranin-O/Fast Green, and analyzed with light microscopy. OA was quantified using a Mankin scoring procedure. Unfolded protein response (UPR) assay was performed and immunohistochemistry (IHC) was used to assay for known OA biomarkers. Results Dmm/+ TMJs showed fissuring of condylar cartilage as early as 6 months of age. Chondrocytes were clustered, leaving acellular regions in the matrix. Significant staining of HtrA1, Ddr2 and Mmp-13 was observed in Dmm/+ mice (p< 0.01). We detected upregulation of the UPR in knee but not TMJ. Conclusions Dmm/+ mice are subject to early-onset OA in the TMJ. We observed upregulation of biomarkers and condylar cartilage degradation concomitant with OA. An upregulated UPR may exacerbate the onset of OA. The Dmm/+ mouse TMJ is a viable model for the study of the progression of OA in humans. PMID:23518238

Ricks, M. L.; Farrell, J.T.; Falk, D. J.; Holt, D W.; Rees, M.; Carr, J.; Williams, T.; Nichols, B.A.; Bridgewater, L. C.; Reynolds, P. R.; Kooyman, D L; Seegmiller, R. E.

2013-01-01

143

Osteoarthritis of the temporomandibular joint in southern sea otters (Enhydra lutris nereis).  

PubMed

Museum skull specimens (n = 1,008) of southern sea otters (Enhydra lutris nereis) were examined macroscopically according to defined criteria for the presence, severity and characteristics of temporomandibular joint osteoarthritis (TMJ-OA). The specimens were from stranded young adult to adult animals. Overall, 4.1% of the specimens had findings consistent with TMJ-OA. Of these, 61.0% were from females and 39.0% were from males. In addition, 85.4% of the affected specimens were from adults and 14.6% were from young adults. However, there was no significant association between age and sex with the presence or severity of TMJ-OA. Lesion severity was mild in 41.5%, moderate in 19.5% and severe in 39.0% of affected specimens. The most prominent changes were the presence of osteophytes and subchondral bone defects and porosity. The mandibular condylar process and fossa were affected equally. The lengths of the right and left mandibular heads were significantly associated with age (P = 0.002 and P = 0.003, respectively) and sex (P = 0.0009 and P = 0.001, respectively), but not with the presence of TMJ-OA. The significance of this disease in sea otters remains elusive, but this condition may play an important role in survival of these animals. PMID:23721871

Arzi, B; Winer, J N; Kass, P H; Verstraete, F J M

2013-11-01

144

Inappropriate use of foreign materials in temporomandibular joint ankylosis surgery: report of two cases.  

PubMed

Gap and interpositional arthroplasties are the most commonly used methods in the treatment of temporomandibular joint ankylosis. Complete resection of ankylotic segments, fibrotic band release and creating gap between the condyle and the glenoid fossa have great importance. Two patients were admitted to our clinic with complaints of difficulty in opening mouth and joint pain. In physical examination, maximum mouth opening values were recorded as 7 mm in one patient and 9 mm in another. An operation was planned due the presence of radiological grade 4 bilateral bony ankylosis. During the operation, foreign materials were found in the joint spaces of the patients. The first patient had a piece of nylon bag in the joint space, whereas the second patient had a silicon sheath used for wound therapy. Following removal of these materials, as a result of the recreation of joint spaces and the placement of suitable silicon blocks, 32 and 34 mm of mouth openings were noted during follow-up. In conclusion, recreated temporomandibular joint spaces after ankylosis surgery may be filled with a variety of autogenous or non-autogenously materials. However, the use of wrong materials inevitably causes recurrence and even worsens the primary condition. PMID:21303319

Güven, Erdem; Yazar, Memet; U?urlu, Alper Mete; Ba?aran, Karaca; Kuvat, Samet Vasfi; Emekli, Ufuk

2011-01-01

145

Importance of the changes in joint effusion shown by magnetic resonance imaging before and after arthroscopic lysis and lavage of the temporomandibular joint  

Microsoft Academic Search

We investigated the changes in the amount of joint effusion estimated from T2-weighted magnetic resonance imaging (MRI) before and after arthroscopic lysis and lavage of the temporomandibular joint (TMJ). We studied 29 consecutive patients, each with internal derangement and osteoarthritis in one TMJ. Before operation, the MRI showed joint effusions in 22 of the patients (76%). After operation, the amount

J. Sato; N. Segami; K. Kaneyama; M. Nishimura; T. Suzuki

2002-01-01

146

Open bite as a complication of total temporomandibular joint replacement: a case report.  

PubMed

Temporomandibular joint total joint replacement, like any surgery, can be associated with either intraoperative or postoperative complications. Intraoperative complications may include injuries to local anatomical structures (e.g., blood vessels, nerves, middle ear, and external auditory canal), or poor positioning and/or adaptation of the prosthesis components to the host bone. Postoperative complications may include infection, hematoma, heterotopic bone formation, implant failure, pain, salivary fistula, foreign body or allergic reactions, and malocclusion. This article reports the occurrence of a postoperative open-bite malocclusion complication, the result of maxillary artery hemorrhage. PMID:22986256

Machon, Vladimir; Hirjak, Dusan; Foltan, Rene

2012-10-01

147

Intra-articular adhesions of the temporomandibular joint: Relation between arthroscopic findings and clinical symptoms  

PubMed Central

Background Intra-articular adhesion (IA) is one of the important pathologic signs of intracapsular temporomandibular joint (TMJ) diseases, but this factor has been rarely described with respect to its arthroscopic characteristics and histology. The purpose of this study was to describe the incidence and distribution of IA in patients with internal derangement (ID) and to investigate the correlation between adhesions and the clinical symptoms of patients with ID of TMJ with closed-lock. Methods A retrospective analysis was conducted of 1822 TMJs with ID that were refractory to nonsurgical treatments and underwent arthroscopic surgery between May 2001 and June 2008 in our department. Clinical findings were assessed on the basis of mandibular range of motion, patients' age and locking duration at the initial visit. ID stages were judged according to the Wilkes and Bronstein classification based on clinical symptoms and pre-operative magnetic resonance imaging. 1506 patients (1822 joints) with ID were divided into an adhesion group (486 patients) and a non-adhesion group (1020 patients). The associations between the two groups with respect to interincisal opening, clicking duration, locking duration and patients' age were statistically analyzed using a t-test. Results Arthroscopy confirmed occurrences of adhesion in 28.76% of the joints (524 joints out of a total of 1822). Grade 1 adhesion was found in 68.89% of those cases; grade 2 in 20.61%; grade 3 in 4.58%; and grade 4 in 5.92%. The percentages of instances of adhesion in different stages were as follows: 13.89% of the joints in Stage II had adhesion, 25.47% in Stage III, 37.99% in Stage IV, and 40.37% in Stage V. There were statistically significant differences for patients' age (t = 10.41, P < 0.001), interincisal opening (t = 9.54, P < 0.001), paining duration (t = 3.66, P < 0.001) and locking duration (t = 3.89, P < 0.001) between the two groups, while no statistically significant difference was found for clicking duration (t = 1.08, P > 0.05). Conclusion The arthroscopic findings confirmed that the incidence ratio of adhesion was high and occurred predominantly with older patients with longer locking duration and less interincisal opening. As the stage of ID increased, the adhesion grade rose. PMID:19534789

Zhang, ShanYong; Li u, XiuMing; Yang, Chi; Cai, XieYi; Chen, MinJie; Haddad, Majd S; Yun, Bai; Chen, ZhuoZhi

2009-01-01

148

Dynamic MRI of the temporomandibular joint at 3 Tesla using a gradient echo sequence , J. L. Go2  

E-print Network

Dynamic MRI of the temporomandibular joint at 3 Tesla using a gradient echo sequence Y-C. Kim1 , J joint (TMJ) dysfunction is a cause of headache, facial pain and referred otalgia, which can be quite debilitating to patients. MRI has been applied in limited circumstances to define contours of the articular

Southern California, University of

149

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

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

2011-01-01

150

Bilateral Mandibular Condylysis from Systemic Sclerosis: Case Report of Surgical Correction with Bilateral Total Temporomandibular Joint Replacement  

PubMed Central

Systemic sclerosis (SSc) is a multisystem connective tissue disease of unknown etiology. The hallmark of SSc is scleroderma, referring to the presence of thickened, hardened skin. Oral and maxillofacial manifestations of the disease are numerous including masklike appearance, trismus, muscular atrophy, thin atrophied lips, secondary microstomia, xerostomia, rigidity of tongue and lips, widening of the periodontal ligament space, trigeminal neuralgia, and resorption of the mandible. A 35-year-old woman with limited cutaneous SSc presented with bilateral mandibular condylysis, severe class II mandibular deficiency, and large anterior open bite and limited range of mandibular opening at 27 mm. Surgical correction consisted of bilateral total temporomandibular joint reconstruction with stock prostheses combined with Le Fort I maxillary impaction and functional advancement genioplasty. This resulted in a functional occlusion with elimination of her open bite and a more esthetic profile. Her occlusion has remained stable at 7 months. The incidence of mandibular resorption in SSc has been found to be 20% to 33%. The mandibular angles are most commonly involved (37.6%), followed by the condyle (20.8%), coronoid process (20.0%), and the posterior border of the ascending ramus (14.4%). Bilateral condylysis is present in 13.7% of the cases. Very few cases of surgical correction of malocclusion induced by SSc-related condylysis have been reported in the literature. To the best of our knowledge, this is the first case report of bilateral condylysis from SSc where surgical replacement of the resorbed condyles was attempted. Bilateral total temporomandibular joint replacement can give these patients a functional occlusion, improved facial balance, and improved quality of life. PMID:22379502

Doucet, Jean-Charles; Morrison, Archie D.

2011-01-01

151

Challenges of airway management in a patient with temporomandibular joint ankylosis complicating forceps delivery--a case report.  

PubMed

Ankylosis of the temporomandibular joint following forceps delivery is a rare anomaly. The aetiopathogenesis involves wrongful application of the forceps or forceful closure of the forceps handle against the condyle with haemathrosis, organisation and subsequent ankylosis. Because of the lack of epidemiological data, there is little information about the true incidence and the management of this rare anomaly. The purpose of this presentation is to report the challenges encountered in the airway management of a six-year old female with right temporomandibular joint ankylosis following forceps delivery in a private hospital setting. PMID:21942132

Ajike, S O; Omisakin, O O; Mohammed, R I; Adebayo, E T

2011-03-01

152

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

SciTech Connect

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.

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

1984-01-01

153

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

NASA Astrophysics Data System (ADS)

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.

Fries, Marc D.; Vohra, Yogesh K.

2002-10-01

154

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

NASA Astrophysics Data System (ADS)

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.

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

155

Immediate effects of the serotonin antagonist granisetron on temporomandibular joint pain in patients with systemic inflammatory disorders.  

PubMed

The aim of this study was to investigate if the 5-HT3 antagonist granisetron reduces temporomandibular joint (TMJ) pain in patients with systemic inflammatory joint disorders. Sixteen patients with systemic inflammatory joint disease with pain localized over the TMJ region and tenderness to digital palpation of the TMJ were included. The current resting pain (VASRest) and the pain during maximum mouth opening (VAS(MVM)) of the TMJs were assessed with a 100 mm visual analogue scale. An electronic pressure algometer was used to estimate the pressure pain threshold (PPT) over the lateral aspect of the TMJ. Venous blood was collected for measurement of the plasma and serum levels of 5-HT, erythrocyte sedimentation rate, rheumatoid factor and C-reactive protein. The selective 5-HT3 receptor antagonist granisetron or saline were injected into the posterior part of the upper TMJ compartment in a randomized double-blind manner. The patients in the granisetron group had lower VASRest than the patients in the saline group after 10 min. In the granisetron group, VASRest was decreased after 10 min, while VAS(MVM) was decreased and PPT increased after 20 min. In the saline group, VAS(MVM) was decreased after 20 min. In conclusion, granisetron has an immediate, short-lasting and specific pain reducing effect in TMJ inflammatory arthritis. The 5-HT3 receptor may therefore be involved in the mediation of TMJ pain in systemic inflammatory joint disorders. PMID:11197756

Voog, O; Alstergren, P; Leibur, E; Kallikorm, R; Kopp, S

2000-12-22

156

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

PubMed

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

An, S-Y; Jung, J-K

2015-01-01

157

A prospective, single-centre study on patient outcomes following temporomandibular joint replacement using a custom-made Biomet TMJ prosthesis.  

PubMed

This study describes the clinical variables in 61 patients following total alloplastic temporomandibular joint reconstruction (TJR) in which the Biomet Microfixation Patient-Patient-Matched TMJ Implant was used. All patients were classified using the Wilkes classification. The visual analogue scale score for jaw pain intensity, the maximum inter-incisal opening (MIO), and the frequency of adverse events were recorded during follow-up; the mean follow-up was 14.2±8.6 months. Significant improvements were found in the MIO (P<0.0005), except at the 3-year follow-up. Additionally, a significant reduction in pain was observed both short and long term (P<0.0005). The incidence of adverse events was low (seven of the 81 alloplastic joints); two joints needed revision. TJR appears to be a relevant treatment option in patients with a broad range of temporomandibular joint disorders in whom none of the joint components are salvageable because of significant disease. Our patients gained an almost normal range of mouth opening and experienced a significant reduction in pain. Our results are promising, however TJR is associated with some side effects. TJR should be considered when less invasive procedures fail and a comprehensive presurgical work-up has been performed. Ongoing prospective studies are needed to consolidate the possible significant treatment outcomes. PMID:24953166

Aagaard, E; Thygesen, T

2014-10-01

158

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

PubMed Central

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

Pihut, M.; Szuta, M.; Ferendiuk, E.; Ze?czak-Wi?ckiewicz, D.

2014-01-01

159

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

PubMed Central

[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.

Ucar, Mehmet; Sarp, Ümit; Koca, ?rfan; Ero?lu, Selma; Yetisgin, Alparslan; Tutoglu, Ahmet; Boyac?, Ahmet

2014-01-01

160

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

NASA Astrophysics Data System (ADS)

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.

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

1996-04-01

161

Analysis of MRI findings in minimum invasive treatment for habitual temporomandibular joint dislocation by autologous blood injection around the temporomandibular joint capsule.  

PubMed

The aim of this study was to investigate magnetic resonance imaging (MRI) findings following autologous blood injection (ABI) for habitual temporomandibular joint (TMJ) dislocation. MRI was performed one hour and four and twelve weeks after ABI, revealing three types of significant findings. The first type was similar to hematoma and/or joint effusion in the articular capsule of the TMJ (type I). The second showed sporadic and diffuse T2 emphasis around the TMJ capsule (type II). The third involved a decreased range of condyle movement compared to before ABI (type III). Furthermore, we analyzed the three types of significant MRI findings. At one hour after ABI, type I was Grade 0 in 0 of 14 patients, Grade 1 in 8, Grade 2 in 2, and Grade 3 in 4. Type II was seen in 9 of the 14 cases and type III in 8. After twelve weeks, all cases of type I were Grade 0, no type II cases were evident, and type III was seen in 11 cases. Injecting autologous blood into surrounding TMJ tissues is an important factor in ABI. Minimally invasive treatment for habitual TMJ dislocation using ABI around the TMJ capsule appears to represent a very effective and safe treatment. PMID:25023782

Oshiro, Nobuyoshi; Yoshida, Hiroaki; Uemura, Mamoru; Suwa, Fumihiko; Morita, Shosuke

2014-10-01

162

Simultaneous chin onlay bone graft using elongated coronoid in the treatment of temporomandibular joint ankylosis.  

PubMed

Temporomandibular joint (TMJ) ankylosis is a disabling condition that causes problems in mastication, digestion, speech, appearance, and hygiene. Treatment goals are to restore the joint function, to improve facial appearance, and to reestablish harmony among them. To achieve these goals, various strategies have been reported as 1-stage or multistage protocols. We describe a novel method to augment the chin structure with elongated coronoid process of the mandible, which is a sequence of TMJ ankylosis. By this 1-stage treatment that includes gap arthroplasty with interpositional temporalis fascia graft and chin augmentation with autogenous bone graft (elongated coronoid), functional disability and facial deformity of the patient with TMJ ankylosis were improved simultaneously. PMID:24336042

Jafarian, Mohammad; Dehghani, Nima

2014-01-01

163

Osteochondroma of the Temporomandibular Joint Treated by Means of Condylectomy and Immediate Reconstruction with a Total Stock Prosthesis  

PubMed Central

ABSTRACT Background Osteochondromas are one of the most common benign tumours of bone, but they are rare in the craniofacial region. These condylar tumours have been variably treated, including resection through local excision or condylectomy with or without reconstruction. Methods A case of osteochondroma of the mandibular condyle and cranial base arising concurrently in the 76 years old patient was presented. The surgical excision of the skull base lesion and condylectomy with immediate reconstruction of temporomandibular joint was applied. Results Based on the history, clinical examination and radiographic findings, osteochondroma of the skull base was diagnosed, with a concurrent lesion of the condylar process. Treatment methods for this patient included excision of the skull base tumour and condylectomy with immediate temporomandibular joint reconstruction using appropriately sized stock total temporomandibular joint prosthesis. At the 24 month follow-up, patient was free of pain and her maximal incisal opening was maintained, with no radiographic evidence of tumour recurrence or failure of the device. Conclusions Temporomandibular joint stock total replacement prosthesis became a good option to reconstruct both the fossa and the condyle in a one-stage surgery, due to the fact that both the condylar/mandibular and the fossa implants were stable in situ from the moment of fixation, with a good outcome at 24 month follow-up, with no loosening of the screws nor failure of the device. PMID:24421981

Caubet-Biayna, Jorge; Iriarte-Ortabe, José-Ignacio

2010-01-01

164

The efficacy of acupuncture and decompression splints in the treatment of temporomandibular joint pain-dysfunction syndrome  

PubMed Central

Objectives: The goal of the present study was to evaluate the results of applying acupuncture or occlusal decompression splints in the treatment of patients diagnosed with the temporomandibular joint pain-dysfunction syndrome. Design of the study: We conducted a randomized clinical trial including 20 patients to whom the mentioned treatments were applied. Results were evaluated through an analogue pain scale, measurements of mouth opening and jaw lateral deviation in millimetres, and assessment of sensitivity to pressure on different points: preauricular, masseter muscle, temporal muscle and trapezius. Parameters were evaluated before and 30 days after the treatment. For standardized pressure, we used a pressure algometer. Results: Patients treated with decompression splints showed reductions in subjective pain and pain upon pressure on temporal, masseter and trapezius muscles, as well as increased mouth opening after the treatment. Patients treated with acupuncture showed pain reduction in the short term and improvements in all of the evaluated para-meters (stronger pressure was required to produce pain; mouth opening was improved). Conclusion: Acupuncture was an effective complement and/or an acceptable alternative to decompression splints in the treatment of myofascial pain and temporomandibular joint pain-dysfunction syndrome. Key words:Temporomandibular joint, temporomandibular dysfunction, acupuncture, decompression splint, arthralgia, myofascial pain, joint palpation. PMID:22549668

Yu-Lu, Si-Lei; Zhang, Bingxin; Bocanegra-Pérez, Sacramento; Durán-Moreno, David; López-Márquez, Adriana; Knezevic, Milan; Castellano-Navarro, José-María; Limiñana-Cañal, José-María

2012-01-01

165

Creating a 3D model of the temporomandibular joint disc on the basis of segmented MRI slices  

Microsoft Academic Search

The paper deals with the processing of MRI (Magnetic Resonance Images), which are segmented, and using consecutive slices a 3D reconstruction of the TMJ (temporomandibular joint) disc is realized. The segmentation method combines spatial continuity of individual slices and a genetic algorithm. Using the genetic algorithm a threshold is set for the selection of video segments. The MRI technique is

Ondrej Smirg; Ondrej Liberda; Andrea Sprlakova; Zdenek Smekal

2011-01-01

166

Hard and soft tissue imaging of the temporomandibular joint 30 years after diagnosis of osteoarthrosis and internal derangement  

Microsoft Academic Search

Purpose: This article describes the clinical and imaging findings in the temporomandibular joints (TMJs) of patients 30 years after the initial diagnosis of osteoarthrosis and internal derangement.Patients and Methods: Fifty-five TMJs with a history of osteoarthrosis and internal derangement and 37 contralateral TMJs that were asymptomatic 30 years ago were examined in 46 former patients. To visualize degenerative changes of

Reny de Leeuw; Geert Boering; Bart van der Kuijl; Boudewijn Stegenga

1996-01-01

167

A model to simulate the mastication motion at the temporomandibular joint  

NASA Astrophysics Data System (ADS)

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.

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

2005-04-01

168

Test-retest reliability of MRI-based disk position diagnosis of the temporomandibular joint.  

PubMed

This study evaluated the test-retest reliability for determining the temporomandibular joint (TMJ) disk position, diagnosed using magnetic resonance imaging (MRI). These assessments were done as a base-line measurement for a prospective cohort study, which examines the risk factors for precipitation and progression of temporomandibular disorders. Fifteen subjects (mean age, 24.2 ± 0.94 years; male/female = 8/7) were recruited from the students of Okayama University Dental School. Sagittal MR TMJ images were taken with a 1.5-T MR scanner (Magneton Vision, Siemens) in close and maximal open positions twice at about 1-week (6-11 days) interval. The images were displayed using 200% magnification on a computer screen with a commercially available image software package (OSIRIS, UIN/HCUG). Three calibrated examiners diagnosed the disk positions using the standardized criteria. The disk position of each joint was classified as normal, anterior disk displacement with or without reduction, and others. The first and second disk position diagnoses were compared, and the test-retest reliability level was calculated using the kappa index. The second disk position diagnosis was consistent with the first in 27 out of 30 joints. The calculated kappa value representing the test-retest reliability level between the first and second disk position diagnosis was 0.812. These results indicated that the test-retest reliability of MRI-based diagnosis of TMJ disk positions at about 1-week interval was substantially high, even though they were not completely consistent. PMID:20953807

Nagamatsu-Sakaguchi, Chiyomi; Maekawa, Kenji; Ono, Tsuyoshi; Yanagi, Yoshinobu; Minakuchi, Hajime; Miyawaki, Shouichi; Asaumi, Junichi; Takano-Yamamoto, Teruko; Clark, Glenn T; Kuboki, Takuo

2012-02-01

169

Assessment of Condylar Changes in Patients with Temporomandibular Joint Pain Using Digital Volumetric Tomography  

PubMed Central

Objective. To evaluate the efficiency of DVT in comparison with OPG in the assessment of bony condylar changes in patients of TMJ pain. Methods. 100 temporomandibular joints of 62 patients with the complaint of temporomandibular joint pain were included in the study. DVT and OPG radiographs were taken for all the 100 joints. Three observers interpreted the DVT and OPG radiograph for the bony changes separately for two times with an interval of one week. The bony changes seen in the condyle were given coding from 0 to 6. (0: Normal, 1: Erosion, 2: Flattening, 3: Osteophyte, 4: Sclerosis, 5: Resorption, and 6: other changes). Interobserver and intraobserver variability was assessed with one-way ANOVA statistics. Z test was used to see the significant difference between OPG and DVT. Results. In the present study the interexaminer reliability for OPG and DVT was 0.903 and 0.978, respectively. Intraexaminer reliability for OPG and DVT was 0.908 and 0.980, respectively. The most common condylar bony change seen in OPG and DVT was erosion followed by flattening and osteophyte. There was significant difference between OPG and DVT in detecting erosion and osteophytes. The other changes observed in our study were Ely's cyst, pointed condyle, and bifid condyle. All the bony changes are more commonly seen in females than males. Conclusion. DVT provides more valid and accurate information on condylar bony changes. The DVT has an added advantage of lesser radiation exposure to the patient and cost effectiveness and could be easily accessible in a dental hospital. PMID:25332835

Shetty, Ujwala Shivarama; Burde, Krishna N.; Naikmasur, Venkatesh G.; Sattur, Atul P.

2014-01-01

170

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

PubMed Central

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

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

2012-01-01

171

An Ex Vivo Study on Immunohistochemical Localization of MMP-7 and MMP-9 in Temporomandibular Joint Discs with Internal Derangement  

PubMed Central

Internal derangement (ID) is among the most common disorders of the temporomandibular joint (TMJ). Previous research by our group highlighted a correlation between apoptosis and TMJ ID. Metalloproteinases (MMP)-7 and -9 have been shown to play an important role in extracellular matrix ECM) homeostasis and, through it, in joint disc remodelling. The immunohistochemical expression of MMP-7 and -9 was investigated in discs from patients with TMJ ID and from healthy donors and compared with the degree of histological tissue degeneration. The collagen fibre arrangement in pathological discs exhibited varying degrees of disruption. New vessels were consistently detected; endothelial cells from these vessels were immunolabelled with both MMP-7 and MMP-9. More or less intense MMP-7 and MMP-9 immunolabelling was detected in the cytoplasm of disc cells from all patients. MMP-7 and MMP-9 immunostaining was significantly different between pathological and normal discs and correlated with the extent of histopathological degeneration. MMP-7 and MMP-9 upregulation in discs from patients with TMJ ID demonstrates their involvement in disc damage in this disorder. A greater understanding of these processes could help identify ways to curb MMP overproduction without affecting their tissue remodelling action. The design of specific inhibitors for these MMPs would not only help to gain insights into the biological roles of MMPs, but would also aid in developing therapeutic interventions for diseases associated with abnormal ECM degradation. PMID:23807291

Loreto, C.; Leonardi, R.; Musumeci, G.; Pannone, G.; Castorina, S.

2013-01-01

172

Local application of Aqua Titan improves symptoms of temporomandibular joint muscle disorder: a preliminary study.  

PubMed

Aqua Titan (AT), comprising microscopic titanium particles dispersed in water, has been reported to have beneficial effects on muscle tissue. This study investigated the effects of local application of AT on symptoms in patients with muscle disorders of the temporomandibular joint (TMJ) compared to patients with joint disorders of the TMJ. Sixteen patients with unilateral masseter muscle pain during motion (muscle disorder group) and six patients with unilateral TMJ pain during motion (joint disorder group) applied an AT-permeated patch over the painful area every night for 2 weeks. Symptoms were evaluated clinically at the initial visit and 1 and 2 weeks later. Clinical symptoms in the joint disorder group showed no tendency towards improvement after 2 weeks. In contrast, mouth opening range with/without pain, visual analogue scale (VAS) scores for pain during mouth opening and eating, and activities of daily living (ADL) scores in the muscle disorder group were improved significantly after 2 weeks. Multiple comparison tests in the muscle disorder group showed significant improvements in the VAS for eating and ADL score after 1 week. These results suggest that the AT patch has a potential supplementary role in the treatment of patients with muscle disorders of the TMJ. PMID:25439132

Matsumoto, K; Tsukimura, N; Ishizuka, T; Kohinata, K; Yonehara, Y; Honda, K

2014-11-28

173

A Case of Spontaneous Temporomandibular Joint Herniation into the External Auditory Canal with Clicking Sound  

PubMed Central

A bony defect of the external auditory canal (EAC) and herniation of the temporomandibular joint (TMJ) can be caused by tumorous conditions, inflammation, trauma, and otologic procedures. Spontaneous TMJ herniation into the EAC can be caused by a congenital bony defect known as patent Huschke's foramen, which is a very rare condition. In our case, an objective clicking sound was produced when the patient opened his mouth. A protruding mass was found in the anterior wall of the EAC during mouth closing, and herniation of the TMJ was confirmed with computed tomography. Therefore, we thought the clicking sound of our case could have resulted from spontaneous TMJ herniation through the patent foramen of Huschke. PMID:24653913

Kim, Tae Hyun; Lee, Sun Kyu; Kim, Su Jin

2013-01-01

174

Sleep Disorders and their Association with Laboratory Pain Sensitivity in Temporomandibular Joint Disorder  

PubMed Central

Study Objectives: We characterized sleep disorder rates in temporomandibular joint disorder (TMD) and evaluated possible associations between sleep disorders and laboratory measures of pain sensitivity. Design: Research diagnostic examinations were conducted, followed by two consecutive overnight polysomnographic studies with morning and evening assessments of pain threshold. Setting: Orofacial pain clinic and inpatient sleep research facility Participants: Fifty-three patients meeting research diagnostic criteria for myofascial TMD. Interventions: N/A Measurements and Results: We determined sleep disorder diagnostic rates and conducted algometric measures of pressure pain threshold on the masseter and forearm. Heat pain threshold was measured on the forearm; 75% met self-report criteria for sleep bruxism, but only 17% met PSG criteria for active sleep bruxism. Two or more sleep disorders were diagnosed in 43% of patients. Insomnia disorder (36%) and sleep apnea (28.4%) demonstrated the highest frequencies. Primary insomnia (PI) (26%) comprised the largest subcategory of insomnia. Even after controlling for multiple potential confounds, PI was associated with reduced mechanical and thermal pain thresholds at all sites (P < 0.05). Conversely, the respiratory disturbance index was associated with increased mechanical pain thresholds on the forearm (P < 0.05). Conclusions: High rates of PI and sleep apnea highlight the need to refer TMD patients complaining of sleep disturbance for polysomnographic evaluation. The association of PI and hyperalgesia at a non-orofacial site suggests that PI may be linked with central sensitivity and could play an etiologic role in idiopathic pain disorders. The association between sleep disordered breathing and hypoalgesia requires further study and may provide novel insight into the complex interactions between sleep and pain-regulatory processes. Citation: Smith MT; Wickwire EM; Grace EG; Edwards RR; Buenaver LF; Peterson S; Klick B; Haythornthwaite JA. Sleep disorders and their association with laboratory pain sensitivity in temporomandibular joint disorder. SLEEP 2009;32(6):779–790. PMID:19544755

Smith, Michael T.; Wickwire, Emerson M.; Grace, Edward G.; Edwards, Robert R.; Buenaver, Luis F.; Peterson, Stephen; Klick, Brendan; Haythornthwaite, Jennifer A.

2009-01-01

175

Assessment of osseous morphology of temporomandibular joint in asymptomatic participants with chewing-side preference.  

PubMed

Chewing-side preference (CSP) may be associated with temporomandibular disorders. However, little information exists regarding whether CSP will lead to osseous changes of temporomandibular joint (TMJ) in asymptomatic participants. The aim of this study was to investigate the relationship between osseous morphology of TMJ in asymptomatic participants with CSP and without CSP. Of the 121 healthy dentate participants, 35 participants with left CSP, 38 with right CSP and other 48 without CSP were scanned by cone-beam computed tomography. The dimensions of the reconstructed images of opposing TMJs were compared. Statistical analyses were performed using spss 16.0 software. The results showed that there were no significant differences between the dimensions of bilateral structures of the TMJ (P1 > 0·05) in participants without CSP. However, the posterior-superior, posterior and lateral joint space of the preferred side were smaller than that of the unpreferred side in participants with CSP (P2 < 0·01) and bilateral TMJ in participants without CSP (P3 < 0·01). In addition, width of condylar neck of the unpreferred side both in sagittal and perpendicular to the long axis of condyle views was greater than that of the preferred side in participants with CSP (P2 < 0·01) and bilateral TMJ of participants without CSP (P4 < 0·01). Also, the inclination of articular eminence of the preferred side in view perpendicular to the long axis of condyle was less than that of the unpreferred side (P2 < 0·05). These findings suggest CSP affects osseous morphology of TMJ in asymptomatic participants. PMID:25316207

Jiang, H; Li, C; Wang, Z; Cao, J; Shi, X; Ma, J; Liu, H

2015-02-01

176

Outcomes of management of early temporomandibular joint disorders: How effective is nonsurgical therapy in the long-term?  

PubMed Central

Aim The first step in the management of Temporomandibular Disorders (TMD) is usually noninvasive, especially if the disorder is in the early stages. Clinically, pain and clicking are early signs and symptoms of TMD. The management of TMD usually includes “splint therapy” and analgesics. In this study, we report our long-term outcomes in the treatment of patients suffering from early TMD. Materials and Methods: We assessed the records of 138 patients who were referred for management of TMD. Selection was based on pain and/or clicking of the Temporomandibular Joint (TMJ), no pathologic lesions of the TMJ, no anterior disc displacement without reduction (closed lock), no Degenerative Joint Disease, no history of migraine, trauma, osteoarthritis, metabolic disease, or malocclusion (deep bite, cross bite, jaw deformity, etc). The patients were treated with an acrylic maxillary Interocclusal Splint (IOS) cuspid-rise type and were told to refrain from biting, yawning and chewing hard food. The outcome of the treatment, potential etiologic factors (Bruxism), signs and symptoms and patient demographics (such as age, sex, treatment duration, etc.) were assessed. The data were analyzed using the Chi-square test to correlate significance. Results: One hundred thirty-eight patients (26 males and 112 females) with early signs and symptoms of TMD (pain and/or click of the TMJ) were treated from 2001 to 2010; 81% were females and 19% were males. All the 138 patients used the IOS at night only. The patients were followed-up for 1–9 years. Data analysis showed that 64% of the patients were completely relieved of signs and symptoms; 22% were moderately relieved (decreased severity of signs and symptoms) and 14% had no noticeable post-treatment changes in clicking or pain (P = 0.001). Patients with bruxism and those presenting with both pain and clicking showed a better response to IOS treatment (P = 0.046 and P = 0.001, respectively). The results also showed that age, sex, severity of symptoms and duration of the treatment did not influence treatment results in this group of patients with early TMD. Conclusion: In this population, TMD was significantly higher in females. Treatment of early TMD with IOS was effective and moderately effective in long-term in over 80% of the patients during the follow-up period of 1–9 years. Bruxism had a significant etiologic role in TMD; occlusal attrition of the dentition, pain of all the teeth, early morning pain of the masticatory muscles and the TMJ are signs and symptoms to suspect nocturnal bruxism. Use of an IOS is recommended to prevent potential damage to the dentition, periodontium and the TMJ in early TMD. PMID:22442579

Mortazavi, Seyed Hossein; Motamedi, Mohammad Hosein Kalantar; Navi, Fina; Pourshahab, Majid; Bayanzadeh, Seyed Masoud; Hajmiragha, Habib; Isapour, Mona

2010-01-01

177

BMPRIA Mediated Signaling Is Essential for Temporomandibular Joint Development in Mice  

PubMed Central

The central importance of BMP signaling in the development and homeostasis of synovial joint of appendicular skeleton has been well documented, but its role in the development of temporomandibular joint (TMJ), also classified as a synovial joint, remains completely unknown. In this study, we investigated the function of BMPRIA mediated signaling in TMJ development in mice by transgenic loss-of- and gain-of-function approaches. We found that BMPRIA is expressed in the cranial neural crest (CNC)-derived developing condyle and glenoid fossa, major components of TMJ, as well as the interzone mesenchymal cells. Wnt1-Cre mediated tissue specific inactivation of BmprIa in CNC lineage led to defective TMJ development, including failure of articular disc separation from a hypoplastic condyle, persistence of interzone cells, and failed formation of a functional fibrocartilage layer on the articular surface of the glenoid fossa and condyle, which could be at least partially attributed to the down-regulation of Ihh in the developing condyle and inhibition of apoptosis in the interzone. On the other hand, augmented BMPRIA signaling by Wnt1-Cre driven expression of a constitutively active form of BmprIa (caBmprIa) inhibited osteogenesis of the glenoid fossa and converted the condylar primordium from secondary cartilage to primary cartilage associated with ectopic activation of Smad-dependent pathway but inhibition of JNK pathway, leading to TMJ agenesis. Our results present unambiguous evidence for an essential role of finely tuned BMPRIA mediated signaling in TMJ development. PMID:25093411

Liu, Chao; Yang, Ling; Sun, Cheng; Ye, Wenduo; Li, Xihai; Chen, Jianquan; Long, Fanxin; Chen, YiPing

2014-01-01

178

Long-Term Symptoms Onset and Heterotopic Bone Formation around a Total Temporomandibular Joint Prosthesis: a Case Report  

PubMed Central

ABSTRACT Background The literature on total alloplastic temporomandibular joint (TMJ) reconstructions is encouraging, and studies on total alloplastic TMJ replacements outcomes showed acceptable improvements in terms of both pain levels and jaw function. Nevertheless, some adverse events, such as heterotopic bone formation around the implanted prosthesis, may occur. In consideration of that, the present manuscript describes a case of heterotopic bone formation around a total temporomandibular joint prosthesis, which occurred several years after the implant. Methods The present manuscript describes a case of heterotopic bone formation around a total TMJ prosthesis, which occurred several years after the implant in patients, who previously underwent multiple failed TMJ surgeries. Results Ten years after the surgical TMJ replacement to solve an ankylotic bone block, the patient came to our attention again referring a progressive limitation in mouth opening. A computerized tomography showed evidence of marked heterotopic bone formation in the medial aspects of the joint, where a new-born ankylotic block occupied most part of the gap created by resecting the coronoid process at the time of the TMJ prosthesis insertion. Conclusions Despite this adverse event has been sometimes described in the literature, this is the first case in which its occurrence happened several years after the temporomandibular joint replacement. It can be suggested that an accurate assessment of pre-operative risk factors for re-ankylosis (e.g., patients with multiple failed temporomandibular joint surgeries) and within-intervention prevention (e.g., strategies to keep the bone interfaces around the implant separated) should be better standardized and define in future studies. PMID:24800055

Guarda-Nardini, Luca; Manfredini, Daniele; Ferronato, Giuseppe

2014-01-01

179

Correlating cone beam CT results with temporomandibular joint pain of osteoarthritic origin  

PubMed Central

Objectives The purpose of this study was to determine whether bony changes in temporomandibular joint (TMJ) osteoarthritis (OA) is correlated with pain and other clinical signs and symptoms. Methods Clinical data and cone beam CT (CBCT) images of 30 patients with TMJ OA were analysed. The criteria of Koyama et al (Koyama J, Nishiyama H, Hayashi T. Follow-up study of condylar bony changes using helical computed tomography in patients with temporomandibular disorder. Dentomaxillofac Radiol 2007; 36: 472–477.) and Ahmad et al [Ahmad M, Hollender L, Anderson Q, Kartha K, Ohrbach R, Truelove EL, et al. Research diagnostic criteria for temporomandibular disorders (RDC/TMD): development of image analysis criteria and examiner reliability for image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107: 844–860.] were used to classify the condyles observed on the CBCT. Clinical measures included self-reported pain, mandibular range of motion, TMJ sound, pain on palpation of the TMJ and masticatory muscles, and pain on jaw function. Generalized linear modelling was used to correlate the clinical and radiographic findings and Spearman's rho was used to correlate the two classification systems. Results There was poor correlation between the maximum condyle change and pain rating (Koyama: r2 = 0.1443, p = 0.3995; Ahmad: r2 = 0.0273, p = 0.9490), maximum mouth opening (Koyama: r2 = 0.2910, p = 0.0629; Ahmad: r2 = 0.2626, p = 0.0951), protrusion (Koyama: r2 = 0.0875, p = 0.7001; Ahmad: r2 = 0.1658, p = 0.3612), right lateral motion (Koyama: r2 = 0.0394, p = 0.9093; Ahmad: r2 = 0.0866, p = 0.6877) and left lateral motion (Koyama: r2 = 0.0943, p = 0.6494; Ahmad: r2 = 0.1704, p = 0.3236). Strong correlation was observed between Koyama et al's and Ahmad et al's classifications for average (r = 0.9216, p < 0.001) and maximum (r = 0.7694; p < 0.0001) bony change. Conclusions There was poor correlation between condylar changes (as observed on CBCT images), pain and other clinical signs and symptoms in TMJ OA. PMID:22116122

Palconet, G; Ludlow, JB; Tyndall, DA; Lim, PF

2012-01-01

180

Temporomandibular joint (TMJ) disc position in patients with TMJ pain assessed by coronal MRI  

PubMed Central

Objectives: To assess the position of the temporomandibular joint (TMJ) disc in patients with TMJ pain and compare it with equivalent published data of asymptomatic volunteers. Methods: The oblique coronal closed- and open-jaw MR images from 66 patients with TMJ pain were evaluated. Clinical examination followed the research diagnostic criteria for temporomandibular disorders. In all coronal images, the transverse condylar axis and the medial and lateral edges of the disc were determined using special software. Inter-rater agreement was calculated [two raters; inter-rater correlation coefficient (ICC)]. The presence of osteoarthrosis (OA) was determined by two independent raters. The influence of OA was estimated in patients (generalized estimation equation model). The results were compared with those of healthy volunteers (t-test). Differences between closed and open jaw in patients were analysed with the Wilcoxon matched-pair test. Results: The ICC was good for the transverse condylar axis (0.987) and the medial edge of the disc (0.799) and fair for the lateral edge (0.355). On average, the disc projected 5.5% to the medial side; laterally, the condyle was partially uncovered by the disc (?16.6%). In the open-jaw position, both the medial and the lateral edges shifted medially (to 17.6% vs ?23.6%, Wilcoxon matched-pair test, p?

Eberhard, L; Giannakopoulos, NN; Rohde, S; Schmitter, M

2013-01-01

181

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

PubMed Central

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

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

2012-01-01

182

Effect of Low-Level Laser on Healing of Temporomandibular Joint Osteoarthritis in Rats  

PubMed Central

Objective: Temporomandibular disorders (TMD) are clinical conditions characterized by pain and sounds of the temporomandibular joint (TMJ). This study was designed to assess the effect of low-level laser therapy (LLLT) on healing of osteoarthritis in rats with TMD. Materials and Methods: Thirty-two male Wistar rats (250–200 g) were housed in standard plastic cages. After injection of Complete Freund’s adjuvant into the TMJ, rats were randomly divided into two groups of 16 (case and control) and anesthetized; then osteoarthritis was induced via intraarticular injection of 50 µl of Complete Freund’s adjuvant; into the bilateral TMJs. In the case group, LLLT was done transcutaneously for 10 minutes daily, starting the day after the confirmation of osteoarthritis. Exposure was performed for 10 minutes at the right side of the TMJ with 880 nm low-level laser with 100 mW power and a probe diameter of 0.8 mm. Control rats were not treated with laser. Results: After three days of treatment the grade of cartilage defects, number of inflammatory cells, angiogenesis, number of cell layers and arthritis in rats in the case group were not significantly different compared with controls (P>0.05). After seven days, the grade of cartilage defects, number of inflammatory cells, number of cell layers, and arthritis in the case group improved compared to controls (P<0.05); angiogenesis in both groups was similar. Conclusion: Treatment of TMD with LLLT after 7 days of irradiation with a wavelength of 880 nm was associated with a greater improvement compared to the control group.

Peimani, Ali; Sardary, Farimah

2014-01-01

183

Synovial fluid sampling from the temporomandibular joint: sample quality criteria and levels of interleukin-1 beta and serotonin.  

PubMed

The aims of this study were to compare two sets of quality criteria (SQC A and B) with respect to synovial fluid (SF) sampling and to present temporomandibular joint (TMJ) SF levels of IL-1 beta and 5-HT. The study comprised 310 TMJ SF samples from 12 healthy individuals (HI) and 59 patients with TMJ inflammatory disorders. Ten HI and 37 patients were selected for investigation of TMJ SF levels and samples were obtained by a push-and-pull method with quantification by vitamin B12. The SQC comprised aspirate weight (AW), dilution factor (DF), blood contamination and hemolysis. IL-1 beta and 5-HT levels did not differ between the samples that satisfied SQC A or B. The proportion of samples that satisfied SQC A was higher than for SQC B. Patients with polyarthritides had significantly higher TMJ SF concentrations of 5-HT and IL-1 beta than HL. In conclusion, there is a recovery of TMJ SF of 0.1-0.2 g with the method used and the criteria set with the highest success rate do not differ from the other one with respect to SF levels of IL-1 beta and 5-HT. This set of sample quality criteria comprised no hemolysis, no or only minor blood contamination, AW > 0.5 g and DF < 0.98. The higher SF levels in the diseased TMJ (polyarthritides) compared to the healthy joint with respect to 5-HT and IL-1 beta is of clinical diagnostic relevance and the presence of 5-HT or IL-1 beta in TMJ SF seems to indicate a pathological joint condition probably of an inflammatory nature. PMID:10207531

Alstergren, P; Kopp, S; Theodorsson, E

1999-02-01

184

The radiological fate of dermis-fat grafts in the human temporomandibular joint using magnetic resonance imaging  

Microsoft Academic Search

The purpose of this study was to investigate the radiological fate of the dermis-fat graft within the temporomandibular joint (TMJ) using magnetic resonance imaging (MRI). Fifteen patients with dermis-fat grafts placed in 17 TMJs following discectomy for severe internal derangement were divided into 3 equal groups according to the time lapse between TMJ surgery and the MRI investigation: 0–6 months,

G. Dimitroulis; N. Trost; W. Morrison

2008-01-01

185

3-D sonography for diagnosis of osteoarthrosis and disk degeneration of the temporomandibular joint, compared with MRI  

Microsoft Academic Search

This study determined the value of three-dimensional (3-D) sonography for the assessment of osteoarthrosis and disk degeneration of the temporomandibular joint (TMJ). Sixty-eight patients (136 TMJ) with clinical dysfunction were examined by 272 sonographic 3-D scans. An 8- to 12.5-MHz motor-angulated transducer positioned inferior-parallel to the zygomatic arch scanned the region-of-interest. 3-D condylar morphology was compared with subsequent magnetic resonance

Constantin A. Landes; Wojciech Goral; Martin G. Mack; Robert Sader

2006-01-01

186

Safe performance of spinal anesthesia in a critical patient with neurofibromatosis, pectus carinatum, and temporomandibular joint dysfunction: A case report  

PubMed Central

Background Neurofibromatosis is a syndrome caused by the abnormal deposition of neural tissues of the nervous system, endocrine system, visceral structures, and skin. On the other hand, pectus carinatum and temporomandibular joint dysfunction are illnesses that adversly affect the respiratory system and cause additional problems in airway management. Case Presentation Fifty-eight-year-old Turkish male patient had neurofibromatosis, pectus carinatum and temporomandibular joint dysfunction. The case was due to be operated on with the diagnosis of incarcerated umbilical hernia. Spinal anesthesia was successfully performed and the duration of the surgery was 1 hour. No postoperative complications were observed and he was discharged from the hospital on the 3rd post-operative day. Conclusion The anesthetic management of patients with neurofibromatosis requires attention to all possible abnormalities and associated disturbances. Furthermore, the presence of pectus carinatum and temporomandibular joint dysfunction also increase the potential risks. The operation was successfully completed with spinal anesthesia that was carefully applied upon taking the required measures and considering all pathologies that may accompany the case and complications that may occur. PMID:20438631

2010-01-01

187

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

PubMed

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

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

2014-09-01

188

Autologous adipose stem cells and polylactide discs in the replacement of the rabbit temporomandibular joint disc.  

PubMed

The temporomandibular joint (TMJ) disc lacks functional replacement after discectomy. We investigated tissue-engineered bilayer polylactide (PLA) discs and autologous adipose stem cells (ASCs) as a potential replacement for the TMJ disc. These ASC discs were pre-cultured either in control or in differentiation medium, including transforming growth factor (TGF)-?1 for one week. Prior to implantation, expression of fibrocartilaginous genes was measured by qRT-PCR. The control and differentiated ASC discs were implanted, respectively, in the right and left TMJs of rabbits for six (n = 5) and 12 months (n = 5). Thereafter, the excised TMJ areas were examined with cone beam computed tomography (CBCT) and histology. No signs of infection, inflammation or foreign body reactions were detected at histology, whereas chronic arthrosis and considerable condylar hypertrophy were observed in all operated joints at CBCT. The left condyle treated with the differentiated ASC discs appeared consistently smoother and more sclerotic than the right condyle. The ASC disc replacement resulted in dislocation and morphological changes in the rabbit TMJ. The ASC discs pre-treated with TGF-?1 enhanced the condylar integrity. While adverse tissue reactions were not shown, the authors suggest that with improved attachment and design, the PLA disc and biomaterial itself would hold potential for TMJ disc replacement. PMID:23720535

Ahtiainen, Katja; Mauno, Jari; Ellä, Ville; Hagström, Jaana; Lindqvist, Christian; Miettinen, Susanna; Ylikomi, Timo; Kellomäki, Minna; Seppänen, Riitta

2013-08-01

189

Prosthesis loading after temporomandibular joint replacement surgery: a musculoskeletal modeling study.  

PubMed

One of the most widely reported complications associated with temporomandibular joint (TMJ) prosthetic total joint replacement (TJR) surgery is condylar component screw loosening and instability. The objective of this study was to develop a musculoskeletal model of the human jaw to assess the influence of prosthetic condylar component orientation and screw placement on condylar component loading during mastication. A three-dimensional model of the jaw comprising the maxilla, mandible, masticatory muscles, articular cartilage, and articular disks was developed. Simulations of mastication and a maximum force bite were performed for the natural TMJ and the TMJ after prosthetic TJR surgery, including cases for mastication where the condylar component was rotated anteriorly by 0 deg, 5 deg, 10 deg, and 15 deg. Three clinically significant screw configurations were investigated: a complete, posterior, and minimal-posterior screw (MPS) configuration. Increases in condylar anterior rotation led to an increase in prosthetic condylar component contact stresses and substantial increases in condylar component screw stresses. The use of more screws in condylar fixation reduced screw stress magnitudes and maximum condylar component stresses. Screws placed superiorly experienced higher stresses than those of all other condylar fixation screws. The results of the present study have important implication for the way in which prosthetic components are placed during TMJ prosthetic TJR surgery. PMID:25565306

Ackland, David C; Moskaljuk, Adrian; Hart, Chris; Vee Sin Lee, Peter; Dimitroulis, George

2015-04-01

190

Proposed graphical system of evaluating disc-condyle displacements of the temporomandibular joint in MRI.  

PubMed

The aim of this preliminary study was to standardize the reading of magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ). The MRI was conducted on a control group of eight subjects. In this study, the analysis of joint relationships was limited to the oblique sagittal plane, during the movement of controlled opening. The sections were analyzed by a computer-assisted quantitative method of graphical evaluation. The total surface area (TS) of the disc section was divided into an anterior surface area (AS) and a posterior area (PA), in accordance with a line joining the center of the condyle (C) to the center of the articular tubercle of the temporal bone (T). The disc-condyle relationships in the chosen plane of section were evaluated by the AS/TS ratio. If TS remains relatively constant, the AS/TS values on average decrease from 0.5 to 0.3 between the closed mouth position and the 25 mm open position. The results show good intra-observer reproducibility (p=0.26), evaluated by Wilcoxon's test. In conclusion, this protocol enables the displacement of the disc-condyle assembly during mouth opening to be described. Observed on a larger sample, the AS/TS would be able to show a range of variability in functional disc positions. PMID:16211323

Benbelaïd, R; Fleiter, B; Zouaoui, A; Gaudy, J F

2005-12-01

191

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

PubMed Central

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

Mottaghi, Ahmad; Zamani, Elham

2014-01-01

192

Characterization of Degenerative Changes in the Temporomandibular Joint of the Bengal Tiger (Panthera tigris tigris) and Siberian Tiger (Panthera tigris altaica)  

PubMed Central

Summary The articulation of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally and a fibrous articular disc. The TMJ disc plays an essential role in distributing load between the two articular surfaces. Degeneration of the disc in the presence of joint pathology has been shown in man; however, TMJ pathology has not been documented previously in tigers (Panthera tigris). The mandibular condyle and TMJ disc of a Bengal tiger (P. tigris tigris) and a Siberian tiger (P. tigris altaica) were evaluated grossly and the TMJ disc was characterized biochemically and mechanically. Characterization of the TMJ disc verified region- and direction-dependent biochemical and mechanical properties, reflective of the functional demands on the joint. Degenerative joint disease was observed in both cases and this was more severe in the Siberian tiger. Simultaneous evaluation of joint pathology, biochemical composition and mechanical properties of the TMJ disc revealed a loss in functional properties (tensile anisotropy) of the disc as joint pathology advanced from moderate to severe. TMJ degeneration may compromise the ability of the animal to eat and thrive and may be a factor contributing to the endangered status of these species. PMID:23809909

Murphy, M. K.; Arzi, B.; Vapniarsky-Arzi, N.; Athanasiou, K. A.

2013-01-01

193

Characterization of degenerative changes in the temporomandibular joint of the bengal tiger (Panthera tigris tigris) and siberian tiger (Panthera tigris altaica).  

PubMed

The articulation of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally and a fibrous articular disc. The TMJ disc plays an essential role in distributing load between the two articular surfaces. Degeneration of the disc in the presence of joint pathology has been shown in man; however, TMJ pathology has not been documented previously in tigers (Panthera tigris). The mandibular condyle and TMJ disc of a Bengal tiger (P. tigris tigris) and a Siberian tiger (P. tigris altaica) were evaluated grossly and the TMJ disc was characterized biochemically and mechanically. Characterization of the TMJ disc verified region- and direction-dependent biochemical and mechanical properties, reflective of the functional demands on the joint. Degenerative joint disease was observed in both cases and this was more severe in the Siberian tiger. Simultaneous evaluation of joint pathology, biochemical composition and mechanical properties of the TMJ disc revealed a loss in functional properties (tensile anisotropy) of the disc as joint pathology advanced from moderate to severe. TMJ degeneration may compromise the ability of the animal to eat and thrive and may be a factor contributing to the endangered status of these species. PMID:23809909

Murphy, M K; Arzi, B; Vapniarsky-Arzi, N; Athanasiou, K A

2013-11-01

194

Condylar distances in hypermobile temporomandibular joints of patients with excessive mouth openings by using computed tomography  

PubMed Central

Objectives: hypermobility in Temporomandibular joint (TMJ) can manifest higher range of motions in mandible. The aim of this study was to compare the position and distances of the head of condyle to glenoid fossa in TMJs of healthy individuals and patients with mild, moderate and severe TMJ hypermobility. Material and Methods: In this clinical study, 69 patients (between the ages of 22 to 42) with manifestation of joint hypermobility were included and Computed tomography were administered for both TMJs. The patients were divided into three groups based on their maximum mouth opening (MMO): (A) with MMO of 50-55 mm; (B) with MMO between 55 to 65 mm; and (C) with MMO >65 mm. Also, 15 healthy people with profiled tomography in the last 6 months were assumed as control group (N) with normal MMO (<50 mm). The position of condyle from articular eminence while MMO; and the distances from anterior, superior and posterior border of condyle and facing wall of glenoid fossa were measured in closed mouth from the tomography of all contributors. The collected data were analyzed by one-way ANOVA, Post Hoc and Chi-Square tests using SPSS software version 15 at significant level of 0.05. Results: The superior and posterior distances were significantly higher in groups A, B and C than healthy individuals (all P values<0.01). The anterior distance was significant between groups B and N only in right TMJ (P=0.013). Conclusions: TMJ hypermobility showed the characteristic of increased condylar distance in posterior and superior specially in higher excessive mouth opening. Key words:Computed tomography, joint hypermobility, mandibular condyle, mouth opening.

Haghigaht, Abbas; Rybalov, Oleg; Hatami, Amin

2014-01-01

195

Outcomes of treatment with custom-made temporomandibular joint total joint prostheses and maxillomandibular counter-clockwise rotation  

PubMed Central

The first 25 consecutive patients with high occlusal plane angulation, dysfunction, and pain who were treated with temporomandibular joint (TMJ) total joint prostheses and simultaneous maxillomandibular counterclockwise rotation were evaluated before surgery (T1), immediately after surgery (T2), and at the longest follow-up (T3) for surgical movements and long-term stability. Subjective ratings were used for patients' facial pain/headache, TMJ pain, jaw function, diet, and disability, and objective functional changes were determined by measuring maximum incisal opening and lateral excursive movements. Results showed that the areas of greatest surgical change included an average decrease in the occlusal plane of 13.3 degrees with advancement at point B of 13.4 mm and at the genial tubercles of 16.3 mm. At longest follow-up, relapse was 0.7 degrees, 0.8 mm, and 1.2 mm, respectively, with no statistically significant changes. Significant subjective pain and dysfunction improvements were observed (P ? 0.001). Maximum incisal opening increased, but lateral excursion decreased. Those who had two or more previous TMJ surgeries showed greater levels of dysfunction at T1 and T3 than those who had one or no previous surgeries, but otherwise patients presented similar amounts of absolute changes. In conclusion, end-stage TMJ patients can achieve significant improvement in their pain, dysfunction, dentofacial deformity, and airway problems in one operation with TMJ reconstruction and mandibular advancement using TMJ custom-made total joint prostheses and simultaneous maxillary osteotomies for maxillomandibular counter-clockwise rotation. PMID:18209749

Pinto, Lécio P.; Cárdenas, Luis E.; Molina, Omar R.

2008-01-01

196

[Topographological-anatomic changes in the structure of temporo-mandibular joint in case of fracture of the mandible condylar process at cervical level].  

PubMed

Pathological changes in soft tissues surrounding the fracture site as well as in the structural elements of temporo-mandibular joint always occured in condylar process fracture with shift at cervical mandibular jaw level. Other changes were also seen in the joint on the opposite normal side. Modelling of condylar process fracture at mandibular cervical level by means of three-dimensional computer model of temporo-mandibular joint contributed to proper understanding of this pathology emergence as well as to prediction and elimination of disorders arising in adjacent to the fracture site tissues. PMID:21378713

Volkov, S I; Bazhenov, D V; Semkin, V A

2011-01-01

197

Change the Myofascial Pain and Range of Motion of the Temporomandibular Joint Following Kinesio Taping of Latent Myofascial Trigger Points in the Sternocleidomastoid Muscle  

PubMed Central

[Purpose] The purpose of this study was to identify the changes in the myofascial pain and range of the motion of temporomandibular joint when Kinesio taping is applied to patients with latent myofascial trigger points of the sternocleidomastoid muscle. [Subjects and Methods] The subjects were 42 males and females aged 20 to 30?years (male 17, female 25). They were randomly divided into the control group and the experimental group, which would receive Kinesio taping. Kinesio taping was applied to the sternocleidomastoid muscle three times per week for two weeks. The pain triggered when the taut band or nodule was palpated was measured. Pain intensity was measured using the visual analog scale (VAS) and pressure pain threshold (PPT). The range of motion of the temporomandibular joint was measured. In all subjects, VAS, PPT, and range of motion of the temporomandibular joint were measured before and after the intervention. [Results] In the experimental group, it was found that pain in the SCM was relived, as the VAS and PPT score decrease significantly and range of motion of temporomandibular joint increase significantly. In comparison between the groups, significant differences were shown in the VAS and PPT scores and in the range of motion of the temporomandibular joint. [Conclusion] Kinesio taping is thought to be an intervention method that can be applied to latent myofascial trigger points. PMID:25276008

Bae, Youngsook

2014-01-01

198

Change the myofascial pain and range of motion of the temporomandibular joint following kinesio taping of latent myofascial trigger points in the sternocleidomastoid muscle.  

PubMed

[Purpose] The purpose of this study was to identify the changes in the myofascial pain and range of the motion of temporomandibular joint when Kinesio taping is applied to patients with latent myofascial trigger points of the sternocleidomastoid muscle. [Subjects and Methods] The subjects were 42 males and females aged 20 to 30?years (male 17, female 25). They were randomly divided into the control group and the experimental group, which would receive Kinesio taping. Kinesio taping was applied to the sternocleidomastoid muscle three times per week for two weeks. The pain triggered when the taut band or nodule was palpated was measured. Pain intensity was measured using the visual analog scale (VAS) and pressure pain threshold (PPT). The range of motion of the temporomandibular joint was measured. In all subjects, VAS, PPT, and range of motion of the temporomandibular joint were measured before and after the intervention. [Results] In the experimental group, it was found that pain in the SCM was relived, as the VAS and PPT score decrease significantly and range of motion of temporomandibular joint increase significantly. In comparison between the groups, significant differences were shown in the VAS and PPT scores and in the range of motion of the temporomandibular joint. [Conclusion] Kinesio taping is thought to be an intervention method that can be applied to latent myofascial trigger points. PMID:25276008

Bae, Youngsook

2014-09-01

199

Evaluation of Temporomandibular Joint Total Replacement with Alloplastic Prosthesis: Observational Study of 27 Patients  

PubMed Central

Background Temporomandibular joint (TMJ) total replacement with alloplastic prostheses has been performed since 1960s. Research in these last two decades has achieved important improvement in the development of biomaterials, design, adaptation, and fixation of the prosthesis components. Objective To evaluate total TMJ replacement with alloplastic prostheses. Methods We studied 27 patients, between 19 and 73 years old, who had total TMJ uni- or bilateral replacement surgery with custom-made alloplastic prostheses manufactured by TMJ Concepts, Inc. (Ventura, CA) between 1996 and 2011. The general data and preoperative measurements were taken from medical records. Subjective data related to pain, diet consistency, and current quality of life were collected with a questionnaire answered by the patients; measures of maximum interincisal opening and lateral mandibular movements were obtained from direct examination. Results We found significant difference (p < 0.05) comparing pre- to postoperative results about improvement in mouth opening, pain relief, and satisfaction with the surgery and diet consistency. Conclusion The results of this study show that total alloplastic TMJ prostheses are an efficient, safe, and stable long-term solution for patients who need TMJ total replacement. PMID:24436755

Briceño, Fernando; Ayala, Ronmell; Delgado, Karlina; Piñango, Sabrina

2013-01-01

200

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

PubMed

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

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

2010-08-01

201

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

PubMed Central

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

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

2013-01-01

202

Overexpression of Shox2 Leads to Congenital Dysplasia of the Temporomandibular Joint in Mice  

PubMed Central

Our previous study reported that inactivation of Shox2 led to dysplasia and ankylosis of the temporomandibular joint (TMJ), and that replacing Shox2 with human Shox partially rescued the phenotype with a prematurely worn out articular disc. However, the mechanisms of Shox2 activity in TMJ development remain to be elucidated. In this study, we investigated the molecular and cellular basis for the congenital dysplasia of TMJ in Wnt1-Cre; pMes-stop Shox2 mice. We found that condyle and glenoid fossa dysplasia occurs primarily in the second week after the birth. The dysplastic TMJ of Wnt1-Cre; pMes-stop Shox2 mice exhibits a loss of Collagen type I, Collagen type II, Ihh and Gli2. In situ zymography and immunohistochemistry further demonstrate an up-regulation of matrix metalloproteinases (MMPs), MMP9 and MMP13, accompanied by a significantly increased cell apoptosis. In addition, the cell proliferation and expressions of Sox9, Runx2 and Ihh are no different in the embryonic TMJ between the wild type and mutant mice. Our results show that overexpression of Shox2 leads to the loss of extracellular matrix and the increase of cell apoptosis in TMJ dysplasia by up-regulating MMPs and down-regulating the Ihh signaling pathway. PMID:25062348

Li, Xihai; Liang, Wenna; Ye, Hongzhi; Weng, Xiaping; Liu, Fayuan; Liu, Xianxiang

2014-01-01

203

Sleep continuity and architecture: Associations with pain-inhibitory processes in patients with temporomandibular joint disorder  

PubMed Central

Recent research suggests bi-directional interactions between the experience of pain and the process of sleep; pain interferes with the ability to obtain sleep, and disrupted sleep contributes to enhanced pain perception. Our group recently reported, in a controlled experimental study, that sleep fragmentation among healthy adults resulted in subsequent decrements in endogenous pain inhibition. The present report follows up that observation by extending this line of research to a sample of patients experiencing persistent pain. Patients with chronic temporomandibular joint disorder (TMD) pain were studied using polysomnography and psychophysical evaluation of pain responses. We assessed whether individual differences in sleep continuity and/or architecture were related to diffuse noxious inhibitory controls (DNIC), a measure of central nervous system pain inhibition. Among 53 TMD patients, higher sleep efficiency and longer total sleep time were positively associated with better functioning of DNIC (r=.42 ? .44, p< .01; p’s< .05 for the multivariate analyses). These results suggest the possibility that disrupted sleep may serve as a risk factor for inadequate pain-inhibitory processing and hint that aggressive efforts to treat sleep disturbance early in the course of a pain condition might be beneficial in reducing the severity or impact of clinical pain. PMID:19168380

Edwards, R.R.; Grace, E; Peterson, S.; Klick, B.; Haythornthwaite, J.A.; Smith, M.T.

2009-01-01

204

Management of acquired open bite associated with temporomandibular joint osteoarthritis using miniscrew anchorage  

PubMed Central

This article reports the orthodontic treatment of a patient with skeletal mandibular retrusion and an anterior open bite due to temporomandibular joint osteoarthritis (TMJ-OA) using miniscrew anchorage. A 46-year-old woman had a Class II malocclusion with a retropositioned mandible. Her overjet and overbite were 7.0 mm and -1.6 mm, respectively. She had limited mouth opening, TMJ sounds, and pain. Condylar resorption was observed in both TMJs. Her TMJ pain was reduced by splint therapy, and then orthodontic treatment was initiated. Titanium miniscrews were placed at the posterior maxilla to intrude the molars. After 2 years and 7 months of orthodontic treatment, an acceptable occlusion was achieved without any recurrence of TMJ symptoms. The retropositioned mandible was considerably improved, and the lips showed less tension upon lip closure. The maxillary molars were intruded by 1.5 mm, and the mandible was subsequently rotated counterclockwise. Magnetic resonance imaging of both condyles after treatment showed avascular necrosis-like structures. During a 2-year retention period, an acceptable occlusion was maintained without recurrence of the open bite. In conclusion, correction of open bite and clockwise-rotated mandible through molar intrusion using titanium miniscrews is effective for the management of TMJ-OA with jaw deformity. PMID:23112945

Yamano, Eizo; Inubushi, Toshihiro; Kuroda, Shingo

2012-01-01

205

Effectiveness of treatment with viscosupplementation in temporomandibular joints with or without effusion.  

PubMed

The objective of this study was to determine whether the effectiveness of viscosupplementation with hyaluronic acid (HA) in patients with temporomandibular joint (TMJ) degenerative disorders depends on the presence of intra-articular effusion. In this study of case-control design, two groups of 25 patients were recruited: patients with a clinical diagnosis of painful chronic TMJ osteoarthritis and magnetic resonance imaging (MRI) signs of TMJ degeneration, with (effusion group) or without (no effusion group) MRI evidence of TMJ effusion. All patients underwent five weekly single-needle arthrocenteses plus medium molecular weight HA and 6 months of follow-up. Several clinical outcome parameters were assessed. For all variables, analysis of variance (ANOVA) for repeated measures was performed to assess the existence of significant within-group and between-group treatment effects. Over time, both groups showed significant improvements in all outcome parameters, which were maintained at the 6-month follow-up (P<0.05). Between-group comparisons showed that the treatment effects did not differ significantly for either the primary outcome variable (pain levels: F=0.849, P=0.548) or secondary outcome variables (chewing efficiency: F=0.854, P=0.544; functional limitation: F=1.35, P=0.226; mouth opening: F=0.658, P=0.707). The null hypothesis that there are no differences in treatment effectiveness between patients with and without effusion could not be rejected. PMID:24893762

Guarda-Nardini, L; Rossi, A; Ramonda, R; Punzi, L; Ferronato, G; Manfredini, D

2014-10-01

206

Stress distribution in the temporomandibular joint after mandibular protraction: A three-dimensional finite element study.  

PubMed

Abstract Objective: To evaluate the stress patterns in temporomandibular joint (TMJ) during mandibular protraction at different horizontal advancements with constant vertical height in a construction bite using a three-dimensional finite element method. Materials and Methods: A three-dimensional computer-aided model was developed from the magnetic resonance imaging (MRI) of a growing boy (age 12 years) using MIMICS software (version 7.0, Materialise, Leuven, Belgium). Stresses with constant vertical opening of 5 mm changing the sagittal advancements from 0 mm to 5 mm and 7.5 mm were recorded. Differences in magnitude and pattern of stresses were compared. Results: The tensile stresses in the posterosuperior aspect of the condylar head and on the posterior aspect of the glenoid fossa migrated posteriorly with increased bite advancements. The location of tensile stresses changed in the condylar head and fossa on mandibular protraction of 5 mm to 7 mm. Conclusion: This study indicates that larger horizontal advancements of construction bites may not be favorable for tissues of TMJ. Clinical application necessitates study on an animal model. PMID:24901066

Shrivastava, Abhinav; Hazarey, Pushpa V; Kharbanda, Om P; Gupta, Anurag

2014-06-01

207

Evaluating anisotropic properties in the porcine temporomandibular joint disc using nanoindentation.  

PubMed

The objective of this study was to determine the viscoelastic properties present within the intermediate zone of the porcine temporomandibular joint (TMJ) disc using nanoindentation. A 50-microm conospherical indenter tip using a displacement-controlled ramp function with a 600 nm/s loading and unloading rate, a 3000-nm peak displacement with a holding period of 30 s was used to indent the samples. Experimental load-relaxation tests were performed on the TMJ disc to determine the response in three different directions; the mediolateral, anteroposterior, and articular surface directions. The experimental data were analyzed using a generalized Maxwell model to obtain values for short- and long-time relaxation modulus and of material time constants. The short time relaxation modulus E ( I ) values were 180.92, 64.99, and 487.77 kPa for testing done on the articular surface, mediolateral, and anteroposterior directions, respectively. Corresponding values for the long-time relaxation modulus E (infinity) were 45.9, 14.97, and 133.5 kPa. The method confirmed anisotropy present within the central intermediate zone of the porcine TMJ disc due to the directional orientation of the collagen fibers. PMID:20195763

Yuya, P A; Amborn, E K; Beatty, M W; Turner, J A

2010-07-01

208

Aetiology and presentation of ankylosis of the temporomandibular joint: report of 23 cases from Abuja, Nigeria.  

PubMed

Several studies have reviewed the management of ankylosis of the temporomandibular joint (TMJ), but only a few focused on the aetiology and clinical features. We retrospectively studied the aetiology and clinical features of patients with ankylosis of the TMJ who presented to the Maxillofacial Unit, National Hospital, Abuja, Nigeria, between 2004 and 2009. There were 13 male and 10 female patients, M:F ratio 1.3:1, age range 6-62, mean (SD) 20 (13) years. The aetiological factors were trauma (n=11) that comprised falls (n=6), untreated fractures of the zygomatic arch (n=4) and myositis ossificans (n=1); infection (n=9), that comprised cancrum oris (n=3) and ear infection (n=6); congenital or unknown (n=2), and coronoid hyperplasia (n=1). The maximum interincisal distance at presentation ranged from 0 to 25 mm (mean (SD) 6.7 (7.2) mm). Seventeen had facial deformities. The diagnoses recorded were as follows: left extracapsular ankylosis, (n=8); right intracapsular bony ankylosis, (n=6); left intracapsular bony ankylosis, (n=4); bilateral intracapsular bony ankylosis, (n=4), and bilateral intracapsular fibrous ankylosis (n=1). Extreme poverty was the main predisposing factor. There is a need for a concerted effort among healthcare providers, policy makers, and the world in general to eradicate poverty and improve healthcare to limit the incidence of ankylosis of the TMJ. PMID:21255886

Bello, Seidu Adebayo; Aluko Olokun, Bayo; Olaitan, Abayomi Ademola; Ajike, Sunday O

2012-01-01

209

Inhibition of Fibrous Adhesion Formation in the Temporomandibular Joint of Tenascin-C Knockout Mice  

PubMed Central

Tenascin-C (TNC) is a large hexameric extracellular matrix glycoprotein that is expressed in developing organs and tumors. It has been reported that TNC is expressed in inflamed synovial membranes and deformed discs of temporomandibular joint (TMJ) disorder. However, the role of TNC in TMJ is not fully known. In this study, the role of TNC in fibrous adhesion formation of TMJ was examined using TNC knockout (TNCKO) mice. Hypermobility was produced by excessive mouth opening method on the TMJ of both wild-type (WT) and TNCKO mice. TMJ wound healing was compared histologically, and the expression of TNC, fibronectin (FN), and ?-smooth muscle actin (?-SMA) in the wounded TMJ was examined by immunohistochemical and immunoblot analyses. Based on histologic analysis, fibrous adhesions were observed in the TMJ of both TNCKO and wild-type (WT) mice after excessive mouth opening. However, fibrous adhesion formation in TNCKO mice occurred later than in WT mice. TNC was expressed in the wounded TMJ disc and mandibular fossa. Although FN and ?-SMA expression in the TMJ of TNCKO and WT mice was up-regulated after excessive mouth opening, FN and ?-SMA protein levels were higher in WT mice at the same time points. In the wounded TMJ, TNC appears to enhance the expression of FN and ?-SMA, and a lack of TNC may reduce fibrous adhesion formation in the TMJ. TNC plays an important role in TMJ wound healing, especially for wounds generated by mechanical stress. PMID:25578971

Shinohara, Y.; Okamoto, K.; Goh, Y.; Kiga, N.; Tojyo, I.; Fujita, S.

2014-01-01

210

Small field of view cone beam CT temporomandibular joint imaging dosimetry  

PubMed Central

Objectives: Cone beam CT (CBCT) is generally accepted as the imaging modality of choice for visualisation of the osseous structures of the temporomandibular joint (TMJ). The purpose of this study was to compare the radiation dose of a protocol for CBCT TMJ imaging using a large field of view Hitachi CB MercuRay™ unit (Hitachi Medical Systems, Tokyo, Japan) with an alternative approach that utilizes two CBCT acquisitions of the right and left TMJs using the Kodak 9000® 3D system (Carestream, Rochester, NY). Methods: 25 optically stimulated luminescence dosemeters were placed in various locations of an anthropomorphic RANDO® Man phantom (Alderson Research Laboratories, Stanford, CT). Dosimetric measurements were performed for each technique, and effective doses were calculated using the 2007 International Commission on Radiological Protection tissue weighting factor recommendations for all protocols. Results: The radiation effective dose for the CB MercuRay technique was 223.6?±?1.1??Sv compared with 9.7?±?0.1??Sv (child), 13.5?±?0.9??Sv (adolescent/small adult) and 20.5?±?1.3??Sv (adult) for the bilateral Kodak acquisitions. Conclusions: Acquisitions of individual right and left TMJ volumes using the Kodak 9000 3D CBCT imaging system resulted in a more than ten-fold reduction in the effective dose compared with the larger single field acquisition with the Hitachi CB MercuRay. This decrease is made even more significant when lower tube potential and tube current settings are used. PMID:24048693

Lukat, T D; Wong, J C M; Lam, E W N

2013-01-01

211

Intra-articular vs. systemic administration of etanercept in antigen-induced arthritis in the temporomandibular joint. Part II: mandibular growth  

Microsoft Academic Search

BACKGROUND: Temporomandibular joint (TMJ) arthritis in children causes alterations in the craniomandibular growth. Resultant abnormalities include; condylar erosions, a posterior mandibular rotation pattern, micrognathia, malocclusion with an anterior open bite, altered joint and muscular function occasionally associated with pain. These alterations may be prevented by early aggressive anti-inflammatory intervention. Previously, we have shown that intra-articular (IA) corticosteroid reduces TMJ inflammation

Peter Stoustrup; Kasper D Kristensen; Annelise Küseler; Thomas K Pedersen; John Gelineck; Troels Herlin

2009-01-01

212

A comparison of ultrasonography and magnetic resonance imaging in the evaluation of temporomandibular joint involvement in rheumatoid arthritis and psoriatic arthritis  

Microsoft Academic Search

Objective. To define the diagnostic value of ultrasonographic (US) examination in comparison with magnetic resonance imaging (MRI) for the assessment of temporomandibular joint (TMJ) involvement in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Methods. MRI and US examinations were performed in 33 patients (22 with RA and 11 with PsA). Alterations of the disc, alterations of the condyle and joint

D. Melchiorre; A. Calderazzi; S. Maddali Bongi; R. Cristofani; L. Bazzichi; C. Eligi; M. Maresca; M. L. Ciompi

2003-01-01

213

Effects of local anesthetics on somatosensory function in the temporomandibular joint area.  

PubMed

There is a need for systematic studies regarding the pathophysiology and pain mechanisms of somatosensory function in the temporomandibular joint (TMJ). So far, the effects on somatosensory functions of local anesthetics (LA) applied to the auriculotemporal (AT) nerve or intraarticularly (IA) into the TMJ have not been studied systemically. This study aimed to examine in a double-blinded, placebo-controlled manner the effects of LA on mechanical and thermal sensitivity in the TMJ area. Twenty-eight healthy subjects (27.4 +/- 6.2 years) without temporomandibular disorders (TMD) participated. The subjects received an AT nerve block (n = 14) or an IA injection (n = 14) with LA (Bupivacaine, 2.5 mg/ml) on one side, and a placebo injection (isotonic saline) on the contralateral side. Mechanical (tactile and pin-prick) and thermal sensitivity (40 and 5 degrees C) were assessed at 11 standardized points in the TMJ area before injections (baseline) as well as 30 min, 1 and 2 h after injections. All stimuli were rated by the subjects on a 0-100 numerical rating scale (NRS). TMJ pressure pain threshold (PPT) and pressure pain tolerance (PPTOL) were assessed laterally over both TMJs using an algometer. IA injections with LA were not associated with any changes in sensitivity of the TMJ or surrounding area. In contrast, AT nerve blocks with LA caused a decrease over time in the pin-prick sensitivity (P = 0.016), which however, did not differ significantly from saline, and an increase of the PPTs 30 min (P = 0.010) and PPTOLs 30 min, 1 h and 2 h (P < 0.05) after LA injections in comparison to saline. No other measures showed a significant change after the injections. Our results showed that IA bupivacaine injection in healthy subjects has no effect on the sensitivity of the TMJ or surrounding area, while AT nerve block has a more pronounced effect on deep mechanical, but not on superficial mechanical or thermal sensitivity. Further research to investigate the effect of LA on somatosensory functions in TMJ patients in comparison with this study results will give valuable information about the sensitivity in the TMJ area. PMID:17588187

Ayesh, Emad E; Ernberg, Malin; Svensson, Peter

2007-07-01

214

Ruptured disc after arthroscopic repositioning in the temporomandibular joint: a retrospective magnetic resonance imaging study.  

PubMed

Our aim was to explore the incidence of rupture after arthroscopic repositioning of the disc of the temporomandibular joint (TMJ) by reviewing magnetic resonance images (MRI) of the TMJ taken before and after operation, and to investigate correlations retrospectively. We studied 247 patients with anterior disc displacement of the TMJ, and categorised them into 3 groups based on the postoperative MRI. The first group comprised those whose disc ruptured after repositioning, the second those who had a possible rupture of the disc after repositioning, and the third had no rupture of the disc after repositioning. Age, sex, duration of symptoms, maximum incisal mouth opening, whether the anterior disc displacement was unilateral or bilateral, and the Wilkes stage, were included in the analysis. The incidence of rupture (5/247) was 2%. Weak points at the intermediate zone of the disc were found in 4 of the 5 joints. The patients whose discs ruptured were significantly younger than the other 2 groups (p=0.001). There was no statistically significant difference in preoperative duration of symptoms and mouth opening among the groups. The proportions of unilateral and bilateral disc displacement (p=0.047) and Wilkes stage (p=0.027) differed among the 3 groups. The Wilkes stages was significantly more advanced in the ruptured group than in the other 2 groups (p=0.027) with 4/5 being bilateral. The weak point in the intermediate zone of the disc on MRI could be a sign of rupture. Teenagers and young adults with anterior disc displacement without reduction, particularly those in whom it is bilateral, are at a higher risk of a rupture after repositioning of the disc by arthroscopy. PMID:24736122

Li, Hui; Cai, Xieyi; Yang, Chi; Wang, Shaoyi; Huang, Linjian

2014-07-01

215

Investigation of joint disease  

Microsoft Academic Search

The role of nuclear medicine in the diagnosis and management of the major arthropathies is critically reviewed, with particular reference to osteoarthritis, rheumatoid and similar forms of arthritis, ankylosing spondylitis, non-specific back pain, gout, the neuropathic joint, avascular necrosis, infection and the consequences of prosthetic joint insertion. Attention is drawn both to practical applications and deficiencies in current techniques and

M. V. Merrick

1992-01-01

216

[A case of Satoyoshi syndrome complicating marginal gingivitis of the mandible and dislocation of the temporomandibular joint].  

PubMed

Satoyoshi syndrome is a very rare disorder, characterized by progressive painful intermittent muscle spasms beginning in adolescence. Universal alopecia, diarrhea, amenorrhea and bony deformities are also cardinal features of this syndrome. Skeletal abnormalities, such as joint deformity, epiphysial destruction and retarded growth, are observed in approximately half of patients. However, no bony changes have previously been reported in the region of the head. We present here a male patient with Satoyoshi syndrome. Muscle cramps began in the lower extremities when he was 13 years old, and gradually spread. At the age of 17 years, masticatory muscle cramps made it difficult to eat and speak fluently, and were considered a cause of malacia in this patient. Finally, recurrent severe cramps in the masseter muscles caused marginal gingivitis of the mandible, necessitated extraction of the teeth and caused dislocation of the temporomandibular joint. After treatment with dantrolen sodium at doses up to 150 mg/day, painful spasm decreased significantly. Since masticatory muscles can cause significant stress to the teeth and the temporomandibular joint, sufficient attention should be paid to the oral region to avoid complications in patients with Satoyoshi syndrome. PMID:12710092

Matsumura, Tsuyoshi; Yokoe, Masaru; Shinno, Susumu

2002-09-01

217

Reducing dietary loading decreases mouse temporomandibular joint degradation induced by anterior crossbite prosthesis  

PubMed Central

Objective Dietary loading has been reported to have an effect on temporomandibular joint (TMJ) remodeling via periodontal-muscular reflex. We therefore examined whether reducing dietary loading decreased TMJ degradation induced by the unilateral anterior crossbite prosthesis as we recently reported. Methods Forty 6-week-old female C57BL/6J mice were randomly divided into two experimental and two control groups. One experimental and one control group received small-size diet and the other two groups received large-size diet. Unilateral anterior crossbite prosthesis was created in the two experimental groups. The TMJ samples were collected 3 weeks after experimental operation. Histological changes in condylar cartilage and subchondral bone were assessed by Hematoxylin & Eosin, toluidine blue, Safranin O and tartrate-resistant acid phosphatase staining. Real-time polymerase chain reaction (PCR) and/or immunohistochemistry were performed to evaluate the expression levels of Collagen II, Aggrecan, a disintegrin and metalloproteinase with thrombospondin motifs 5 (ADAMTS-5) and RANKL/RANK/OPG in TMJ condylar cartilage and/or subchondral bone. Results Thinner and degraded cartilage, reduced cartilage cellular density, decreased expression levels of Collagen II and Aggrecan, loss of subchondral bone and enhanced osteoclast activity were observed in TMJs of both experimental groups. However, the cartilage degradation phenotype was less severe and cartilage ADAMTS-5 mRNA was lower while OPG/RANKL ratio in cartilage and subchondral bone was higher in the small-size than large-size diet experimental group. No differences of histomorphology and the tested molecules were found between the two control groups. Conclusions The current findings suggest that a lower level of functional loading by providing small-size diet could reduce TMJ degradation induced by the biomechanical stimulation from abnormal occlusion. PMID:24316289

Liu, Y.-D.; Liao, L.-F.; Zhang, H.-Y.; Lu, L.; Jiao, K.; Zhang, M.; Zhang, J.; He, J.-J.; Wu, Y.-P.; Chen, D.; Wang, M.-Q.

2014-01-01

218

Temporomandibular Joint Disorder Complaints in Tinnitus: Further Hints for a Putative Tinnitus Subtype  

PubMed Central

Objective Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ) disorder complaints and compared the two groups with respect to etiologic factors. Methods 1204 Tinnitus patients from the Tinnitus Research Initiative (TRI) Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan. Results Tinnitus patients with TMJ complaints (22% of the whole group) were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt), onset related events (whiplash etc.), character (pulsatile or not), hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.). Conclusion Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical features that are highly relevant for specific therapeutic management. PMID:22723902

Vielsmeier, Veronika; Strutz, Jürgen; Kleinjung, Tobias; Schecklmann, Martin; Kreuzer, Peter Michael; Landgrebe, Michael; Langguth, Berthold

2012-01-01

219

Delayed gadolinium-enhanced MRI of the fibrocartilage disc of the temporomandibular joint – a feasibility study  

PubMed Central

Objective To 1) test the feasibility of delayed Gadolinium-Enhanced Magnetic Resonance Imaging of Cartilage (dGEMRIC) at 3 T in the temporomandibular joint (TMJ) and 2) to determine the optimal delay for measurements of the TMJ disc after i.v. contrast agent (CA) administration. Design MRI of the right and left TMJ of six asymptomatic volunteers was performed at 3 T using a dedicated coil. 2D inversion recovery (2D-IR) sequences were performed at 4 time points covering 120 minutes and 3D gradient-echo (3D GRE) dual flip-angle sequences were performed at 14 time points covering 130 minutes after the administration of 0.2 mmol/kg of Gd-diethylenetriamine pentaacetic acid ion (Gd-DTPA)2-, i.e., 0.4 mL of Magnevist™ per kg body weight. Pair-wise tests were used to assess differences between pre-and post-contrast T1 values. Results 2D-IR sequences showed a statistically significant drop (p < 0.001) in T1 values after i.v. CA administration. The T1 drop of 50% was reached 60 minutes after bolus injection in the TMJ disc. The 3D GRE dual flip-angle sequences confirmed these results and show plateau of T1 after 60 minutes. Conclusions T1(Gd) maps calculated from dGEMRIC data allow in vivo assessment of the fibrocartilage disc of the TMJ. The recommended measurement time for dGEMRIC in the TMJ after i.v. CA administration is from 60 to 120 minutes. PMID:25131629

Pittschieler, Elisabeth; Szomolanyi, Pavol; Schmid-Schwap, Martina; Weber, Michael; Egerbacher, Monika; Traxler, Hannes; Trattnig, Siegfried

2014-01-01

220

Validity of functional diagnostic examination for temporomandibular joint disc displacement with reduction.  

PubMed

The choice of approach for diagnosing temporomandibular joint (TMJ) anterior disc displacement with reduction (ADDR), viz. functional examination or TMJ imaging, is debatable and complicated by findings of low agreement between these approaches. Our aim was to investigate the validity of functional ADDR diagnostics using clinical examination and opto-electronic mandibular movement recordings versus magnetic resonance imaging (MRI). 53 participants (32 women and 21 men, mean age ± s.d. of 28.7 ± 10.1 years) underwent a clinical examination, mandibular movement recording and MRI of their TMJs within 1 month. All were performed and analysed in a single-blind design by different experienced examiners for each technique. The sensitivity and specificity of each functional diagnostic method was calculated, with MRI as the gold standard. Anterior disc displacement with reduction was diagnosed in 27.6% of the TMJs clinically, in 15.2% using the movement recordings and in 44.8% on MRI. The specificity of the clinical examination for diagnosing ADDR was 81.0%, and of the movement recordings, 96.6%. The sensitivity was 38.3% and 29.8%, respectively. The chance of having a false-positive functional diagnosis of ADDR compared with MRI is low, and disagreement between the functional methods and MRI is mainly due to the high number of MRI diagnoses in asymptomatic subjects. In view of the fact that ADDR becomes clinically relevant only when it interferes with TMJ function, the functional diagnostic approach can be considered benchmark in ADDR recognition. PMID:24533784

Marpaung, C M; Kalaykova, S I; Lobbezoo, F; Naeije, M

2014-04-01

221

Temporomandibular joint pantomography using charge-coupled device, photostimulable phosphor, and film receptors: a comparison.  

PubMed

Our objective was to compare the accuracy and practicality in use of three available imaging receptors for temporomandibular joint (TMJ) imaging; namely, two computer-assisted and one traditional analog x-ray film system. A standardized tissue-equivalent encased human skull specimen was imaged using lateral and posteroanterior (PA) pantomographic projections with the Orthopantomograph OP 100 (Instrumentarium Imaging, Tuusula, Finland) and three different receptor modalities: (1) Ektavision film with Ektavision screens (Eastman Kodak, Rochester, NY); (2) DenOptix photostimulable phosphor screens (Dentsply/Gendex, Chicago, IL); and (3) the charge-coupled device (CCD) receptor, DigiPan (TREX/Trophy Radiology, Marne-la-Vallée, France). The effective focal trough was found for each receptor using lead resolution grids placed at fractional millimeter distances along empirically determined beam projection angulations. The time to acquire and process images was also established. We found that the CCD system permitted real-time display, whereas the use of traditional film took 2 minutes to load the cassette in a darkroom and perform the exposure, and then a further 2 minutes to unload and process. The storage phosphor took 3 minutes to unload the cassette and process the image and a further 20 seconds to clear the plate following laser scanning. Film produced the greatest maximum resolution followed by the storage phosphor and the CCD. In conclusion, CCD-based TMJ pantomography provided an instant image. The photostimulable phosphor system used was the least satisfactory in terms of the time expended to obtain an image, but provided better spatial resolution than the CCD. Ektavision film/screens provided the best spatial resolution in this investigation. PMID:10342155

Farman, T T; Farman, A G

1999-05-01

222

Accurate 3D kinematic measurement of temporomandibular joint using X-ray fluoroscopic images  

NASA Astrophysics Data System (ADS)

Accurate measurement and analysis of 3D kinematics of temporomandibular joint (TMJ) is very important for assisting clinical diagnosis and treatment of prosthodontics and orthodontics, and oral surgery. This study presents a new 3D kinematic measurement technique of the TMJ using X-ray fluoroscopic images, which can easily obtain the TMJ kinematic data in natural motion. In vivo kinematics of the TMJ (maxilla and mandibular bone) is determined using a feature-based 2D/3D registration, which uses beads silhouette on fluoroscopic images and 3D surface bone models with beads. The 3D surface models of maxilla and mandibular bone with beads were created from CT scans data of the subject using the mouthpiece with the seven strategically placed beads. In order to validate the accuracy of pose estimation for the maxilla and mandibular bone, computer simulation test was performed using five patterns of synthetic tantalum beads silhouette images. In the clinical applications, dynamic movement during jaw opening and closing was conducted, and the relative pose of the mandibular bone with respect to the maxilla bone was determined. The results of computer simulation test showed that the root mean square errors were sufficiently smaller than 1.0 mm and 1.0 degree. In the results of clinical application, during jaw opening from 0.0 to 36.8 degree of rotation, mandibular condyle exhibited 19.8 mm of anterior sliding relative to maxillary articular fossa, and these measurement values were clinically similar to the previous reports. Consequently, present technique was thought to be suitable for the 3D TMJ kinematic analysis.

Yamazaki, Takaharu; Matsumoto, Akiko; Sugamoto, Kazuomi; Matsumoto, Ken; Kakimoto, Naoya; Yura, Yoshiaki

2014-04-01

223

The efficacy of low-level laser therapy for the treatment of myogenous temporomandibular joint disorder.  

PubMed

Low-level laser therapy (LLLT) has been commonly used for the treatment of painful musculoskeletal conditions, but the results of previous studies on this subject are controversial. The aim of this study was to evaluate the efficacy of LLLT in the management of patients with myogenic temporomandibular joint disorders (TMDs). In this randomized, double-blind clinical trial, 20 patients with myogenic TMD were randomly divided into laser and placebo groups. In the laser group, a pulsed 810-nm low-level laser (average power 50 mW, peak power 80 W, 1,500 Hz, 120 s, 6 J, and 3.4 J/cm(2) per point) was used on painful muscles three times a week for 4 weeks. In the placebo group, the treatment was the same as that in the laser group, but without energy output. The patients were evaluated before laser therapy (T1), after six sessions of laser application (T2), at the end of treatment (T3), and 1 month after the last application (T4), and the level of pain and the amount of mouth opening were measured. There was a significant increase in mouth opening and a significant reduction of pain symptoms in the laser group (p??0.05). Between-group comparisons revealed no significant difference in pain intensity and mouth opening measurement at any of the evaluation time points (p?>?0.05). LLLT can produce a significant improvement in pain level and mouth opening in patients affected with myogenic TMD. PMID:23318917

Ahrari, Farzaneh; Madani, Azam S; Ghafouri, Zahra S; Tunér, Jan

2014-03-01

224

Interposition arthroplasty in post-traumatic temporomandibular joint ankylosis: A retrospective study.  

PubMed

Temporomandibular joint ankylosis which is most frequently caused by trauma, presents with restriction in mouth opening in early stages and if children are the victim and not treated early, it presents with growth retardation of the involved mandibular side. Various methods are available for surgical correction. We have reviewed our experience with the efficacy of different interpositional materials in post-traumatic cases in our set up with special reference to temporal fascia over last three years. Twenty seven patients with history of trauma, mostly fall from height, have been studied. They were evaluated clinically and by computed tomography (CT) scan, orthopantogram and x- ray lateral oblique view. The most common age group was 10-15 years with mean 12.5 years and male to female ratio 1:2. Preoperative mouth opening (inter incisor distance) was 1-2 mm in 17 cases and 2-4 mm in 10 cases. We have used temporalis fascia in nine, costochondral graft in seven, silastic sheets in five and T-plates in six cases. Post-operatively, adequate mouth opening of 30-50 mm was observed in six months follow-up and more than 50 mm at one year follow up in 21 cases out of which nine cases have interpositional material as temporalis fascia alone. The postoperative period was uneventful in all cases and none required re-operation for recurrences. We conclude that interpositional arthroplasty, especially with pedicled temporal fascia, is the best method to prevent recurrences and establish good mouth opening and full range of jaw movements. PMID:20368853

Tripathy, Satyaswarup; Yaseen, Mohd; Singh, Nitya N; Bariar, L M

2009-07-01

225

Diagnostic accuracy of fat-saturated T2-weighted magnetic resonance imaging in the diagnosis of perforation of the articular disc of the temporomandibular joint  

Microsoft Academic Search

The accuracy of diagnosing a perforation of the articular disc of the temporomandibular joint (TMJ) is poor with conventional magnetic resonance imaging (MRI). We recently reported that a high signal-intensity area is usually found on fat-saturated T2-weighted MRI in the joint space between the articular disc and cartilage surface in joints in which the disc is displaced. A discrete image

Shinya Yura; Koji Nobata; Tsuyoshi Shima

226

Relationship between temporomandibular joint dynamics and mouthguards: feasibility of a test method.  

PubMed

A test system was developed establishing the feasibility of collecting biomechanical data as they relate to the use of mouthguards. Previous experimental studies have examined the physical and mechanical properties of mouthguard materials. This information has been used as a guide for establishing material standards and specifications for the fabrication of mouthguards, but it lacks the key biomechanical parameters required for a thorough mouthguard evaluation. The current study was designed to assess whether the impact force, condylar deflection, and strain superior to the temporomandibular joint region could be measured. A drop test was conducted on a cadaveric specimen to simulate loading at the chin point. To measure the force of impact, an accelerometer was attached to an impactor of known mass. High-speed biplanar (1000 frames per second) radiographs were used to determine condylar displacement. Radio-opaque markers were inserted into the bone at predetermined locations. Total displacement of these markers was determined in reference to anatomical landmarks. Strain gauges were attached to the mandible and skull to monitor the effects of the condyle impacting the base of the skull. Based on the data collected, forces were calculated by determining the product of the time-based acceleration and known mass. A measurable change in force between the mouthguards and the control (no mouthguard) was demonstrated. The average condylar displacement was successfully measured and indicated as an increase in total deflection for impacts conducted with mouthguards. Quantifiable strain was measured in the region above the mandibular fossa with and without the insertion of a mouthguard at all impact conditions. However, it was determined that additional gauges would provide critical data. Key biomechanical parameters for chin-point impacts were determined in the current study. The technique demonstrated that both displacement within the mandibular fossa and loading of the condyles occur during the impact event. Although the current study established a technique that can be used to examine the relationship between mouthguards and jaw-joint injuries, the role, if any, mouthguards play in the reduction of injuries cannot be established until a thorough analysis is completed. PMID:15355384

Walilko, Timothy; Bir, Cynthia; Godwin, William; King, Albert

2004-10-01

227

A critical review of interpositional grafts following temporomandibular joint discectomy with an overview of the dermis-fat graft.  

PubMed

The aim of this critical review is to determine what constitutes an ideal disc replacement material and whether any of the existing materials reported in the literature satisfy the requirements of an effective disc substitute following temporomandibular joint (TMJ) discectomy. Over the last half century a myriad of interpositional materials have been used in the TMJ but nearly all have been less than successful. The disasters that followed the early use of alloplastic interpositional implants in the 1980s prompted the increased use of autogenous grafts in the 1990s. Whilst studies by the author on the use of dermis-fat grafts have been largely positive, there are still concerns that make the dermis-fat graft a less than ideal interpositional material for use in discectomized joint cavities. In reviewing the literature, it is clear that there is still no ideal interpositional material that satisfies all the criteria for replacement of a missing articular disc following TMJ discectomy. PMID:21195585

Dimitroulis, G

2011-06-01

228

Otitis interna, media, and externa with destruction of the left tympanic bulla and subluxation and septic arthritis of the left temporomandibular joint in an alpaca (Vicugna pacos)  

PubMed Central

A 1.5-year-old, 37.7 kg, female alpaca was evaluated for a 2-week history of weight loss, left ear droop, and deviation of the rostral mandible to the right. Antemortem radiography and postmortem examination revealed otitis interna, media, and externa, destruction of the left tympanic bulla, and subluxation and septic arthritis of the left temporomandibular joint. PMID:23997267

Galvan, Noe; Middleton, John R.; Cook, Cristi; Britt, Lisa G.; Kuroki, Keiichi

2013-01-01

229

A possible etiology of the internal derangement of the temporomandibular joint based on the MRI observations of the lateral pterygoid muscle  

Microsoft Academic Search

The purpose of this study was to evaluate the relationship of the temporomandibular joint (TMJ) internal derangement and lateral pterygoid muscle (LPM) by magnetic resonance imaging (MRI). In this study, 115 subjects with TMJ internal derangement (total 230 TMJs) and 21 subjects without clinical symptoms (total 42 TMJs) were included. TMJ disc position and LPM were evaluated using MRI. LPM attachments were categorized into

N. Taskaya-Y?lmaz; G. Ceylan; L. Incesu; M. Muglali

2005-01-01

230

Clinical versus magnetic resonance imaging findings with internal derangement of the temporomandibular joint: An evaluation of anterior disc displacement without reduction  

Microsoft Academic Search

Purpose: The purpose of this study was to investigate whether the clinical finding of anterior disc displacement without reduction (ADWOR) and pain in the temporomandibular joint (TMJ) is correlated to the magnetic resonance imaging (MRI) findings of TMJ internal derangement (ID). Patients and methods: The TMJ group was composed of 55 TMJ pain patients who were assigned a clinical diagnosis

Katharina Innerhofer; Ansgar Rudisch; Stefan Bertram

2002-01-01

231

Effect of different doses of transforming growth factor-?? on cartilage and subchondral bone in osteoarthritic temporomandibular joints.  

PubMed

Transforming growth factor-beta (TGF-?) plays an important part in the repair of cartilage in osteoarthritis. It has been hypothesised that intra-articular injection of TGF-?? promotes repair of cartilage and protects the subchondral bone from damage in osteoarthritic temporomandibular joints (TMJs). We made bilateral partial perforations of the disc to induce osteoarthritic joints in 36 rabbits. TGF-?? 20, 40, or 80 ng were injected into the right joint, and vehicle alone was injected into the left joint. Four additional animals were used as normal controls. Microcomputed tomography was used to quantify the three-dimensional microarchitecture of subchondral bone, followed by assessment of the proteoglycan content. All joints treated with TGF-?? were covered by a layer of well-organised fibrocartilage, and had increased proteoglycan content and normal microarchitectural properties, whereas the joint treated by vehicle alone had typical osteoarthritis-related degradation of cartilage and sclerosis of subchondral bone. These results suggested that TGF-?? is an effective way of treating osteoarthritis of the TMJ. PMID:22763343

Ying, Binbin; Chen, Kan; Hu, Jing; Man, Cheng; Feng, Ge; Zhang, Bi; Zhu, Songsong

2013-04-01

232

Upregulation of cystathionine-?-synthetase expression contributes to inflammatory pain in rat temporomandibular joint  

PubMed Central

Background Hydrogen sulfide (H2S), an endogenous gaseotransmitter/modulator, is becoming appreciated that it may be involved in a wide variety of processes including inflammation and nociception. However, the role for H2S in nociceptive processing in trigeminal ganglion (TG) neuron remains unknown. The aim of this study was designed to investigate whether endogenous H2S synthesizing enzyme cystathionine-?-synthetase (CBS) plays a role in inflammatory pain in temporomandibular joint (TMJ). Methods TMJ inflammatory pain was induced by injection of complete Freund’s adjuvant (CFA) into TMJ of adult male rats. Von Frey filaments were used to examine pain behavioral responses in rats following injection of CFA or normal saline (NS). Whole cell patch clamp recordings were employed on acutely isolated TG neurons from rats 2 days after CFA injection. Western blot analysis was carried out to measure protein expression in TGs. Results Injection of CFA into TMJ produced a time dependent hyperalgesia as evidenced by reduced escape threshold in rats responding to VFF stimulation. The reduced escape threshold was partially reversed by injection of O-(Carboxymethyl) hydroxylamine hemihydrochloride (AOAA), an inhibitor for CBS, in a dose-dependent manner. CFA injection led to a marked upregulation of CBS expression when compared with age-matched controls. CFA injection enhanced neuronal excitability as evidenced by depolarization of resting membrane potentials, reduction in rheobase, and an increase in number of action potentials evoked by 2 and 3 times rheobase current stimulation and by a ramp current stimulation of TG neurons innervating the TMJ area. CFA injection also led to a reduction of IK but not IA current density of TG neurons. Application of AOAA in TMJ area reduced the production of H2S in TGs and reversed the enhanced neural hyperexcitability and increased the IK currents of TG neurons. Conclusion These data together with our previous report indicate that endogenous H2S generating enzyme CBS plays an important role in TMJ inflammation, which is likely mediated by inhibition of IK currents, thus identifying a specific molecular mechanism underlying pain and sensitization in TMJ inflammation. PMID:24490955

2014-01-01

233

ACTIVATION OF B-CATENIN SIGNALLING LEADS TO TEMPOROMANDIBULAR JOINT DEFECTS  

PubMed Central

Despite extensive research in knee and hip osteoarthritis (OA), the underlying mechanism of temporomandibular joint (TMJ) disorder remains largely unknown. The purpose of this study was to determine whether the constitutive activation of ?-catenin in the middle and deep layers of the articular cartilage can compromise the homeostasis of this tissue in the TMJ. Co12CreERT2 transgenic mice were bred with RosamT/mG reporter mice to determine Cre recombination efficiency. Co12CreERT2 mice were then crossed with ?-cateninflox (ex3)/+ mice to generate ?-catenin conditional activation mice, ?-catenin(ex3)Co12ER. TMJ samples were harvested when the mice were 1-, 3- or 6-month-old and evaluated using histology, histomorphometry and immunohistochemistry. ?-catenin(ex3)Co12ER mice were further crossed with Mmp13flox/flox and Adamts5?/? mice to generate ?-catenin(ex3)/Mmp13)Co12ER and ?-catenin(ex3)Co12ER)/Adamts5?/? double mutant mice to investigate the role of Mmp13 and Adamts5 in the development of TMJ disorder. High levels of Cre-recombination were seen in Co12CreERT2;RosamT/mG mice. Progressive TMJ defects developed in 1-, 3- and 6-month-old ?-catenin(ex3)Co12ER mice, as revealed by histology and histomorphometry. Results further demonstrated that the defects observed in ?-catenin(ex3)Co12ER mice were significantly decelerated after deletion of the Mmp13 or Adamts5 gene in (?-catenin(ex3)/Mmp13)co12ER or ?-catenin(ex3)Co12ER/ Adamts5?/? double mutant mice. In summary, we found that ?-catenin is a critical gene in the induction of TMJ cartilage degeneration, and over-expressing ?-catenin in TMJ cartilage leads to defects assembling an OA-like phenotype. Deletion of Mmp13 and Adamts5 in ?-catenin(ex3)Co12ER mice ameliorates the development of TMJ defects. This study suggests that Mmp13 and Adamts5 could be potential therapeutic targets for the treatment of TMJ disorders. PMID:25340802

Wang, M.; Li, S.; Xie, W.; Shen, J.; Im, H-J.; Holz, J.D.; Wang, M.; Diekwisch, T.G.H.; Chen, D.

2014-01-01

234

Mandibular condylectomy in a cow with a chronic luxation of the temporomandibular joint  

PubMed Central

A cow, presented after being struck by a motor vehicle, continued to have difficulty eating after mandibular fracture repair. Imaging showed a temporomandibular luxation and a mandibular condylectomy was performed. Mastication improved greatly but the cow was euthanized due to infection. This is the first report of mandibular condylectomy in cattle. PMID:24891643

Sparks, Holly D.; Roquet, Imma; MacKay, Angela; Barber, Spencer

2014-01-01

235

The use of low level laser therapy in the treatment of temporomandibular joint disorders. Review of the literature  

PubMed Central

Introduction: The temporomandibular disorders (TMDs) have been identified as the most important cause of pain in the facial region. The low level laser therapy (LLLT) has demonstrated to have an analgesic, anti-inflammatory and biostimulating effects. The LLLT is a noninvasive, quick and safe, non-pharmaceutical intervention that may be beneficial for patients with TMDs. However the clinical efficiency of LLLT in the treatment of this kind of disorders is controversial. Objectives: Literature review in reference to the use of LLLT in the treatment of TMDs, considering the scientific evidence level of the published studies. Material and Methods: A MEDLINE and COCHRANE database search was made for articles. The keywords used were “temporomandibular disorders” and “low level laser therapy” or “phototherapy” and by means of the Boolean operator “AND”. The search provided a bank of 35 articles, and 16 relevant articles were selected to this review. These articles were critically analyzed and classified according to their level of scientific evidence. This analysis produced 3 literature review articles and 13 are clinical trials. The SORT criteria (Strength of Recommendation Taxonomy) was used to classify the articles. Results: Only one article presented an evidence level 1, twelve presented an evidence level 2, and three presented an evidence level 3. According to the principle of evidence-based dentistry, currently there is a scientific evidence level B in favor of using LLLT for treatment of TMDs. Discussion and conclusions: Publications on the use of LLLT for treatment of TMDs are limited making difficult to compare the different studies due to the great variability of the studied variables and the selected laser parameters. The great majority of the studies concluded that the results should be taken with caution due to the methodological limitations. Key words:Low level laser therapy; phototherapy; temporomandibular joint disorders. PMID:23722130

Herranz-Aparicio, Judit; Vázquez-Delgado, Eduardo; Arnabat-Domínguez, Josep; España-Tost, Antoni

2013-01-01

236

ADAMTS-4 and ADAMTS-5 expression in human temporomandibular joint discs with internal derangement, correlates with degeneration.  

PubMed

Temporomandibular joint (TMJ) internal derangement (ID) is one of the most common form of temporomandibular disorders. There is evidence showing the increased expression of matrix metalloproteinases (MMPs) in the cells from degenerated TMJ disc. ADAMTS are a large family of metalloproteases which are responsible for proteoglycans degradation. The present study aimed to evaluate ADAMTS-4 and ADAMTS-5 immunohistochemical expression in human TMJ discs from patients affected by ID, and to find out if there is any correlation with the degree of histopathological changes. Eighteen temporomandibular displaced disc specimens and sixteen TMJ disc control were used for the present study. Specimens were immunohistochemically processed and ADAMTS-4 and ADAMTS-5 expression were obtained respectively for the anterior (AB), intermediate (IB) and posterior (PB) bands and compared to the histopathological degeneration score (HDS). Immunoreactivity for ADAMTS-4 and -5, was observed in both not degenerated and degenerated human TMJ discs. Both the percentage of ADAMTS-4 and -5 immunostained cells (ES) and the intensity of staining (IS) were significantly greater in affected specimens compared with those in control discs. The ADAMTS-5 ES and IS of the 3 bands of the disc correlated to the TMJ disc HDS (0.001 < P < 0.05), on the other hand only AB and IB, ADAMTS-4 immunostaining scores correlated to HDS. According to these findings it can be assumed in that the more histopathological changes in the disc are detected, the higher levels of ADAMTS are produced. This in turn can lead to ECM breakdown and in turn to a more advanced disc displacement. PMID:25477257

Leonardi, Rosalia; Crimi, Salvatore; Almeida, Luis Eduardo; Pannone, Giuseppe; Musumeci, Giuseppe; Castorina, Sergio; Rusu, Mugurel Constantin; Loreto, Carla

2014-12-01

237

MRI evaluation of the classification, frequency, and disc morphology of temporomandibular joint disc displacements: a multicenter retrospective study in a Turkish population  

Microsoft Academic Search

Objectives  Magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) and temporomandibular disorders (TMDs) have been discussed\\u000a in detail for various populations. As no such study has examined the Turkish population, we determined the frequency of TMDs\\u000a in the Turkish population through a multicentric investigation using MRI.\\u000a \\u000a \\u000a \\u000a Methods  This retrospective study examined 504 TMJs of 252 symptomatic patients who had undergone bilateral

Ahmet Arslan; Kaan Orhan; Candan Semra Paksoy; Ozlem Ucok; Murat Ozbek; Sema Dural; Aydan Kanli

2009-01-01

238

Determination of a pressure pain threshold cut-off value for the diagnosis of temporomandibular joint arthralgia.  

PubMed

Temporomandibular joint (TMJ) disorders are divided by the American Academy of Orofacial Pain into five categories. The most common ones are joint pain, as arthralgia and joint disorders, as disc displacements. An important clinical presentation of arthralgia is the painful tenderness to manual palpation or decreased pressure pain threshold (PPT). The authors conducted a study to determine the appropriate PPT value to discriminate asymptomatic TMJ individuals from those with moderate to severe arthralgia. Forty-nine individuals was evaluated and divided into groups: TMJ arthralgia, asymptomatic disc displacement and control group. Magnetic resonance images were obtained for all the groups, and algometry was performed on the TMJ lateral pole. Patients with arthralgia filled out a visual analogue scale (VAS). anova test with 1% of significance analysed the data. Specificity, sensitivity and ROC curve were also determined. Arthralgia group had significant lower PPT (mean of 1.07 kgf cm(-2) ) than the others. Asymptomatic disc displacement group (mean of 1.64 kgf cm(-2) ) has shown significant lower PPT than the control (mean of 2.35 kgf cm(-2) ). 89.66% of specificity and 70% of sensitivity were obtained when 1.36 kgf cm(-2) was applied to the TMJ (ROC area = 0.90). This value was considered to be the most appropriate to detected moderate to severe TMJ arthralgia. Indeed, the presence of disc displacement seems to significantly decrease PPT levels in asymptomatic subjects. The PPT value of 1.36 kgf cm(-2) can be used in the calibration procedures of the professionals involved with temporomandibular disorders and orofacial pain. PMID:24612404

Cunha, C O; Pinto-Fiamengui, L M S; Castro, A C P C; Lauris, J R P; Conti, P C R

2014-05-01

239

A discoidin domain receptor 1 knock-out mouse as a novel model for osteoarthritis of the temporomandibular joint.  

PubMed

Discoidin domain receptor 1 (DDR-1)-deficient mice exhibited a high incidence of osteoarthritis (OA) in the temporomandibular joint (TMJ) as early as 9 weeks of age. They showed typical histological signs of OA, including surface fissures, loss of proteoglycans, chondrocyte cluster formation, collagen type I upregulation, and atypical collagen fibril arrangements. Chondrocytes isolated from the TMJs of DDR-1-deficient mice maintained their osteoarthritic characteristics when placed in culture. They expressed high levels of runx-2 and collagen type I, as well as low levels of sox-9 and aggrecan. The expression of DDR-2, a key factor in OA, was increased. DDR-1-deficient chondrocytes from the TMJ were positively influenced towards chondrogenesis by a three-dimensional matrix combined with a runx-2 knockdown or stimulation with extracellular matrix components, such as nidogen-2. Therefore, the DDR-1 knock-out mouse can serve as a novel model for temporomandibular disorders, such as OA of the TMJ, and will help to develop new treatment options, particularly those involving tissue regeneration. PMID:23912900

Schminke, Boris; Muhammad, Hayat; Bode, Christa; Sadowski, Boguslawa; Gerter, Regina; Gersdorff, Nikolaus; Bürgers, Ralf; Monsonego-Ornan, Efrat; Rosen, Vicki; Miosge, Nicolai

2014-03-01

240

Alloplastic total temporomandibular joint replacement using stock prosthesis: a one-year follow-up report of two cases  

PubMed Central

Alloplastic total replacement of the temporomandibular joint (TMJ) was developed in recent decades. In some conditions, previous studies suggested the rationale behind alloplastic TMJ replacement rather than reconstruction with autogenous grafts. Currently, three prosthetic products are available and approved by the US Food and Drug Administration. Among these products, customized prostheses are manufactured, via computer aided design/computer aided manufacturing (CAD/CAM) system for customized design; stock-type prostheses are provided in various sizes and shapes. In this report, two patients (a 50-year-old female who had undergone condylectomy for the treatment of osteochondroma extending to the cranial base on the left condyle, and a 21-year-old male diagnosed with left temporomandibular ankylosis) were treated using the alloplastic total replacement of TMJ using stock prosthesis. The follow-up results of a favorable one-year, short-term therapeutic outcome were obtained for the alloplastic total TMJ replacement using a stock-type prosthesis. PMID:24516821

Lee, Sang-Hoon; Ryu, Da-Jung; Kim, Hye-Sun; Kim, Hyung-Gon

2013-01-01

241

Diagnostic validity (sensitivity and specificity) of panoramic X-rays in osteoarthrosis of the temporomandibular joint.  

PubMed

Objective: To establish the diagnostic validity of panoramic X-rays (PRx) in temporomandibular osteoarthrosis (OA) using the clinical and imaging criteria (magnetic resonance imaging, MRI) of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) as gold standards. Methods: Eighty-four patients with full clinical records (RDC/TMD), PRx, and MRI scans were selected. Two stomatologists evaluated the PRx for OA. The MRI findings were derived from the radiologist report. Intra/inter-examiner concordance was established. The diagnostic concordance between clinical signs and MRI was determined. Both were used as gold standards to calculate the validity of PRx in OA. Results: The diagnostic validity of PRx with MRI as gold standard was sensitivity?=?69·0% and specificity?=?67·9%. The diagnostic validity of PRx with clinical criteria as gold standard was sensitivity?=?61·6% and specificity ?=?57·9%. Discussion: Panoramic X-rays have scant diagnostic validity in temporomandibular osteoarthrosis when taking MRI or clinical criteria of RDC/TMD as gold standards. PMID:25079854

Poveda-Roda, Rafael; Bagan, José; Carbonell, Enrique; Margaix, Maria

2014-07-31

242

Prospective analysis of the incidence of metal allergy in patients listed for total replacement of the temporomandibular joint.  

PubMed

We prospectively analysed the incidence of metal allergies in patients listed for total replacement of the temporomandibular joint (TMJ) and the efficacy of patch testing to prevent rejection phenomena. All patients (n=101) that required a prosthetic TMJ between March 2004 and August 2012 were tested preoperatively. A total of 39% had an allergy to one or more metals and they were given all-titanium prostheses. Following the introduction of this protocol no patients have shown signs of an allergic rejection within 6 months of operation. We suggest that all patients listed for total TMJ replacement should have patch tests for metal allergies and that all-titanium prostheses are used when allergy is detected. PMID:23850381

Sidebottom, A J; Mistry, K

2014-01-01

243

Tenosynovial, Diffuse Type Giant Cell Tumor of the Temporomandibular Joint, Diagnosis and Management of a Rare Tumor  

PubMed Central

The purpose of this paper was to describe a rare unusual case of primary mandibular condylar tenosynovial giant cell tumor of diffuse type with predominantly intraosseous growth and its management by resection and functional reconstruction with a vascularized costochondral graft. Clinical presentation was swelling in the right condylar area and limited mouth opening with radiological evidence of central bone destruction and magnetic resonance imaging showed central hemosiderin deposition. Fine needle aspiration did not lead to a diagnosis and an open biopsy had to be performed. Management consisted of tumor resection and reconstruction with a free vascularized costochondral graft. Tenosynovial diffuse type giant cell tumor of the temporomandibular joint is very rare. Complete resection leads to a low recurrence rate and reconstruction with a costochondral free vascularized flap leads to an excellent functional outcome.

Bredell, Marius; Schucknecht, Bernhard; Bode-Lesniewska, Baete

2015-01-01

244

Tumor Necrosis Factor-? in Temporomandibular Joint Synovial Fluid Predicts Treatment Effects on Pain by Intra-Articular Glucocorticoid Treatment  

PubMed Central

The aim of this study was to investigate the influence of tumor necrosis factor-? (TNF-?) in temporomandibular joint (TMJ) synovial fluid and blood on the treatment effect on TMJ pain by intra-articular injection of glucocorticoid in patients with chronic inflammatory TMJ disorders. High pretreatment level of TNF-? in the synovial fluid was associated with a decrease of TNF-? and elimination of pain upon maximal mouth opening. Elimination of this TMJ pain was accordingly associated with decrease in synovial fluid level of TNF-?. There was also a significant decrease of C-reactive protein and TMJ resting pain after treatment. In conclusion, this study indicates that presence of TNF-? in the synovial fluid predicts a treatment effect of intra-articular injection of glucocorticoid on TMJ movement pain in patients with chronic TMJ inflammatory disorders. PMID:17392588

Fredriksson, Lars; Alstergren, Per; Kopp, Sigvard

2006-01-01

245

Synovial chondromatosis of the temporomandibular joint: clinical, cytologic, histologic, radiologic, therapeutic aspects, and differential diagnosis of an uncommon lesion.  

PubMed

Synovial chondromatosis (SC) of the temporomandibular joint (TMJ) is a rare disorder with an indolent clinical course that leads to nonspecific symptoms, dysfunction, and anatomic distortion of the TMJ. We describe a case of SC in an 82-year-old male that presented as an incidental 2 cm cystic tumor of the left TMJ, during diagnostic work-up for unrelated symptoms. A fine needle aspiration of the lesion yielded fragments of abnormal mature cartilage and myxoid fluid. The diagnosis of SC was suggested after correlating the clinical and pathologic findings. Open TMJ surgery was performed for definitive diagnosis and therapy. This manuscript describes the clinical, radiologic, cytologic, and pathologic features of this entity, and relates the differential diagnosis to other cartilaginous lesions and neoplasms of the TMJ. Awareness of this disorder is important to provide adequate care and avoid overtreatment. PMID:23850367

Sink, Jill; Bell, Brian; Mesa, Hector

2014-03-01

246

Versatility of full thickness skin-subcutaneous fat grafts as interpositional material in the management of temporomandibular joint ankylosis.  

PubMed

The authors present a review of seven patients (eight joints) with temporomandibular ankylosis treated between 2007 and 2008. The aim of this retrospective study was to present the experience of using full thickness skin-subcutaneous fat grafts, harvested from the patient's abdomen as interpositional material after gap arthroplasty. All patients presented with osseous ankylosis and were graded according to Topazian's classification. Postoperative follow up ranged from 12 to 24 months. Maximal inter-incisal opening (MIO) on presentation ranged from 0 to 8mm, which stabilized to 27-44mm at follow up. There was no evidence of re-ankylosis. This study found merit in the use of autogenous full thickness skin-subcutaneous fat graft as an interpositional material for up to 2 years following ankylosis release. PMID:20952163

Thangavelu, A; Santhosh Kumar, K; Vaidhyanathan, A; Balaji, M; Narendar, R

2011-01-01

247

Management of obstructive sleep apnea syndrome secondary to temporomandibular joint ankylosis by mandibular elongation using distraction osteogenesis.  

PubMed

Obstructive sleep apnea syndrome (OSAS) is associated with repetitive nocturnal upper airway obstruction leading to daytime sleepiness, cardiovascular derangements, and can be a debilitating, even life-threatening condition. The most favorable treatment for patients with OSAS is multidisciplinary care by a team that represents various dental and medical disciplines. Prescribed therapies might include weight loss, behavior modification, oral appliances, soft tissue surgery, skeletal surgery, or some combination of approaches. Osteogenesis by mandibular distraction has proved effective in children in the treatment of obstructive apnea syndrome associated with congenital malformations. In the adult, the possibility of using distraction osteogenesis in the management of OSAS remains to be defined. We report a case of an adult patient treated for OSAS secondary to temporomandibular joint ankylosis by mandibular distraction followed by interpositional arthroplasty. PMID:22557901

Guruprasad, Yadavalli; Hemavathy, O R

2012-01-01

248

Management of obstructive sleep apnea syndrome secondary to temporomandibular joint ankylosis by mandibular elongation using distraction osteogenesis  

PubMed Central

Obstructive sleep apnea syndrome (OSAS) is associated with repetitive nocturnal upper airway obstruction leading to daytime sleepiness, cardiovascular derangements, and can be a debilitating, even life-threatening condition. The most favorable treatment for patients with OSAS is multidisciplinary care by a team that represents various dental and medical disciplines. Prescribed therapies might include weight loss, behavior modification, oral appliances, soft tissue surgery, skeletal surgery, or some combination of approaches. Osteogenesis by mandibular distraction has proved effective in children in the treatment of obstructive apnea syndrome associated with congenital malformations. In the adult, the possibility of using distraction osteogenesis in the management of OSAS remains to be defined. We report a case of an adult patient treated for OSAS secondary to temporomandibular joint ankylosis by mandibular distraction followed by interpositional arthroplasty. PMID:22557901

Guruprasad, Yadavalli; Hemavathy, O. R.

2012-01-01

249

A FUNCTIONAL RELATIONSHIP BETWEEN TRIGEMINAL ASTROGLIAL ACTIVATION AND NR1 EXPRESSION IN A RAT MODEL OF TEMPOROMANDIBULAR JOINT INFLAMMATION  

PubMed Central

Objective To examine the hypothesis that glial activation would regulate the expression of the NR1 subunit of the N-methyl-D-aspartate receptor in the trigeminal subnucleus caudalis (Sp5C) after temporomandibular joint (TMJ) inflammation. Methods Inflammation of temporomandibular joint (TMJ) was produced in rats by injecting 50?l complete Freund's adjuvant (CFA) into unilateral TMJ space. Sham control rats received incomplete Freund's adjuvant (IFA) injection. Mechanical nociception in the affected and non-affected TMJ site was tested by using a digital algometer. Fractalkine, fluorocitrate, and/or MK801 were intracisternally administrated to examine the relationship between astroglial activation and NR1 upregulation. Results CFA TMJ injection resulted in persistent ipsilateral mechanical hyperalgesia 1, 3 and 5 days after CFA injection. The inflammation also induced significant upregulation of CX3CR1 and GFAP beginning on day 1, and of NR1 beginning on day 3, within the ipsilateral Sp5C. Intracisternal administration of fluorocitrate for 5 days blocked the development of mechanical hyperalgesia as well as the upregulation of GFAP and NR1 in the Sp5C. Conversely, intracisternal injection of fractalkine for 5 days exacerbated the expression of NR1 in Sp5C and mechanical hyperalgesia induced by TMJ inflammation. Moreover, once daily intracisternal fractalkine administration for five days in naïve rats induced the upregulation of NR1 and mechanical hyperalgesia. Conclusions These results suggest that astroglial activation contributes to the mechanism of TMJ pain through the regulation of NR1 expression in Sp5C. PMID:23110394

Wang, Shuxing; Song, Li; Tan, Yonghui; Ma, Yuxin; Tian, Yinghong; Jin, Xu; Lim, Grewo; Zhang, Shuzhuo; Chen, Lucy; Mao, Jianren

2012-01-01

250

The reproducibility of muscle and joint tenderness detection methods and maximum mandibular movement measurement for the temporomandibular system.  

PubMed

The purpose of this study was (1) to evaluate the reproducibility of two masticatory muscle and joint tenderness detection methods; (2) to evaluate the reproducibility of maximum mandibular movement measurements; and (3) to investigate factors influencing examiner agreement. The tenderness assessment procedures involved application of a standard pressure for 2 seconds over four anatomically defined masticatory muscle sites, one control forehead site, and two temporomandibular joint sites on each side of the face. One technique utilized a pressure algometer (PAP), while the other technique required that a trained examiner apply pressure with the index fingertip (FPP). Seventy-two subjects (36 patients and 36 controls) were evaluated in a single-blind study design. Control subjects were matched for age, gender, and race with temporomandibular disorder subjects. Each subject was examined twice with each of the described methods in a randomized, fully balanced sequence by calibrated examiners. Tenderness levels were determined by the subject via self-report of pain upon pressure using a standard set of verbal descriptors. Maximum pain-free, active, and passive opening, and maximum active right and left lateral movements were measured using a millimeter ruler. Intraclass correlation coefficients (ICC) for the tenderness assessment methods ranged from 0.220 to 0.739 for the FPP method and from 0.391 to 0.880 for the PAP method. ICCs for mandibular movement measurement were much less variable, ranging from 0.59 to 0.68 for lateral movement and from 0.78 to 0.93 for opening movement. These results indicate good to excellent agreement between calibrated examiners for mandibular movement measurement and for tenderness assessment methods at two masseter (i.e., superficial and deep) and the anterior temporalis sites. Only fair agreement was found for the middle temporalis and lateral TMJ capsule sites using these methods. PMID:9656895

Goulet, J P; Clark, G T; Flack, V F; Liu, C

1998-01-01

251

Temporomandibular Joint Bone Tissue Resorption in Patients with Early Rheumatoid Arthritis Can Be Predicted by Joint Crepitus and Plasma Glutamate Level  

PubMed Central

The aim was to investigate whether bone tissue resorption in early RA is related to crepitus of the temporomandibular joint (TMJ) and systemic levels of inflammatory mediators and markers and sex steroid hormones. Twentynine women and 18 men with recently diagnosed RA were examined for TMJ bone erosions with computerized tomography and TMJ crepitus was assessed. Blood samples were analyzed for glutamate, 5-HT, TNF, IL-1?, IL-6, VEGF, inflammatory markers, and estradiol, progesterone and testosterone. The TMJ erosion score was positively correlated to glutamate, and TMJ crepitus where crepitus, glutamate and ESR explained 40% of the variation in the bone erosion score. In the patients without crepitus, bone erosion score was positively correlated to glutamate, which was not the case in the patients with crepitus. In conclusion, the results of this study show that TMJ bone tissue resorption can be predicted by TMJ crepitus and glutamate in early RA. PMID:20671920

Hajati, Anna-Kari; Näsström, Karin; Alstergren, Per; Bratt, Johan; Kopp, Sigvard

2010-01-01

252

Sensitivity and specificity of a new MRI method evaluating temporo-mandibular joint disc–condyle relationships: an in vivo study  

Microsoft Academic Search

The aim of this study was to evaluate sensitivity and specificity of a new method to locate temporo-mandibular joint (TMJ) disc using magnetic resonance imaging (MRI) and analyze disc–condyle relationships, in asymptomatic subjects and patients with disc displacement. Twenty-nine sagittal MRI of 16 subjects, 8 asymptomatic volunteers and 8 subjects with anterior disc displacement, were carried out during controlled opening

R. Benbelaïd; B. Fleiter

2006-01-01

253

Involvement of NMDA receptor mechanisms in jaw electromyographic activity and plasma extravasation induced by inflammatory irritant application to temporomandibular joint region of rats  

Microsoft Academic Search

The aim of this study was to examine the possible role of N-methyl- d-aspartate (NMDA) receptor mechanisms in responses induced by the small-fibre excitant and inflammatory irritant mustard oil injected into the temporomandibular joint (TMJ) region of rats. The effects of the non-competitive NMDA antagonist MK-801 were tested on the mustard oil-evoked increases in electromyographic (EMG) activity of the masseter

X.-M Yu; B. J Sessle; D. A Haas; A Izzo; H Vernon; J. W Hu

1996-01-01

254

Bilateral synovial chondromatosis in the knee joint with both intra and extra-articular diseases  

PubMed Central

Synovial chondromatosis is a rare disease of unknown etiology. It usually occurs unilaterally in the large joints like the knee, but may occur in the shoulder, elbow, hip, ankle and temporomandibular joints. The disease is usually intracapsular, but can also be extracapsular on rare occasions. The diagnosis of synovial chondromatosis is given after an anamnesis, physical examination and radiographic examination. However, the diagnosis is obtained after histological examination of the synovial tissue. We report an unusual presentation of bilateral synovial chondromatosis in the knee joint, with both intra and extracapsular localization. never described in the literature. Although synovial chondromatosis is described as a benign disease, it can be very destructive and debilitating. These lesions can mimic a malignant tumor and present a diagnostic problem.

Bassir, Rida-Allah; Ismael, Farid; Elbardouni, Ahmed; Mahfoud, Mustapha; Berrada, Mohamed Saleh; Elyaacoubi, Moradh

2014-01-01

255

Two cases of posterior open bite caused by the thickness of retrodiscal tissue in the temporomandibular joint.  

PubMed

There have been few reports of mouth closing disturbances in the final phase of occlusion caused by the posterior thickness of the retrodiscal tissue. Two such cases are described here. The first was a 70-year-old female suffering from a painless mouth closing disturbance on the right side of the temporomandibular joint (TMJ). She complained of a feeling like there was an air cushion. The second case was a 51-year-old male with a painless mouth closing disturbance on the left side of the TMJ. In both cases, magnetic resonance imaging (MRI) revealed enlargement of the posterior joint space on the affected side. The conditions of these two cases were improved by local injection of steroid preparations; however further additional treatments were required, including mandible traction in one case and dental prosthetics in the other. Consequently, we consider that the local injection of steroid preparations is useful as an initial treatment, while the use of local injection of steroid preparations alone is not sufficient for the treatment of posterior thickness of the retrodiscal tissue. PMID:24907131

Hasegawa, T; Shibuya, Y; Minamikawa, T; Komori, T

2014-09-01

256

Sliding reconstruction of the condyle using posterior border of mandibular ramus in patients with temporomandibular joint ankylosis.  

PubMed

The traditional approach for ankylosis is gap arthroplasty or interpositional arthroplasty followed by reconstruction of the condyle using, for example, costochondral grafts. As these are non-pedicled grafts, there is eventual resorption with subsequent decrease in height of the ramus, facial asymmetry and deviated mouth opening. The authors have applied the method of total and partial sliding vertical osteotomy on the posterior border of the mandibular ramus for reconstruction of the mandible condyle as a pedicled graft for the correction of temporomandibular joint (TMJ) ankylosis. From 2004 to 2008, 18 patients who were diagnosed with TMJ ankylosis underwent operations for resection of the ankylosed condyle. Two methods were performed depending on the level of osteotomy on the posterior part of the mandibular ramus. All patients were followed-up for an average of 36 months (range 24-48 months). All patients showed apparent improved joint function with no cases of re-ankylosis. The results showed that sliding vertical osteotomy on the posterior border of the mandibular ramus seems to be an alternative and promising method for condylar reconstruction in patients with TMJ bony ankylosis. PMID:21620677

Liu, Y; Khadka, A; Li, J; Hu, J; Zhu, S; Hsu, Y; Wang, Q; Wang, D

2011-11-01

257

Long-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint arthritis.  

PubMed

The long-term effect of intra-articular injections of sodium hyaluronate and corticosteroid (betamethasone) was compared in a sample of 24 patients who had pain and tenderness to palpation in the temporomandibular joint (TMJ arthritis) of at least six months duration, and who had not responded to conservative treatment. The two drugs were randomly allocated to the patients. The drugs, 0.5 ml, were injected twice into the superior joint compartment of the TMJ with a two-week interval between injections. The effect on subjective symptoms, clinical signs, and bite force was assessed. At the one and two-year follow-ups both the hyaluronate-and the corticosteroid-group had significantly reduced subjective symptoms as well as clinical signs, and the maximum voluntary bite force was significantly increased. The differences in effect between treatments were not statistically significant. It was concluded that both drugs have a significant long-term effect on chronic arthritis of the TMJ and that either of the drugs can be helpful; however, sodium hyaluronate might be the best alternative due to the least risk for side effects. PMID:3478440

Kopp, S; Carlsson, G E; Haraldson, T; Wenneberg, B

1987-11-01

258

A Comparative Study between Use of Arthroscopic Lavage and Arthrocentesis of Temporomandibular Joint Based on Computational Fluid Dynamics Analysis  

PubMed Central

Arthroscopic lavage and arthrocentesis, performed with different inner-diameter lavage needles, are the current minimally invasive techniques used in temporomandibular joint disc displacement (TMJ-DD) for pain reduction and functional improvement. In the current study, we aimed to explore the biomechanical influence and explain the diverse clinical outcomes of these two approaches with computational fluid dynamics. Data was retrospectively analyzed from 78 cases that had undergone arthroscopic lavage or arthrocentesis for TMJ-DD from 2002 to 2010. Four types of finite volume models, featuring irrigation needles of different diameters, were constructed based on computed tomography images. We investigated the flow pattern and pressure distribution of lavage fluid secondary to caliber-varying needles. Our results demonstrated that the size of outflow portal was the critical factor in determining irrigated flow rate, with a larger inflow portal and a smaller outflow portal leading to higher intra-articular pressure. This was consistent with clinical data suggesting that increasing the mouth opening and maximal contra-lateral movement led to better outcomes following arthroscopic lavage. The findings of this study could be useful for choosing the lavage apparatus according to the main complaint of pain, or limited mouth opening, and examination of joint movements. PMID:24223868

Zhu, Ping; Zhou, Wenyan; Han, Yi; Zheng, Youhua; Zhang, Zhiguang

2013-01-01

259

Internal derangements of the temporomandibular joint: comparison of assessment with three-dimensional gradient-echo and spin-echo MRI  

Microsoft Academic Search

Our purpose was to assess the diagnostic accuracy of three-dimensional (3D) gradient-echo (GRE) MRI in the diagnosis of internal\\u000a derangements of the temporomandibular joint (TMJ). We studied 140 joints in 70 patients with TMJ internal derangements. We\\u000a obtained 3D-GRE and spin-echo (SE) images in the closed-mouth position; the images were reviewed for disc displacement as\\u000a well as bone and cartilage

I. Yamada; Y. Murata; H. Shibuya; S. Suzuki

1997-01-01

260

The effect of interocclusal appliances on temporomandibular joints as assessed by 3D reconstruction of MRI scans.  

PubMed

Magnetic resonance imaging (MRI) enables simultaneous visualization of hard and soft tissues. The aims of the present study were to computer generate three-dimensional (3D) images, reconstructed from MRI scans of normal temporomandibular joints (TMJ), to assess the relative positions of the disc, condyle and articular surface of the temporal bone and to study the effect of two mandibular group function interocclusal appliances (IOAs). Bilateral MRI scans of 2 mm slice thickness were generated for the TMJs of 12 asymptomatic subjects with the image acquisition coils orientated in a corrected oblique sagittal plane. MRI scans were generated for all subjects with 3 mm interincisal distance IOAs, while a subgroup (n = 4) was also scanned with a 5 mm interincisal IOA in situ. An average of 10 slices through each TMJ were generated for the closed mouth and IOA positions. Three-dimensional reconstruction was performed on a 486 IBM compatible computer using a suite of nine programs not commercially available. Three-dimensional images allowed visualization of composite images of joint relationships. Subjective assessment indicated that joint relations in 3D were more informative than multiple separate 2D MRI scans. With the 3 mm IOA in situ, the disc was positioned posteriorly and superiorly to the condyle in three of 12 cases. In four of 12 cases the condyle, and in two of 12 cases both the disc and condyle, were positioned anteriorly and inferiorly. With the 5 mm IOA changes in condyle/disc and condyle/fossa relationships were more variable. It was concluded that 3D images of TMJs enabled the assessment of the positional changes of the condyle/disc and condyle/fossa relationships as altered by IOAs. However, the role of IOAs on the internal arrangements within the TMJ remains variable and is deserving of further study. PMID:11355235

Chu, S A; Suvinen, T I; Clement, J G; Reade, P C

2001-03-01

261

Reproducibility of examiner performance for muscle and joint palpation in the temporomandibular system following training and calibration.  

PubMed

The purpose of this investigation was to assess examiner ability to consistently perform specific tasks related to muscle and joint palpation. Four trained and calibrated examiners were asked 1) to deliver index finger pressures within a high (1.5-2.1 kg) and low (0.5-1.1 kg) target pressure range and 2) to precisely locate one joint palpation and four muscle sites. After passing a calibration test, the performance of the examiners was monitored during the course of a replicability study assessing the consistency of clinical findings during repeated exams for TM disorders. (1) Index finger pressure was regularly tested over a 3-month period with a hand held pressure algometer, and the reading of each trial was recorded. Data analysis showed a high proportion of trials within the pressure range (overall 89.5%). Examiner performance across target range of pressures was statistically different for success rate and mean pressure delivered. The differences in the mean finger pressure delivered by each examiner (intraexaminer variation) was low and varied from 0.12 to 0.22 kg/cm2 for the desired range of pressures. (2) Paired examiners were asked to independently and sequentially mark palpation sites over the forehead, superficial and deep masseter, anterior temporalis, and lateral capsule of the temporomandibular joint. Replicability of site locations was assessed by measuring, with a boley gauge, the distance between sites selected by the paired examiners. Except for the superficial masseter and the anterior temporalis, the paired examiners selected palpation sites within a distance of 7 mm more than 85% of the time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8485973

Goulet, J P; Clark, G T; Flack, V F

1993-04-01

262

Experimental investigations of the use of an erbium:YAG laser on temporomandibular joint (TMJ) structures: first experimental results  

NASA Astrophysics Data System (ADS)

The following paper introduces the results of an interdisciplinary research project. With the aid of photomacroscopic examination, light and scanning electron microscope investigations, changes to temporomandibular joint structures were detected in vitro after irradiation with an Erbium:YAG laser system. The solid-state Erbium:YAG laser, operating at a wavelength of 2.94 micrometers was used in the normal- spiking mode. The free-running laser beam was focussed onto freshly excised porcine tissue samples using a 108-mm sapphire lens. In this study the output was generally pulsed at a repetition rate of 4 Hz, with a pulse duration varying from 120 microsecond(s) to 500 microsecond(s) . Between 50 mJ and 500 mJ per pulse were applied to create pinpoint lesions. The optimum average energy density and pulse duration of the Erbium:YAG laser radiation for the purpose of TMJ-surgery (as far as it concerns meniscus and articulating facets) - which means efficient etch rate and minimal adjacent injury - seems to be about 24-42 J/cm2 and 120 microsecond(s) -240 microsecond(s) , respectively.

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

1995-04-01

263

Is aggressive gap arthroplasty essential in the management of temporomandibular joint ankylosis?-a prospective clinical study of 15 cases.  

PubMed

The purpose of this three-year, prospective, follow-up study was to evaluate whether aggressive gap arthroplasty is essential in the management of ankylosis of the temporomandibular joint (TMJ). Fifteen patients were treated by the creation of a minimal gap of 5-8mm and insertion of an interpositional gap arthroplasty using the temporalis fascia. Eleven patients had unilateral coronoidectomy and 4 bilateral coronoidectomy based on Kaban's protocol. Preoperative assessment included recording of history, clinical and radiological examinations, personal variables, the aetiology of the ankylosis, the side affected, and any other relevant findings. Patients were assessed postoperatively by a surgeon unaware of the treatment given for a minimum of 3 years, which included measurement of the maximal incisal opening, presence of facial nerve paralysis, recurrence, and any other relevant findings. Of the 15 patients (17 joints), 12 had unilateral and three had bilateral involvement, with trauma being the most common cause. The patients were aged between 7 and 29 years (mean (SD) age 20 (8) years). Preoperative maximal incisal opening was 0-2mm in 8 cases and 2-9mm in 9. Postoperatively adequate mouth opening of 30-40mm was achieved in all cases, with no recurrence or relevant malocclusion during 3-year follow up. However, patients will be followed up for 10 years. Aggressive gap arthroplasty is not essential in the management of ankylosis of the TMJ. Minimal gap interpositional arthroplasty with complete removal of the mediolateral ankylotic mass is a feasible and effective method of preventing recurrence. PMID:23219020

Babu, Lokesh; Jain, Manoj Kumar; Ramesh, C; Vinayaka, N

2013-09-01

264

Prospective comparison study of one-year outcomes for all titanium total temporomandibular joint replacements in patients allergic to metal and cobalt-chromium replacement joints in patients not allergic to metal.  

PubMed

We aimed to ascertain whether there are any early differences in outcome between all titanium temporomandibular joint (TMJ) prostheses in patients allergic to metal and standard cobalt-chromium prostheses in patients not allergic to metal. All patients who had primary TMJ prostheses placed with one-year follow-up between March 2003 and February 2011 were included. We reviewed the basic characteristics of patients. The outcome variables measured included disease, pain, mouth opening, and diet. A total of 55 patients with 77 joint replacements fulfilled the inclusion criteria. Forty patients had standard cobalt-chromium alloy (Co-Cr-Mo) prostheses (20 unilateral and 20 bilateral), and 15 had all titanium prostheses (13 unilateral and 2 bilateral). Osteoarthritis was the most common disease in both groups. There was significant improvement in pain score at reviews at 6 weeks (p=0.001) and 12 months (p=0.03). Values between groups were not significant (p=0.48 at 6 weeks, and p=0.10 at 1 year). Mouth opening in each group improved significantly with continued gains between assessments at 6 weeks and 12 months (p=0.001) but there were no significant differences between groups. Diet scores were significantly improved one year postoperatively in both groups (p=0.001), but differences between groups were not significant (p=0.90). At one year, outcomes for all titanium prostheses in patients allergic to metal were similarly favourable to those in patients who had no hypersensitivity to metal and had standard prostheses. No patient developed a hypersensitivity reaction, and no all titanium prosthesis failed during the one-year follow-up period. PMID:23522619

Hussain, O T; Sah, S; Sidebottom, A J

2014-01-01

265

Total alloplastic temporomandibular joint reconstruction combined with orthodontic treatment in a patient with idiopathic condylar resorption.  

PubMed

This case report describes the successful treatment of an adult patient with skeletal Class II open-bite malocclusion secondary to idiopathic condylar resorption. Total alloplastic joint reconstruction and counterclockwise rotation of the maxillomandibular complex combined with orthodontic treatment provided a satisfying outcome with maximum functional and esthetic improvement. PMID:21889086

Chung, Chooryung J; Choi, Yoon-Jeong; Kim, In-Sil; Huh, Jong-Ki; Kim, Hyung-Gon; Kim, Kyung-Ho

2011-09-01

266

Prevalence of bone marrow signal abnormalities observed in the temporomandibular joint using magnetic resonance imaging  

Microsoft Academic Search

aPurpose The purpose of this investigation was to determine the prevalence of bone marrow signal abnormalities in patients referred for temperomandibular joint (TMJ) magnetic resonance imaging (MRI). This investigation was done because of prior studies suggesting that condylar marrow signal abnormalities indicate avascular necrosis.Subjects and Methods Retrospective review was done of 449 consecutive TMJ MR examinations in 415 patients from

James M Lieberman; Catherine L Gardner; Antonino O Motta; Robert D Schwartz

1996-01-01

267

Regulation of the Trigeminal NR1 Subunit Expression Induced by Inflammation of the Temporomandibular Joint Region in Rats  

PubMed Central

Expression of the N-methyl-D-aspartate receptor (NMDA) receptor in trigeminal nuclei has been shown to play a role in the mechanisms of trigeminal pain. Here, we examined the hypothesis that the upregulation of the NR1 subunit of the NMDA receptor (NR1) in the trigeminal subnucleus caudalis (Sp5c) following inflammation of the temporomandibular joint (TMJ) region would be regulated by interleukin-6 (IL-6) and the nuclear factor kappa B (NF-?B). Inflammation of a unilateral TMJ region was produced in rats by injecting 50 ?l of complete Freund’s adjuvant (CFA) into a TMJ and adjacent tissues, which resulted in persistent pain behavior as assessed using algometer before (baseline) and on day 1, 3 and 7 after the CFA injection. The CFA injection also induced a significant upregulation of NR1 and NF-?B on day 3 and 7, and of IL-6 on day 1, 3, and 7, within the ipsilateral Sp5c, as compared with the sham TMJ injection group. Once daily intracisternal injection of an IL-6 antiserum or NF-?B inhibitor (PDTC) for six days, beginning on day 1 immediately after the CFA injection, prevented both the upregulation of NR1 in the ipsilateral Sp5C and pain behavior. Moreover, once daily intracisternal IL-6 administration for six days in naïve rats induced the NR1 upregulation and pain behavior similar to that after TMJ inflammation. These results indicate that the upregulation of IL-6 and NF-?B after inflammation of the unilateral TMJ region is a critical regulatory mechanism for the expression of NR1 in the ipsilateral Sp5c, which contributed to the development of TMJ pain behavior in rats. PMID:19058915

Wang, Shuxing; Lim, Grewo; Mao, Ji; Sung, Backil; Mao, Jianren

2012-01-01

268

Regulation of the trigeminal NR1 subunit expression induced by inflammation of the temporomandibular joint region in rats.  

PubMed

Expression of the N-methyl-d-aspartate (NMDA) receptor in trigeminal nuclei has been shown to play a role in the mechanisms of trigeminal pain. Here, we examined the hypothesis that the upregulation of the NR1 subunit of the NMDA receptor (NR1) in the trigeminal subnucleus caudalis (Sp5c) following inflammation of the temporomandibular joint (TMJ) region would be regulated by interleukin-6 (IL-6) and the nuclear factor-kappa B (NF-kappaB). Inflammation of a unilateral TMJ region was produced in rats by injecting 50mul of complete Freund's adjuvant (CFA) into a TMJ and adjacent tissues, which resulted in persistent pain behavior as assessed using algometer before (baseline) and on days 1, 3, and 7 after the CFA injection. The CFA injection also induced a significant upregulation of NR1 and NF-kappaB on days 3 and 7, and of IL-6 on days 1, 3, and 7, within the ipsilateral Sp5c, as compared with the sham TMJ injection group. Once daily intracisternal injection of an IL-6 antiserum or NF-kappaB inhibitor (PDTC) for 6 days, beginning on day 1 immediately after the CFA injection, prevented both the upregulation of NR1 in the ipsilateral Sp5C and pain behavior. Moreover, once daily intracisternal IL-6 administration for 6 days in naïve rats induced the NR1 upregulation and pain behavior similar to that after TMJ inflammation. These results indicate that the upregulation of IL-6 and NF-kappaB after inflammation of the unilateral TMJ region is a critical regulatory mechanism for the expression of NR1 in the ipsilateral Sp5c, which contributed to the development of TMJ pain behavior in rats. PMID:19058915

Wang, Shuxing; Lim, Grewo; Mao, Ji; Sung, Backil; Mao, Jianren

2009-01-01

269

The Effect of Fibromyalgia and Widespread Pain on the Clinically Significant Temporomandibular Muscle and Joint Pain Disorders - A Prospective 18-Month Cohort Study  

PubMed Central

Although most cases of Temporomandibular Muscle and Joint Disorders (TMJD) are mild and self-limiting, about 10% of TMJD patients develop severe disorders associated with chronic pain and disability. It has been suggested that fibromyalgia and widespread pain play a significant role in the Temporomandibular Muscle and Joint Disorders (TMJD) chronicity. This paper assessed the effects of fibromyalgia and widespread pain on clinically significant TMJD pain (GCPS II-IV). Four hundred eighty-five participants recruited from the Minneapolis/St. Paul area through media advertisements and local dentists received examinations and completed the Graded Chronic Pain Scale (GCPS) at baseline and at 18th months. Baseline widespread pain (OR: 2.53, P=0.04) and depression (OR: 5.30, P=0.005) were associated with onset of clinically significant pain (GCPS II-IV) within 18 months after baseline. The risk associated with baseline fibromyalgia was moderate, but not significant (OR: 2.74, P=0.09). Persistence of clinically significant pain was related to fibromyalgia (OR: 2.48, P=0.02) and with depression (OR: 2.48, P=0.02). These results indicate that these centrally generated pain conditions play a role in the onset and persistence of clinically significant TMJD. PMID:20466595

Velly, Ana Miriam; Look, John O.; Schiffman, Eric; Lenton, Patricia A.; Kang, Wenjun; Messner, Ronald P.; Holcroft, Christina A.; Fricton, James R.

2010-01-01

270

Topical diagnostics of traumatic condylar injuries and alloplastic reconstruction of temporomandibular joint heads.  

PubMed

Condylar fractures have an important place in facial traumatic injuries. Classification of condylar fractures according to clinical-anatomic picture is common in clinical practice. According to this classification there are: 1) fractures of mandibular joint head, aka intraarticular fractures, 2) condylar neck fractures or high extra articular fractures, 3) condylar base fractures. Radiographic imaging plays important role in diagnosing condylar fractures along with knowledge of clinical symptoms. We used computer tomography imaging in our clinical practice. Three-dimensional imaging of computer tomography gives exact information about location of condylar fractures, impact of fractured fragments, displacement of condylar head from articular fossa. This method is mostly important for the cases which are hard to diagnose (fractures of mandibular joint head, aka intraarticular fractures). For this group of patients surgical treatment is necessary with the method of arthroplasty. We have observed 5 patients with bilateral, fragmented, high condylar fractures. In all cases the surgery was performed on both sides with bone cement and titanium mini-plates. Long-term effects of the treatment included observation from 6 months to 2 years. In all cases anatomic and functional results were good. Shape of the mandible is restored, opening of mouth 3-3.5 cm, absence of malocclusion. PMID:24850598

Gvenetadze, Z; Danelia, T; Nemsadze, G; Gvenetadze, G

2014-04-01

271

An Inductive, Scaffold-Based, Regenerative Medicine Approach to Reconstruction of the Temporomandibular Joint Disk  

PubMed Central

Purpose A device composed of extracellular matrix (ECM) was investigated as an inductive template in vivo for reconstruction of the TMJ disk following discectomy. Methods A scaffold material composed of porcine derived ECM was configured to mimic the shape and size of the TMJ. This device was implanted in a canine model of bilateral TMJ discectomy. Following discectomy, one side was repaired with an ECM scaffold material and the contralateral side was left empty as a control. At 6 months post-implantation the joint space was opened, the joints evaluated for signs of gross pathologic degenerative changes, and newly formed tissue was excised for histologic, biochemical, and biomechanical analysis. Results The results show that implantation of an initially acellular material supported the formation of site-appropriate, functional host tissue which resembled that of the native TMJ disk. Further, this prevented gross degenerative changes in the temporal fossa and mandibular condyle. No tissue formation and mild to severe gross pathologic changes were observed in the contralateral controls. Conclusion These results suggest that an ECM based bioscaffold may represent an off-the-shelf solution for TMJ disk replacement. PMID:22365981

Brown, Bryan N.; Chung, William L.; Almarza, Alejandro J.; Pavlick, Matthew; Reppas, Serafim; Ochs, Mark W.; Russell, Alan J.; Badylak, Stephen F.

2012-01-01

272

Trattamento con un dispositivo ortodontico per l'impegno temporomandibolare nell'artrite idiopatica giovanile. Osservazioni su 72 casi Temporomandibular joint involvement in juvenile idiopathic arthritis: treatment with an orthodontic appliance  

Microsoft Academic Search

SUMMARY Introduction and purpose: About 65% of children suffering from juvenile idiopathic arthritis (JIA) shows a more or less marked involvement of temporo-mandibular joint (TMJ) with altered mandibular growth, resorption of the condyles, occlusary instability, reduced chewing ability and facial dysmorphia. The purpose of our study is to prevent and to treat the progressive evolution of JIA on craniofacial growth

C. Bellintani; P. Ghiringhelli; V. Gerloni; M. Gattinara; G. Farronato; F. Fantini

273

Alterations in intermediate filaments expression in disc cells from the rat temporomandibular joint following exposure to continuous compressive force  

PubMed Central

The articular disc in the temporomandibular joint (TMJ) that serves in load relief and stabilizing in jaw movements is a dense collagenous tissue consisting of extracellular matrices and disc cells. The various morphological configurations of the disc cells have given us diverse names, such as fibroblasts, chondrocyte-like cells and fibrochondrocytes; however, the characteristics of these cells have remained to be elucidated in detail. The disc cells have been reported to exhibit heterogeneous immunoreaction patterns for intermediate filaments including glial fibrillary acidic protein (GFAP), nestin and vimentin in the adult rat TMJ. Because these intermediate filaments accumulate in the disc cells as tooth eruption proceeds during postnatal development, it might be surmised that the expression of these intermediate filaments in the disc cells closely relates to mechanical stress. The present study was therefore undertaken to examine the effect of a continuous compressive force on the immunoexpression of these intermediate filaments and an additional intermediate filament – muscle-specific desmin – in the disc cells of the TMJ disc using a rat experimental model. The rats wore an appliance that exerts a continuous compressive load on the TMJ. The experimental period with the appliance was 5 days as determined by previous studies, after which some experimental animals were allowed to survive another 5 days after removal of the appliance. Histological observations demonstrated that the compressive force provoked a remarkable acellular region and a decrease in the thickness of the condylar cartilage of the mandible, and a sparse collagen fiber distribution in the articular disc. The articular disc showed a significant increase in the number of desmin-positive cells as compared with the controls. In contrast, immunopositive cells for GFAP, nestin and vimentin remained unchanged in number as well as intensity. At 5 days after removal of the appliance, both the disc and cartilage exhibited immunohistological and histological features in a recovery process. These findings indicate that the mature articular cells are capable of producing desmin instead of the other intermediate filaments against mechanical stress. The desmin-positive disc cells lacked ?-smooth muscle actin (?-SMA) in this study, even though desmin usually co-exists with ?-SMA in the vascular smooth muscle cells or pericytes. Because the precursor of a pericyte has such an immunoexpression pattern during angiogenesis, there is a further possibility that the formation of new vessels commenced in response to the extraordinary compressive force. PMID:22458657

Magara, Jin; Nozawa-Inoue, Kayoko; Suzuki, Akiko; Kawano, Yoshiro; Ono, Kazuhiro; Nomura, Shuichi; Maeda, Takeyasu

2012-01-01

274

Implant-supported prostheses with temporomandibular joint reproduction after hemimandibular resection: a case report  

PubMed Central

Summary Aim of the study The change in anatomy and physiology resulting from radical mandible surgery is often exacerbated by radiation therapies that make the mucosa atrophic and susceptible to irritation and ulceration rendering the task of areating functional complete dentures for edentulous subjects very challenging to prosthodontists. The aim of this study is to describe an implant supported denture rehabilitation in an edentulous hemimandibulectomized patient with a singular prosthetic design in order to compensate for the lack of a condylar process. Materials and methods The subject of the clinical case, had a history of squamous cell carcinoma of the right tonsillar region for which it was subjected to a hemimandibulectomy and was primarily rehabilitated with an over denture mounted onto a bar furnished by a resin condylar eminence in articulation with the glenoid fossa of the upper denture. The need to provide greater stabilization for the upper prosthesis led to a maxillary implant insertion and to the realization of a new joint connection that was constituted inferiorly by a titanium condyle and superiorly by a teflon acetabulum. Discussion The prosthetic balance guaranteed by the second rehabilitation greatly affected the biomechanics of mastication leading to a reduction of eccentric interferences, a stabilization of centric occlusion, and a lowering of intensity contraction by masticatory muscles. This difference is well represented by two and three-dimensional plans obtained from the application of a T-Scan III device. Conclusions The rehabilitative solution proposed was effective in resolving the lateral deviation, in relieving masticatory and speech discomfort, as well as restoring an aesthetically acceptable appearance in a hemimandibulectomized and not reconstructed patient.

Carini, Fabrizio; Longoni, Salvatore; Pisapia, Valeria; Gatti, Gianbattista; Monai, Dario; Porcaro, Gianluca

2014-01-01

275

Abnormal function of the temporomandibular joints and related musculature. Orthodontic implications. Part II.  

PubMed

Timing of mandibular growth and orthodontic treatment are coincidental, not cause-and-effect. Comparison of cephalometric radiographic tracings made before, during, and after treatment has shown no evidence that orthodontic forces can either arrest or stimulate growth of the condyle. Conversely, the growth behavior of the condyles can have a profound effect on the time required to achieve an orthodontic correction and on the anatomic and functional relationships at the end of treatment and later. Mandibular growth at the moment of orthodontic force application can have important effects on facial growth and function. If there is no growth, the mandible may rotate downward and backward, and condyle displacement and clicking can occur. Future growth rarely leads to recovery of such alterations. With adequate growth at the moment of orthodontic force application, the freeway space is maintained and horizontal tooth movement does not alter mandibular position. The position of the maxillary incisors in the face must be based on many considerations going far beyond arbitrary conformity to some "standard" values based on averages. Functional relationships and their effects on the joints are one of those considerations, along with esthetics. Dynamic thinking requires that maxillary incisors not be over-retracted, anticipating continued growth of the condyle that can reposition the body of the mandible and lower incisors downward and forward. This can occur before, during, or many years after treatment. If a tight incisor relationship is established, or develops naturally, in the early or midteens, and the condyles later outgrow the maxilla, clicking may well develop. Anterior translation of the mandible with the new growth is impeded by the incisors, so posterior displacement of the condyles occurs instead. This is most likely to occur in straight ("good") faces. Facial morphology, or pattern, has an impact on function. In the straight facial pattern, these problems usually involve incisor interference. In convex faces, the problems more often involve vertical molar interferences. Each of these presents its own unique problems and treatment requirements. PMID:3461729

Thompson, J R

1986-07-01

276

[Chronic diseases of the ankle joint].  

PubMed

The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemophilic patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use of MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or high-resolution coils, the investigation of the ankle joint still offers a wide spectrum of innovation for the next years, which is particularly enforced by the increasing demand for specific diagnosis of chronic diseases in orthopedic medicine. PMID:10065476

Rand, T; Trattnig, S; Breitenseher, M; Kreuzer, S; Wagesreither, S; Imhof, H

1999-01-01

277

Update on the surgical management of temporomandibular joint-centered tendon sheath giant cell tumor with intradural extension: introducing a cost-effective method in using temporal bone for skull base reconstruction in preventing brain hernia.  

PubMed

Tendon sheath giant cell tumor is an idiopathic proliferative and destructive disease of the synovium. It is rare and tends to arise in large joints, for example, knee and ankle, but it can also arise in temporomandibular joints (TMJs). Because of its destructive nature, immediate treatment upon diagnosis is recommended. Radical resection proved to be an excellent choice for superior local control. However, the unfavorable anatomic location of TMJ and infratemporal fossa tumor with intradural extension make such a resection impractical. Hereby, we reported a case of resection of a TMJ tendon sheath giant cell tumor with intradural extension using a transcranial approach. This involves a complex radical resection with subsequent reconstruction. Transposition of temporal bone flap is a novel state-of-the-art technique in reconstructing the middle fossa floor defect by providing a three-dimensional rigid architecture to support the brain. Temporal bone flap is a reliable plug for rigid support in preventing brain hernia and cerebrospinal fluid leak. Despite its complexity, this cost-effective technique is relatively straightforward to learn and is applicable across all socioeconomic groups. PMID:25072977

Ong, Hui Shan; Zhang, Chen Ping; Wu, Yi Qun; Ji, Tong

2014-09-01

278

Temporomandibular Joint, Open  

MedlinePLUS

... Internships for... High School and College Students Recent College Graduates Dental and Medical Students See All Careers & Training Opportunities Job Openings Loan Repayment Programs Careers in Dental Research See All Continuing Education ...

279

Temporomandibular Joint, Closed  

MedlinePLUS

... Internships for... High School and College Students Recent College Graduates Dental and Medical Students See All Careers & Training Opportunities Job Openings Loan Repayment Programs Careers in Dental Research See All Continuing Education ...

280

Is running associated with degenerative joint disease  

SciTech Connect

Little information is available regarding the long-term effects, if any, of running on the musculoskeletal system. The authors compared the prevalence of degenerative joint disease among 17 male runners with 18 male nonrunners. Running subjects (53% marathoners) ran a mean of 44.8 km (28 miles)/wk for 12 years. Pain and swelling of hips, knees, ankles and feet and other musculoskeletal complaints among runners were comparable with those among nonrunners. Radiologic examinations (for osteophytes, cartilage thickness, and grade of degeneration) also were without notable differences among groups. They did not find an increased prevalence of osteoarthritis among the runners. Our observations suggest that long-duration, high-mileage running need to be associated with premature degenerative joint disease in the lower extremities.

Panush, R.S.; Schmidt, C.; Caldwell, J.R.; Edwards, N.L.; Longley, S.; Yonker, R.; Webster, E.; Nauman, J.; Stork, J.; Pettersson, H.

1986-03-07

281

Is running associated with degenerative joint disease  

Microsoft Academic Search

Little information is available regarding the long-term effects, if any, of running on the musculoskeletal system. The authors compared the prevalence of degenerative joint disease among 17 male runners with 18 male nonrunners. Running subjects (53% marathoners) ran a mean of 44.8 km (28 miles)\\/wk for 12 years. Pain and swelling of hips, knees, ankles and feet and other musculoskeletal

R. S. Panush; C. Schmidt; J. R. Caldwell; N. L. Edwards; S. Longley; R. Yonker; E. Webster; J. Nauman; J. Stork; H. Pettersson

1986-01-01

282

The short-term effect of intra-articular injections of sodium hyaluronate and corticosteroid on temporomandibular joint pain and dysfunction.  

PubMed

The short-term effect of intra-articular injections of sodium hyaluronate and a corticosteroid (betamethasone) was compared in a sample of 33 patients who had pain and tenderness to palpation in the temporomandibular joint of at least six months duration that had not responded to previous conservative treatment. The two drugs were randomly allocated to the patients. A volume of 0.5 ml of the drug was injected twice into the superior joint compartment of the TMJ with a two-week interval between injections. The effect on subjective symptoms, clinical signs, and bite force was assessed. Both drugs reduced the symptoms and signs significantly, and no statistically significant difference in effect could be found between drugs in this regard. The results indicate that the difference between the drugs in terms of short-term therapeutic effects is small, and that sodium hyaluronate could be used as an alternative to corticosteroid for patients who have signs of TMJ inflammation, especially for those who have symptomatic osteoarthrosis. PMID:3858479

Kopp, S; Wenneberg, B; Haraldson, T; Carlsson, G E

1985-06-01

283

Temporomandibular Disorders: Evaluation and Management.  

PubMed

Temporomandibular disorders remain a common cause of visits to primary care physicians, internists, pediatricians, and emergency departments. Advances in the clinical diagnosis, radiographic imaging, and classification of these disorders have improved long-term management. There are several types of disorders of the masticatory muscles and the temporomandibular joint as well as associated structures and each may have a complex cause, clinical course, and response to therapy. Host susceptibility plays a role at several stages of these disorders. Future research offers greater possibility in defining this heterogeneous group of disorders and providing more focused and effective treatment strategies. PMID:25443680

De Rossi, Scott S; Greenberg, Martin S; Liu, Frederick; Steinkeler, Andrew

2014-11-01

284

The effects of a 6-month tai chi qigong training program on temporomandibular, cervical, and shoulder joint mobility and sleep problems in nasopharyngeal cancer survivors.  

PubMed

Introduction. Nasopharyngeal cancer (NPC) survivors often sustain head-neck-shoulder impairments from conventional treatments, which could disturb sleep. This novel study aimed to examine the efficacy of Tai Chi (TC) Qigong in optimizing temporomandibular joint (TMJ), cervical, and shoulder joint mobility and reducing sleep problems in NPC survivors. Methods. Fifty-two NPC survivors participated in the study. The experimental group (n = 25) received 6 months of TC Qigong training (1.5 h/session; 4 sessions/wk including self-practice) while the control group (n = 27) received no training. Cervical side flexion and rotation, shoulder flexion and horizontal flexion range of motion (ROM), mouth opening capacity (interincisor distance), and sleep problems (Medical Outcomes Study Sleep Scale) were assessed at baseline, mid-intervention (3 months), immediately after TC Qigong training, and at 6-month follow-up. Results. Intention-to-treat analysis revealed improvement in cervical side flexion ROM only (P < .008) and unchanged shoulder and TMJ mobility (P > .008) after the TC Qigong training. Deterioration was observed in shoulder flexion ROM and mouth opening capacity in the no-training controls over time (P < .008). Sleep problems also decreased in the TC Qigong group (P < .008), and this effect was most profound during the follow-up period. In addition, improvement in cervical side flexion ROM was associated with a reduction in sleep problems in the experimental group after TC Qigong training (P < .05). Conclusions. The 6-month TC Qigong intervention improved neck mobility, maintained TMJ and shoulder joint mobility, and reduced sleep problems for NPC survivors. TC Qigong could be an effective nonpharmacological intervention for managing progressive trismus, chronic neck and shoulder hypomobility, and reducing sleep problems among NPC survivors. PMID:25411207

Fong, Shirley S M; Ng, Shamay S M; Lee, H W; Pang, Marco Y C; Luk, W S; Chung, Joanne W Y; Wong, Janet Y H; Masters, Rich S W

2015-01-01

285

A systematic review and meta-analysis of the clinical outcomes for various surgical modalities in the management of temporomandibular joint ankylosis.  

PubMed

A systematic review and meta-analysis was performed to assess the clinical outcomes of the following four methods for the management of temporomandibular joint (TMJ) ankylosis: gap arthroplasty (GA), interpositional gap arthroplasty (IPG) using the temporalis muscle, reconstruction of the TMJ using a costochondral graft (CCG), and alloplastic joint reconstruction (AJR) of the TMJ. A comprehensive electronic and manual search of the literature without date or language restriction was performed in December 2013 to identify randomized controlled trials, controlled clinical trials (CCTs), and retrospective studies with the aim of comparing the four surgical modalities for TMJ ankylosis. Sixteen publications were included: seven were CCTs and nine were retrospective. A significant difference was found between GA and IPG in maximal inter-incisal opening (MIO) and recurrence rate (P=0.04 and P=0.02, respectively). A significant difference was found between IPG and CCG reconstruction in MIO (P=0.01), but no significant difference with regard to the recurrence rate (P=0.71). There was a significant difference between costochondral joint (CCJ) and AJR for MIO and pain (P=0.04 and P=0.03, respectively). The results of the meta-analysis showed that IPG results in a significant improvement in MIO and lower recurrence rate when compared to GA. Also, IPG shows a greater improvement in MIO and comparable recurrence rate when compared to CCG reconstruction. GA and CCG reconstruction have a comparable recurrence rate. Lastly, CCJ provides greater MIO when compared to AJR, whereas AJR is superior to CCJ in reducing pain. PMID:25468632

Al-Moraissi, E A; El-Sharkawy, T M; Mounair, R M; El-Ghareeb, T I

2014-11-15

286

The Use of a Bioadhesive (BioGlue®) Secured Conchal Graft and Mandibular Distraction Osteogenesis to Correct Pediatric Facial Asymmetry as Result of Unilateral Temporomandibular Joint Ankylosis  

PubMed Central

The rehabilitation of children affected by early traumatic facial deformity is a challenge for both the craniofacial team and the child's family. Although the immediate goals of surgery are to restore both form and function, the psychological needs of the growing child must also be addressed. Early surgery may be required to assist integration of the child into the community and thereby avert both social isolation and stigmatization of the child. Timed correctly, such surgery has the potential to harness the patient's own growth to assist in correction of the deformity and to maintain some of the surgical gains. The use of autogenous tissue rather than nondegradable implants to facilitate craniofacial reconstruction in the growing child avoids some of the concerns associated with permanent implants. These include both their potential to adversely affect growth and to migrate. The purpose of this article is to illustrate how advances in tissue adhesion using protein polymers (BioGlue®; CryoLife, Inc., Kennesaw, GA) and bone regeneration techniques (distraction osteogenesis) have been used to correct the disfiguring and functional problems associated with unilateral temporomandibular joint ankylosis acquired in early childhood. PMID:24436736

Muhammad, Joseph Kamal; Al Hashimi, Bader Abdulla; Al Mansoor, Abu Bakr; Ali, Iqbal

2013-01-01

287

The effect of interocclusal appliances on temporomandibular joints as assessed by 3D reconstruction of MRI scans  

Microsoft Academic Search

Magnetic resonance imaging (MRI) enables simultaneous visualization of hard and soft tissues. The aims of the present study were to computer generate three-dimensional (3D) images, reconstructed from MRI scans of normal temporo- mandibular joints (TMJ), to assess the relative positions of the disc, condyle and articular surface of the temporal bone and to study the effect of two mandibular group

Sandra A. Chu; Tuija I. Suvinen; John G. Clement; Peter C. Reade

2001-01-01

288

Brain signature of chronic orofacial pain: a systematic review and meta-analysis on neuroimaging research of trigeminal neuropathic pain and temporomandibular joint disorders.  

PubMed

Brain neuroimaging has been widely used to investigate the bran signature of chronic orofacial pain, including trigeminal neuropathic pain (TNP) and pain related to temporomandibular joint disorders (TMD). We here systematically reviewed the neuroimaging literature regarding the functional and structural changes in the brain of TNP and TMD pain patients, using a computerized search of journal articles via PubMed. Ten TNP studies and 14 TMD studies were reviewed. Study quality and risk of bias were assessed based on the criteria of patient selection, the history of medication, the use of standardized pain/psychological assessments, and the model and statistics of imaging analyses. Qualitative meta-analysis was performed by examining the brain regions which showed significant changes in either brain functions (including the blood-oxygen-level dependent signal, cerebral blood flow and the magnetic resonance spectroscopy signal) or brain structure (including gray matter and white matter anatomy). We hypothesized that the neuroimaging findings would display a common pattern as well as distinct patterns of brain signature in the disorders. This major hypothesis was supported by the following findings: (1) TNP and TMD patients showed consistent functional/structural changes in the thalamus and the primary somatosensory cortex, indicating the thalamocortical pathway as the major site of plasticity. (2) The TNP patients showed more alterations at the thalamocortical pathway, and the two disorders showed distinct patterns of thalamic and insular connectivity. Additionally, functional and structural changes were frequently reported in the prefrontal cortex and the basal ganglia, suggesting the role of cognitive modulation and reward processing in chronic orofacial pain. The findings highlight the potential for brain neuroimaging as an investigating tool for understanding chronic orofacial pain. PMID:24759798

Lin, Chia-Shu

2014-01-01

289

Case report 692: Synovial chondrometaplasia of the 1st costovertebral joint.  

PubMed

Synovial chondrometaplasia, also known as synovial chondromatosis, is a rare disease affecting the synovial membrane and characterized by a nodular proliferation of metaplastic cartilage. It most commonly involves large joints such as the knee, hip, and elbow, but its presence in unusual locations such as small joints and the temporomandibular joint has been described. To our knowledge, this is the first case report of synovial chondrometaplasia involving the costovertebral joint in a patient with a previous injury to that area. PMID:1546336

Milchgrub, S; Mulhollan, T; Vuitch, M F; Wheatherall, P T

1992-01-01

290

Congenital cheek teratoma with temporo-mandibular joint ankylosis managed with ultra-thin silicone sheet interpositional arthroplasty.  

PubMed

Primary cheek teratomas are rare with < 5 reported cases. None had associated temporo mandibular joint ankylosis (TMJA). The fundamental aim in the treatment of TMJA is the successful surgical resection of ankylotic bone, prevention of recurrence, and aesthetic improvement by ensuring functional occlusion. Early treatment is necessary to promote proper growth and function of mandible and to facilitate the positive psychological development of child. Inter-positional arthroplasty with ultra-thin silicone sheet was performed. Advantages include short operative time, less foreign material in the joint space leading to negligible foreign body reactions and least chances of implant extrusion. Instead of excising a large bony segment, a thin silicone sheet was interposed and then sutured ensuring preservation of mandibular height. Aggressive post-operative physiotherapy with custom made dynamic jaw exerciser was used to prevent recurrence. PMID:24163567

Bhatnagar, Ankur; Verma, Vinay Kumar; Purohit, Vishal

2013-01-01

291

Congenital cheek teratoma with temporo-mandibular joint ankylosis managed with ultra-thin silicone sheet interpositional arthroplasty  

PubMed Central

Primary cheek teratomas are rare with < 5 reported cases. None had associated temporo mandibular joint ankylosis (TMJA). The fundamental aim in the treatment of TMJA is the successful surgical resection of ankylotic bone, prevention of recurrence, and aesthetic improvement by ensuring functional occlusion. Early treatment is necessary to promote proper growth and function of mandible and to facilitate the positive psychological development of child. Inter-positional arthroplasty with ultra-thin silicone sheet was performed. Advantages include short operative time, less foreign material in the joint space leading to negligible foreign body reactions and least chances of implant extrusion. Instead of excising a large bony segment, a thin silicone sheet was interposed and then sutured ensuring preservation of mandibular height. Aggressive post-operative physiotherapy with custom made dynamic jaw exerciser was used to prevent recurrence. PMID:24163567

Bhatnagar, Ankur; Verma, Vinay Kumar; Purohit, Vishal

2013-01-01

292

Anteriorly pedicled wide temporalis muscle flap with the minimum zygomatic osteotomy technique for post-discectomy temporomandibular joint arthroplasty.  

PubMed

An anteriorly pedicled temporalis muscle flap has been shown to be a suitable interpositional material for the treatment of ankylosis and post-discectomy arthroplasty. The passage of the wide flap beneath the zygomatic arch into the joint space can be difficult owing to its bulk, causing excessive trauma to the vascularized pedicle. We describe the use of minimum zygomatic osteotomy without fixation for the passage of an anteriorly pedicled wide temporalis muscle flap for post-discectomy arthroplasty. PMID:25059518

Saigusa, Makoto; McNaught, Michael J

2014-10-01

293

Activation of peripheral kappa/delta opioid receptors mediates 15-deoxy-(Delta12,14)-prostaglandin J2 induced-antinociception in rat temporomandibular joint.  

PubMed

This study assessed the effect of the agonist 15d-PGJ(2) administered into the rat temporomandibular joint (TMJ) on nociceptive behavioral and the anti-inflammatory potential of this prostaglandin on TMJ. It was observed that 15-deoxy-(Delta12,14)-prostaglandin J(2) (15d-PGJ(2)) significantly reduced formalin-induced nociceptive behavior in a dose dependent manner, however injection of 15d-PGJ(2) into the contralateral TMJ failed to reduce such effects. This antinociceptive effect is dependent on peroxisome proliferator-activated receptors-gamma (PPAR-gamma) since pre-treatment with GW9662 (PPAR-gamma receptor antagonist) blocked the antinociceptive effect of 15d-PGJ(2) in the TMJ. In addition, the antinociceptive effect of 15d-PGJ(2) was also blocked by naloxone suggesting the involvement of peripheral opioids in the process. Confirming this hypothesis pre-treatment with kappa, delta, but not mu receptor antagonists significantly reduced the antinociceptive effect of 15d-PGJ(2) in the TMJ. Similarly to opioid agonists, the 15d-PGJ(2) antinociceptive action depends on the nitric oxide (NO)/guanilate cyclase (cGMP)/ATP-sensitive potassium channel blocker(K(+)(ATP)) channel pathway since it was prevented by the pre-treatment with the inhibitors of nitric oxide synthase (NOS; aminoguanidine), cGMP (ODQ), or the K(+)(ATP) (glibenclamide). In addition, 15d-PGJ(2) (100 ng/TMJ) inhibits 5-HT-induced TMJ hypernociception. Besides, TMJ treated with 15d-PGJ(2) showed lower vascular permeability, assessed by Evan's Blue extravasation, and also lower neutrophil migration induced by carrageenan administration. Taken together, these results demonstrate that 15d-PGJ(2) has a potential peripheral antinociceptive and anti-inflammatory effect in the TMJ via PPAR-gamma activation. The results also suggest that 15d-PGJ(2) induced-peripheral antinociceptive response in the TMJ is mediated by kappa/delta opioid receptors by the activation of the intracellular l-arginine/NO/cGMP/K(+)(ATP) channel pathway. The pharmacological properties of the peripheral administration of 15d-PGJ(2) highlight the potential use of this PPAR-gamma agonist on TMJ inflammatory pain conditions. PMID:19647045

Pena-dos-Santos, D R; Severino, F P; Pereira, S A L; Rodrigues, D B R; Cunha, F Q; Vieira, S M; Napimoga, M H; Clemente-Napimoga, J T

2009-11-10

294

Nanocrystalline diamond thin films on titanium-6 aluminum-4 vanadium alloy temporomandibular joint prosthesis simulants by microwave plasma chemical vapor deposition  

NASA Astrophysics Data System (ADS)

A course of research has been performed to assess the suitability of nanocrystal-line diamond (NCD) films on Ti-6Al-4V alloy as wear-resistant coatings in biomedical implant use. A series of temporomandibular (TMJ) joint condyle simulants were polished and acid-passivated as per ASTM F86 standard for surface preparation of implants. A 3-mum-thick coating of NCD film was deposited by microwave plasma chemical vapor deposition (MPCVD) over the hemispherical articulation surfaces of the simulants. Plasma chemistry conditions were measured and monitored by optical emission spectroscopy (OES), using hydrogen as a relative standard. The films consist of diamond grains around 20 nm in diameter embedded in an amorphous carbon matrix, free of any detectable film stress gradient. Hardness averages 65 GPa and modulus measures 600 GPa at a depth of 250 nm into the film surface. A diffuse film/substrate boundary produces a minimal film adhesion toughness (GammaC) of 158 J/m2. The mean RMS roughness is 14.6 +/- 4.2 nm, with an average peak roughness of 82.6 +/- 65.9 nm. Examination of the surface morphology reveals a porous, dendritic surface. Wear testing resulted in two failed condylar coatings out of three tests. No macroscopic delamination was found on any sample, but micron-scale film pieces broke away, exposing the substrate. Electrochemical corrosion testing shows a seven-fold reduction in corrosion rate with the application of an NCD coating as opposed to polished, passivated Ti-6Al-4V, producing a corrosion rate comparable to wrought Co-Cr-Mo. In vivo biocompatibility testing indicates that implanted NCD films did not elicit an immune response in the rabbit model, and osteointegration was apparent for both compact and trabecular bone on both NCD film and bare Ti-6Al-4V. Overall, NCD thin film material is reasonably smooth, biocompatible, and very well adhered. Wear testing indicates that this material is unacceptable for use in demanding TMJ applications without improvements to wear resistance behavior. Identified problems include high surface roughness due to an inadequate seeding procedure and a porous film surface. It is believed that these problems can be solved by future research, in which case NCD thin films should prove to-be well-suited as wear resistant coatings in biomedical applications.

Fries, Marc Douglas

295

Quantitative 3D Ultrashort Time-to-Echo (UTE) MRI and Micro-CT (?CT) Evaluation of the Temporomandibular Joint (TMJ) Condylar Morphology  

PubMed Central

Objective Temporomandibular dysfunction involves osteoarthritis of the TMJ, including degeneration and morphologic changes of the mandibular condyle. Purpose of this study was to determine accuracy of novel 3D-UTE MRI versus micro-CT (?CT) for quantitative evaluation of mandibular condyle morphology. Material & Methods Nine TMJ condyle specimens were harvested from cadavers (2M, 3F; Age 85 ± 10 yrs., mean±SD). 3D-UTE MRI (TR=50ms, TE=0.05 ms, 104 ?m isotropic-voxel) was performed using a 3-T MR scanner and ?CT (18 ?m isotropic-voxel) was performed. MR datasets were spatially-registered with ?CT dataset. Two observers segmented bony contours of the condyles. Fibrocartilage was segmented on MR dataset. Using a custom program, bone and fibrocartilage surface coordinates, Gaussian curvature, volume of segmented regions and fibrocartilage thickness were determined for quantitative evaluation of joint morphology. Agreement between techniques (MRI vs. ?CT) and observers (MRI vs. MRI) for Gaussian curvature, mean curvature and segmented volume of the bone were determined using intraclass correlation correlation (ICC) analyses. Results Between MRI and ?CT, the average deviation of surface coordinates was 0.19±0.15 mm, slightly higher than spatial resolution of MRI. Average deviation of the Gaussian curvature and volume of segmented regions, from MRI to ?CT, was 5.7±6.5% and 6.6±6.2%, respectively. ICC coefficients (MRI vs. ?CT) for Gaussian curvature, mean curvature and segmented volumes were respectively 0.892, 0.893 and 0.972. Between observers (MRI vs. MRI), the ICC coefficients were 0.998, 0.999 and 0.997 respectively. Fibrocartilage thickness was 0.55±0.11 mm, as previously described in literature for grossly normal TMJ samples. Conclusion 3D-UTE MR quantitative evaluation of TMJ condyle morphology ex-vivo, including surface, curvature and segmented volume, shows high correlation against ?CT and between observers. In addition, UTE MRI allows quantitative evaluation of the fibrocartilaginous condylar component. PMID:24092237

Geiger, Daniel; Bae, Won C.; Statum, Sheronda; Du, Jiang; Chung, Christine B.

2014-01-01

296

Temporomandibular arthritis in familial Mediterranean fever.  

PubMed

Temporomandibular joint arthritis is a rare manifestation of familial Mediterranean fever and should be considered in patients of Mediterranean origin. Recently we treated four patients suffering from this condition, and intra-articular corticosteroid injection resulted in rapid resolution of the pain and disability in two. Computed tomography confirmed the usefulness of this therapeutic modality. PMID:1468924

Tovi, F; Gatot, A; Fliss, D

1992-01-01

297

Treatment of Nongout Joint Deposition Diseases: An Update  

PubMed Central

This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD), basic calcium phosphate (BCP) deposition disease, hemochromatosis (HH), ochronosis, oxalosis, and Wilson's disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1) treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators' effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson's disease. NSAIDs should be avoided because of the liver affection they may worsen. PMID:24895535

Richette, Pascal; Flipo, René-Marc

2014-01-01

298

The Pilot Study of Fibrin with Temporomandibular Joint Derived Synovial Stem Cells in Repairing TMJ Disc Perforation  

PubMed Central

TMJ disc related diseases are difficult to be cured due to the poor repair ability of the disc. TMJ-SDSCs were ideal cell sources for cartilage tissue engineering which have been widely used in hyaline cartilage regeneration. Fibrin gel has been demonstrated as a potential scaffold for neocartilage formation. The aim of this study was to repair the TMJ disc perforation using fibrin/chitosan hybrid scaffold combined with TMJ-SDSCs. Rat TMJ-SDSCs were cultured on hybrid scaffold or pure chitosan scaffolds. The cell seeding efficiency, distribution, proliferation, and chondrogenic differentiation capacity were investigated. To evaluate the in vivo repair ability of cell/scaffold construct, rat TMJ disc explants were punched with a defect to mimic TMJ disc perforation. Cell seeded scaffolds were inserted into the defect of TMJ disc explants and then were implanted subcutaneously in nude mice for 4 weeks. Results demonstrated that fibrin may improve cell seeding, proliferation, and chondrogenic induction in vitro. The in vivo experiments showed more cartilage ECM deposition in fibrin/chitosan scaffold, which suggested an enhanced reparative ability. This pilot study demonstrated that the regenerative ability of TMJ-SDSCs seeded in fibrin/chitosan scaffold could be applied for repairing TMJ disc perforation. PMID:24822210

Gong, Zhongcheng; Li, Jian; Meng, Qinggong; Fang, Wei; Long, Xing

2014-01-01

299

The pilot study of fibrin with temporomandibular joint derived synovial stem cells in repairing TMJ disc perforation.  

PubMed

TMJ disc related diseases are difficult to be cured due to the poor repair ability of the disc. TMJ-SDSCs were ideal cell sources for cartilage tissue engineering which have been widely used in hyaline cartilage regeneration. Fibrin gel has been demonstrated as a potential scaffold for neocartilage formation. The aim of this study was to repair the TMJ disc perforation using fibrin/chitosan hybrid scaffold combined with TMJ-SDSCs. Rat TMJ-SDSCs were cultured on hybrid scaffold or pure chitosan scaffolds. The cell seeding efficiency, distribution, proliferation, and chondrogenic differentiation capacity were investigated. To evaluate the in vivo repair ability of cell/scaffold construct, rat TMJ disc explants were punched with a defect to mimic TMJ disc perforation. Cell seeded scaffolds were inserted into the defect of TMJ disc explants and then were implanted subcutaneously in nude mice for 4 weeks. Results demonstrated that fibrin may improve cell seeding, proliferation, and chondrogenic induction in vitro. The in vivo experiments showed more cartilage ECM deposition in fibrin/chitosan scaffold, which suggested an enhanced reparative ability. This pilot study demonstrated that the regenerative ability of TMJ-SDSCs seeded in fibrin/chitosan scaffold could be applied for repairing TMJ disc perforation. PMID:24822210

Wu, Yang; Gong, Zhongcheng; Li, Jian; Meng, Qinggong; Fang, Wei; Long, Xing

2014-01-01

300

Chiropractic care of a patient with temporomandibular disorder and atlas subluxation  

Microsoft Academic Search

Objective: To describe the chiropractic care of a patient with cervical subluxation and complaints associated with temporomandibular disorder. Clinical Features: A 41-year-old woman had bilateral ear pain, tinnitus, vertigo, altered or decreased hearing acuity, and headaches. She had a history of ear infections, which had been treated with prescription antibiotics. Her complaints were attributed to a diagnosis of temporomandibular joint

Joel Alcantara; Gregory Plaugher; Darrel D. Klemp; Chris Salem

2002-01-01

301

The radiology of joint disease. Volume 2. Third edition  

SciTech Connect

This book explains the diagnostic criteria and radiologic appearance of joint disease - principally arthritis. It covers the soft tissues, alignment abnormalities, bony mineralization, and abnormalities of the cartilage space of the hand; arthritis from head to foot; and the differential diagnosis of arthritis.

Forrester, D.M.; Brown, J.C.

1987-01-01

302

The joint capsule: structure, composition, ageing and disease.  

PubMed Central

The joint capsule is vital to the function of synovial joints. It seals the joint space, provides passive stability by limiting movements, provides active stability via its proprioceptive nerve endings and may form articular surfaces for the joint. It is a dense fibrous connective tissue that is attached to the bones via specialised attachment zones and forms a sleeve around the joint. It varies in thickness according to the stresses to which it is subject, is locally thickened to form capsular ligaments, and may also incorporate tendons. The capsule is often injured, leading to laxity, constriction and/or adhesion to surrounding structures. It is also important in rheumatic disease, including rheumatoid arthritis and osteoarthritis, crystal deposition disorders, bony spur formation and ankylosing spondylitis. This article concentrates on the specialised structures of the capsule--where capsular tissues attach to bone or form part of the articulation of the joint. It focuses on 2 joints: the rat knee and the proximal interphalangeal (PIP) joint of the human finger. The attachments to bone contain fibrocartilage, derived from the cartilage of the embryonic bone rudiment and rich in type II collagen and glycosaminoglycans. The attachment changes with age, when type II collagen spreads into the capsular ligament or tendon, or pathology--type II collagen is lost from PIP capsular attachments in rheumatoid arthritis. Parts of the capsule that are compressed during movement adapt by becoming fibrocartilaginous. Such regions accumulate cartilage-like glycosaminoglycans and may contain type II collagen, especially in aged material.(ABSTRACT TRUNCATED AT 250 WORDS) Images Fig. 1 Fig. 2 Fig. 3 PMID:7928639

Ralphs, J R; Benjamin, M

1994-01-01

303

Individual variations in the vascular content of retrodiscal tissue in the temporomandibular joint: a study using histological sections of human foetuses and magnetic resonance images of adults without pathology.  

PubMed

The vascular content of retrodiscal tissue in the temporomandibular joint (TMJ) plays a critical role in joint function, and its morphology is therefore likely relatedto TMJ pain. Using histological sections of human foetuses as well as T2-weighted magnetic resonance images (MRI), we measured the vascular content of retrodiscal tissue. MRI showing no pathology in and around the TMJ were obtained from18 young patients who had been suffering from headache. In 10 small foetuses (12-14 weeks of gestation) as well as 10 larger foetuses (30-37 weeks), the vascular content showed individual variations exceeding 5 times the minimum value (0.24 vs. 0.04 mm2 per 1 mm²), but no difference between foetal stages was evident. In the MRI from young adults, the variation was less than twice the minimum value (13.6 vs. 8.7 mm² per 100 mm²). The vascular density appeared to be lower in adults than in foetuses. In both foetuses and adults, the thickness (anteroposterior length) of the tissue did not correlate with the vascular sectional area. These findings suggest that the considerable inter-individual differences evident in the vascular content of foetal retrodiscal tissue may be reduced during further development. PMID:24902093

Yamamoto, M; Cho, K H; Choi, S S; Rodríguez-Vázquez, J F; Murakami, G; Abe, S

2014-05-01

304

Is the incidence of temporomandibular disorder increased in polycystic ovary syndrome?  

PubMed

The prevalence of temporomandibular disorders is higher among women than men (ratio 3:1 -9:1). Polycystic ovary syndrome(PCOS) is the most common endocrine disorder in women, which is characterised by chronic low-grade inflammation and excess of androgenic hormones that lead to metabolic aberrations and ovarian dysfunction. Increased activities of various matrix metalloproteinases (particularly MMP-2 and 9) in the serum of these patients has been reported, and it has been hypothesised that high activities of MMP may contribute to loss of matrix and chronic inflammation of the fibrocartilage in temporomandibular disorders. Our aim was to evaluate the incidence of temopormandibular dysfunction in women with PCOS compared with an age-matched, disease-free, control group. We studied 50 patients with previously diagnosed PCOS and 50 volunteers who had normal menstrual cycles. We made a comprehensive clinical examination of the temporomandibular joint (TMJ) and muscles of mastication in both groups and recorded the Visual Analogue Scores (VAS) for pain. There were significant differences (p<0.001) in the incidence of temporomandibular disorders (n=43 (86%) in the PCOS group compared with n=12 24% in the control group), muscle tenderness(n=32 (64%) in the PCOS group compared with n=14 (28%) in the control group) and pain in the TMJ (mean (SD) VAS 2.9 (2.61) compared with 0.3 (1.56). We confirm the higher incidence and severity of disorders of the TMJ in patients with PCOS and suspect that chronic low-grade inflammation may play a part in the aetiology of the disease. PMID:25124832

Soydan, Sidika Sinem; Deniz, Kagan; Uckan, Sina; Unal, Asl? Dogruk; Tutuncu, Neslihan Basc?l

2014-11-01

305

Case-Based Learning for Orofacial Pain and Temporomandibular Disorders.  

ERIC Educational Resources Information Center

The use of interactive computer-based simulation of cases of chronic orofacial pain and temporomandibular joint disfunction patients for clinical dental education is described. Its application as a voluntary study aid in a third-year dental course is evaluated for effectiveness and for time factors in case completion. (MSE)

Clark, Glenn T.; And Others

1993-01-01

306

The radiology of joint disease. 3rd Ed  

SciTech Connect

The book is a systematic radiographic approach to the arthritides. Part one deals with hand abnormalities ''to facilitate the teaching of basic principles and to dramatize the differences between radiographic features of various arthritides,'' as stated in the forward of the first edition. Part two, ''Arthritis from Head to Foot,'' illustrates the same diseases as they affect other joints. The ABCs (alignment, bone mineralization, cartilage space, soft tissue) approach is followed throughout the book. For example, reflex sympathetic dystrophy syndrome is dealt with in six different locations, and metatarsal stress fractures are mentioned in a chapter on erosions in rheumatoid arthritis.

Forrester, D.M.; Brown, J.C.

1987-01-01

307

Regenerative Therapies for Equine Degenerative Joint Disease: A Preliminary Study  

PubMed Central

Degenerative joint disease (DJD) is a major cause of reduced athletic function and retirement in equine performers. For this reason, regenerative therapies for DJD have gained increasing interest. Platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) were isolated from a 6-year-old donor horse. MSCs were either used in their native state or after chondrogenic induction. In an initial study, 20 horses with naturally occurring DJD in the fetlock joint were divided in 4 groups and injected with the following: 1) PRP; 2) MSCs; 3) MSCs and PRP; or 4) chondrogenic induced MSCs and PRP. The horses were then evaluated by means of a clinical scoring system after 6 weeks (T1), 12 weeks (T2), 6 months (T3) and 12 months (T4) post injection. In a second study, 30 horses with the same medical background were randomly assigned to one of the two combination therapies and evaluated at T1. The protein expression profile of native MSCs was found to be negative for major histocompatibility (MHC) II and p63, low in MHC I and positive for Ki67, collagen type II (Col II) and Vimentin. Chondrogenic induction resulted in increased mRNA expression of aggrecan, Col II and cartilage oligomeric matrix protein (COMP) as well as in increased protein expression of p63 and glycosaminoglycan, but in decreased protein expression of Ki67. The combined use of PRP and MSCs significantly improved the functionality and sustainability of damaged joints from 6 weeks until 12 months after treatment, compared to PRP treatment alone. The highest short-term clinical evolution scores were obtained with chondrogenic induced MSCs and PRP. This study reports successful in vitro chondrogenic induction of equine MSCs. In vivo application of (induced) MSCs together with PRP in horses suffering from DJD in the fetlock joint resulted in a significant clinical improvement until 12 months after treatment. PMID:24465787

Broeckx, Sarah; Zimmerman, Marieke; Crocetti, Sara; Suls, Marc; Mariën, Tom; Ferguson, Stephen J.; Chiers, Koen; Duchateau, Luc; Franco-Obregón, Alfredo

2014-01-01

308

Joint Leveling for Advanced Kienbock’s Disease  

PubMed Central

PURPOSE The use of joint leveling procedures to treat Kienbock’s disease has been limited by the degree of disease advancement. This study was designed to compare clinical and radiographic outcomes of wrists with more advanced Kienbock’s disease (stage IIIB) to wrists with less advanced disease (stage II/IIIA) following radius shortening osteotomy. METHODS This retrospective study enrolled 31 adult wrists (30 patients, mean age 39 years), treated by radius shortening osteotomy between two institutions for either stage IIIB (n=14) or stage II/IIIA (n=17) disease. Evaluation was carried out at a mean of 74 months (IIIB, 77 months; II/IIIA, 72 months). Radiographic assessment determined disease progression. Clinical outcomes were determined by validated patient-based and objective measures. RESULTS Patient-based outcome ratings of wrists treated for stage IIIB were similar to those with stage II/IIIA [QuickDASH (15 vs 12:p=.63), MMWS (84 vs 87:p=.59), VAS pain (1.2 vs 1.7:p=.45), VAS function (2.6 vs 2.1:p=.59)]. The average flexion/extension arc was 102° for wrists with stage IIIB and 106° for wrists with stage II/IIIA Kienbock’s (p=.70). Grip strength was 77% of the opposite side for stage IIIB wrists versus 85% for stage II/IIIA (p=.25). Postoperative carpal height ratio and radioscaphoid angle were worse (p<.05) for wrists treated for stage IIIB (0.46:65°) than stage II/IIIA (0.53:53°) disease. Radiographic disease progression occurred in 7 wrists (6 stage II/IIIA: 1 stage IIIB). The one stage IIIB wrist that progressed underwent wrist arthrodesis. CONCLUSIONS In this limited series, clinical outcomes of radius shortening using validated, patient-based assessment instruments and objective measures failed to demonstrate predicted “clinically relevant” differences between stage II/IIIA and IIIB Kienbock’s. Provided the high percentage successful clinical outcomes in this case series of 14 stage IIIB wrists, we believe that static carpal malalignment does not preclude radius shortening osteotomy. Level of Evidence IV; retrospective case series PMID:20971577

Calfee, Ryan P.; Van Steyn, Marlo O.; Gyuricza, Cassie; Adams, Amelia; Weiland, Andrew J.; Gelberman, Richard H.

2010-01-01

309

Temporomandibular disorders. Part 2: conservative management  

PubMed Central

Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables. PMID:24976744

Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

2014-01-01

310

Temporomandibular disorders. Part 2: conservative management.  

PubMed

Appropriate management of temporomandibular disorders (TMD) requires an understanding of the underlying dysfunction associated with the temporomandibular joint (TMJ) and surrounding structures. A comprehensive examination process, as described in part 1 of this series, can reveal underlying clinical findings that assist in the delivery of comprehensive physical therapy services for patients with TMD. Part 2 of this series focuses on management strategies for TMD. Physical therapy is the preferred conservative management approach for TMD. Physical therapists are professionally well-positioned to step into the void and provide clinical services for patients with TMD. Clinicians should utilize examination findings to design rehabilitation programs that focus on addressing patient-specific impairments. Potentially appropriate plan of care components include joint and soft tissue mobilization, trigger point dry needling, friction massage, therapeutic exercise, patient education, modalities, and outside referral. Management options should address both symptom reduction and oral function. Satisfactory results can often be achieved when management focuses on patient-specific clinical variables. PMID:24976744

Shaffer, Stephen M; Brismée, Jean-Michel; Sizer, Phillip S; Courtney, Carol A

2014-02-01

311

Synovium Fragment-Derived Cells Exhibit Characteristics Similar to Those of Dissociated Multipotent Cells in Synovial Fluid of the Temporomandibular Joint  

PubMed Central

Multipotent mesenchymal stem cells (MSCs) found in the synovial fluid (SFMSCs) of the tempromandibular joint (TMJ) remain poorly understood. During TMJ arthrocentesis, we discovered that synovial fluid collected from some patients with TMJ disorders contained not only SFMSCs but also synovium fragments (SFs). In this study, we attempted to characterize both the SFMSCs and SF-derived cells (SFCs) in order to further understand the role of MSCs in the synovial fluid of the TMJ. The SFs were membranous and translucent and consisted of several cell layers, indicating that their origin was only from the intima. SFCs were obtained by digestion of the SFs and subsequently expanded in vitro. SFMSCs were enriched by centrifugation of the synovial fluid and expanded in vitro. SFCs and SFMSCs displayed a similar fibroblast-like, spindle-shaped morphology, and we observed that some SFMSCs grew out of small tissue masses in culture. Flow cytometric analysis showed that both groups of cells expressed similar surface markers, including CD90, CD44, CD105, and CD73. However, both were negative for Stro-1, CD146, CD45, CD34, CD11b, CD19, and HLA-DR. Immunofluorescent staining showed that both SFs and SFMSCs expressed vascular cell adhesion molecule 1. Both SFCs and SFMSCs could be induced to differentiate down osteogenic, chondrogenic, adipogenic, and neurogenic lineages in vitro. Together, our results indicate that the intima is the most likely tissue origin of SFMSCs in the TMJ. Moreover, the SFs are composed of only intima and thus offer an improved source of synovium-derived MSCs compared to synovium specimens obtained by surgery, which contain both intima and subintima. PMID:25003199

Sun, Yang-peng; Zheng, You-hua; Liu, Wen-jing; Zheng, Yu-liang; Zhang, Zhi-guang

2014-01-01

312

Host and parasite diversity jointly control disease risk in complex communities  

E-print Network

Host and parasite diversity jointly control disease risk in complex communities Pieter T. J, Berkeley, CA, and approved September 10, 2013 (received for review June 3, 2013) Host­parasite interactions parasites. To date, however, surprisingly few studies have explored the joint effects of host and parasite

Johnson, Pieter

313

Easing Arthritis: Research offers new hope for people with common joint disease.  

MedlinePLUS

... Current Issue Past Issues Easing Arthritis: Research offers new hope for people with common joint disease Past ... knees, pain plagued her every step. Living in New York City, Saisselin relied on walking and public ...

314

Nutraceutical Therapies for Degenerative Joint Diseases: A Critical Review  

Microsoft Academic Search

There is growing recognition of the importance of nutritional factors in the maintenance of bone and joint health, and that nutritional imbalance combined with endocrine abnormalities may be involved in the pathogenesis of osteoarthritis (OA) and osteochondritis dissecans (OCD). Despite this, dietary programs have played a secondary role in the management of these connective tissue disorders. Articular cartilage is critically

Robert Goggs; Anne Vaughan-Thomas; Peter D. Clegg; Stuart D. Carter; John F. Innes; Ali Mobasheri; Mehdi Shakibaei; Wolfgang Schwab; Carolyn A. Bondy

2005-01-01

315

MRI evidence of high signal intensity and temporomandibular arthralgia and relating pain. Does the high signal correlate to the pain?  

Microsoft Academic Search

In order to investigate the relationship between various temporomandibular joint (TMJ) pain levels and the detection of high signal intensity (joint effusion) on T2 weighted magnetic resonance imaging (MRI), 19 consecutive patients who complained of unilateral painful TMJ hypomobility (closed locking) were involved in this study. All patients were clinically examined in a routine manner, and all patients rated their

Y. Tsuda; J. Konishi; K BESSHO; T IIZUKA

1996-01-01

316

Joint Genome-Wide Profiling of miRNA and mRNA Expression in Alzheimer's Disease Cortex Reveals Altered  

E-print Network

Joint Genome-Wide Profiling of miRNA and mRNA Expression in Alzheimer's Disease Cortex Reveals in Alzheimer's disease (AD). In this study, we used microarrays for the first joint profiling and analysis@usc.edu (CEF); xjzhou@usc.edu (XJZ) Introduction Neurodegeneration and dementia in Alzheimer's disease (AD

Zhou, Xianghong Jasmine

317

Ulnar variance and the role of joint levelling procedure for Kienböck's disease  

Microsoft Academic Search

Forty patients with Kienböck's disease were reviewed to determine the relationship between ulnar variance and the development of Kienböck's disease in a Japanese cohort. The joint levelling procedures designed to correct ulnar variance were evaluated in 11 patients after a mean of 9.7 years following surgery. The mean ulnar variance was 0.50±1.67 in patients with Kienböck's disease and 0.56±1.76 in

Keiichi Muramatsu; Koichiro Ihara; Shinya Kawai; Kazuteru Doi

2003-01-01

318

Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats  

PubMed Central

Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD) and examination findings were assessed to determine sensitivity, specificity and likelihood estimations. Results Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%), and thickening, 0-59% (specificity, 74-99%). Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5); the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral). Conclusions Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD. PMID:22281125

2012-01-01

319

Efficacy of glucosamine, chondroitin, and methylsulfonylmethane for spinal degenerative joint disease and degenerative disc disease: a systematic review  

PubMed Central

Background: Nutritional supplements are commonly used for a variety of musculoskeletal conditions, including knee and hip degenerative joint disease. Although these supplements are occasionally recommended for patients with degenerative disc disease and spinal degenerative joint disease, the evidence supporting this use is unknown. Objective: To systematically search and assess the quality of the literature on the use of glucosamine, chondroitin sulfate, and methylsulfonylmethane for the treatment of spinal osteoarthritis / degenerative joint disease, and degenerative disc disease. Data Sources: The Index of Chiropractic Literature, AMED, Medline, and CINAHL were searched for randomized controlled trials in English from 1984 to July 2009. Data Extraction and Synthesis: Data from studies meeting the inclusion criteria was extracted and reviewed by three reviewers. The Jadad scale was used to assess study quality. No attempts were made at meta-analysis due to variation in study design. Results: Two articles met the inclusion criteria. One study was found to have good quality but reported negative results for the supplemented group compared with placebo, the other study had low quality but reported significant positive results for the supplemented group when compared with a no intervention control group. Conclusion: There was little literature found to support the use of common nutritional supplements for spinal degeneration, making it difficult to determine whether clinicians should recommend them. PMID:21403782

Stuber, Kent; Sajko, Sandy; Kristmanson, Kevyn

2011-01-01

320

The tissue architecture of synovial membranes in inflammatory and non-inflammatory joint diseases  

Microsoft Academic Search

Utilizing monoclonal reagents directed towards antigens of the monocyte-macrophage lineage and Ia antigens, the tissue architecture of synovial membranes obtained from patients with non-inflammatory joint diseases and patients with rheumatoid arthritis was studied. Emphasis was placed on the localization of the type I, type II and type III synoviocytes that previously had been defined by their cell surface phenotype with

G. R. Burmester; P. Locher; B. Koch; R. J. Winchester; A. Dimitriu-Bona; J. R. Kalden; W. Mohr

1983-01-01

321

Effect of low-level laser therapy on pain levels in patients with temporomandibular disorders: a systematic review  

PubMed Central

Temporomandibular disorders (TMD) are characterized by the presence of temporomandibular joint (TMJ) and/or masticatory muscle pain and dysfunction. Low-level laser is presented as an adjuvant therapeutic modality for the treatment of TMD, especially when the presence of inflammatory pain is suspected. Objective To systematically review studies that investigated the effect of low level laser therapy (LLLT) on the pain levels in individuals with TMD. Material and Methods The databases Scopus, embase, ebsco and PubMed were reviewed from January/2003 to October/2010 with the following keywords: laser therapy, low-level laser therapy, temporomandibular joint disorders, temporomandibular joint dysfunction syndrome, temporomandibular joint, temporomandibular, facial pain and arthralgia, with the inclusion criteria for intervention studies in humans. exclusion criteria adopted were intervention studies in animals, studies that were not written in english, Spanish or Portuguese, theses, monographs, and abstracts presented in scientific events. Results After a careful review, 14 studies fit the criteria for inclusion, of which, 12 used a placebo group. As for the protocol for laser application, the energy density used ranged from 0.9 to 105 J/cm2, while the power density ranged from 9.8 to 500 mW. The number of sessions varied from 1 to 20 and the frequency of applications ranged from daily for 10 days to 1 time per week for 4 weeks. A reduction in pain levels was reported in 13 studies, with 9 of these occurring only in the experimental group, and 4 studies reporting pain relief for both the experimental group and for the placebo. Conclusion Most papers showed that LLLT seemed to be effective in reducing pain from TMD. However, the heterogeneity of the standardization regarding the parameters of laser calls for caution in interpretation of these results. Thus, it is necessary to conduct further research in order to obtain a consensus regarding the best application protocol for pain relief in patients with TMD. PMID:23329239

MAIA, Mila Leite de Moraes; BONJARDIM, Leonardo Rigoldi; QUINTANS, Jullyana de Souza Siqueira; RIBEIRO, Maria Amália Gonzaga; MAIA, Luiz Guilherme Martins; CONTI, Paulo César Rodrigues

2012-01-01

322

Joint association discovery and diagnosis of Alzheimer's disease by supervised heterogeneous multiview learning.  

PubMed

A key step for Alzheimer's disease (AD) study is to identify associations between genetic variations and intermediate phenotypes (e.g., brain structures). At the same time, it is crucial to develop a noninvasive means for AD diagnosis. Although these two tasks-association discovery and disease diagnosis-have been treated separately by a variety of approaches, they are tightly coupled due to their common biological basis. We hypothesize that the two tasks can potentially benefit each other by a joint analysis, because (i) the association study discovers correlated biomarkers from different data sources, which may help improve diagnosis accuracy, and (ii) the disease status may help identify disease-sensitive associations between genetic variations and MRI features. Based on this hypothesis, we present a new sparse Bayesian approach for joint association study and disease diagnosis. In this approach, common latent features are extracted from different data sources based on sparse projection matrices and used to predict multiple disease severity levels based on Gaussian process ordinal regression; in return, the disease status is used to guide the discovery of relationships between the data sources. The sparse projection matrices not only reveal the associations but also select groups of biomarkers related to AD. To learn the model from data, we develop an efficient variational expectation maximization algorithm. Simulation results demonstrate that our approach achieves higher accuracy in both predicting ordinal labels and discovering associations between data sources than alternative methods. We apply our approach to an imaging genetics dataset of AD. Our joint analysis approach not only identifies meaningful and interesting associations between genetic variations, brain structures, and AD status, but also achieves significantly higher accuracy for predicting ordinal AD stages than the competing methods. PMID:24297556

Zhe, Shandian; Xu, Zenglin; Qi, Yuan; Yu, Peng

2014-01-01

323

Defining a role for fibroblasts in the persistence of chronic inflammatory joint disease  

PubMed Central

The most surprising feature of the inflammatory response in rheumatoid arthritis is not that it occurs but that it does not resolve. The persistence of the chronic inflammatory response in conjunction with ongoing joint destruction is an all too familiar finding in many patients with rheumatoid arthritis. Despite the use of effective anti-inflammatory agents and disease modifying drugs, a significant proportion of patients with rheumatoid arthritis continue to have resistant disease. Complete clinical remission is unusual for more than six months and a formal cure of the disease remains elusive. In this report we focus on how attempts to address the question of why rheumatoid arthritis persists have led to a different interpretation of the pathogenesis of rheumatoid disease; one in which alterations in stromal cells such as fibroblasts play an important role in the switch from resolving to persistent disease. PMID:15479882

Buckley, C; Filer, A; Haworth, O; Parsonage, G; Salmon, M

2004-01-01

324

Host and parasite diversity jointly control disease risk in complex communities  

PubMed Central

Host–parasite interactions are embedded within complex communities composed of multiple host species and a cryptic assemblage of other parasites. To date, however, surprisingly few studies have explored the joint effects of host and parasite richness on disease risk, despite growing interest in the diversity–disease relationship. Here, we combined field surveys and mechanistic experiments to test how transmission of the virulent trematode Ribeiroia ondatrae was affected by the diversity of both amphibian hosts and coinfecting parasites. Within natural wetlands, host and parasite species richness correlated positively, consistent with theoretical predictions. Among sites that supported Ribeiroia, however, host and parasite richness interacted to negatively affect Ribeiroia transmission between its snail and amphibian hosts, particularly in species-poor assemblages. In laboratory and outdoor experiments designed to decouple the relative contributions of host and parasite diversity, increases in host richness decreased Ribeiroia infection by 11–65%. Host richness also tended to decrease total infections by other parasite species (four of six instances), such that more diverse host assemblages exhibited ?40% fewer infections overall. Importantly, parasite richness further reduced both per capita and total Ribeiroia infection by 15–20%, possibly owing to intrahost competition among coinfecting species. These findings provide evidence that parasitic and free-living diversity jointly regulate disease risk, help to resolve apparent contradictions in the diversity–disease relationship, and emphasize the challenges of integrating research on coinfection and host heterogeneity to develop a community ecology-based approach to infectious diseases. PMID:24082092

Johnson, Pieter T. J.; Preston, Daniel L.; Hoverman, Jason T.; LaFonte, Bryan E.

2013-01-01

325

Joint disease, the hallmark of haemophilia: what issues and challenges remain despite the development of effective therapies?  

PubMed

Although effective therapies for haemophilia have been available for decades, the prevention and treatment of joint disease remain major clinical concerns for all haemophilia patients. Early identification of joint disease is vital to initiate or modify treatment, and prevent arthropathy. However, there remains a need for more sensitive and accurate methods, which may also detect improvement in patient outcome with new therapies or different prophylaxis regimens. These topics were explored at the Ninth Zürich Haemophilia Forum. A summary of our shared views on the limitations of current assessment methods, and the potential advantages of more recently developed tools, is provided. Ultrasonography enables more frequent routine monitoring and the early detection of joint disease. In addition, serological markers may provide suitable biomarkers of early arthropathy. To prevent arthropathy, in our opinion, prophylaxis is key to prevent joint bleeds and subsequent initiation of the 'vicious circle of joint disease'. However, issues remain, including when prophylaxis should be started, stopped, and if it is efficacious for inhibitor patients. Once joint bleeding has occurred, enhanced on-demand treatment should be considered. For more advanced stages of joint disease, the issues regarding the treatment options available are explored. Radiosynovectomy should be performed to treat chronic synovitis, and may prevent the need for elective orthopaedic surgery (EOS). Ultimately, however, EOS can be considered once all other treatment options have been explored. While, bypassing agents have facilitated the use of EOS in inhibitor patients, a multidisciplinary approach and careful surveillance is required for good patient outcome. PMID:24613700

Lambert, Thierry; Auerswald, Günter; Benson, Gary; Hedner, Ulla; Jiménez-Yuste, Victor; Ljung, Rolf; Morfini, Massimo; Remor, Eduardo; Santagostino, Elena; Zupan?i? Šalek, Silva

2014-06-01

326

Patients with peripheral arterial disease exhibit reduced joint powers compared to velocity-matched controls  

PubMed Central

Previous studies have shown major deficits in gait for individuals with peripheral arterial disease before and after the onset of pain. However, these studies did not have subjects ambulate at similar velocities and potential exists that the differences in joint powers may have been due to differences in walking velocity. The purpose of this study was to examine the joint moments and powers of peripheral arterial disease limbs for subjects walking at similar self-selected walking velocities as healthy controls prior to onset of any symptoms. Results revealed peripheral arterial disease patients have reduced peak hip power absorption in midstance (p=0.017), reduced peak knee power absorption in early and late stance (p=0.037 and p=0.020 respectively), and reduced peak ankle power generation in late stance (p=0.021). This study reveals that the gait of patients with peripheral arterial disease walking prior to the onset of any leg symptoms is characterized by failure of specific and identifiable muscle groups needed to perform normal walking and that these gait deficits are independent of reduced gait velocity. PMID:22677467

Wurdeman, Shane R.; Koutakis, Panagiotis; Myers, Sara A.; Johanning, Jason M.; Pipinos, Iraklis I.; Stergiou, Nicholas

2012-01-01

327

Joint Effects of Smoking and Silicosis on Diseases to the Lungs  

PubMed Central

Smokers are subject to being more susceptible to the long-term effects of silica dust, whilst it remains unclear whether the joint effect of smoking and silicosis differs amongst diseases to the lungs; this study aims to address this knowledge gap. This was a historical cohort study comprised of 3202 silicotics in Hong Kong during 1981–2005 who were followed up till 31/12/2006. We estimated the standardized mortality ratio (SMR) in the smoking and never smoking silicotics using the mortality rates of male general population indiscriminately by smoking status, but these SMRs were regarded as biased. We adjusted these biased SMRs using “smoking adjustment factors (SAF)”. We assessed the multiplicative interaction between smoking and silicosis using ‘relative silicosis effect (RSE)’ that was the ratio of SAF-corrected SMR of smoking silicotics to the never smokers. A RSE differs significantly from one implies the presence of multiplicative interaction. A significant excess SMR was observed for respiratory diseases (lung cancer, chronic obstructive pulmonary diseases [COPD], silicosis) and other diseases to the lungs (pulmonary heart disease, tuberculosis). All the ‘biased-SMRs’ in smokers were higher than those in never smokers, but the SAF-corrected SMRs became higher in never smokers. The RSE was 0.95 (95%CI: 0.37–3.55), 0.94 (95%CI: 0.42–2.60), and 0.81 (95%CI: 0.60–1.19) for lung cancer, COPD, and silicosis; whilst it was 1.21 (95%CI: 0.32–10.26) for tuberculosis and 1.02 (95%CI: 0.16–42.90) for pulmonary heart disease. This study firstly demonstrated the joint effect of smoking and silicosis may differ amongst diseases to the lungs, but power is limited. PMID:25105409

Tse, Lap Ah; Yu, Ignatius T. S.; Qiu, Hong; Leung, Chi Chiu

2014-01-01

328

Horner's syndrome associated with a mandibular symphyseal fracture and bilateral temporomandibular luxation.  

PubMed

Interruption of the postganglionic neuron in the sympathetic pathway to the eye is reported to be a common cause of Horner's syndrome in the cat, although there are few clinical reports identifying the site and nature of the lesion responsible. A case of Horner's syndrome resulting from trauma to the periorbital structures following reduction of temporomandibular joint luxation is presented. In this case, the ophthalmic abnormalities resolved spontaneously over eight days. PMID:11791777

Baines, S J; Langley-Hobbs, S

2001-12-01

329

Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings  

Microsoft Academic Search

This study was performed to investigate the relationships between disk displacement, joint effusion, and degenerative changes in patients with temporomandibular disorders using MRI. Randomly selected MRIs of 508 temporomandibular joints of 254 patients (92 males and 162 females, mean age was 30.5±12.0 years) were reviewed retrospectively. Seventy-eight percent (198 out of 254) of the patients complained of joint pain. Compared

Hee-Seok Roh; Wook Kim; Young-Ku Kim; Jeong-Yun Lee

330

Joint sparing correction of cavovarus feet in Charcot-Marie-Tooth disease: what are the limits?  

PubMed

Charcot-Marie-Tooth disease is an inherited neuropathy that results in lower limb muscle imbalance and a resultant cavovarus deformity of the foot. With recognized poor outcomes of triple arthrodeses in the young patient, joint sparing surgery is preferred, which takes the form of osteotomies, soft-tissue releases, and tendon transfers to achieve a plantigrade and balanced foot. Due to the variability in muscle involvement and the presence of both mobile and fixed deformities, surgery must be individualized to each patient. PMID:24215832

Barton, Tristan; Winson, Ian

2013-12-01

331

Treatment of temporomandibular myofascial pain with deep dry needling  

PubMed Central

Objectives: The present study was designed to evaluate the usefulness of deep dry needling in the treatment of temporomandibular myofascial pain. Study Design: We selected 36 patients with myofascial pain located in the external pterygoid muscle (30 women/6 men, mean age=27 years with SD±6,5). We studied differences in pain with a visual analog scale and range of mandibular movements before and after intervention. Results: We found a statistically significant relationship (p<0,01) between therapeutic intervention and the improvement of pain and jaw movements, which continued up to 6 months after treatment. Pain reduction was greater the higher was the intensity of pain at baseline. Conclusions: Although further studies are needed, our findings suggest that deep dry needling in the trigger point in the external pterygoid muscle can be effective in the management of patients with myofascial pain located in that muscle. Key words:Temporomandibular joint, myofascial pain, external pterygoid muscle, trigger point, deep dry needling. PMID:22549679

Gonzalez-Perez, Luis M.; Granados-Nuñez, Mercedes; Urresti-Lopez, Francisco J.

2012-01-01

332

Bone marrow derived stem cells in joint and bone diseases: a concise review.  

PubMed

Stem cells have huge applications in the field of tissue engineering and regenerative medicine. Their use is currently not restricted to the life-threatening diseases but also extended to disorders involving the structural tissues, which may not jeopardize the patients' life, but certainly influence their quality of life. In fact, a particularly popular line of research is represented by the regeneration of bone and cartilage tissues to treat various orthopaedic disorders. Most of these pioneering research lines that aim to create new treatments for diseases that currently have limited therapies are still in the bench of the researchers. However, in recent years, several clinical trials have been started with satisfactory and encouraging results. This article aims to review the concept of stem cells and their characterization in terms of site of residence, differentiation potential and therapeutic prospective. In fact, while only the bone marrow was initially considered as a "reservoir" of this cell population, later, adipose tissue and muscle tissue have provided a considerable amount of cells available for multiple differentiation. In reality, recently, the so-called "stem cell niche" was identified as the perivascular space, recognizing these cells as almost ubiquitous. In the field of bone and joint diseases, their potential to differentiate into multiple cell lines makes their application ideally immediate through three main modalities: (1) cells selected by withdrawal from bone marrow, subsequent culture in the laboratory, and ultimately transplant at the site of injury; (2) bone marrow aspirate, concentrated and directly implanted into the injury site; (3) systemic mobilization of stem cells and other bone marrow precursors by the use of growth factors. The use of this cell population in joint and bone disease will be addressed and discussed, analysing both the clinical outcomes but also the basic research background, which has justified their use for the treatment of bone, cartilage and meniscus tissues. PMID:25005462

Marmotti, Antonio; de Girolamo, Laura; Bonasia, Davide Edoardo; Bruzzone, Matteo; Mattia, Silvia; Rossi, Roberto; Montaruli, Angela; Dettoni, Federico; Castoldi, Filippo; Peretti, Giuseppe

2014-09-01

333

Independent and joint effects of the MAPT and SNCA genes in Parkinson's disease  

PubMed Central

Objective We studied the independent and joint effects of the genes encoding alpha-synuclein (SNCA) and microtubule associated protein tau (MAPT) in Parkinson's disease (PD) as part of a large meta-analysis of individual data from case-control studies participating in the Genetic Epidemiology of Parkinson's Disease (GEO-PD) consortium. Methods Participants of Caucasian ancestry were genotyped for a total of four SNCA (rs2583988, rs181489, rs356219, rs11931074) and two MAPT (rs1052553, rs242557) SNPs. Individual and joint effects of SNCA and MAPT SNPs were investigated using fixed- and random-effects logistic regression models. Interactions were studied both on a multiplicative and an additive scale, and using a case-control and case-only approach. Results Fifteen GEO-PD sites contributed a total of 5302 cases and 4161 controls. All four SNCA SNPs and the MAPT H1-haplotype defining SNP (rs1052553) displayed a highly significant marginal association with PD at the significance level adjusted for multiple comparisons. For SNCA, the strongest associations were observed for SNPs located at the 3? end of the gene. There was no evidence of statistical interaction between any of the four SNCA SNPs and rs1052553 or rs242557, neither on the multiplicative nor on the additive scale. Interpretation This study confirms the association between PD and both SNCA SNPs and the H1 MAPT haplotype. It shows, based on a variety of approaches, that the joint action of variants in these two loci is consistent with independent effects of the genes without additional interacting effects. PMID:21391235

Elbaz, Alexis; Ross, Owen A.; Ioannidis, John P.A.; Soto-Ortolaza, Alexandra I; Moisan, Frédéric; Aasly, Jan; Annesi, Grazia; Bozi, Maria; Brighina, Laura; Chartier-Harlin, Marie-Christine; Destée, Alain; Ferrarese, Carlo; Ferraris, Alessandro; Gibson, J. Mark; Gispert, Suzana; Hadjigeorgiou, Georgios M.; Jasinska-Myga, Barbara; Klein, Christine; Krüger, Rejko; Lambert, Jean-Charles; Lohmann, Katja; van de Loo, Simone; Loriot, Marie-Anne; Lynch, Timothy; Mellick, George D.; Mutez, Eugénie; Nilsson, Christer; Opala, Grzegorz; Puschmann, Andreas; Quattrone, Aldo; Sharma, Manu; Silburn, Peter A.; Stefanis, Leonidas; Uitti, Ryan J.; Valente, Enza Maria; Vilariño-Güell, Carles; Wirdefeldt, Karin; Wszolek, Zbigniew K.; Xiromerisiou, Georgia; Maraganore, Demetrius M.; Farrer, Matthew J.

2011-01-01

334

Joint disease mapping using six cancers in the Yorkshire region of England  

PubMed Central

Objectives The aims of this study were to model jointly the incidence rates of six smoking related cancers in the Yorkshire region of England, to explore the patterns of spatial correlation amongst them, and to estimate the relative weight of smoking and other shared risk factors for the relevant disease sites, both before and after adjustment for socioeconomic background (SEB). Methods Data on the incidence of oesophagus, stomach, pancreas, lung, kidney, and bladder cancers between 1983 and 2003 were extracted from the Northern & Yorkshire Cancer Registry database for the 532 electoral wards in the Yorkshire region. Using postcode of residence, each case was assigned an area-based measure of SEB using the Townsend index. Standardised incidence ratios (SIRs) were calculated for each cancer site and their correlations investigated. The joint analysis of the spatial variation in incidence used a Bayesian shared-component model. Three components were included to represent differences in smoking (for all six sites), bodyweight/obesity (for oesophagus, pancreas and kidney cancers) and diet/alcohol consumption (for oesophagus and stomach cancers). Results The incidence of cancers of the oesophagus, pancreas, kidney, and bladder was relatively evenly distributed across the region. The incidence of stomach and lung cancers was more clustered around the urban areas in the south of the region, and these two cancers were significantly associated with higher levels of area deprivation. The incidence of lung cancer was most impacted by adjustment for SEB, with the rural/urban split becoming less apparent. The component representing smoking had a larger effect on cancer incidence in the eastern part of the region. The effects of the other two components were small and disappeared after adjustment for SEB. Conclusion This study demonstrates the feasibility of joint disease modelling using data from six cancer sites. Incidence estimates are more precise than those obtained without smoothing. This methodology may be an important tool to help authorities evaluate healthcare system performance and the impact of policies. PMID:18662387

Downing, Amy; Forman, David; Gilthorpe, Mark S; Edwards, Kimberley L; Manda, Samuel OM

2008-01-01

335

Joint Disorders  

MedlinePLUS

A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

336

Physical therapy and anesthetic blockage for treating temporomandibular disorders: A clinical trial  

PubMed Central

Purpose: the aim of this study was to evaluate the use of physical therapy and anesthetic blockage of the auriculotemporal nerve as a treatment for temporomandibular joint disorders. Methods: the sample comprised of twenty patients with a diagnosis of disc displacement with/ without reduction and arthralgia according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD Axis I Group IIa, IIb and IIIa). Ten patients (group 1) underwent a cycle of eight anesthetic blockages of the auriculotemporal nerve with injections (1 per week) of 1 ml of bupivacaine 0.5% without vasoconstrictor for 8 weeks. The other 10 patients (group 2) received anesthetic blockage and physical therapy (massage and muscular stretching exercises). After the end of treatment all patients were evaluated at baseline, 1st week, 4th week and 2 months. The t-Student and F (ANOVA) tests were used for statistical analysis, with a significance rate of 5%. Results: there was a significant difference when both groups were compared according to VAS score (p=0.027). There was no significant difference for the other variables: MMO and jaw protrusion. Conclusion: the anesthetic blockage and physical therapy, when used together, are effective in the reduction of pain in patients with TMD. Key words:Temporomandibular joint disorders, physical therapy, physiotherapy and nerve block, local anesthetic, bupivacaine. PMID:23229236

Nascimento, Mirella M.; Porto, Gabriela G.; Ferdinanda, Greiciane; Nogueira, Cyntia M.; Raimundo, Ronaldo C.

2013-01-01

337

Influence of Adult Height on Rheumatoid Arthritis: Association with Disease Activity, Impairment of Joint Function and Overall Disability  

PubMed Central

Objectives To investigate whether normal variation of adult height is associated with clinical characteristics in rheumatoid arthritis (RA), including disease activity (DAS28), impairment of joint function (mechanical joint score, MJS) and overall disability (health assessment questionnaire, HAQ). Methods A cohort (134 males, 287 females) of consecutively recruited RA patients of Northern European origin was studied. Height, weight and demographic information were obtained. A core set of disease measurements, including DAS28, MJS and HAQ, were recorded at baseline, 12 and 24 months. Other clinical variables (e.g. disease duration, IgM rheumatoid factor, antibodies to cyclic citrullinated peptide, C-reactive protein, erythrocyte sedimentation rate) were recorded at baseline. Socioeconomic status, smoking status, comorbid condition, other autoimmune conditions and drug therapy were also recorded. Associations were analyzed using univariate statistics and multivariate linear regression models. Mediation tests were also carried out for evaluating the relationship between gender, height and disease measures. Results In males, height was inversely associated with DAS28, MJS and HAQ (at baseline and over 24 months) independent of other factors (e.g. weight, body mass index, age, disease duration, osteoporosis, autoantibodies, erosive disease, joint replacement, steroid use, smoking status, socioeconomic status and comorbid disease). In females, a similar trend was seen but the relationships were non significant. In the whole population, the association of female gender with more active disease and poor function disappeared after adjustment for height. Mediation analysis indicated that height served as a full mediator in the relationship of gender with disease activity and overall disability. Confirmation of these findings was demonstrated in a second RA population (n?=?288). Conclusion Adult height is inversely associated with disease activity, impairment of joint function and overall disability in RA, particularly in males. The association of female sex with more severe disease activity and disability appears to be mediated by smaller stature. PMID:23705017

Chen, Ying; Yu, Zanzhe; Packham, Jonathan C.; Mattey, Derek L.

2013-01-01

338

Replacement of Missing Anterior Teeth in a Patient with Temporomandibular Disorder  

PubMed Central

The loss of anterior teeth leads to extreme psychological trauma, along with functional and esthetic debilitations. Healthy anterior teeth play an important role of protecting the posterior teeth during excursive mandibular movement. Loss of anterior teeth induces posterior interference with extended disocclusion time. Posterior disocclusion is critical to remove the harmful force on the teeth temporomandibular joint and eliminate muscle hypertonicity. Occlusal interference is considered as contributing factor to temporomandibular disorder (TMD) symptoms. Prosthesis design should eliminate deleterious tooth contacts. Establishing optimum anterior guidance is a key to establishing harmonious functional occlusion in addition to the correction of the esthetic and phonetic disabilities. This case report explains the steps involved in the rehabilitation of the TMD patient with loss of maxillary anterior teeth. PMID:24715993

Haralur, Satheesh B.; Saeed Al-Shahrani, Omar

2014-01-01

339

Anti-CarP antibodies as promising marker to measure joint damage and disease activity in patients with rheumatoid arthritis.  

PubMed

Anti-citrullinated protein antibodies (ACPA) are important serological markers in the diagnosis of rheumatoid arthritis (RA) and are part of the recent disease classification criteria. However, there is a strong need for reliable markers for measuring and predicting joint damage and disease activity. Recently, antibodies directed against carbamylated antigens (anti-CarP antibodies) were identified. A total of 120 RA patients were tested for anti-CCP antibodies using different methods and for anti-CarP antibodies using carbamylated fetal calf serum according to the method described by Shi et al. Additionally, ACPA fine specificities (to three citrullinated peptides) were measured. Disease activity was assessed at baseline using the disease activity score 28 (DAS28) in 80 patients. For 40 RA patients, joint erosion score (JES) was established. The median JES was 14.1 with a standard deviation of 11.5. Anti-CarP antibodies were correlated with joint erosion score (? = 0.34, 95 % CI 0.03-0.59; p = 0.0332). No correlation between ACPA and joint erosion score was observed. No individual marker correlated with DAS28. When one ACPA peptide was combined with anti-CarP antibodies in a score (ACPA peptide 1 divided by anti-CarP), a statistically relevant correlation was found (p = 0.0264). In this small cohort, the presence of anti-CarP antibodies, but not ACPA correlate with joint erosion score. Anti-CarP antibodies combined with ACPA fine specificities correlated with DAS28. Therefore, anti-CarP antibodies might represent a promising marker to predict joint damage and disease activity in RA patients. PMID:25391608

Yee, Alvin; Webb, Tyler; Seaman, Andrea; Infantino, Maria; Meacci, Francesca; Manfredi, Mariangela; Benucci, Maurizio; Lakos, Gabriella; Favalli, Ennio; Shioppo, Tommaso; Meroni, Pier-Luigi; Mahler, Michael

2015-02-01

340

Benign joint hypermobility syndrome in soldiers; what is the effect of military training courses on associated joint instabilities?  

PubMed Central

Background: Hypermobile joints are joints with beyond normal range of motion and may be associated with joint derangements. This study aimed to evaluate the prevalence of benign joint hypermobility syndrome (BJHS) among soldiers and effect of training courses on related joint instabilities. Materials and Methods: In a prospective cohort study on 721 soldiers of Iran Army in Isfahan in 2013 the prevalence of joint hypermobility was obtained by using Beighton criteria. Soldiers divided in two groups of healthy and suffered based on their scores. The prevalence of ankle sprain, shoulder and temporomandibular joint (TMJ) dislocations identified before beginning service by history-taking and reviewing paraclinical documents. After 3 months of military training, a recent occurrence of mentioned diseases was revaluated in two groups. The collected data were analyzed using SPSS-20 software using Independent-T and Chi-square tests. Results: The frequency of BJHS before military training was 29.4%. After passing military training period, the incidence of ankle sprain was significantly higher in suffered group achieving the minimum Beighton score (BS) of 4 (4.3%, P = 0.03), 5 (5.5%, P = 0.005) and also 6 out of 9 (6.5%, P = 0.01). The incidence of TMJ dislocation was not significantly different based on a minimum score of 4, while it was higher in suffered group when considering the score of 5 (2.1%) and 6 (2.6%) for discrimination of two groups (P = 0.03). There was no significant difference between two groups in case of shoulder dislocation anyway. Conclusion: Military training can increase the incidence of ankle sprains and TMJ dislocations in hypermobility persons with higher BS in comparison with healthy people. Therefore, screening of joint hypermobility may be useful in identifying individuals at increased risk for joint instabilities. PMID:25364364

Azma, Kamran; Mottaghi, Peyman; Hosseini, Alireza; Abadi, Hossein Hassan; Nouraei, Mohammad Hadi

2014-01-01

341

Joint symptoms and diseases associated with moisture damage in a health center.  

PubMed

Rheumatic diseases do not usually cluster in time and space. It has been proposed that environmental exposures may initiate autoimmune responses. We describe a cluster of rheumatic diseases among a group of health center employees who began to complain of symptoms typically related to moldy houses, including mucocutaneous symptoms, nausea and fatigue, within a year of moving into a new building. Dampness was found in the insulation space of the concrete floor below ground level. Microbes indicating mold damage and actinobacteria were found in the flooring material and in the outer wall insulation. The case histories of the personnel involved were examined. All 34 subjects working at the health center had at least some rheumatic complaints. Two fell ill with a typical rheumatoid factor (RF)-positive rheumatoid arthritis (RA), and 10 had arthritis that did not conform to any definite arthritic syndrome (three met the classification criteria for RA). Prior to moving into the problem building one subject had suffered reactive arthritis, which had then recurred. Another employee had undiagnosed ankylosing spondylitis and later developed psoriatic arthritis, and another developed undifferentiated vasculitis. A total of 16 subjects developed joint pains, 11 of these after beginning work at the health center. Three subjects developed Raynaud's symptom. Fourteen cases had elevated levels of circulating immune complexes in 1998, 17 in 1999, but there were only three cases in 2001, when the health center had been closed for 18 months. The high incidence of joint problems among these employees suggests a common triggering factor for most of the cases. As some of the symptoms had tended to subside while the health center was closed, the underlying causes are probably related to the building itself and possibly to the abnormal microbial growth in its structures. PMID:14677010

Luosujärvi, R A; Husman, T M; Seuri, M; Pietikäinen, M A; Pollari, P; Pelkonen, J; Hujakka, H T; Kaipiainen-Seppänen, O A; Aho, K

2003-12-01

342

Joint Aspiration (Arthrocentesis)  

MedlinePLUS

... JIA, formerly called rheumatoid arthritis, or JRA), systemic lupus erythematosus (SLE), and Lyme disease. Joint aspiration is ... Lyme Disease Risk Juvenile Idiopathic Arthritis Living With Lupus Bones, Muscles, and Joints Lyme Disease Arthritis Word! ...

343

Hip joint disease in psoriatic arthritis: risk factors and natural history  

PubMed Central

Patients and methods: 504 patients with PsA according to ESSG criteria were studied. Mean follow up was 5.7 years (range <1–45). Mean age at onset of psoriasis was 32 years and of PsA, 39 years. The most common pattern of PsA at onset was oligoarticular (49%) and at the latest examination, polyarticular (65%). Sacroiliitis or spondylitis was diagnosed in 94 (18.7%) patients. Results: 32 (6.3%) patients developed psoriatic hip arthropathy, and of these, 26 (81%) also had sacroiliitis or spondylitis. In 7/17 (41%) patients the hip became affected within 1 year after the onset of PsA. Hip disease occurred more often in younger patients. Sex, pattern of peripheral arthritis, duration of psoriasis before arthritis affected the distal interphalangeal joints, dactylitis, or enthesitis were not associated with the risk of hip disease. Seventeen patients were followed up and nine required hip arthroplasty. Sixteen (50%) first had arthroplasty within 5 years after the onset of hip pain. Conclusions: Psoriatic hip arthropathy occurs infrequently in PsA and is associated with earlier onset of arthritis and psoriatic spondylitis. Bilateral hip involvement and rapid progression to hip arthroplasty are common. PMID:15958761

Michet, C; Mason, T; Mazlumzadeh, M

2005-01-01

344

The value of synovial fluid assays in the diagnosis of joint disease: a literature survey  

PubMed Central

Objective: To carry out a critical appraisal of the literature in an attempt to assess the current value of synovial fluid (SF) analysis in the diagnosis of joint disease. Methods: A literature search was undertaken using the Medline, Biomed, Bids, Pubmed, and Embase electronic databases using the keywords: synovial fluid (SF) analysis, SF crystals, joint sepsis, acute arthritis, and SF cell counts, cytology, biomarkers, and microbiology. Results: Publications fell into three main categories. Firstly, reports assessing the value of the three traditional assays (microbiology, white blood cell counts, and microscopy for pathogenic crystals). For these quality control evidence was found to be sparse, and tests for sensitivity, specificity, and reliability showed worrying variations. These poor standards in SF analysis may be due to lack of inclusion of some tests within routine pathology services. Secondly, claims for the usefulness of "new" assays (cytology and biochemical markers). For cytology, the supporting evidence was mainly anecdotal and there were no reports on specificity, sensitivity, and reliability. Interpretation difficulties are a major hindrance to the clinical use of biochemical assays, which remain primarily research tools. Finally, work on the diagnostic value of SF analysis in general. The appraisal confirmed that SF analysis remains of major diagnostic value in acute arthritis, where septic arthritis or crystal arthropathy is suspected, and in intercritical gout. Conclusions: Given the importance of SF tests, rationalisation of their use, together with improved quality control, should be immediate priorities. Further investigation is recommended into the contribution of SF inspection and white cell counts to diagnosis, as well as of the specificity and sensitivity of SF microbiological assays, crystal identification, and cytology. PMID:12006320

Swan, A; Amer, H; Dieppe, P

2002-01-01

345

Interleukin-17+CD8+ T Cells Are Enriched in the Joints of Patients With Psoriatic Arthritis and Correlate With Disease Activity and Joint Damage Progression  

PubMed Central

Objective Psoriatic arthritis (PsA) is associated with HLA class I genes, in contrast to the association with HLA class II in rheumatoid arthritis (RA). Since IL-17+ cells are considered important mediators of synovial inflammation, we sought to determine whether IL-17–producing CD8+ T cells may be found in the joints of patients with PsA and whether these cells might contribute to the disease process. Methods Mononuclear cells from paired samples of synovial fluid (SF) and peripheral blood (PB) from patients with PsA or patients with RA were stimulated ex vivo, and CD4? T cells were examined by flow cytometry for cytokine expression, cytotoxic markers, and frequencies of ?/? or mucosal-associated invariant T cells. Clinical measures of arthritis activity (C-reactive protein [CRP] level, erythrocyte sedimentation rate [ESR], Disease Activity Score in 28 joints [DAS28]) and power Doppler ultrasound (PDUS) scores for the presence of active synovitis in the aspirated knee were recorded and assessed for correlations with immunologic markers. Results Within the CD3+ T cell compartment, both IL-17+CD4? (predominantly CD8+) and IL-17+CD4+ T cells were significantly enhanced in the SF compared to the PB of patients with PsA (P = 0.0003 and P = 0.002, respectively; n = 21), whereas in patients with RA, only IL-17+CD4+ T cells were increased in the SF compared to the PB (P = 0.008; n = 14). The frequency of IL-17+CD4? T cells in PsA SF was positively correlated with the CRP level (r = 0.52, P = 0.01), ESR (r = 0.59, P = 0.004), and DAS28 (r = 0.52, P = 0.01), and was increased in patients with erosive disease (P < 0.05). In addition, the frequency of IL-17+CD4? T cells positively correlated with the PDUS score, a marker for active synovitis (r = 0.49, P = 0.04). Conclusion These results show, for the first time, that the PsA joint, but not the RA joint, is enriched for IL-17+CD8+ T cells. Moreover, the findings reveal that the levels of this T cell subset are correlated with disease activity measures and the radiographic erosion status after 2 years, suggesting a previously unrecognized contribution of these cells to the pathogenesis of PsA. PMID:24470327

Menon, Bina; Gullick, Nicola J; Walter, Gina J; Rajasekhar, Megha; Garrood, Toby; Evans, Hayley G; Taams, Leonie S; Kirkham, Bruce W

2014-01-01

346

Conditioned pain modulation in temporomandibular disorders (TMD) pain patients.  

PubMed

The aims were to investigate (1) if temporomandibular disorders (TMD) patients with temporomandibular joint (TMJ) pain had different conditioned pain modulation (CPM) compared with healthy subjects and, (2) if clinical pain characteristics influenced CPM. Sixteen TMD pain patients and 16 age-matched healthy subjects were participated. A mechanical conditioning stimulus (CS) was applied to pericranial muscles provoking a pain intensity of 5/10 on a visual analogue scale. Pressure pain thresholds (PPT) and pressure pain tolerance thresholds (PPTol) were assessed at masseter, forearm and painful TMJ (only PPT) before, during, and 20 min after CS. Data were analyzed with ANOVAs. The correlations between CPM effect and ratings of TMD pain intensity on a numerical rating scale (NRS) or the pain duration were calculated (correlation coefficient; R). The relative PPT and PPTol increases (mean for the three assessment sites) during CS were significantly higher than baseline in healthy subjects (43.0 ± 3.6, 33.0 ± 4.0 %; P < 0.001, P < 0.001) but not in the TMD pain patients (4.9 ± 2.7, -1.4 ± 4.1 %; P = 0.492, P = 1.000) with significant differences between groups (P < 0.001). In the patients, the relative PPT changes during CS were not significantly higher than baseline at TMJ (5.3 ± 3.8 %, P = 0.981) and masseter (-2.8 ± 4.8 %, P = 1.000) but significantly higher at forearm (12.3 ± 4.7 %, P = 0.039). No correlation was detected between TMD pain intensity and CPM effect (R = -0.261; P = 0.337) or between pain duration and CPM effect (R = -0.423; P = 0.103) at painful TMJ. These findings indicate that CPM is impaired in TMD pain patients especially at sites with chronic pain but not at pain-free sites and that the clinical pain characteristics do not influence CPM. PMID:24897946

Oono, Yuka; Wang, Kelun; Baad-Hansen, Lene; Futarmal, Simple; Kohase, Hikaru; Svensson, Peter; Arendt-Nielsen, Lars

2014-10-01

347

Frequency of temporomandibular arthralgia among myofascial pain patients with pain on palpation of ipsilateral masseter.  

PubMed

Aims: The masseter muscle is a common source of referred pain to the temporomandibular joint (TMJ), with a possibility of false positive diagnoses for arthralgia when diagnosed by research diagnostic criteria for temporomandibular disorders (RDC/TMD) clinical examination. The current study investigated the distribution of arthralgia diagnoses among individuals with myofascial pain, with or without pain on masseter palpation. Methodology: The study was conducted with 255 outpatients. Clinical data and questionnaires were directly entered into software that deploys algorithms based on the diagnostic criteria of the RDC/TMD, and automatically classifies and stores the diagnosis of each patient evaluated. An association between diagnostic subgroups was verified by calculating the odds ratio (OR), and the statistical significance was tested using the Chi-square test. Results: A higher frequency of concordance (about three times greater) between myofascial pain and arthralgia occurred when there was pain on palpation in the region of the ipsilateral masseter muscle, and the association was statistically significant. Conclusions: The results of this study revealed a threefold increase in the risk for the presence of temporomandibular arthralgia in cases of myofascial pain combined with pain on palpation in the region of the ipsilateral masseter muscle. PMID:25200308

Macedo, Leonora Cristiana da Silva Parente; Filho, Gilberto Senechal de Goffredo; Tesch, Ricardo de Souza; Góes, Cristina Pessoa de Queiroz Farias

2014-09-01

348

Blood Cadmium and Lead and Chronic Kidney Disease in US Adults: A Joint Analysis  

PubMed Central

Environmental cadmium and lead exposures are widespread, and both metals are nephrotoxic at high exposure levels. Few studies have evaluated the associations between low-level cadmium and clinical renal outcomes, particularly with respect to joint cadmium and lead exposure. The geometric mean levels of blood cadmium and lead were 0.41 ?g/L (3.65 nmol/L) and 1.58 ?g/dL (0.076 ?mol/L), respectively, in 14,778 adults aged ?20 years who participated in the National Health and Nutrition Examination Survey (1999–2006). After adjustment for survey year, sociodemographic factors, chronic kidney disease risk factors, and blood lead, the odds ratios for albuminuria (?30 mg/g creatinine), reduced estimated glomerular filtration rate (eGFR) (<60 mL/minute/1.73 m2), and both albuminuria and reduced eGFR were 1.92 (95% confidence interval (CI): 1.53, 2.43), 1.32 (95% CI: 1.04, 1.68), and 2.91 (95% CI: 1.76, 4.81), respectively, comparing the highest with the lowest blood cadmium quartiles. The odds ratios comparing participants in the highest with the lowest quartiles of both cadmium and lead were 2.34 (95% CI: 1.72, 3.18) for albuminuria, 1.98 (95% CI: 1.27, 3.10) for reduced eGFR, and 4.10 (95% CI: 1.58, 10.65) for both outcomes. These findings support consideration of cadmium and lead as chronic kidney disease risk factors in the general population and provide novel evidence of risk with environmental exposure to both metals. PMID:19700501

Navas-Acien, Ana; Tellez-Plaza, Maria; Guallar, Eliseo; Muntner, Paul; Silbergeld, Ellen; Jaar, Bernard

2009-01-01

349

Arthroscopic synovial biopsy in definitive diagnosis of joint diseases: An evaluation of efficacy and precision  

PubMed Central

Context: Arthritis is an important cause of morbidity, presenting as monoarticular or polyarticular lesion. Arthroscopic synovial aspiration and biopsy can help in arriving specific etiological diagnosis. Aim and Objectives: To evaluate the efficacy of arthroscopic synovial biopsy as a diagnostic aid and study the characteristics of synovial fluid in various joint diseases. Materials and Methods: Arthroscopic synovial biopsy along with synovial fluid analysis was studied in 30 of the 50 enrolled cases arthritis. The fluid was subjected to physical, biochemical, and cytological analysis. Results: Both rheumatoid (n = 14, 28%) and tubercular (n = 13, 26%) arthritis were found to be more common compared to other etiologies. Next common etiology observed was chronic nonspecific synovitis (n = 10, 20%). Clinicopathological correlation was seen in 34 out of 50 cases. As a diagnostic tool, synovial biopsy had a sensitivity of 85%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 62%. Conclusion: Arthroscopic synovial biopsy is a simple and easy to perform technique and is an important useful investigative adjunct that may give conclusive diagnosis where clinical diagnosis is equivocal. PMID:23776821

Singhal, Onis; Kaur, Viplesh; Kalhan, Shivani; Singhal, Manish Kumar; Gupta, Anshu; Machave, YV

2012-01-01

350

Increased concentrations of proteoglycan components in the synovial fluids of patients with acute but not chronic joint disease.  

PubMed Central

Synovial fluid samples (139) from 121 patients with rheumatoid arthritis, osteoarthritis, pseudogout, chronic pyrophosphate arthritis, gout, and reactive arthritis were analysed for cartilage proteoglycan components. Keratan sulphate (KS) epitope was determined by a competitive radioimmunoassay, and total sulphated glycosaminoglycans (S-GAG) were determined after papain digestion by a specific dye binding assay. Increased concentration of both KS epitope and S-GAG were found in synovial fluid from joints with acute inflammatory arthropathy (gout, pseudogout, and reactive arthritis). Analysis of consecutive samples from the same joint at different stages showed that the concentration of KS epitope or total S-GAG varied with acute inflammatory activity. In samples from patients with chronic conditions during active and inactive inflammatory phases concentrations were much lower and not distinguishable among these disease groups. The detection of raised concentration of proteoglycan components may reflect the rapid depletion or greatly increased turnover of proteoglycan in the articular cartilage during acute inflammation in the joint. This did not appear to be sustained in most patients with chronic joint diseases. PMID:2461686

Ratcliffe, A; Doherty, M; Maini, R N; Hardingham, T E

1988-01-01

351

Partial antiviral activities detection of chicken Mx jointing with neuraminidase gene (NA) against Newcastle disease virus.  

PubMed

As an attempt to increase the resistance to Newcastle Disease Virus (NDV) and so further reduction of its risk on the poultry industry. This work aimed to build the eukaryotic gene co-expression plasmid of neuraminidase (NA) gene and myxo-virus resistance (Mx) and detect the gene expression in transfected mouse fibroblasts (NIH-3T3) cells, it is most important to investigate the influence of the recombinant plasmid on the chicken embryonic fibroblasts (CEF) cells. cDNA fragment of NA and mutant Mx gene were derived from pcDNA3.0-NA and pcDNA3.0-Mx plasmid via PCR, respectively, then NA and Mx cDNA fragment were inserted into the multiple cloning sites of pVITRO2 to generate the eukaryotic co-expression plasmid pVITRO2-Mx-NA. The recombinant plasmid was confirmed by restriction endonuclease treatment and sequencing, and it was transfected into the mouse fibroblasts (NIH-3T3) cells. The expression of genes in pVITRO2-Mx-NA were measured by RT-PCR and indirect immunofluorescence assay (IFA). The recombinant plasmid was transfected into CEF cells then RT-PCR and the micro-cell inhibition tests were used to test the antiviral activity for NDV. Our results showed that co-expression vector pVITRO2-Mx-NA was constructed successfully; the expression of Mx and NA could be detected in both NIH-3T3 and CEF cells. The recombinant proteins of Mx and NA protect CEF cells from NDV infection until after 72 h of incubation but the individually mutagenic Mx protein or NA protein protects CEF cells from NDV infection till 48 h post-infection, and co-transfection group decreased significantly NDV infection compared with single-gene transfection group (P<0. 05), indicating that Mx-NA jointing contributed to delaying the infection of NDV in single-cell level and the co-transfection of the jointed genes was more powerful than single one due to their synergistic effects. PMID:23977111

Zhang, Yani; Fu, Dezhi; Chen, Hao; Zhang, Zhentao; Shi, Qingqing; Elsayed, Ahmed Kamel; Li, Bichun

2013-01-01

352

Partial Antiviral Activities Detection of Chicken Mx Jointing with Neuraminidase Gene (NA) against Newcastle Disease Virus  

PubMed Central

As an attempt to increase the resistance to Newcastle Disease Virus (NDV) and so further reduction of its risk on the poultry industry. This work aimed to build the eukaryotic gene co-expression plasmid of neuraminidase (NA) gene and myxo-virus resistance (Mx) and detect the gene expression in transfected mouse fibroblasts (NIH-3T3) cells, it is most important to investigate the influence of the recombinant plasmid on the chicken embryonic fibroblasts (CEF) cells. cDNA fragment of NA and mutant Mx gene were derived from pcDNA3.0-NA and pcDNA3.0-Mx plasmid via PCR, respectively, then NA and Mx cDNA fragment were inserted into the multiple cloning sites of pVITRO2 to generate the eukaryotic co-expression plasmid pVITRO2-Mx-NA. The recombinant plasmid was confirmed by restriction endonuclease treatment and sequencing, and it was transfected into the mouse fibroblasts (NIH-3T3) cells. The expression of genes in pVITRO2-Mx-NA were measured by RT-PCR and indirect immunofluorescence assay (IFA). The recombinant plasmid was transfected into CEF cells then RT-PCR and the micro-cell inhibition tests were used to test the antiviral activity for NDV. Our results showed that co-expression vector pVITRO2-Mx-NA was constructed successfully; the expression of Mx and NA could be detected in both NIH-3T3 and CEF cells. The recombinant proteins of Mx and NA protect CEF cells from NDV infection until after 72 h of incubation but the individually mutagenic Mx protein or NA protein protects CEF cells from NDV infection till 48 h post-infection, and co-transfection group decreased significantly NDV infection compared with single-gene transfection group (P<0. 05), indicating that Mx-NA jointing contributed to delaying the infection of NDV in single-cell level and the co-transfection of the jointed genes was more powerful than single one due to their synergistic effects. PMID:23977111

Zhang, Yani; Fu, Dezhi; Chen, Hao; Zhang, Zhentao; Shi, Qingqing; Elsayed, Ahmed Kamel; Li, Bichun

2013-01-01

353

Biomarkers and Local Responses to Temporomandibular Joint Disorders  

E-print Network

Treatment with a Substance P Receptor Antagonist Is Neuroprotective in the Intrastriatal 6-Hydroxydopamine Model of Early Parkinson’Treatment with a Substance P Receptor Antagonist Is Neuroprotective in the Intrastriatal 6-Hydroxydopamine Model of Early Parkinson’

Barkhordarian, Andreh

2013-01-01

354

Simulation of the human TMJ behavior based on interdependent joints topology  

Microsoft Academic Search

The temporomandibular joint (TMJ) is one of the most important and complex joints of the body and its pathologies affect a great percentage of the human population. The simulation of the TMJ behavior during opening, closing and chewing movements can be very useful to the understanding of this articulation by physicians, helping them to prevent or fix problems due to

Marta B. Villamil; Luciana P. Nedel; Carla M. D. S. Freitas; Benoit Macq

355

Pathology of osteonecrosis of the femoral head. A review of experience at the Hospital for Joint Diseases, New York.  

PubMed

Pathological examination of the resected femoral heads from approximately 2000 total hip replacement operations carried out at the Hospital for Joint Diseases from 1984 to 1989 identified the presence of osteonecrosis in 345 patients (377 femoral heads). In 232 patients the osteonecrosis, referred to as "idiopathic," had occurred in the absence of a subcapital fracture. The present paper describes the pathology of the necrotic lesions in these 232 patients. The use of undecalcified sections and microradiography provides evidence of bone marrow calcification which, at the margin of the lesion, is sufficient to influence the radiographic features of the lesion significantly. Although a subchondral fracture is an almost constant feature of osteonecrosis when it occurs in a femoral head with a normal articular cartilage, no such fracture was found in cases in which osteonecrosis had occurred in an osteoarthritic joint. PMID:1626289

Sissons, H A; Nuovo, M A; Steiner, G C

1992-01-01

356

Temporomandibular disorder in a patient with pseudoxanthoma elasticum: a case report and review.  

PubMed

Pseudoxanthoma elasticum (PXE) is a disorder characterized by progressive degeneration of elastic fibers and ectopic mineralization. Cutaneous manifestations are a hallmark of this disease and organs that may be affected by the disease process include cardiovascular, central nervous system, ocular and gastrointestinal systems. Oral manifestations of PXE have been previously reported as intramucosal nodules observed on various intraoral surfaces. We present a case of a 46-year-old female with PXE diagnosed with temporomandibular disorder (TMD). To our knowledge, this is the first report of a patient with TMD coexisting with PXE in the scientific literature. PMID:23980559

Nadeau, Christine; Kuperstein, Arthur S; Mupparapu, Muralidhar; Stoopler, Eric T

2013-01-01

357

Neuroendocrine, immune, and local responses related to temporomandibular disorders.  

PubMed

Orofacial pain frequently originates from pathologic conditions in the masticatory muscles or temporomandibular joints (TMJs). The mediators and mechanisms that monitor pain and inflammation, centrally or peripherally, are of great interest in the search for new treatment modalities. The neuropeptides substance P (SP), calcitonin gene-related peptide (CGRP), and neuropeptide Y (NPY) have all been found at high levels in the synovial fluid of arthritic TMJs in association with spontaneous pain, while serotonin (5-HT) has been found in association with hyperalgesia/allodynia of the TMJ. Interleukin-1 beta (IL-1 beta) and tumor necrosis factor alpha (TNF alpha) have been found in arthritic TMJs, but not in healthy TMJs, in association with hyperalgesia/allodynia of the TMJ as well as spontaneous pain. Anterior open bite, which may be a clinical sign of TMJ destruction, has been found in association with high levels of CGRP, NPY, and IL-1 beta in the synovial fluid of the TMJ. Interleukin-1 beta has also been related to radiographic signs of joint destruction. Prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) are both present in the arthritic TMJ, and PGE2 has been shown to be associated with hyperalgesia/allodynia of the TMJ. Very little is known about pain and inflammatory mediators in muscles. However, we know that 5-HT and PGE2 are involved in the development of pain and hyperalgesia/allodynia of the masseter muscle in patients with fibromyalgia, whereas local myalgia (myofascial pain) seems to be modulated by other, as yet unknown mediators. Interaction between the peripheral nervous system (sensory and sympathetic nerves), the immune system, and local cells is probably of great importance for the modulation of pain and inflammation in the TMJ and orofacial musculature. PMID:11889652

Kopp, S

2001-01-01

358

CD4 T cells in the rheumatoid joint are oligoclonally activated and change during the course of disease.  

PubMed Central

OBJECTIVE--To assess the nature of T cell receptor (TCR) utilisation by CD4 T cells in the rheumatoid joint. METHODS--Sequencing of the joining (NDJ) region of TCR beta chain mRNA isolated from synovial fluid CD4 T cells was performed in three patients in order to determine if oligoclonal expansion of particular sequences was present. Two patients were studied longitudinally to determine if these sequences changed over time. RESULTS--A number of dominant clonotypes were found within the TCR transcripts sequenced in each patient. In the two patients who were studied longitudinally, different dominant clonotypes were detected over time. No single clonotype was persistently dominant during the period of study. CONCLUSIONS--The pattern of TCR usage showed multiple oligoclonally expanded CD4 T cells within the rheumatoid joint. The change in clonotypes within the joint over time suggests that different antigens may be able to elicit synovial inflammation during the course of rheumatoid disease. PMID:7763112

Khazaei, H A; Lunardi, C; So, A K

1995-01-01

359

In an interconnected world: joint research priorities for the environment, agriculture and infectious disease  

PubMed Central

In 2008 the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) commissioned ten think-tanks to work on disease-specific and thematic reference groups to identify top research priorities that would advance the research agenda on infectious diseases of poverty, thus contributing to improvements in human health. The first of the thematic reference group reports – on environment, agriculture and infectious diseases of poverty – was recently released. In this article we review, from an insider perspective, the strengths and weaknesses of this thematic reference group report and highlight key messages for policy-makers, funders and researchers. PMID:24472225

2014-01-01

360

Current panorama of temporomandibular disorders' field in Brazil  

PubMed Central

In 2012, the recognition of the specialty of Temporomandibular Disorders and Orofacial Pain completed ten years. Given this scenario, it is extremely important to track the current situation of this field of knowledge in Brazil, specifically in the area of research and training. We hope to discuss the importance of the recognition of this specialty and the inclusion of these subjects in undergraduate programs in Dentistry. Objective The objective of this study is to perform a bibliometric survey of researches regarding Temporomandibular Disorders and Orofacial Pain conducted in the country, determine the number of specialization courses in Orofacial Pain and the number of specialists in the field. Methods The bibliometric survey was conducted based on the Dissertations Portal of Coordination for the Improvement of Higher education Personnel (CAPES) and on PubMed. The panorama of the field of Orofacial Pain and Temporomandibular disorders in Brazil was determined by searching on the website of the Brazilian Council of Dentistry. Results We found 731 theses and dissertations with Temporomandibular Disorders and Orofacial Pain as the main subjects; 81 accredited/recognized Courses on Orofacial Pain and Temporomandibular Dysfunction completed; 8 accredited/recognized Specialization Courses on Orofacial Pain and Temporomandibular Dysfunction still in progress, and 1,064 registered specialists in Orofacial Pain and Temporomandibular Dysfunction in the Brazilian Council of Dentistry. Search in the PUBMED database yielded 576 articles published with the participation of Brazilian researchers as first authors and/or co-authors in the period from 2000 to 2013. From this amount, only 5 were published in Portuguese, while all the others were published in english. We can also notice that the number of published articles increases over time. Conclusion The number of researches related to temporomandibular disorders has increased over the last ten years, as well as the number of specialization courses and the number of specialists, which represents a major breakthrough for this field of knowledge. PMID:25025553

MACHADO, Naila Aparecida de Godoi; LIMA, Fernanda Ferruzzi; CONTI, Paulo César Rodrigues

2014-01-01

361

Joint symptoms and diseases associated with moisture damage in a health center  

Microsoft Academic Search

Rheumatic diseases do not usually cluster in time and space. It has been proposed that environmental exposures may initiate autoimmune responses. We describe a cluster of rheumatic diseases among a group of health center employees who began to complain of symptoms typically related to moldy houses, including mucocutaneous symptoms, nausea and fatigue, within a year of moving into a new

R. A. Luosujärvi; T. M. Husman; M. Seuri; M. A. Pietikäinen; P. Pollari; J. Pelkonen; H. T. Hujakka; O. A. Kaipiainen-Seppänen; K. Aho

2003-01-01

362

Drug therapies for peripheral joint disease in psoriatic arthritis: a systematic review.  

PubMed

In 2009, GRAPPA published their first evidence-based recommendations for the treatment of psoriasis and psoriatic arthritis (PsA). Since then, new information has been published and drugs developed. We summarize evidence for the efficacy of available treatments for peripheral joint involvement in PsA. We performed a systematic review of current literature on the efficacy of different therapies, management, and therapeutic strategies for peripheral arthritis involvement in PsA, in order to provide information for the development of the new GRAPPA treatment recommendations. PMID:25362711

Acosta Felquer, Maria Laura; Coates, Laura C; Soriano, Enrique R; Ranza, Roberto; Espinoza, Luis R; Helliwell, Philip S; FitzGerald, Oliver; McHugh, Neil; Roussou, Euthalia; Mease, Philip J

2014-11-01

363

The importance of urgent cytological examination of synovial fluids in differentiation inflammatory and non-inflammatory joint diseases.  

PubMed

The aim of this study was to imply the possibilities of the urgent cytological examination of synovial fluids in differential diagnosis of arthropathies and to motivate the clinicians to use this method. It gave valuable information particularly with respect to differentiate the inflammatory and non-inflammatory joint diseases. This study included 115 synovial fluids obtained by fine needle aspiration (FNA) of the swollen knee from the patients in the period between 2003 and 2008. At our department the urgent cytological examination of the synovial fluids consisted of macroscopic analysis that includes volume, colour, clarity, viscosity and mucin clot test, native microscopic analysis for crystals and tissue fragments, counting the total nucleated cell count and semiquantitative microscopic analysis for neutrophil granulocyte percentage on the slides stained with Hemacolor rapid staining. All cytological analyses were done within one hour since FNA. According to our results the clarity, viscosity, mucin clot test, the total nucleated cell count and the neutrophil granulocyte percentage enabled distinction between inflammatory and non-inflammatory diseases with statistically significant difference at the 0.01 level but we could not differentiate these two groups of illnesses according to volume and colour. In inflammation the total nucleated cell count and the neutrophil granulocyte percentage was greater than in non-inflammation, the clarity was only translucent and opaque, the viscosity was low and the mucin clot test was negative. In non-inflammatory diseases the clarity varied from transparent to opaque, the total nucleated cell count and the neutrophil granulocyte percentage was smaller than in inflammatory diseases, the viscosity was high and consequently the mucin test was highly positive in all samples. Crystals were detected in only 12 samples of synovial fluids, mostly in inflammation and they were all monosodium urate (MUS) so we could diagnose gout. We could conclude that the urgent cytological analysis of the synovial fluid is a very useful, simple and reliable basic diagnostic screening test in differentiation inflammatory and non-inflammatory joint diseases and we recommended using it as the initial test in the diagnostic procedure of these illnesses using our protocol. PMID:20432743

Ostovi?, Karmen Trutin; Kai?, Gordana; Ostovi?, Ines; Skoro, Marija; Novak, Nina-Petra; Morovi?-Vergles, Jadranka

2010-03-01

364

The prevalence of chondrocalcinosis (CC) of the acromioclavicular (AC) joint on chest radiographs and correlation with calcium pyrophosphate dihydrate (CPPD) crystal deposition disease.  

PubMed

Digital imaging combined with picture archiving and communication system (PACS) access allows detailed image retrieval and magnification. Calcium pyrophosphate dihydrate (CPPD) crystals preferentially deposit in fibrocartilages, the cartilage of the acromioclavicular (AC) joint being one such structure. We sought to determine if examination of the AC joints on magnified PACS imaging of chest films would be useful in identifying chondrocalcinosis (CC). Retrospective radiographic readings and chart reviews involving 1,920 patients aged 50 or more who had routine outpatient chest radiographs over a 4-month period were performed. Knee radiographs were available for comparison in 489 patients. Medical records were reviewed to abstract demographics, chest film reports, and diagnoses. AC joint CC was identified in 1.1 % (21/1,920) of consecutive chest films. Patients with AC joint CC were 75 years of age versus 65.4 in those without CC (p?joint CC, and of these, five also had knee CC (83 %). Of the 483 without AC joint CC, 62 (12 %) had knee CC (p?=?0.002). Patients with AC joint CC were more likely to have a recorded history of CPPD crystal deposition disease than those without AC joint CC (14 versus 1 %, p?=?0.0017). The prevalence of AC joint CC increases with age and is associated with knee CC. A finding of AC joint CC should heighten suspicion of pseudogout or secondary osteoarthritis in appropriate clinical settings and, in a young patient, should alert the clinician to the possibility of an associated metabolic condition. PMID:23609408

Parperis, Konstantinos; Carrera, Guillermo; Baynes, Keith; Mautz, Alan; Dubois, Melissa; Cerniglia, Ross; Ryan, Lawrence M

2013-09-01

365

Evidence from Raman Spectroscopy of a Putative Link Between Inherent Bone Matrix Chemistry and Degenerative Joint Disease  

PubMed Central

Objective Osteoarthritis (OA) is a common debilitating disease that results in degeneration of cartilage and bone in the synovial joints. Subtle changes in the molecular structure of the subchondral bone matrix occur and may be associated with cartilage changes. The aim of this study was to explore whether the abnormal molecular changes observed in the matrix of OA subchondral bone can be identified with Raman spectroscopy. Methods Tibial plateaus from patients undergoing total knee replacement for OA (n = 10) were compared with healthy joints from patients undergoing leg amputation (n = 5; sex- and laterality-matched) and with non-OA cadaveric knee specimens (n = 5; age-matched). The samples were analyzed with Raman spectroscopy, peripheral quantitative computed tomography, and chemical analysis to compare changes in defined load-bearing sites in both the medial and lateral compartments. Results OA subchondral bone matrix changes were detected by Raman spectroscopy. Within each cohort, there was no spectral difference in bone matrix chemistry between the medial and lateral compartments, whereas a significant spectral difference (P < 0.001) was observed between the non-OA and OA specimens. Type I collagen chain ratios were normal in the non-OA specimens but were significantly elevated in the OA specimens. Conclusion In comparing the results of Raman spectroscopy with those obtained by other standard techniques, these findings show, for the first time, that subchondral bone changes, or inherent differences, exist in both the medial and lateral (beneath intact cartilage) compartments of OA knees. The development of Raman spectroscopy as a screening tool, based on molecular-specific modifications in bone, would facilitate the identification of clinical disease, including early molecular changes. PMID:24470432

Kerns, Jemma G; Gikas, Panagiotis D; Buckley, Kevin; Shepperd, Adam; Birch, Helen L; McCarthy, Ian; Miles, Jonathan; Briggs, Timothy W R; Keen, Richard; Parker, Anthony W; Matousek, Pavel; Goodship, Allen E

2014-01-01

366

CT Images of a Severe TMJ Osteoarthritis and Differential Diagnosis with Other Joint Disorders  

PubMed Central

Osteoarthritis (OA) is the most common arthritis which affects the human body and can affect the temporomandibular joint (TMJ). The diagnosis of TMJ OA is essentially based on clinical examination. However, laboratory tests and radiographic exams are also useful to exclude other diseases. The diagnosis of OA may be difficult because of other TMJ pathologies that can have similar clinical and radiographic aspects. The purpose of this study was to describe an unusual case of bilateral TMJ OA in an advanced stage and discuss its most common clinical, laboratory, and radiographic findings, focusing on their importance in the differential diagnosis with other TMJ diseases. Erosion, sclerosis, osteophytes, flattening, subchondral cysts, and a reduced joint space were some of the radiographic findings in TMJ OA. We concluded that, for the correct differential diagnosis of TMJ OA, it is necessary to unite medical history, physical examination, laboratory tests, and radiographic findings. Computed tomography is the test of choice for evaluating bone involvement and for diagnosing and establishing the degree of the disease. PMID:24381768

Ferrazzo, K. L.; Osório, L. B.; Ferrazzo, V. A.

2013-01-01

367

Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations  

PubMed Central

Chronic obstructive pulmonary disease (COPD) is a major public health problem in India. Although several International guidelines for diagnosis and management of COPD are available, yet there are lot of gaps in recognition and management of COPD in India due to vast differences in availability and affordability of healthcare facilities across the country. The Indian Chest Society (ICS) and the National College of Chest Physicians (NCCP) of India have joined hands to come out with these evidence-based guidelines to help the physicians at all levels of healthcare to diagnose and manage COPD in a scientific manner. Besides the International literature, the Indian studies were specifically analyzed to arrive at simple and practical recommendations. The evidence is presented under these five headings: (a) definitions, epidemiology, and disease burden; (b) disease assessment and diagnosis; (c) pharmacologic management of stable COPD; (d) management of acute exacerbations; and (e) nonpharmacologic and preventive measures. The modified grade system was used for classifying the quality of evidence as 1, 2, 3, or usual practice point (UPP). The strength of recommendation was graded as A or B depending upon the level of evidence. PMID:24049265

Gupta, Dheeraj; Agarwal, Ritesh; Aggarwal, Ashutosh Nath; Maturu, V. N.; Dhooria, Sahajal; Prasad, K. T.; Sehgal, Inderpaul S.; Yenge, Lakshmikant B.; Jindal, Aditya; Singh, Navneet; Ghoshal, A. G.; Khilnani, G. C.; Samaria, J. K.; Gaur, S. N.; Behera, D.

2013-01-01

368

Local Massage with Topical Analgesic, a Novel Treatment Modality for Temporomandibular Muscular Pain, a Case Study Report of 5 Consecutive Cases  

PubMed Central

Introduction: Temporomandibular disorders (TMDs) represent a group of painful conditions involving the muscles of mastication and the temporomandibular joint. Ping On Ointment has been used in the Chinese Orthopedics as a soothing massage balm for muscular aches, strain and sprain. If topical application of the ointment can be effective for the treatment of TMD muscular pain, it may be the long-sought-after method for safe, simple, cheap, non-invasive, and effective treatment modality of TMD muscular pain. Purpose: This report documented a case study of the first five consecutive cases using this treatment modality. Results: All cases resulted in complete remission of pain within one month of topical massage. Conclusion: This treatment method has high potential to benefit a significant number of people and randomized control trials should be performed. PMID:19506702

Wong, R.W.K; Rabie, A.B.M

2008-01-01

369

Bone marrow edema of the mandibular condyle related to internal derangement, osteoarthrosis, and joint effusion  

Microsoft Academic Search

Purpose: The purpose of this prospective study was to evaluate whether common magnetic resonance imaging (MRI) variables such as temporomandibular joint (TMJ) internal derangement, osteoarthrosis, and effusion may predict the diagnostic group of bone marrow edema of the mandibular condyle. Materials and Methods: The relationship between bone marrow edema and TMJ disc displacement, osteoarthrosis, and effusion was analyzed in MRIs

Iris Brandlmaier; Christoph Schmid; Stefan Bertram; Ansgar Rudisch

2003-01-01

370

The association between dental status and temporomandibular osseous changes: a morphological study on Roman-Byzantine skeletons.  

PubMed

The aim of this study was to evaluate the association between dental status and the prevalence and severity of osseous changes in the temporomandibular joints of human skulls from the Roman-Byzantine period. Fifty-eight skulls from 36 men and 22 women between the ages of 19 and 63 years were studied, and the following parameters were evaluated: morphological osseous changes in the articular surface of the condyles, tooth wear and molar support. A significant correlation between age and dental wear or loss of molar support was observed, although no correlation was noted between age and morphological osseous changes in the condyles. The loss of molar support was significantly correlated with morphological osseous changes of the condyles, whereas no significant correlation was found between dental wear and condylar changes. This study demonstrates that the loss of molar support can serve as a predictor of osseous changes in the condyle. Reduced molar support may be one of the aetiologies associated with morphological osseous changes in temporomandibular joints. Further studies should to be performed to investigate this potential correlation. PMID:22995047

Levartovsky, S; Gavish, A; Nagar, Y; Sarphati, L; Levartovsky, D; Winocur, E

2012-12-01

371

Joint swelling  

MedlinePLUS

Swelling of a joint ... Joint swelling may occur along with joint pain . The swelling may cause the joint to appear larger or abnormally shaped. Joint swelling can cause pain or stiffness. After an ...

372

Are temporomandibular disorders and tinnitus associated?  

PubMed

The current study aimed to research the prevalence of temporomandibular disorders (TMD) in patients with subjective tinnitus, as compared to controls, and the association between symptoms of TMD, tinnitus, and chronic pain. Two hundred patients were divided into two groups, according to the presence (experimental) or not (control) of subjective tinnitus. The subgroups were determined according to the RDC/TMD criteria. The Pain Pressure Threshold (PPT) values of the masseter and temporalis muscles were recorded bilaterally, and a Visual Analog Scale (VAS) was used to address subjective pain. The most prevalent TMD subgroups in the tinnitus patients (p < 0.05) were myofascial pain with limited opening (39.0%), disc displacement with reduction (44.33%), and arthralgia (53.54%). The severity of tinnitus was significantly associated with the severity of chronic pain (p = .000). The PPT values were lower (p > 0.05), while the Visual Analog Scale (VAS) was statistically higher (p = .000) for the tinnitus patients. These results suggest that an association exists between TMD and subjective tinnitus. PMID:22916668

Saldanha, Aline Dantas Diógenes; Hilgenberg, Priscila Brenner; Pinto, Lívia Maria Sales; Conti, Paulo Cesar Rodrigues

2012-07-01

373

Clinical evaluation of internal joint derangement using sonography  

Microsoft Academic Search

Objectives  Currently, the most precise method for imaging the soft tissue of the temporomandibular joint (TMJ) is magnetic resonance\\u000a imaging (MRI), but this technique is often unavailable because of its high cost or is otherwise unsuitable. In the absence\\u000a of complete information about the TMJ disc, treatment decisions are based only on the results of clinical exams and conventional\\u000a radiography of

Shoaleh Shahidi; Abdol Aziz Haghnegahdar; Maryam Naz Falamaki; Leila Khojastehpoor

2008-01-01

374

Current Insights into the Joint Genetic Basis of Type 2 Diabetes and Coronary Heart Disease  

PubMed Central

The large-scale genome-wide association studies conducted so far identified numerous allelic variants associated with type 2 diabetes (T2D), coronary heart disease (CHD) and related cardiometabolic traits. Many T2D- and some CHD-risk loci are also linked with metabolic traits that are hallmarks of insulin resistance (lipid profile, abdominal adiposity). Chromosome 9p21.3 and 2q36.3 are the most consistently replicated loci appearing to share genetic risk for both T2D and CHD. Although many glucose- or insulin-related trait variants are also linked with T2D risk, none of them is associated with CHD. Hence, while T2D and CHD are strongly clinically linked together, further ongoing analyses are needed to clarify the existence of a shared underlying genetic signature of these complex traits. The present review summarizes an updated picture of T2D-CHD genetics as of 2013, aiming to provide a platform for targeted studies dissecting the contribution of genetics to the phenotypic heterogeneity of T2D and CHD. PMID:24729826

2014-01-01

375

The Revised Research Diagnostic Criteria for Temporomandibular Disorders: Methods used to Establish and Validate Revised Axis I Diagnostic Algorithms  

PubMed Central

AIMS To derive reliable and valid revised Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms for clinical TMD diagnoses. METHODS The multi-site RDC/TMD Validation Project’s dataset (614 TMD community and clinic cases, and 91 controls) was used to derive revised algorithms for Axis I TMD diagnoses. Validity of diagnostic algorithms was assessed relative to reference standards, the latter based on consensus diagnoses rendered by 2 TMD experts using criterion examination data, including temporomandibular joint imaging. Cut-offs for target validity were sensitivity ? 0.70 and specificity ? 0.95. Reliability of revised algorithms was assessed in 27 study participants. RESULTS Revised algorithm sensitivity and specificity exceeded the target levels for myofascial pain (0.82, 0.99, respectively) and myofascial pain with limited opening (0.93, 0.97). Combining diagnoses for any myofascial pain showed sensitivity of 0.91 and specificity of 1.00. For joint pain, target sensitivity and specificity were observed (0.92, 0.96) when arthralgia and osteoarthritis were combined as “any joint pain.” Disc displacement without reduction with limited opening demonstrated target sensitivity and specificity (0.80, 0.97). For the other Group II disc displacements and Group III osteoarthritis and osteoarthrosis, sensitivity was below target (0.35 to 0.53), and specificity ranged from 0.80 to meeting target. Kappa for revised algorithm diagnostic reliability was ? 0.63. CONCLUSION Revised RDC/TMD Axis I TMD diagnostic algorithms are recommended for myofascial pain and joint pain as reliable and valid. However, revised clinical criteria alone, without recourse to imaging, are inadequate for valid diagnosis of two of the three disc displacements and osteoarthritis/osteoarthrosis. PMID:20213032

Schiffman, Eric L.; Ohrbach, Richard; Truelove, Edmond L.; Feng, Tai; Anderson, Gary C.; Pan, Wei; Gonzalez, Yoly M.; John, Mike T.; Sommers, Earl; List, Thomas; Velly, Ana M.; Kang, Wenjun; Look, John O.

2011-01-01

376

Differentiation of orofacial pain related to Lyme disease from other dental and facial pain disorders.  

PubMed

The diagnostic process for the orofacial pain patient is often perplexing. Compounding the process of solving a diagnostic mystery is the multiplicity of etiologic factors. The propensity for Lyme disease to present with symptoms mimicking dental and temporomandibular disorders makes the task even more complex. It is hoped that the reader is cognizant of the fact that a pathologic process of dental structures--the teeth and their attachments to the mandible and maxilla, the temporomandibular joints, masticatory musculature, and vascular supply and sensory innervation of the oromandibular anatomy--may also be the source of facial pain. Although unique, similar complaints may also be manifestations of other causes, including pain associated with Lyme disease. The informed and fastidious clinician does not overlook these possibilities when evaluating the headache and facial pain patient. The clinician should be equipped with the knowledge and minimal armamentarium to evaluate the patient appropriately. To paraphrase from Sherlock Holmes, we must first eliminate the impossible, whatever is left is the truth, no matter how unlikely. A differential diagnosis must be achieved based on clinical experience, unbiased observations, and probability. PMID:9142482

Heir, G M

1997-04-01

377

Clinical signs indicative of temporomandibular disorders in adults: time trends and associated factors.  

PubMed

The study aimed to examine possible time trends in the prevalence of clinical signs indicative of temporomandibular disorder (TMD) in an adult population, to analyse possible associations between TMD signs and associated factors and to estimate the need for TMD treatment. Three independent, stratified and randomly selected samples of around 100 individuals in the age groups of 20, 30, 40, 50, 60 and 70 years participated in the Jönköping studies in 1983,1993 and 2003. The study material consisted of 1,693 subjects who, after answering a questionnaire and being interviewed about the presence of TMD symptoms, were clinically examined in terms of the presence of TMD signs according to the Clinical Dysfunction Index (Di) by Helkimo. Associations between clinical signs and the Di as dependent variables and each of the independent variables of age group, gender, reported bruxism, trauma, self-perceived healthiness and the year of investigation were analysed in binary logistic regression models. Estimates of the need for TMD treatment were based on the presence of a combination of severe symptoms and clinical signs. The prevalence of severely impaired jaw movement capacity, relating to horizontal movements, had increased in 2003. The prevalence of muscle pain and temporomandibular joint pain upon posterior palpation was found to vary statistically significantly between 1993 and 2003. Gender differences were noted in these changes overtime. Female gender, advancing age, awareness of bruxism, self-perceived health impairment and the wearing of complete dentures were associated with TMD signs and a higher degree of clinical dysfunction. The estimated need for TMD treatment increased from 5% in 1983 to 8% in 2003 and was higher in women than in men. In conclusion, the results indicate that the prevalence of some TMD signs and of estimated treatment need increased during the period 1983-2003. PMID:23721032

Köhler, Alkisti Anastassaki; Hugoson, Anders; Magnusson, Tomas

2013-01-01

378

The True-Positive Rate of a Screening Questionnaire for Temporomandib-ular Disorders  

PubMed Central

Background: Temporomandibular disorders (TMD) occur at an incidence of 5–12% in the general population. We aimed to investigate the rate of true-positives for a screening questionnaire for TMD (SQ-TMD) and differences in the characteristics between the true-positive and false-negative groups. Materials and Methods: Seventy-six individuals (16 men, 60 women; mean age, 41.1 ± 16.5 years) were selected from pa-tients with TMD who had visited the Temporomandibular Joint Clinic at Tokyo Medical and Dental University. The patients were assessed using a questionnaire that contained items on TMD screening (SQ-TMD); pain intensity (at rest, maximum mouth-opening, and chewing), as assessed using the visual analog scale (VAS); and TMD-related limitations of daily func-tion (LDF-TMD). A logistic regression analysis was performed to assess the factors potentially influencing the true-positive rate. Results: Of the 76 subjects, 62 (81.6%) were true-positive for the questionnaire based on the SQ-TMD scores. The mean VAS score for maximum mouth-opening and chewing and the mean LDF-TMD score were significantly greater in the true-positive group than those in the false-negative group. The results of the logistic regression analysis showed that only the VAS score for chewing was a statistically significant factor (P < 0.05). Conclusion: The true-positive rate of TMD using SQ-TMD was very high. The results indicate that SQ-TMD can be used to screen TMD in patients with moderate or severe pain and difficulty in living a healthy daily life.

Nishiyama, Akira; Otomo, Natsuko; Tsukagoshi, Kaori; Tobe, Shoko; Kino, Koji

2014-01-01

379

Bayesian belief network analysis applied to determine the progression of temporomandibular disorders using magnetic resonance imaging.  

PubMed

Objectives: This study investigated the applicability of a Bayesian belief network (BBN) to magnetic resonance images (MRI), to diagnose temporomandibular disorders (TMD). Our aim was to determine the progression of TMD, focusing on how each findings affect each other. Methods: We selected 1.5T MRI findings (33 variables) and diagnoses (bone changes and disc displacement) of TMD patients from 2007 to 2008. There were a total of 295 cases with 590 sides of temporomandibular joints (TMJ). The data were modified according to the Research Diagnostic Criteria of TMD. We compared the accuracy of the BBN using 11 algorithms (NPC, PC, greedy search-and-score with BIC, Chow-Liu tree, Rebane-Pearl poly tree, TAN, ML, AIC, MDL, K2, and C4.5), a multiple regression analysis, and an artificial neural network using resubstitution validation and 10-fold cross-validation. Results: There were 191 TMJs (32.4%) with bone changes and 340 (57.6%) with articular disc displacement. The BBN PC algorithm using resubstitution validation and 10-fold cross-validation was more than 99% accurate. However, the main advantage of a BBN is that it can represent the causal relationships between different findings and assign conditional probabilities, which can then be used to interpret the progression of TMD. Conclusions: Osteoarthritic bone changes progressed from condyle to articular fossa, and finally to mandibular bone contours. Disc displacement was directly related to severe bone changes. Early bone changes were not directly related to disc displacement. TMJ functional factors (condylar translation, bony space, and disc form) and age mediated between bone changes and disc displacement. PMID:25472616

Iwasaki, Hirokazu

2014-12-01

380

Laser Acupuncture Therapy in Patients with Treatment-Resistant Temporomandibular Disorders  

PubMed Central

Objective To investigate the clinical effects of laser acupuncture therapy for temporomandibular disorders (TMD) after ineffective previous treatments. Methods A retrospective observational study was conducted in 29 treatment-resistant TMD patients (25 women, 4 men; age range, 17–67 years). Subjects were treated 3 times per week for 4 weeks with the Handylaser Trion (GaAlAs laser diode, 810 nm, 150 mW, pulsed waves), which delivered 0.375 J of energy (5 s) to ST7, ST6, and LI4 and 3 J (40 s) to each Ashi point, 7.5–26.25 J/cm2 in total. The visual analog scale (VAS) and maximal mouth opening (MMO) were evaluated before and after treatment. Results VAS analysis showed that the patients were free of pain at rest (endpoint) after 5.90±6.08 sessions of laser acupuncture for acute TMD and after 16.21±17.98 sessions for chronic TMD. The VAS score on palpation of the temporomandibular joint reduced to 0.30±0.67 for patients with acute TMD (p?=?0.005) and to 0.47±0.84 for those with chronic TMD (p<0.001). The MMO significantly increased in patients with acute TMD (7.80±5.43 mm, p?=?0.008) and in patients with chronic TMD (15.58±7.87 mm, p<0.001). Conclusions Our study shows that laser acupuncture therapy improves the symptoms of treatment-resistant TMD. Further studies with a more appropriate design, involving long-term follow-up examinations in a larger patient sample, are needed to evaluate its efficacy. PMID:25329855

Hung, Yu-Chiang; Tseng, Ying-Jung; Hung, I-Ling; Hsu, Sheng-Feng

2014-01-01

381

The joint associations of occupational, commuting, and leisure-time physical activity, and the Framingham risk score on the 10-year risk of coronary heart disease  

Microsoft Academic Search

Aims To determine joint associations of different kinds of physical activity and the Framingham risk score (FRS) with the 10-year risk of coronary heart disease (CHD) events. Methods and results Study cohorts included 41 053 Finnish participants aged 25-64 years without history of CHD and stroke. The multivariable-adjusted 10-year hazard ratios (HRs) of coronary events associated with low, moderate, and

Gang Hu; Jaakko Tuomilehto; Katja Borodulin; Pekka Jousilahti

2007-01-01

382

Multisystem Dysregulation in Painful Temporomandibular Disorders  

PubMed Central

Multiple physiological and psychological regulatory domains may contribute to the pathophysiology of pain in temporomandibular disorder (TMD) and other bodily pain conditions. The purpose of this study was to evaluate the relationship between multisystem dysregulation and the presence of TMD pain, as well as the presence of different numbers of comorbid pain conditions in TMD. Secondary data analysis was conducted in 131 non-TMD (without comorbid pain) controls, 14 TMD subjects without comorbid pain, 78 TMD subjects with 1 comorbid pain, and 67 TMD subjects with multiple comorbid pain conditions who participated in a TMD genetic study. Twenty markers from sensory, autonomic, inflammatory, and psychological domains were evaluated. The results revealed that 1) overall dysregulation in multiple system domains (OR [odds ratio] = 1.6, 95% confidence interval [CI] = 1.4–1.8), particularly in the sensory (OR = 1.9, 95% CI = 1.3–2.9) and the psychological (OR = 2.1, 95% CI = 2.1–2.7) domains, were associated with increased likelihood of being a painful TMD case; and 2) dysregulations in individual system domains were selectively associated with the increased odds of being a TMD case with different levels of comorbid persistent pain conditions. These outcomes indicate that heterogeneous multisystem dysregulations may exist in painful TMD subgroups, and multidimensional physiological and psychological assessments can provide important information regarding pathophysiology, diagnosis, and management of pain in TMD patients. Perspective The concurrent assessment of multiple physiological and psychological systems is critical to our understanding of the pathophysiological processes that contribute to painful TMD and associated comorbid conditions, which will ultimately guide and inform appropriate treatment strategies that address the multisystem dysregulation associated with complex and common persistent pain conditions. PMID:23721875

Chen, Hong; Nackley, Andrea; Miller, Vanessa; Diatchenko, Luda; Maixner, William

2013-01-01

383

DISEASE IN WILDLIFE OR EXOTIC SPECIES Characterization of Degenerative Changes in the  

E-print Network

in the Temporomandibular Joint of the Bengal Tiger (Panthera tigris tigris) and Siberian Tiger (Panthera tigris altaica) M condyle and TMJ disc of a Bengal tiger (P. tigris tigris) and a Siberian tiger (P. tigris altaica) were severe in the Siberian tiger. Simultaneous evaluation of joint pathology, biochemical composition

Athanasiou, Kyriacos

384

Avaliação anamnésica de sintomas de disfunção temporomandibular em crianças asmáticas Anamnestic evaluation of temporomandibular dysfunction symptoms in asthmatic children  

Microsoft Academic Search

Mechanical respiratory dysfunction in asthmatic children, contributing to overuse the secondary respiratory muscles related to cervical spine and allergic sinunasal alterations, leading to development of mouth breathing (MB), might induce craniocervical disorders and predispose asthmatic patients to Temporomandibular Disorders (TMD). The purpose of this study was to assess the presence and features of TMD symptoms in asthmatic children by using

Thaís Cristina Chaves; Dirceu Costa; Débora Bevilaqua Grossi; Fabiana Bertolli

385

Virtual restoration of anatomic jaw relationship to obtain a precise 3D model for total joint prosthesis construction for treatment of TMJ ankylosis with open bite.  

PubMed

Temporomandibular joint (TMJ) reconstruction with a TMJ Concepts total joint prosthesis (TMJ Concepts, Ventura, USA) requires a precise 3D model of the jaws in centric occlusion. The authors present a virtual procedure for repositioning the lower jaw in centric occlusion to obtain a precise stereolithographic model for TMJ reconstruction using a custom-made total joint prosthesis in a case of TMJ ankylosis and anterior open bite. PMID:20599355

Zizelmann, C; Bucher, P; Rohner, D; Gellrich, N-C; Kokemueller, H; Hammer, B

2010-10-01

386

Identifying potential predictors of pain–related disability in Turkish patients with chronic temporomandibular disorder pain  

PubMed Central

Background The aims of this study were to examine whether patients’ psychosocial profiles influence the location of pain, and to identify the clinical and psychosocial predictors of high levels of pain-related disability in temporomandibular disorders (TMD) patients with chronic pain at least 6?months in duration. Methods The Research Diagnostic Criteria of TMD (RDC/TMD) data for Axis I and II were obtained for 104 consecutive patients seeking treatment. Data were analyzed using descriptive statistics, t-test, Mann–Whitney U-test, chi-square test, One-way ANOVA, Kruskal-Wallis test, and binary multiple logistic regression tests. Patients were classified into two groups according to Graded Chronic Pain Scale scores: Grade III and IV were scored for patients with high levels of pain-related disability, whereas Grade I and II were scored for patients with low disability. Results Muscle and joint pain were found in 64.9% and 31.8% of the patients, respectively, and 27.3% of the patients suffered from both muscle and joint pain. Psychosocial disability was found in 26% of patients. There were no statistically significant differences among the diagnostic subgroups with regards to the demographic, behavioral, psychological, and psychosocial characteristics. Patients with high levels of pain-related disability had significantly higher depression, somatization, pain intensity and jaw disability scores than those with low levels of pain-related disability. Patients with high levels of pain-related disability were more likely to have higher pain intensity, to report higher somatization symptoms and functional impairment, and were less likely to have joint pain than those with low levels of pain related disability. Conclusion In conclusion, the Turkish version RDC/TMD, based on a dual axis system, may be used to screen chronic TMD patients at high-risk for pain-related disability who need comprehensive care treatment program. PMID:23565825

2013-01-01

387

[Temporomandibular disorders in fibromyalgia syndrome: a short-communication.  

PubMed

Fibromyalgia syndrome (FMS) is a chronic painful syndrome and the coexistence of a painful condition caused by Temporomandibular Disorders (TMD) and FMS has been frequently raised for several studies, however, more likely hypothesis is that a set of FMS characteristics may lead to the onset of TMD symptoms and they are not merely coexisting conditions. Therefore, our aim is presenting a review of literature about the relation between fibromyalgia and the signs and symptoms of temporomandibular disorders. For this purpose, a bibliographic search was performed of the period of 1990-2013, in the Medline, Pubmed, Lilacs and Scielo databases, using the keywords fibromyalgia, temporomandibular disorders and facial pain. Here we present a set of findings in the literature showing that fibromyalgia can lead to TMD symptoms. These studies demonstrated greater involvement of the stomatognathic system in FMS and myogenic disorders of masticatory system are the most commonly found in those patients. FMS appears to have a series of characteristics that constitute predisposing and triggering factors for TMD. PMID:25440696

Gui, Maísa Soares; Pimentel, Marcele Jardim; Barbosa, Célia Marisa Rizzatti

2014-10-22

388

develop noninflammatory degenerative joint disease. Proc Natl Acad Sci U S A. 1994;91:5070-5074.  

E-print Network

predisposition for her- niation of a lumbar disc in patients who are less than twenty-one years old. J Bone Joint by different amino acid substitutions in the X position of the type II collagen Gly-X-Y triple helix. Am J Hum Hennessy, PharmD, MSCE Brian L. Strom, MD, MPH L OSS OF BONE MASS ACCOMPANIES THE AGING PROCESS

Hennessy, Sean

389

Cross sectional evaluation of biochemical markers of bone, cartilage, and synovial tissue metabolism in patients with knee osteoarthritis: relations with disease activity and joint damage  

PubMed Central

OBJECTIVE—To analyse the relations between the urinary levels of type II collagen C-telopeptide (CTX-II) and glucosyl-galactosyl pyridinoline (Glc-Gal-PYD)—two newly developed biochemical markers of type II collagen and synovial tissue destruction respectively—disease activity and the severity of joint destruction in patients with knee osteoarthritis (OA). The clinical performance of these two new markers was compared with that of a panel of other established biochemical markers of connective tissue metabolism.?METHODS—The following biochemical markers were measured in a group of 67 patients with knee OA (mean age 64 years, median disease duration eight years ) and in 67 healthy controls: for bone, serum osteocalcin, serum and urinary C-telopeptide of type I collagen (CTX-I); for cartilage, urinary CTX-II, serum cartilage oligomeric matrix protein (COMP), and serum human cartilage glycoprotein 39 (YKL-40); for synovium, urinary Glc-Gal-PYD, serum type III collagen N-propeptide (PIIINP), serum hyaluronic acid (HA); and for inflammation, serum C reactive protein. Biochemical markers were correlated with pain and physical function (WOMAC index) and with quantitative radiographic evaluation of the joint space using the posteroanterior view of the knees flexed at 30°.?RESULTS—All bone turnover markers were decreased in patients with knee OA compared with controls (?36%, ?38%, and ?52%, p<0.0001 for serum osteocalcin, serum CTX-I and urinary CTX-I, respectively). Serum COMP (+16%, p=0.0004), urinary CTX-II (+25%, p=0.0009), urinary Glc-Gal-PYD (+18%, p=0.028), serum PIIINP (+33%, p<0.0001), and serum HA (+ 233%, p<0.0001) were increased. By univariate analyses, increased urinary Glc-Gal-PYD (r=0.41, p=0.002) and decreased serum osteocalcin (r=?0.30, p=0.025) were associated with a higher total WOMAC index. Increased urinary CTX-II (r=?0.40, p=0.0002) and Glc-Gal-PYD (r=?0.30, p=0.0046) and serum PIIINP (r=?0.29, p=0.0034) were the only markers which correlated with joint surface area. By multivariate analyses, urinary Glc-Gal-PYD and CTX-II were the most important predictors of the WOMAC index and joint damage, respectively.?CONCLUSION—Knee OA appears to be characterised by a systemic decrease of bone turnover and increased cartilage and synovial tissue turnover. CTX-II, Glc-Gal-PYD, and PIIINP may be useful markers of disease severity in patients with knee OA.?? PMID:11350852

Garnero, P; Piperno, M; Gineyts, E; Christgau, S; Delmas, P; Vignon, E

2001-01-01

390

Genotyping for disease associated HLA DR ?1 alleles and the need for early joint surgery in rheumatoid arthritis: a quantitative evaluation  

PubMed Central

OBJECTIVE—To determine the value of HLA DR ?1 disease associated epitope (DAE) and erythrocyte sedimentation (ESR) in predicting the need for major joint replacement in rheumatoid arthritis (RA).?METHODS—Sixty five RA patients who had undergone hip, knee or shoulder arthroplasty within 15 years of disease onset and 65 who had not. HLA DR ?1 genotype was determined by polymerase chain reaction. ESR at first hospital visit was noted.?RESULTS—Significantly more patients with two DAE required surgery, (32% v 9%), ?2 = 13.9, p=0.001, odds ratio=5.4 (95% CI: 1.8, 16). Sensitivity was poor, 32%, specificity high, 91%. Presentation ESR was higher in surgery patients compared with non-surgery patients, 52 mm 1st h v 25 mm 1st h, p< 0.001, but was independent of DAE status. Sensitivity of an ESR of 30 mm 1st h was 75%, specificity 53%.?CONCLUSION—The presence of two DAE is a risk factor for major joint surgery in RA and is independent of ESR, whereas in those with one or no DAE, a high ESR is an important predictor.?? Keywords: HLA DR ?1; erythrocyte sedimentation rate; rheumatoid arthritis PMID:10343527

Crilly, A.; Maiden, N.; Capell, H.; Madhok, R.

1999-01-01

391

Validity and Agreement between the 28-Joint Disease Activity Score Based on C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis  

PubMed Central

Objective. To validate the agreement between the 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) and the 28-joint disease activity score based on C-reactive protein (DAS28-CRP) in a group of Danish patients with rheumatoid arthritis (RA). Methods. Data from 109 Danish RA patients initiating biologic treatment were analysed at baseline and following one year of treatment. Participants were retrospectively enrolled from a previous cohort study and were considered eligible for this project if CRP and ESR were measured at baseline and at the follow-up visit. To assess the extent of agreement between the two DAS28 definitions, the “European League Against Rheumatism” (EULAR) response criteria based on each definition were calculated with cross-classification. Weighted Kappa (?) coefficients were calculated, and Bland-Altman plots were used to illustrate degree of agreement between DAS28 definitions. Results. The 75 eligible patients were classified as EULAR good, moderate, and nonresponders with good agreement (61/75; 81%) between DAS28-CRP and DAS28-ESR (? = 0.75 (95% CI: 0.63 to 0.88)). Conclusions. According to our findings, DAS28-CRP and DAS28-ESR are interchangeable when assessing RA patients and the two versions of DAS28 are comparable between studies.

Nielung, Louise; Christensen, Robin; Danneskiold-Samsøe, Bente; Bliddal, Henning; Holm, Christian Cato; Ellegaard, Karen; Slott Jensen, Hanne; Bartels, Else Marie

2015-01-01

392

Anti-Lubricin Monoclonal Antibodies Created Using Lubricin-Knockout Mice Immunodetect Lubricin in Several Species and in Patients with Healthy and Diseased Joints  

PubMed Central

Lubricin, encoded by the gene PRG4, is the principal lubricant in articulating joints. We immunized mice genetically deficient for lubricin (Prg4-/-) with purified human lubricin, and generated several mAbs. We determined each mAb’s binding epitope, sensitivity, and specificity using biologic samples and recombinant lubricin sub-domains, and we also developed a competition ELISA assay to measure lubricin in synovial fluid and blood. We found the mAbs all recognized epitopes containing O-linked oligosaccharides conjugated to the peptide motif KEPAPTTT. By western blot, the mAbs detected lubricin in 1 ?l of synovial fluid from several animal species, including human. The mAbs were specific for lubricin since they did not cross-react with other synovial fluid constituents from patients with camptodactyly-arthropathy-coxa vara-pericarditis syndrome (CACP), who genetically lack this protein. The competition ELISA detected lubricin in blood samples from healthy individuals but not from patients with CACP, indicating blood can be used in a diagnostic test for patients suspected of having CACP. Lubricin epitopes in blood do not represent degradation fragments from synovial fluid. Therefore, although blood lubricin levels did not differentiate patients with inflammatory joint disease from healthy controls, epitope-specific anti-lubricin mAbs could be useful for monitoring disease activity in synovial fluid. PMID:25642942

Ai, Minrong; Cui, Yajun; Sy, Man-Sun; Lee, David M.; Zhang, Ling Xiu; Larson, Katherine M.; Kurek, Kyle C.; Jay, Gregory D.; Warman, Matthew L.

2015-01-01

393

Hip joints  

NSDL National Science Digital Library

The human hips are an example of a ball-and-socket joint. Ball-and-socket joints have the ability to rotate in a circular motion. The joint where the arm connects to the shoulder is also a type of ball-and-socket joint.

Connie Raab (National Institutes of Health;)

2006-05-17

394

Qualitative study of young, adult, and aged Wistar rats temporomandibular synovial membrane employing light, scanning, and transmission electron microscopy.  

PubMed

The aim of this study was to analyze the rat temporomandibular joint (TMJ) synovial membrane at different ages using light, scanning, and transmission electron microscopy. Under light microscopic analysis, the TMJ structures were observed such as condyle, capsule, disk, the synovial membrane collagen type, and cells distribution. In the scanning electron microscopy, the synovial membrane surface exhibited a smooth aspect in young animals and there was an increase with ageing in the number of folds. The transmission electron microscopic analysis showed more synoviocytes in the synovial layer in the young group and still a great number of vesicles and cisterns dilation of rough endoplasmic reticulum in the aged group. In the three groups, a dense layer of collagen fibers in the synovial layer and cytoplasmic extensions were clearly seen. It was possible to conclude that synovial membrane structures in aged group showed alterations contributing to the decrease in joint lubrication and in the sliding between disk and joint surfaces. These characteristic will reflect in biomechanics of chewing, and may cause the TMJ disorders, currently observed in clinical processes. PMID:22791633

Duro, Christiano Cony; Ciena, Adriano Polican; De Almeida, Sonia Regina Yokomizo; Righetti, Marta Maria Da Silva; Grisolia, Débora De Freitas; Issa, João Paulo Mardegan; Da Silva, Marcelo Cavenaghi Pereira; Watanabe, Ii-Sei

2012-11-01

395

Adaptation of DICOM 3.0 to jaw joint movement images  

NASA Astrophysics Data System (ADS)

Kinetic MRI images has been developed and often applied to the diagnosis of soft tissues. The diagnosis of the temporomandibular joint seemed to be one of the typical application fields and has been already clinically performed in some hospitals. Kinetic MRI images cannot be dealt with by DICOM systems, since the information elements and transfer syntax has not been defined yet. We tried to define them and examined its performances. Several objects of temporomandibular joint kinetic MRI images in Quick TIME format were created using the newly defined information elements. The objects were transferred and stored to a DICOM image server using CTN software. The stored images were successfully reconstructed and replayed. The outline of the newly defined information elements, the procedures for making and reconstruction of the objects were discussed in this paper.

Negishi, Tohru; Katoh, Tsuguhisa; Fukushi, Masahiro; Senoo, Atsushi; Nomura, Yukihiro; Shimanishi, Satoshi

2000-05-01

396

Local infliximab injection of sacroiliac joints in non-radiographic axial spondyloarthritis: Impact on clinical and magnetic resonance imaging parameters of disease activity.  

PubMed

Objectives. To evaluate the effectiveness of infliximab (IFX) injection into sacroiliac joints (SIJs) of non-radiographic axial spondyloarthritis (nr-axial SpA) and its impact on clinical and MRI parameters of disease activity. Methods. Thirty-seven patients fulfilling the Association of Spondyloarthritis International Society (ASAS) criteria for axial SpA were initially studied, with disease duration not exceeding 1 year and failed to respond to non-steroidal anti-inflammatory drugs (NSAIDs). Only SpA having active sacroiliitis on MRI without spondylitis (number = 7) were selected to receive bilateral SIJ injection of 20 mg IFX. Follow-up MRI was done at 24 weeks post-injection. Patients were clinically evaluated before, and 12 and 24 weeks after SIJ injection. Evaluation included back pain and stiffness scores, and Bath Ankylosing Spondylitis (BAS) Disease indices and C-reactive protein (CRP) levels. ASAS response criteria were also assessed. Results. Twelve and twenty-four weeks after injection, there was significant decrease in back pain, stiffness, and BAS Disease Activity and Global indices. BAS Functional index, CRP, and mean bone marrow edema score of SIJs were decreased without reaching statistical significance. All patients achieved ASAS20 and five (71.4%) achieved ASAS40. Conclusion. SIJ injection of IFX could be a therapeutic option in early nr-axial SpA who failed to respond to NSAIDs. PMID:25401227

Soliman, Eiman; El-Tantawi, Gihan; Matrawy, Khaled; Aldawoudy, Akram; Naguib, Abir

2014-11-17

397

Adaptive plasticity in mammalian masticatory joints  

NASA Astrophysics Data System (ADS)

Genetically similar white rabbits raised on diets of different mechanical properties, as well as wild-type and myostatin-deficient mice raised on similar diets, were compared to assess the postweaning effects of elevated masticatory loads due to increased jaw-adductor muscle and bite forces on the proportions and properties of the mandibular symphysis and temporomandibular joint (TMJ). Microcomputed tomography (microCT) was used to quantify bone structure at a series of equidistant external and internal sites in coronal sections for a series of joint locations. Discriminant function analyses and non-parametric ANOVAs were used to characterize variation in biomineralization within and between loading cohorts. In both species, long-term excessive loading results in larger joint proportions, thicker articular and cortical bone, and increased biomineralization of hard tissues. Such adaptive plasticity appears designed to maintain the postnatal integrity of masticatory joint systems for a primary loading environment(s). This behavioral signal may be increasingly mitigated in older organisms by the interplay between adaptive and degradative joint tissue responses.

Ravosa, Matthew J.; Kunwar, Ravinder; Nicholson, Elisabeth K.; Klopp, Emily B.; Pinchoff, Jessie; Stock, Stuart R.; Stack, M. Sharon; Hamrick, Mark W.

2006-08-01

398

Joint Use of Skull Base Surgery in a Case of Pediatric Parotid Gland Carcinoma  

PubMed Central

Parotid gland carcinoma is extremely rare in children. We report a case of pediatric parotid gland carcinoma with extensive infiltration into surrounding tissues including the skin and temporomandibular joint capsule at initial examination. Total resection of the parotid gland was conducted together with skull base surgery and mandibular dissection. The patient was a 14-year-old girl. In addition to the skin and temporomandibular joint, infiltration into the anterior wall of the external auditory meatus and masseter muscle was also seen, and T4N0M0 stage IV parotid carcinoma was diagnosed. Skin was resected together with the pinna, and temporal craniotomy and skull base surgery were performed to resect the temporomandibular joint capsule and external auditory meatus en bloc, and mandible dissection was conducted. Facial nerves were resected at the same time. Level I to level IV neck dissection was also conducted. A latissimus dorsi myocutaneous flap was used for reconstruction. The postoperative permanent pathology diagnosis was high-grade mucoepidermoid carcinoma with a low-grade component. Postoperatively, radiotherapy at 50?Gy alone has been conducted, with no recurrence or metastasis observed for over 4 years. PMID:24949210

Tsukahara, Kiyoaki; Nakamura, Kazuhiro; Motohashi, Ray; Endo, Minoru; Sato, Hiroki; Katsube, Yasuaki; Suzuki, Mamoru

2014-01-01

399

Adaptability of stock TMJ prosthesis to joints that were previously treated with custom joint prosthesis.  

PubMed

The purpose of this study was to determine if a temporomandibular joint (TMJ) replaced by a custom joint prosthesis could have been replaced by a stock joint prosthesis. Stereolithic models of patients treated with TMJ Concepts® patient fitted joint prosthesis (e.g., custom) were obtained. Biomet Microfixation® TMJ prostheses (e.g. stock) were adapted to these models. Intra-operative insertion of prosthesis, fit and size of stock joints were simulated and evaluated. Adaptability and stability of condyle and fossa as well as their articulation were recorded. 20 models consisting of 34 joints were examined by two oral and maxillofacial surgeons who were blinded to the patient's diagnosis. Overall, 77% of the stock TMJ system fit the stereolithic models. 3mm or less of bone modification was necessary to achieve an acceptable fit. In the majority of the cases examined, a stock TMJ prosthesis had good anatomical adaptation to stereolithic models of patients previously treated with custom TMJ prosthesis, so a stock TMJ prosthesis could have been an acceptable option for these patients. Further prospective clinical studies to compare both systems are necessary. PMID:22169167

Abramowicz, S; Barbick, M; Rose, S P; Dolwick, M F

2012-04-01

400

Defective Gp130-Mediated Signal Transducer and Activator of Transcription (Stat) Signaling Results in Degenerative Joint Disease, Gastrointestinal Ulceration, and Failure of Uterine Implantation  

PubMed Central

The receptor subunit gp130 transduces multiple cell type–specific activities of the leukemia inhibitory factor (LIF)/interleukin (IL)-6 family of cytokines through the signal transducer and activator of transcription (STAT) and src homology 2 domain–bearing protein tyrosine phosphatase (SHP)-2/ras/Erk pathways. To define STAT-dependent physiological responses, we generated mice with a COOH-terminal gp130?STAT “knock-in” mutation which deleted all STAT-binding sites. gp130?STAT mice phenocopyed mice deficient for IL-6 (impaired humoral and mucosal immune and hepatic acute phase responses) and LIF (failure of blastocyst implantation). However, unlike mice with null mutations in any of the components in the gp130 signaling pathway, gp130?STAT mice also displayed gastrointestinal ulceration and a severe joint disease with features of chronic synovitis, cartilaginous metaplasia, and degradation of the articular cartilage. Mitogenic hyperresponsiveness of synovial cells to the LIF/IL-6 family of cyto-kines was caused by sustained gp130-mediated SHP-2/ras/Erk activation due to impaired STAT-mediated induction of suppressor of cytokine signaling (SOCS) proteins which normally limits gp130 signaling. Therefore, the joint pathology in gp130?STAT mice is likely to arise from the disturbance of the otherwise balanced activation of the SHP-2/ras/Erk and STAT signaling cascades emanating from gp130. PMID:11457894

Ernst, Matthias; Inglese, Melissa; Waring, Paul; Campbell, Ian K.; Bao, Shisan; Clay, Fiona J.; Alexander, Warren S.; Wicks, Ian P.; Tarlinton, David M.; Novak, Ulrike; Heath, Joan K.; Dunn, Ashley R.

2001-01-01

401

Is rheumatoid arthritis a B-cell haematological disease with a predilection for the joints? Following the B cell thread to its logical conclusion.  

PubMed

B-cell depleting therapy (BCDT) is effective in suppressing synovitis and erosions in rheumatoid arthritis suggesting that a cell of the B-lymphocyte lineage is critical in the pathogenesis of this disease. Non-Hodgkins lymphoma (NHL) also responds to BCDT but multiple myeloma (MM), does not as cells have differentiated beyond the CD20-bearing stage. However, there are similarities between B-NHL, MM and RA that suggest all 3 conditions could be initiated and perpetuated by the same cellular players. Numerous plasma cells and B cells are present within rheumatoid synovial membrane, and subarticular bone where they contribute to osteitis. On MRI scans this appears as bone oedema, which has been demonstrated to precede the development of bone erosions. Plasma cell clonality has been detected within RA synovial membrane and bone marrow. It is proposed that RA could represent a "forme fruste" of a B cell neoplastic condition, with production of autoantibodies that target a self-antigen within the joint. The activation of rheumatoid bone osteoclasts by anticitrullinated protein antibodies supports this theory. The erosions of RA would have parallels with the lytic lesions of MM but autoantigen targeting dictates that erosions occur at joint margins. This theory is discussed from rheumatologic and haematologic perspectives. PMID:24447777

McQueen, Fiona M; Issa, Samar

2014-03-01

402

Temporomandibular disorders, otologic symptoms and depression levels in tinnitus patients.  

PubMed

The aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorders (TMD) and otologic symptoms in patients with and without tinnitus. The influence of the level of depression was also addressed. The tinnitus group was comprised of 100 patients with tinnitus, and control group was comprised of 100 individuals without tinnitus. All subjects were evaluated using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) to determine the presence of TMD and depression level. Chi-square, Spearman Correlation and Mann-Whitney tests were used in statistical analysis, with a 5% significance level. TMD signs and symptoms were detected in 85% of patients with tinnitus and in 55% of controls (P?0·001). The severity of pain and higher depression levels were positively associated with tinnitus (P?0·001). It was concluded that tinnitus is associated with TMD and with otalgia, dizziness/vertigo, stuffy sensations, hypoacusis sensation and hyperacusis, as well as with higher depression levels. PMID:22035253

Hilgenberg, P B; Saldanha, A D D; Cunha, C O; Rubo, J H; Conti, P C R

2012-04-01

403

Dysfunctional Patients with Temporomandibular Disorders: Evaluating the Efficacy of a Tailored Treatment Protocol.  

ERIC Educational Resources Information Center

Forty-eight dysfunctional patients with temporomandibular disorders (TMD) were randomly assigned to treatments consisting of an intraoral appliance, stress management, and either nondirective supportive counseling or cognitive therapy. Results support tailored treatment of dysfunctional TMD. (KW)

Turk, Dennis C.; And Others

1996-01-01

404

Malocclusions and Clinical Signs orSubjective Symptoms of Temporomandibular Disorders (TMD) inAdults  

Microsoft Academic Search

Aim and Method: The objective was to determine with reference to a representative sample of 4310 men and women aged 20 to 81 (response rate 68.8%) drawn from the population-based Study of Health in Pomerania (SHIP-0) whether associations exist between malocclusions and temporomandibular dysfunctions in adults. Besides clinically investigated signs, subjectively perceived symptoms of temporomandibular disorders (TMD) were studied in

Dietmar Gesch; Olaf Bernhardt; Dietrich Alte; Thomas Kocher; Ulrich John; Elke Hensel

2004-01-01

405

Oral Health, Temporomandibular Disorder, and Masticatory Performance in Patients with Charcot-Marie-Tooth Type 2  

PubMed Central

Background. The aim of this study was to evaluate the oral health status of temporomandibular disorders (TMD) and bruxism, as well as to measure masticatory performance of subjects with Charcot-Marie-Tooth type 2 (CMT2). Methods and Results. The average number of decayed, missing, and filled teeth (DMFT) for both groups, control (CG) and CMT2, was considered low (CG = 2.46; CMT2 = 1.85, P = 0.227). The OHIP-14 score was considered low (CG = 2.86, CMT2 = 5.83, P = 0.899). The prevalence of self-reported TMD was 33.3% and 38.9% (P = 0.718) in CG and CMT2 respectively and for self-reported bruxism was 4.8% (CG) and 22.2% (CMT2), without significant difference between groups (P = 0.162). The most common clinical sign of TMD was masseter (CG = 38.1%; CMT2 = 66.7%) and temporalis (CG = 19.0%; GCMT2 = 33.3%) muscle pain. The geometric mean diameter (GMD) was not significantly different between groups (CG = 4369; CMT2 = 4627, P = 0.157). Conclusion. We conclude that the CMT2 disease did not negatively have influence either on oral health status in the presence and severity of TMD and bruxism or on masticatory performance. PMID:24391462

Rezende, Rejane L. S.; Bonjardim, Leonardo R.; Neves, Eduardo L. A.; Santos, Lidiane C. L.; Nunes, Paula S.; Garcez, Catarina A.; Souza, Cynthia C.; Araújo, Adriano A. S.

2013-01-01

406

Prevalence of temporomandibular dysfunction in a group of scuba divers  

PubMed Central

Background: Temporomandibular dysfunction (TMD) has been reported to be a common problem in divers, with a prevalence of up to 68%. No evidence for this is available. Objective: To investigate the prevalence of TMD in divers. Method: Sixty three subjects were asked to retrospectively complete a questionnaire on symptoms of TMD after diving in warm and cold water areas and in daily life. Results: The prevalence of TMD was greater in female divers. The prevalence of TMD while diving was about 26%, comparable to that experienced in daily life. Conclusion: Improvements in mouthpiece design and lighter demand valves mean that TMD is now probably exacerbated by diving rather than caused by it. PMID:14751950

Aldridge, R; Fenlon, M

2004-01-01

407

Lyme Disease  

MedlinePLUS

Lyme disease is a bacterial infection you get from the bite of an infected tick. The first symptom ... Muscle and joint aches A stiff neck Fatigue Lyme disease can be hard to diagnose because you may ...

408

Ceramic joints  

DOEpatents

Butt joints between materials having different coefficients of thermal expansion are prepared having a reduced probability of failure of stress facture. This is accomplished by narrowing/tapering the material having the lower coefficient of thermal expansion in a direction away from the